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Objectives: This review aimed to determine the form, results, and barriers to exercise-based rehabilitation programs for severe COVID-19 survivors. Methods: Searching for the article was carried out from August to October 2021. We used the PubMed database as a search media with the keywords ([‘COVID-19’ OR ‘COVID 19’ OR ‘SARS CoV-2’ OR ‘post COVID-19’] AND [‘rehabilitation’]). Original articles and case reports published in the last 2 years (July 2019-2022), written in English, available in full text, and accessible in PDF or HTML format were included. Articles were excluded if they did not fit the research topic after reading the full text. Results: There were a total of 7461 articles found at the initial screening using keywords. In the next screening using the inclusion and exclusion criteria and after reading the whole article, we found 9 articles that matched the topic. Of these, 7 articles were original articles and 2 case reports. All of the articles explained the forms and outcomes of exercise-based rehabilitation in severe cases of COVID-19 survivors. However, no article explained the barriers to rehabilitation. Discussion: Exercise was generally given to increase exercise tolerance in severe COVID-19 survivors in both inpatient and outpatient cardiopulmonary rehabilitation programs. The form of exercise was aerobic, strength, or endurance training, and other forms of exercise such as balance training as well as breathing exercises. The type and intensity of exercises given were tailored to the patient’s needs. Research showed that exercise-based rehabilitation programs resulted in a positive impact on increasing the survivor’s quality of life, functional capability, and exercise tolerance. A previous study explained that barriers to rehabilitation in COVID-19 were related to the patient’s health condition, COVID-19 infectivity, and issues related to health services.

Abstract Background Misinformation regarding COVID-19 pandemic and vaccination is damaging COVID-19 vaccine trust and acceptance in Low- and Middle-Income Countries (LMIC). Identification of misinformation and designing locally acceptable solutions are needed to improve COVID-19 vaccine acceptance. This study aimed to utilize community-led co-design methodology to evaluate misinformation regarding COVID-19 and develop contextual interventions to address misinformation in a marginalized peri urban slum communities of Landhi town Karachi, Pakistan. Methods This study was conducted between January and December 2021, in marginalized peri-urban slum dwellers of Muslimabad Colony, Landhi Town Karachi, Pakistan. We used a community-centred co-design methodology embedded within mixed study design to identify misinformation, co-design, test and implement locally acceptable solutions. The co-design methodology involved five stages of the design thinking model: (1) Empathize, (2) Define, (3) Ideate, (4) Prototype, and (5) Test. The project involved active engagement and participation of wide range of stakeholders and community beneficiaries (end users) including local EPI vaccinators, informal healthcare workers, religious leaders (male and female), schoolteachers (male and female), local government representatives, community leaders, housewives, youth, and general population. To develop a trusting relationship, and understand local culture, values, practices, and traditions, we allowed one month of observation period (observe, engage, watch, and listen) in the beginning, followed by door-to-door survey along with focus group discussions (FGD) and in-depth interviews (IDI) at baseline. Co-design workshops (separate for male and female) were conducted at each stage of co-design methodology to design and test locally acceptable solutions. Conclusion Community-centred co-design methodology was not only successful in designing, testing, and evaluating locally acceptable solutions but it also actively engaged and empowered the marginalized population living in peri urban slum communities of Karachi, Pakistan.

Introduction The outbreak of COVID-19 has produced an unprecedented number of trials and articles.

Abstract Fibrodysplasia ossificans progressiva (FOP) is a rare genetic disorder associated with increased immune activity and severe, progressive heterotopic ossification. We previously described a cohort of 32 patients with FOP who were either exposed to SARS-CoV-2 or received a COVID-19 vaccine1 and showed that these patients did not develop heterotopic ossification after COVID-19 vaccination. Here, we present additional clinical data from new subjects and additional long-term follow-up from the first cohort. We enrolled 15 new subjects between August 24th, 2021 and May 17th, 2022 and collected additional self-reported outcomes. The larger cohort with 47 individuals encompassing 49 events showed that patients with FOP exhibited no additional change in FOP disease activity or flare activity resulting from COVID-19 infection or after receipt of a SARS-CoV-2 vaccine. Thus, although any vaccination carries a risk of inducing heterotopic ossification in patients with FOP, our results show that patients with FOP who choose to receive a COVID-19 vaccination may be able to tolerate the procedure without a high risk of heterotopic ossification when following the published guidelines.

Patients with cancer can be immunocompromised because of their disease and/or due to anticancer therapy. In this population, severe influenza virus infections are associated with an elevated risk of morbidity and mortality. Influenza vaccination is therefore highly recommended in cancer patients, including those receiving anticancer therapy. However, vaccination coverage remains far below the recommended target for vulnerable subjects. Six specialists in oncology, hematology, immunology, and public health/vaccinology convened with the objective of developing strategies, based on evidence and clinical experience, for improving influenza vaccination coverage in cancer patients. This viewpoint provides an overview of current influenza vaccination recommendations in cancer patients, discusses barriers to vaccination coverage, and presents strategies for overcoming said barriers. New immunization issues raised by the COVID-19 pandemic are also addressed. Future directions include improving public education on influenza vaccination, providing the media with accurate information, improving knowledge among healthcare professionals, improving access to vaccines for cancer patients, co-administration of the influenza and COVID-19 vaccines, increased collaboration between oncologists and other health professionals, increased accessibility of digital vaccination registries to specialists, shared information platforms, and promoting immunization campaigns by healthcare systems with the support of scientific societies.

Covid-19 has once again brought into focus our limited preparedness to deal with epidemics. Most nations, across the globe, have responded with a resolve to come stronger out of this crisis and leaderships across the world have shown great commitment to protecting its people from Covid-19. Covid-19 has also taught us a few things for the future. One such learning has been that a strong shift in focus towards non-communicable diseases driving health infrastructure across the globe for the last few decades has come at neglect of communicable diseases. In that sense, therefore, the current pandemic has been a wake-up call. Organised Medicine Academic Guild (OMAG), an umbrella organization of professional associations gathered a group of health experts to develop a policy document on epidemic preparedness to limit the influence of epidemics like Covid-19.

