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WHAT IS KNOWN ON THE SUBJECT?: The COVID-19 pandemic has brought new sources of stress and challenges for people dealing with obsessive compulsive disorder (OCD). WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The study uncovered the unique experiences of Jordanian patients with OCD during the COVID-19 pandemic, revealing three main themes: Navigating Constraints: The Dual Pathways of Social Engagement and Avoidance, estranging family attachments and shifting OCD landscapes. Family dynamics played a significant role, with some families unintentionally exacerbating OCD symptoms through excessive accommodation, while others openly expressed irritation, both contributing to worsened symptoms. The research unveiled a notable deficiency in the availability of professional mental health support for individuals with OCD throughout the pandemic. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Accessible and culturally appropriate e-mental health interventions can bridge the gap in mental health support, especially during crises like the pandemic. It is crucial to involve family members in the treatment process to address family dynamics that may either support or hinder recovery among patients with OCD., Abstract: INTRODUCTION: Pandemics, like COVID-19, can significantly harm the mental well-being and overall quality of life for individuals and their families. Those with pre-existing mental conditions, especially obsessive compulsive disorder (OCD), are more vulnerable to negative psychosocial effects since the fear of being infected or transmitting infection to others are some of the main characteristics of the illness. There is a need for a nuanced understanding of the personal, social and cultural experiences of people with OCD within their specific psychosocial context., Aim: To explore how Jordanian patients with OCD experienced their illness during COVID-19., Method: A descriptive phenomenological design using semi-structured interviews with a purposive sample of 12 patients diagnosed with OCD and experiencing different types of OCD symptoms. Data were analysed thematically, and reported based on the critical appraisal skills programme (CASP) checklist for qualitative studies., Results: Three main themes emerged: (1) Navigating Constraints: The Dual Pathways of Social Engagement and Avoidance (seeking solace through social interaction and embracing quarantine as an opportunity for social avoidance); (2) Estranging family attachments (enforcing proximity and struggling with intimacy); and (3) Shifting OCD landscapes (transforming existing obsessions and escaping to new compulsions). The interviews documented a complete lack of references to receiving professional mental health support throughout the pandemic., Discussion: This study aligns with previous research indicating a surge in OCD severity during the pandemic, fuelled by distressing news and heightened hygiene measures. Notably, it underscores the strain on familial relationships, with some cases showing protective effects but many demonstrating worsening symptoms due to excessive family accommodation. The absence of professional mental health support during the pandemic raises questions about the quality and accessibility of mental health services in Jordan., Implications for Practice: The findings underscore the need for continued mental health support and intervention, particularly during times of heightened stress and isolation. Integrating e-mental health resources and cultural adaptation can play a vital role in providing accessible and effective support for individuals with OCD, including those in the Jordanian Arab culture. As we navigate future challenges, it is crucial to prioritize the well-being of individuals with OCD and ensure they have access to appropriate and tailored mental health services., (© 2024 John Wiley & Sons Ltd.)

The COVID-19 pandemic and subsequent quarantine measures have disrupted people's normal pace of life and created excessive pressure. The current study examined the mitigating effect of search for meaning in life on individual depressive symptoms and the mediating role of optimism during COVID-19 lockdown period. A total of 462 participants (M age  = 37.42 years, SD = 13.15, 166 males) residing in Wuhan, China were recruited online at the beginning of April 2020 when the city was still under lockdown measures. Data were collected four times spanning from April to May 2020, with an interval of roughly 2 weeks in between. The results indicated that search for meaning and optimism was positively correlated with each other concurrently, and both of them were negatively correlated with depressive symptoms. Specifically, search for meaning at T1 could positively predict optimism at T2, which in turn negatively predicted depressive symptoms at T3, suggesting that optimism acted as the mediator for the buffering effects of search for meaning on one's depressive symptoms. Results highlighted the protective role of search for meaning for individual psychological adjustment under such adverse situation as COVID-19 epidemic, and provided practical implications for people to deal with stressful period like quarantine., (© 2024 International Union of Psychological Science.)

At the beginning of 2020, the entire world was shocked by a global health emergency. According to the literature, fear, high mortality and health restrictions had significant psychological consequences on the population. This study evaluates the French lockdown's impact on the grieving process and how people worked through their grief. Two semi-structured interviews were conducted with 31 participants who had lost a loved one between March 2020, June, and September 2021 (T0) and 6 months later (T1). Subsequently, they were divided into two groups: those who lost someone during the first lockdown (Group 1) and those who lost someone outside the lockdown periods (Group 2). The interviews were analysed using the ALCESTE software, a statistical analysis tool for textual data based on word co-occurrences. This research significantly advances the understanding of bereavement during crises, providing new perspectives and practical insights for policymakers, healthcare professionals and support organisations. Its methodological innovation and detailed analysis contribute to the ongoing discussion on grief and resilience in challenging circumstances. Ultimately, this study lays the foundation for improved support and intervention strategies tailored to the needs of bereaved individuals during crises., (© 2024 The Author(s). International Journal of Psychology published by John Wiley & Sons Ltd on behalf of International Union of Psychological Science.)