The COVID-19 outbreak is having a significant impact on both cardiac rehabilitation (CR) inpatient and outpatient healthcare organization. The variety of clinical and care scenarios we are observing in Italy depends on the region, the organization of local services and the hospital involved. Some hospital wards have been closed to make room to dedicated beds or to quarantine the exposed health personnel. In other cases, CR units have been converted or transformed into COVID-19 units. The present document aims at defining the state of the art of CR during COVID-19 pandemic, through the description of the clinical and management scenarios frequently observed during this period and the exploration of the future frontiers in the management of cardiac rehabilitation programs after the COVID-19 outbreak.

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The COVID-19 pandemic originating in the Wuhan province of China in late 2019 has impacted global health, causing increased mortality among elderly patients and individuals with comorbid conditions. During the passage of the virus through affected populations, it has undergone mutations, some of which have recently been linked with increased viral load and prognostic complexities. Several of these variants are point mutations that are difficult to diagnose using the gold standard quantitative real-time PCR (qRT-PCR) method and necessitates widespread sequencing which is expensive, has long turn-around times, and requires high viral load for calling mutations accurately. Here, we repurpose the high specificity of Francisella novicida Cas9 (FnCas9) to identify mismatches in the target for developing a lateral flow assay that can be successfully adapted for the simultaneous detection of SARS-CoV-2 infection as well as for detecting point mutations in the sequence of the virus obtained from patient samples. We report the detection of the S gene mutation N501Y (present across multiple variant lineages of SARS-CoV-2) within an hour using lateral flow paper strip chemistry. The results were corroborated using deep sequencing on multiple wild-type (n = 37) and mutant (n = 22) virus infected patient samples with a sensitivity of 87% and specificity of 97%. The design principle can be rapidly adapted for other mutations (as shown also for E484K and T716I) highlighting the advantages of quick optimization and roll-out of CRISPR diagnostics (CRISPRDx) for disease surveillance even beyond COVID-19. This study was funded by Council for Scientific and Industrial Research, India.

In recent years, several innovations have emerged in the field of education, including Blended-Learning, Massive Open Online Courses, Flipped Classroom and Gamification. In particular, several investigations have highlighted the effectiveness of student response systems, or clickers, in different subjects and disciplines. Although some literature reviews have been published on this subject, none of them offer a review of a large volume of publications from a multidisciplinary approach. Similarly, in the literature there are no studies that have analyzed scientific collaborations on this subject. To respond to these concerns, we proposed the use of a bot to retrieve information from a large number of papers (1696 documents co-authored by a total of 4091 researchers) included in the Scopus database. The disciplines covered include natural sciences, engineering and technology, medical and health sciences, agricultural and veterinary sciences, social sciences and humanities, and the arts. The review of the literature reveals that student response systems are generally well-perceived by teachers and students in all the disciplines. Another interesting result achieved from visual data obtained using network visualization software and word clouds is that student response systems are mainly used in some disciplines, such as physics, chemistry, medicine, and nursing. It is clearly observed that the relationship between researchers from the same country is stronger than between researchers from different countries. Finally, some reflections are included on the role of student response systems in online teaching, especially regarding the changes experienced after the COVID-19 pandemic.

The COVID-19 pandemic has resulted in school closures and distancing requirements that have disrupted both work and family life for many. Concerns exist that these disruptions caused by the pandemic may not have influenced men and women researchers equally. Many medical journals have published papers on the pandemic, which were generated by researchers facing the challenges of these disruptions. Here we report the results of an analysis that compared the gender distribution of authors on 1893 medical papers related to the pandemic with that on papers published in the same journals in 2019, for papers with first authors and last authors from the United States. Using mixed-effects regression models, we estimated that the proportion of COVID-19 papers with a woman first author was 19% lower than that for papers published in the same journals in 2019, while our comparisons for last authors and overall proportion of women authors per paper were inconclusive. A closer examination suggested that women’s representation as first authors of COVID-19 research was particularly low for papers published in March and April 2020. Our findings are consistent with the idea that the research productivity of women, especially early-career women, has been affected more than the research productivity of men.

Respiratory physiotherapy in patients with COVID-19 infection in acute setting: a Position Paper of the Italian Association of Respiratory Physiotherapists (ARIR) On February 2020, Italy, especially the northern regions, was hit by an epidemic of the new SARS-Cov-2 coronavirus that spread from China between December 2019 and January 2020. The entire healthcare system had to respond promptly in a very short time to an exponential growth of the number of subjects affected by COVID-19 (Coronavirus disease 2019) with the need of semi-intensive and intensive care units.

The COVID-19 pandemic emphasized the need to review our requirements for true guidance and reliability from science and individual, professional, and public health ethics. The aim of this study was to determine the ethical and scientific perspectives of doctors about performing research during the COVID-19 pandemic and to assess anxiety levels about this topic within the framework of the literature. Doctors completed a ‘preliminary survey form' containing questions determining sociodemographic data and statements about research and ethics during the pandemic and the ‘state and trait anxiety inventories' in the internet environment. In our study, the alpha value was 0.90 for the state anxiety inventory and 0.70 for the trait anxiety inventory. Of the 398 doctors participating in the study, 45.2% were women and 54.8% were men. Among doctors, 89.7% stated they read articles related to the COVID-19 pandemic. The group of doctors who fully disagreed with the view that it was inappropriate to perform research during the pandemic due to the nature of the disease and transmission risks and who had read more articles than the other groups were found to have statistically significantly higher state anxiety inventory points. The COVID-19 pandemic led to many problems for scientific and ethical concepts. New concerns were added to existing ethical concerns and national and international ethics committees need to work to resolve these concerns. [Med-Science 2022; 11(4.000): 1641-7]

Background: Since 2020 SARS-CoV-2 spreads pandemically, infecting more than 119 million people, causing >2·6 million fatalities. Symptoms of SARS-CoV-2 infection vary greatly, ranging from asymptomatic to fatal. Different populations react differently to the disease, making it very hard to track the spread of the infection in a population. Measuring specific anti-SARS-CoV-2 antibodies is an important tool to assess the spread of the infection or successful vaccinations. To achieve sufficient sample numbers, alternatives to venous blood sampling are needed not requiring medical personnel or cold-chains. Dried-blood-spots (DBS) on filter-cards have been used for different studies, but not routinely for serology. Methods: We developed a semi-automated protocol using self-sampled DBS for SARS-CoV-2 serology. It was validated in a cohort of matched DBS and venous-blood samples (n = 1710). Feasibility is demonstrated with two large serosurveys with 10247 company employees and a population cohort of 4465 participants. Findings: Sensitivity and specificity reached 99·20% and 98·65%, respectively. Providing written instructions and video tutorials, 99·87% (4465/4471) of the unsupervised home sampling DBS cards could be analysed. Interpretation: DBS-sampling is a valid and highly reliable tool for large scale serosurveys. We demonstrate feasibility and accuracy with a large validation cohort including unsupervised home sampling. This protocol might be of big importance for surveillance in resource-limited settings, providing low-cost highly accurate serology data. Funding: Provided by Bavarian State Ministry of Science and the Arts, LMU University-Hospital; Helmholtz-Centre-Munich, German Ministry for Education and Research (project01KI20271); University of Bonn; University of Bielefeld; the Medical Biodefense Research Program of Bundeswehr-Medical-Service; Euroimmun, RocheDiagnostics provided discounted kits and machines

Objectives: Over the past one year, the effect of 2019-nCoV is drastically increasing and affecting entire human population. Due to these pandemic situations, people are facing many health-related problems which includes life threatening fears, heart problems, taking more unneeded medicine and most importantly critical thinking which leads to mental stress. This paper proposes the different possible strategies which help the people for avoiding these issues. Case Presentation: An approach for delivering a possible strategy on avoiding human health issues due to COVID-19 is done by the successful collection of reports from many infected people. The information from physical examination to successful treatment stages were analyzed from different infected patients and reported. Here, we reviewed the methodologies adopted for preventing the spread of corona virus from various origin and have listed the characteristic features of its behavior based on the real case reports. Method: The different age group patients are reviewed and possible relevant characteristic points on the important protocol, treatment procedure, steps to control the spread of this virus, guidelines to avoid other health issues and maintaining body health for fighting COVID-19 were collected and presented in the form of case reports. Conclusion: The different techniques which are presented in this paper help the patients as well as people in the world to face the pandemic situation very effectively mainly to live with COVID-19. This paper also presents the prospective study and summarizes the effects of corona virus in human health based on the infected patients experience. The systematic review on the characteristics of corona virus will provide a strong guideline to the people to identify and face the critical situation in very informative manner. [ABSTRACT FROM AUTHOR]

Abstract Objectives Hospitals must maintain their effective operations during and after disasters. Due to the current increase in disasters, hospital resilience has drawn scholarly attention. This study aimed to review studies on the changes in the definition of hospital resilience after COVID‐19, build a conceptual framework for careful measurement, and identify the main dimensions of hospital resilience emphasized during the COVID‐19 pandemic. Design The initial phase of this study was a systematic review of articles published before the COVID‐19 pandemic to extract the hospital resilience‐related dimensions for the second phase. The second phase involved text‐mining articles published both before and after the emergence of COVID‐19. Setting In the systematic review phase, 12 databases were searched from 2006 to January 2020, including Scopus, Web of Science, MEDLINE through PubMed, Embase, ERIC, ProQuest, the Cochrane Library, Emerald, Springer, Science Direct/ELSEVIER, Google Scholar, and SID (for Persian language papers). Then, after COVID‐19, articles published in these databases between January 2020 and May 2022 were evaluated using text mining. Result During the systematic phase, 17 out of 1530 papers published before COVID‐19 were synthesized to collect components of hospital disaster resilience. These identified components were the inputs for the text‐mining phase. The text mining on pre‐COVID papers resulted in six clusters, with the highest weight (0.65) belonging to general resilience and disaster preparedness, while in the post‐COVID text mining phase, including 70 papers, 8 clusters have been identified, with the highest weight cluster (0.78) focusing on the mental and psychological aspects of resilience among healthcare workers. Conclusion Following the COVID pandemic, scholarly attention has shifted to the more personal dimensions of hospital resilience, including psychological resiliency. It seems necessary for policymakers to focus more on the individual and psychological resilience of hospital staff.

Sickle cell disease (SCD) is a collection of genetic lesions that manifest in the diminished effectiveness of hemoglobin. We collected and reviewed the recent and extant literature on SARS-CoV-2 (COVID-19) and SCD. We posit an answer to the question associated with any adaptive responses to COVID-19 in individuals with SCD. We collected papers from MEDLINE and all available published papers on COVID-19 and SCD. Unlike a formal meta-analysis, given the early phase of this review in the pandemic, we did not seek unpublished papers. We found an emerging literature where case studies dominated, and traditional large N epidemiological studies were absent. Patients with SCD share many comorbid illnesses with an increased risk of mortality associated with contracting COVID-19. There is sufficient empirical justification to accelerate research on the impact of a viral pathogen like COVID-19 on individuals with SCD. *************************************************************** List of all authors: Michaela Boggan,1,2,3 Christopher L. Edwards,1,2,3 Jordan Meek,1,2,3 Mary Wood,4 W. Jeff Bryson,5 John J. Sollers,1,2,3 Debra O. Parker,1,2,3 Camela S. Barker,2,5 Jessica Miller,2,6 Brianna Downey,2,5 Asha Lockett,2,5 Jazmin Rosales,1,2,3 Courtney Munroe, Jr.,2 Noa Wax,2,5 Sharena Scott,1,2,3 Bridget Pittman,1,2,3 Merell Turner,1,2,3 Hillary T. Dietahin,1,2,3 Eric Smith,1,2,3 Alexandria McDougald,1,2,3 Samantha Beavers,1,2,3 Lakaiya Meadows,1,2,3 Maya Walker,1,2,3 Andrea Richardson,1,2,3 John J. Sollers, IV,2,8 Grace D. Donahue,2,8 Goldie Byrd,7 Malik Muhammad,1,2 Alvin Kidd,9 Walter Charles,1,2 Jonathan Livingston,1,2,3 Shiv Sudhakar10 1North Carolina Central University; 2NCCU Psychoneuroendocrine and Rare Diseases Laboratory; 3NCCU Debra O. Parker Research Incubator; 4Duke University Medical Center; 5Fielding Graduate University; 6Bridges Point Sickle Cell Foundation; 7Wake Forest Medical Center; 8Thomas Moore University; 9Livingston College; 10California Northstate University, United States

Objective(s): The Covid-19 pandemic indicated that our biological characteristics alone are not enough to deal with diseases. Resilience refers to the dynamic process of positive adaptation to unpleasant and unfortunate experiences which reflects our ability to control the situation and manipulate the situation optimally. This capability includes internal dimensions, the role of experiences and mental patterns, and external dimensions including the coordinates or community's efforts in mastering challenges. However, studies only focus on the concept of social resilience as an external dimension, and the role of culture as an independent component of identity has been ignored. In this review, the need to conceptualize cultural resilience has been put on the agenda. In fact, the capabilities that culture provides through the various components that enable us to have the ability to adapt, change conditions, and improve performance in critical situations are studied. Methods: This was a review of the literature. PubMed, Science Direct, Google Scholar, Magiran, and SID databases were investigated using the keywords resilience, community, culture, and hardness in Persian and English papers from 1990 to 2018. The articles were evaluated in multiple stages and finally 32 papers were analyzed. Results: As a result, we conceptualized that cultural resilience could include the following components: belongingness and rootedness, trust, commitment, sense of pride, and attachment. Conclusion: Cultural resilience can be considered as the ability to adapt and deal with a crisis with the help of historical styles, myths, customs, and cultural beliefs.

Abstract Background Pandemics and climate change each challenge health systems through increasing numbers and new types of patients. To adapt to these challenges, leading health systems have embraced a Learning Health System (LHS) approach, aiming to increase the efficiency with which data is translated into actionable knowledge. This rapid review sought to determine how these health systems have used LHS frameworks to both address the challenges posed by the COVID-19 pandemic and climate change, and to prepare for future disturbances, and thus transition towards the LHS2.0. Methods Three databases (Embase, Scopus, and PubMed) were searched for peer-reviewed literature published in English in the five years to March 2023. Publications were included if they described a real-world LHS’s response to one or more of the following: the COVID-19 pandemic, future pandemics, current climate events, future climate change events. Data were extracted and thematically analyzed using the five dimensions of the Institute of Medicine/Zurynski-Braithwaite’s LHS framework: Science and Informatics, Patient-Clinician Partnerships, Continuous Learning Culture, Incentives, and Structure and Governance. Results The search yielded 182 unique publications, four of which reported on LHSs and climate change. Backward citation tracking yielded 13 additional pandemic-related publications. None of the climate change-related papers met the inclusion criteria. Thirty-two publications were included after full-text review. Most were case studies (n = 12, 38%), narrative descriptions (n = 9, 28%) or empirical studies (n = 9, 28%). Science and Informatics (n = 31, 97%), Continuous Learning Culture (n = 26, 81%), Structure and Governance (n = 23, 72%) were the most frequently discussed LHS dimensions. Incentives (n = 21, 66%) and Patient-Clinician Partnerships (n = 18, 56%) received less attention. Twenty-nine papers (91%) discussed benefits or opportunities created by pandemics to furthering the development of an LHS, compared to 22 papers (69%) that discussed challenges. Conclusions An LHS 2.0 approach appears well-suited to responding to the rapidly changing and uncertain conditions of a pandemic, and, by extension, to preparing health systems for the effects of climate change. LHSs that embrace a continuous learning culture can inform patient care, public policy, and public messaging, and those that wisely use IT systems for decision-making can more readily enact surveillance systems for future pandemics and climate change-related events. Trial registration PROSPERO pre-registration: CRD42023408896.

Introduction. SARS-CoV-2 respiratory infection is associated with significant morbidity and mortality, especially in hospitalized high-risk patients. We aimed to evaluate the effects of treatment options (vitamin D, anticoagulation, isoprinosine, ivermectin) on hospital mortality in non-vaccinated patients during the 2021 spring wave in the Czech Republic. Methods. Initially, 991 patients hospitalized in the period January 1, 2021, to March 31, 2021, with PCR-confirmed SARS-CoV-2 acute respiratory infection in two university and five rural hospitals were included in the study. After exclusion of patients with an unknown outcome, a total of 790 patients entered the final analysis. The effects of different treatments were assessed in this cohort by means of propensity score matching. Results. Of the 790 patients, 282 patients died in the hospital; 37.7% were male and 33.3% were female. Age, sex, state of the disease, pneumonia, therapy, and several comorbidities were matched to simulate a case-control study. For anticoagulation treatment, 233 cases (full-dose) vs. 233 controls (prophylactic dose) were matched. The difference in mortality was significant in 16 of the 50 runs. For the treatment with isoprinosine, ivermectin, and vitamin D, none of the 50 runs led to a significant difference in hospital mortality. Conclusion. Prophylactic-dose anticoagulation treatment in our study was found to be beneficial in comparison with the full dose. Supplementation with vitamin D did not show any meaningful benefit in terms of lowering the hospital mortality. Neither ivermectin nor, isoprinosine was found to significantly decrease hospital mortality.

When the COVID-19 pandemic struck and China reported the first case to the World Health Organization in December 2019, there was no evidence-based treatment to combat it. With the catastrophic situation that followed, materialised by a considerable number of deaths, researchers, doctors, traditional healers, and governments of all nations committed themselves to find therapeutic solutions, including preventive and curative. There are effective treatments offered both by modern medicine and traditional medicine for COVID-19 today. However, other therapeutic proposals have not been approved due to the lack of effectiveness and scientific rigour during their development process. Proponents of modern medicine prefer biomedical therapies while in some countries, traditional treatments are used regularly because of their availability, affordability and satisfaction they bring to the population. In this paper, we propose a transactional medicine approach where the interaction between traditional and modern medicine produces a change. With this approach, the promoters of traditional medicine and those of modern medicine will be able to acquire knowledge through the experience produced by their encounters. Transactional medicine aims to be a model for decolonising medicine and recognising the value of both traditional and modern medicine in the fight against COVID-19 and other global emerging pathogens. [ABSTRACT FROM AUTHOR]

Context: There are growing numbers of long-term care facilities (LTCFs) in low- and middle-income countries (LMICs). In 2020, a network of academics and stakeholders developed the CIAT (Coordinate, Identify, Assess and Targeted support) Framework, an emergency COVID-19 policy guidance that sought to address specific needs of LMIC government agencies responsible for LTCFs. Objective: This paper reviews the South African COVID-19 response experience, with particular reference to Western Cape Province, and assesses the degree to which policy responses conformed with the CIAT Framework. Methods: The paper draws on an opportunistic, improvised research design, based on the establishment of a pragmatic partnership between the authors and local government stakeholders. This entailed proactive engagement and informal discussions with policymakers as the pandemic unfolded, as well as privileged access to official documents. Findings and implications: Responses to the pandemic, especially in the early months, did not follow the CIAT Framework. They were hindered by government departments’ poor coordination, weak information systems, and dysfunctional engagement with LTCFs. These problems dated back to before the pandemic and require structural reform to long-term care policy. Limitations: The lack of data on LTCFs in South Africa (though itself an important finding) prevents analysis of policy effects at the level of individual facilities.

Debates on whether early Christians relied solely on exorcism and other miraculous healing under the assumption that all diseases are a result of demonic activity, continue. On the one end of this scholarly continuum are those who hold that early Christians only approached disease and healing as purely spiritual phenomena (hence, focusing on exorcism and other kinds of miraculous healing), while, on the other end, others have argued that early Christians accepted a naturalistic view of the causes for diseases and, consequently, sought naturalistic solutions to diseases. However, like in many other areas of life and thought in early Christianity, there is truth in both of these contentions. Rather than choose sides in this debate, this paper will argue that, just like in other areas, early Christians chose and modified existing approaches to sickness and death based on their understanding of the scriptural teachings on these subjects. As such, their approaches provide some key lessons to the current Covid-19 stricken church. [ABSTRACT FROM AUTHOR]

Against the background of the war in Ukraine, the COVID-19 pandemic has waned from public consciousness as the threat of the virus to health is outweighed by safety concerns during the war. Pandemic restrictions in the European region are being lifted despite low vaccination rates in Central and Eastern European countries and a lack of effective containment strategies. However, Central and Eastern European countries are influenced most by the flow of refugees from neighboring Ukraine where a triple health crisis occurs: an overloaded health system, an ongoing COVID-19 pandemic, and the war. The aim: to review the progress regarding viral surveillance technologies that use genomics, digital, and informational tools, to find the gap in the literature and formulate policy recommendations for continuing surveillance in the context of permacrisis. Unstructured search was conducted through scientific (PubMed and Google Scholar databases) and grey literature using the keywords. The paper highlights aspects of war-related problems of infectious diseases control in Europe, new challenges in healthcare connected with COVID-19 pandemic and war in Ukraine and provides discussion on the role of innovative surveillance systems in tackling infection outbreaks (with COVID-19 pandemic as an example). The paper overviews perspectives of the implementation of the discussed measures. Future COVID-19 outbreaks and new variants are possible. Complex adaptive system models, new tools, and the next level of health and digital intelligence are needed to provide timely and valuable insights. Combining lessons learned from the COVID-19 pandemic, the threat of war, and the need for continuous outbreaks surveillance, new public health and digital intelligence tools must be designed and implemented at regional, European, and global levels.

Background: Virtual reality can play an important role during the COVID-19 pandemic in the health care sector. This technology has the potential to supplement the traditional in-hospital medical training and treatment, and may increase access to training and therapies in various health care settings. Objective: This systematic review aimed to describe the literature on health care--targeted virtual reality applications during the COVID-19 crisis. Methods: We conducted a systematic search of the literature on the PsycINFO, Web of Science, and MEDLINE databases, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The search string was as follows: "[(virtual reality)] AND [(COVID-19) OR (coronavirus) OR (SARS-CoV-2) OR (healthcare)]." Papers published in English after December 2019 in peer-reviewed journals were selected and subjected to the inclusion and exclusion criteria. We used the Mixed Methods Appraisal Tool to assess the quality of studies and the risk of bias. Results: Thirty-nine studies met the inclusion criteria. Seventeen studies showed the usefulness of virtual reality during the COVID-19 crisis for reducing stress, anxiety, depression, and pain, and promoting physical activity. Twenty-two studies revealed that virtual reality was a helpful learning and training tool during the COVID-19 crisis in several areas, including emergency medicine, nursing, and pediatrics. This technology was also used as an educational tool for increasing public understanding of the COVID-19 pandemic. Different levels of immersion (ie, immersive and desktop virtual reality), types of head-mounted displays (ie, PC-based, mobile, and standalone), and content (ie, 360° videos and photos, virtual environments, virtual reality video games, and embodied virtual agents) have been successfully used. Virtual reality was helpful in both face-to-face and remote trials. Conclusions: Virtual reality has been applied frequently in medicine during the COVID-19 pandemic, with positive effects for treating several health conditions and for medical education and training. Some barriers need to be overcome for the broader adoption of virtual reality in the health care panorama. [ABSTRACT FROM AUTHOR]

This article is an overview and reflection of the findings of an evaluative study conducted on a program called “Techno-Covid Partnership” (TCP) implemented in April 2020 at the Centre Hospitalier de l’Université de Montréal (CHUM) in Montreal, Canada. In the context of the COVID-19 pandemic, the CHUM decided in April 2020 to implement telehealth, virtual care, and telemonitoring platforms and technologies to maintain access to care and reduce the risks of contamination and spread of COVID-19 as well as to protect users of health services and health professionals. Three technological platforms for telehealth and remote care and monitoring have been developed, implemented, and evaluated in real-time within the framework of the TCP program. A cross-sectional study was carried out in which a questionnaire was used and administered to users of telehealth platforms including patients and healthcare professionals. The methods and results of the study have been published previously published. In the completion of the two articles published in this context, in this paper, we briefly recall the context of the study and the method performed. The main focus of the paper is on presenting a critical overview and reflection on the major findings of our evaluation of the use of telehealth platforms from the point of view of patients and health professionals and discuss certain paradoxes i.e., the advantages, challenges, recommendations, and other perspectives that emerged in this study.

ObjectiveTo visualize the international research hotspots and frontiers of primary healthcare workers burnout during the COVID-19 pandemic based on CiteSpace.MethodsPublications from January 1 2020 to November 1 2022 were retrieved from the web of science core collection database. Annual published articles， keyword co-occurrence， cluster analysis and emergent word evolution were analyzed. Using CiteSpace 5.8.R3 and Excel 2017， visualized knowledge graphs and the data tables were generated.ResultsA total of 411 articles were included with a still upward trend. The top 4 institutions with the largest number of papers were Harvard Medical Scchool （14 studies）， University of Melbourne （11 studies）， Stanford University （9 studies）， and Monash University （9 studies）. High-frequency words of hot areas covered job satisfaction， occupational burnout， and mental health. Meanwhile the words environment （0.38） and social support （0.13） had high betweenness centrality. A total of 9 clusters were formed. Risk factors and supporting strategies were put in place most focused frontiers.ConclusionThe number of papers in the field of primary healthcare workers burnout is on the rise， the international research hotspots are expanding and the predictors of burnout are prominent. From an international perspective， the study provides further reference for Chinese primary healthcare staff job burnout research.

The COVID-19 pandemic presented the unique challenge of having to deliver novel vaccines during a public health crisis. For pediatric patients, it was further complicated by the delayed timeline for authorizing the vaccine and the differences in dosing/products depending on the patient’s age. This paper investigates the relationship between the spatial accessibility and uptake of the COVID-19 vaccine in King County, WA, USA. Public data for COVID-19 vaccine sites were used to calculate spatial accessibility using an enhanced two-step floating catchment area (E2SFCA) technique. Spatial regression analyses were performed to look at the relationship between spatial accessibility and ZIP-code-level vaccination rates. The relationships of these data with other socioeconomic and demographic variables were calculated as well. Higher rates of vaccine accessibility and vaccine coverage were found in adolescent (12- to 17-year-old) individuals relative to school-age (5- to 11-year-old) individuals. Vaccine accessibility was positively associated with coverage in both age groups in the univariable analysis. This relationship was affected by neighborhood educational attainment. This paper demonstrates how measures such as E2SFCA can be used to calculate the accessibility of the COVID-19 vaccine in a region and provides insight into some of the ecological factors that affect COVID-19 vaccination rates.

Background: COVID-19 is a respiratory disease identified in December 2019 in Wuhan, China, and it has become one of the century›s most significant public health concerns. Dentists are among the most exposed medical professionals to the risk of COVID-19 infection, and they must modify their routine clinical attitudes and behaviors. This study sought to assess the current status of dental professionals› knowledge, attitudes, and practices, as well as their adherence to COVID-19 pandemic guidelines.Methods: A scoping review protocol was developed by searching scientific papers in EBSCO, MEDLINE, CENTRAL, Google Scholar, Web of Science, and Scopus electronic databases using “COVID-19” and “Dentistry” as key search terms to find relevant papers published until March 13, 2021. Two authors reviewed the potentially relevant articles in full. All cross-sectional or cohort studies that evaluated the knowledge, attitudes, or practices of dentists through questionnaires were selected for the review.Results: The search strategy led to the identification of a total of 405 articles which were subsequently assessed for eligibility. By application of inclusion and exclusion criteria, the obtained results were further reduced to 25 citations. The results were organized into the following categories: knowledge (transmission, signs and symptoms, incubation period, etc), attitudes (protective measurements, occupational risk of infection), and practices (protective measurements, personal protective equipment, current status of dental treatments, etc).Conclusion: The research study came to the conclusion that the majority of dentists have sufficient knowledge of COVID-19 infection and comprehend the significance of performing only emergency procedures and delaying elective procedures. Moreover, most of them believed that more awareness programs on COVID-19 prevention are needed for both the dental fraternity and the public.

Polypharmacy, the use of multiple and potentially inappropriate medications, is an increasing problem among older adults. The global polypharmacy prevalence is 34.6% in patients with COVID-19, and polypharmacy in COVID-19 increases with age. The present paper proposes that polypharmacy in older adults with COVID-19 and other comorbid conditions is linked to the medication outcome reporting bias of randomized controlled trials. Outcome reporting bias can occur when treatment efficacy is reported as relative risk reductions, which overestimates medication benefits and exaggerates disease/illness risk reductions compared to unreported absolute risk reductions. The comorbidities common in patients with COVID-19 include high blood pressure, cardiovascular disease, dementia or cerebrovascular disease, and diabetes. Accordingly, the present paper reassesses the relative and absolute risk reductions in clinical trials from a small convenience sample of antihypertension, statin, anticoagulant, and antihyperglycemic medications. Examples demonstrate a wide gap between reported relative risk reductions and unreported absolute risk reductions in medication clinical trials. This paper concludes that medication clinical trial outcome reporting bias is an important upstream factor that contributes to biased medication benefits and poor clinical decision making, leading to polypharmacy in older adults with COVID-19 and other comorbid conditions. Public health campaigns are urgently needed to educate the public about the link between polypharmacy and medication outcome reporting bias.

Aims. The study analysed post-acute COVID-19 symptoms and the pulmonary function test (PFT) results in patients surviving the native strain of the virus. Methods. The study was prospective; the inclusion criteria were positive PCR test for SARS-CoV-2 and age 18-100. Exclusion criteria were active respiratory infection, known or suspicious pre-existing pulmonary disease, cardiac failure, recent or acute pulmonary embolism, anaemia, and neuromuscular diseases. The recruitment period was 1st March 2020 - 25th December 2020. The initial examination was performed 4-12 weeks after the disease onset. All subjects underwent physical examination, anamnesis, chest x-ray and PFT. Results. The study involved 785 subjects (345 male) mean age 53.8 (SD 14.6). The disease severity groups were: mild (G1), moderate (G2) and severe/critical (G3). Anosmia was present in the acute disease phase in 45.2% of G1 patients, but only in 4.5% of G3 patients. Dyspnoea occurred frequently in more severe groups (40%, 51.8% and 63.7% for G1, G2 and G3 respectively), while cough and fatigue showed no relationship to disease severity. Females were more likely to experience persistent symptoms. PFT results were significantly decreased in more severe groups compared to the mild COVID-19 patients, diffusing capacity was 86.3%, 79% and 68% of predicted values in G1, G2 and G3 respectively. Conclusion. Anosmia during the acute phase was associated with mild disease, persisting dyspnoea was more frequent after more severe COVID-19. Females tended to have persisting symptoms in post-acute phase more frequently. PFT results showed decrease with disease severity.

This paper reviews currently available data on the novel coronavirus and clinical features of COVID-19, followed by a detailed section on possible modifications of immunomodulatory therapy in multiple sclerosis patients with COVID-19, based on what we know so far. There are discussed: (i) The COVID-19 disease (Epidemiological background SARS-CoV-1 coronavirus; Autoimmune response to COVID-19; Asymptomatic course; SARS-CoV-2 test; COVID-19 symptoms), (ii) Treatment of COVID-19 (Experimental plasma treatment; Antiviral therapy; Antimalarial treatment scheme; Biological treatment; Corticosteroid treatment; Symptomatic treatment; Vaccine preparation) and (iii) Multiple sclerosis and SARS-CoV-2 infection (Epidemiological recommendation).

Regular physical activity (PA) is essential for health maintenance and disease prevention. COVID- 19 and its social isolation affected patients with cardiovascular (CV) disease. This is a scoping review aiming to map, analyze, and summarize the impacts caused by the isolation of the COVID-19 pandemic concerning PA and CV health in adults. Methods: The review was based on PRISMA-ScR. PubMed, PubMed Central, BVS/BIREME, Scopus, Web of Science, CINAHL, Brazilian Digital Library of Theses and Dissertations, and SciELO databases were selected to search. Two search phases were performed: May 2021 and March 2022. English-language full-text papers were included. Initially, the titles and abstracts of the retrieved documents were read and screened based on the research question. A third reviewer resolved disagreement through consensus meetings. An assessment form was adapted for data extraction. The study was registered in the Open Science Framework platform under the DOI https://doi.org/10.17605/OSF.IO/AH6P8. Results: 11 papers were included and demonstrated that regular PA could be challenging in social isolation environments. Most participants were moderately active and performed low-intensity PA. Confinement led to the limitation of everyday activities, nutritional disorders, and reduced PA, contributing to weight gain. Quarantine was associated with stress and depression, leading to an unhealthy diet. Possible solutions point to home PA, considering the baseline health and CV status. Conclusion: The post-COVID- 19 era and its consequences point to the pressing need for planning strategies that increase and maintain home PA as a protective measure for the general population, considering CV health, resources, and household space.

Since the coronavirus disease 2019 (COVID-19) outbreak caused by the severe acute respiratory syndrome-coronavirus-2 virus (SARS-CoV-2), various complications have been reported. Although most COVID-19 cases exhibited flu-like symptoms, COVID-19 may dysregulate the immune response and promote overwhelming levels of inflammation in some patients. Inflammatory bowel disease (IBD) is caused by dysregulated or inappropriate immune responses to environmental factors in a genetically susceptible host, and a SARS-CoV-2 infection may act as a possible cause of IBD. This paper describes two pediatric patients who developed Crohn’s disease following a SARS-CoV-2 infection. They were previously healthy before the SARS-CoV-2 infection. On the other hand, they started to develop fever and gastrointestinal symptoms several weeks after recovery from the infection. They were diagnosed with Crohn’s disease by imaging and endoscopic studies, and their symptoms improved after treatment with steroids and azathioprine. This paper suggests that a SARS-CoV-2 infection may trigger IBD in predisposed patients.

Abstract Background This study aims to identify the characteristics and future directions of online medical education in the context of the novel coronavirus outbreak new through visual analytics using CiteSpace and VOSviewer bibliometric methods. Method From Web of Science, we searched for articles published between 2020 and 2022 using the terms online education, medical education and COVID-19, ended up with 2555 eligible papers, and the articles published between 2010 and 2019 using the terms online education, medical education and COVID-19, and we ended up with 4313 eligible papers. Results Before the COVID-19 outbreak, Medical students and care were the most frequent keywords and the most cited author was BRENT THOMA with 18 times. The United States is the country with the greatest involvement and research impact in the field of online medical education. The most cited journal is ACAD MED with 1326 citations. After the COVID-19 outbreak, a surge in the number of research results in related fields, and ANXIETY and four secondary keywords were identified. In addition, the concentration of authors of these publications in the USA and China is a strong indication that local epidemics and communication technologies have influenced the development of online medical education research. Regarding the centrality of research institutions, the most influential co-author network is Harvard Medical School in the United States; and regarding the centrality of references, the most representative journal to which it belongs is VACCINE. Conclusion This study found that hey information such as keywords, major institutions and authors, and countries differ in the papers before and after the COVID-19 outbreak. The novel coronavirus outbreak had a significant impact on the online education aspect. For non-medical and medical students, the pandemic has led to home isolation, making it difficult to offer face-to-face classes such as laboratory operations. Students have lost urgency and control over the specifics of face-to-face instruction, which has reduced the quality of teaching. Therefore, we should improve our education model according to the actual situation to ensure the quality of teaching while taking into account the physical and psychological health of students.

Abstract Background The emergence of coronavirus disease 2019 (COVID-19) pandemic has brought an unprecedented burden on health systems and personnel globally. This pandemic potentially can result in increased frequency of stress and burnout experienced among healthcare workers (HCWs), especially in lower-and-middle-income countries with inadequate health professionals, yet little is known about their experience. This study aims to describe the range of research evidence on occupational stress and/burnout among HCWs compounded by the COVID-19 pandemic in Africa, as well as identify research gaps for further investigations to inform health policy decisions towards stress and/burnout reduction in this era and when a future pandemic occurs. Method Arksey and O’Malley’s methodological framework will be used to guide this scoping review. Literature searches will be conducted in PubMed, CINAHL, SCOPUS, Web of Science, Science Direct, and Google Scholar for relevant articles published in any language from January 2020 to the last search date. The literature search strategy will include keywords and Boolean and medical subject heading terms. This study will include peer-reviewed papers about Africa, with a focus on stress and burnout among HCWs in the COVID-19 era. In addition to the database searches, we will manually search the reference list of included articles as well as the World Health Organization’s website for relevant papers. Using the inclusion criteria as a guide, two reviewers will independently screen the abstracts and full-text articles. A narrative synthesis will be conducted, and a summary of the findings reported. Discussion This study will highlight the range of literature HCWs’ experience of stress and/or burnout including the prevalence, associated factors, interventions/coping strategies, and reported effects on healthcare services during the COVID-19 era in Africa. This study’s findings will be relevant to inform healthcare managers plan to mitigate stress and/or burnout as well prepare for such future pandemics. This study’s findings will be disseminated in a peer-review journal, scientific conference, academic and research platforms, and social media.

Background: The extensive use of various electronic games and communication devices, particularly among children and adolescents, has raised concerns, particularly during the COVID-19 pandemic. This study investigated the link between screen time and internalizing disorders, such as anxiety and depression, among individuals aged ≤18 during the global COVID-19 pandemic. Methods: This systematic review aims to summarize scientific publications from 2019 to early 2022 by searching databases, including the Cochrane Library, PubMed, Web of Science, Scopus, and PsycINFO, to identify suitable studies. In each paper, we searched the following keywords and their synonyms: screen, child, high school, middle school, and psychiatric disorders. The quality of the selected papers was evaluated using a checklist recommended by the National Institutes of Health (NIH) for observational cohort studies. Results: Out of 986 reports identified, we included 12 papers with 14,483 participants. The study revealed a negative correlation between screen time (TV, computer, video games, and mobile phones) and behavioral outcomes. Smartphones were the most frequently used devices, with video games being more prevalent among older participants for education, communication, and entertainment purposes. The prevalence of depression ranged between 10% and 25%. Furthermore, anxiety and depression were identified as predictors of increased screen usage. Some results displayed variation based on the type of screen exposure, the questionnaires used, and the age of the participants. Conclusions: The findings imply an indirect association between increased screen time and depression and anxiety. It is crucial to consider limitations on screen time exposure and parental supervision as measures to prevent certain mental disorders.

BackgroundThe importance of advance care planning (ACP) has been highlighted by the advent of life-threatening COVID-19. Anecdotal evidence suggests changes in implementation of policies and procedures is needed to support uptake of ACPs. We investigated the barriers and enablers of ACP in the COVID-19 context and identify recommendations to facilitate ACP, to inform future policy and practice.MethodsWe adopted the WHO recommendation of using rapid reviews for the production of actionable evidence for this study. We searched PUBMED from January 2020 to April 2021. All study designs including commentaries were included that focused on ACPs during COVID-19. Preprints/unpublished papers and Non-English language articles were excluded. Titles and abstracts were screened, full-texts were reviewed, and discrepancies resolved by discussion until consensus.ResultsFrom amongst 343 papers screened, 123 underwent full-text review. In total, 74 papers were included, comprising commentaries (39) and primary research studies covering cohorts, reviews, case studies, and cross-sectional designs (35). The various study types and settings such as hospitals, outpatient services, aged care and community indicated widespread interest in accelerating ACP documentation to facilitate management decisions and care which is unwanted/not aligned with goals. Enablers of ACP included targeted public awareness, availability of telehealth, easy access to online tools and adopting person-centered approach, respectful of patient autonomy and values. The emerging barriers were uncertainty regarding clinical outcomes, cultural and communication difficulties, barriers associated with legal and ethical considerations, infection control restrictions, lack of time, and limited resources and support systems.ConclusionThe pandemic has provided opportunities for rapid implementation of ACP in creative ways to circumvent social distancing restrictions and high demand for health services. This review suggests the pandemic has provided some impetus to drive adaptable ACP conversations at individual, local, and international levels, affording an opportunity for longer term improvements in ACP practice and patient care. The enablers of ACP and the accelerated adoption evident here will hopefully continue to be part of everyday practice, with or without the pandemic.