Background: During the coronavirus disease 2019 (COVID-19) pandemic, the Australian state of Victoria (in particular, its capital, Melbourne) experienced some of the longest lockdowns in the world., Objective: This repeated cross-sectional study examined changes between March to June 2019 (pre-pandemic) and April to August 2022 (6 to 11 months following pandemic-related lockdowns) in overweight and obesity prevalence, physical activity, sedentary behaviour, sleep, diet quality, and health-related quality of life (HRQoL) among primary school children in north-east Victoria, Australia., Methods: Height and weight were measured for Grade 2, 4, and 6 students in 2019 (3889 children) and 2022 (1816 children). Grade 4 and 6 students self-reported on their movement behaviours, diet quality, and HRQoL., Results: Participation declined among schools (2019:56%, 2022:34%) and students (2019:87%, 2022:75%). Compared to children in 2019, children in 2022 had a higher prevalence of overweight and obesity; were less likely to have met guidelines for moderate-to-vigorous physical activity, recreational screen time, and vegetable consumption; had higher intakes of takeaway food, energy-dense nutrient-poor snacks, and sugar-sweetened beverages; and had lower HRQoL., Conclusion: Children's health-related behaviours and outcomes seemed not to have returned to pre-pandemic levels 6 to 11 months after the final lockdowns lifted for their communities. Continued monitoring and interventions targeting the drivers of childhood obesity are urgently needed., (© 2024 The Author(s). Pediatric Obesity published by John Wiley & Sons Ltd on behalf of World Obesity Federation.)

Objectives: COVID-19 lockdowns were introduced to control the pandemic, however, they resulted in a global disruption of daily life and of individual and global health. Reduced accessibility of health services, unavailability of food and drugs, and mental health challenges had a huge impact on older people and on people living with disabling conditions such as Parkinson's disease (PD). We assessed whether and to what extent the more disabled and vulnerable people with Parkinson's (PwP) were affected by lockdowns., Method: We analysed responses collected through a web-based survey of PwP according to their self-sufficiency [self-sufficient (SS); nearly self-sufficient (nSS); non-self-sufficient, cared for by family (NSS/F); non-self-sufficient, needs professional care (NSS/PC)]., Results: Fears due to COVID-19 and difficulties with food supply were highest in NSS/F PwP. Difficulties with the supply of Parkinson's medication or other drugs were apparently not an issue, while problems accessing primary care physicians and neurologists were similar across all patient groups. On the contrary, difficulties with daily and motor activities were higher in NSS/F and NSS/PC PwP. PwP symptoms worsened in all groups, with NSS/F and NSS/PC participants experiencing the worst deterioration. Notably, the deterioration of PwP symptoms was specifically related to changes in daily and motor activities, with participants who reported less engagement in daily and motor activities experiencing the worst deterioration., Conclusion: Findings strongly support the need for decision-makers and healthcare providers to carefully re-evaluate the risk-benefit ratio of limiting healthcare accessibility for PwP, since evidence shows that lockdown measures primarily impact the groups who are most fragile and vulnerable.

Background: School shooting events and lockdowns have increased in the United States, raising concerns about their impact on youth mental health., Method: This study assessed the association between school lockdowns and changes in youth mental health in 10,049 children who participated in the Adolescent Brain and Cognitive Development study. The exposure was school lockdowns related to violence and shooting incidents, and the outcomes were Child Behavior Checklist scores on five mental health disorders., Results: Approximately 20.3% of children reported ever experiencing a school lockdown with 39.3% of these lockdowns occurring in the past year. Past-year lockdown exposure (versus no lockdown exposure) was associated with increased symptoms of anxiety disorders (β = 0.20, 95% CI: 0.01, 0.38), somatic disorders (β = 0.23, 95% CI: 0.09, 0.38), and stress problems (β = 0.30, 95% CI: 0.05, 0.56). Among children who reported a past-year lockdown, those indicating clinical ranges of ADHD (OR = 2.23, 95% CI: 1.17, 4.25) or stress problems (OR = 2.75, 95% CI: 1.05, 7.25) had higher odds than their counterparts of reporting that the lockdown had a lot/some impact (versus little/no impact)., Implications for School Health Policy, Practice, and Equity: Emergency preparedness in schools should prioritize mental health support post-lockdowns., Conclusions: Research and funding are needed to understand the nature, frequency, and consequences of school lockdowns., (© 2025 American School Health Association.)

This study explored the relationship between the ingroup range of individuals and their willingness to assist various social groups during the COVID-19 pandemic and whether or not age moderates this relationship. A total of 291 South Koreans (Mage = 31.91 years, SD = 11.99) participated in an online survey and provided data on ingroup range, intention to provide help, and age. The results demonstrated that individuals with a broader ingroup range displayed a stronger willingness to distribute quarantine supplies for COVID-19 across diverse social groups (β = .12, p < .05). This finding aligned with the ingroup bias phenomenon, in which individuals tend to favor one's group. Importantly, age moderated the association between ingroup range and willingness to help (B = -.19, p < .05). Specifically, the intention of younger individuals (θX → Y|(M = -11.985) = 4.40, CI = 1.79-7.01) and middle-aged individuals (θX → Y|(M = .000) = 2.14, CI = .31-3.98) to assist diverse social groups significantly varied according to their ingroup range, whereas no such relationship existed among older individuals (θX → Y|(M = 11.985) = -.11, CI = -2.64-2.42). We provided an in-depth discussion into the potential reasons that underlie the stronger willingness of older individuals to extend aid beyond their ingroup range during the pandemic compared with those of younger individuals. We then suggested strategies for encouraging acts of prosociality during crises, such as the COVID-19 pandemic, which particularly emphasize the pattern observed in younger participants with a narrow ingroup range., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Lee, Park. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: COVID-19 lockdown measures have profoundly altered lifestyle habits, exposing individuals to significant health risks Aim: This study aims to assess the impact of quarantine measures in Tunisia, with a focus on examining changes in dietary habits, levels of physical activity, psychological patterns, and factors contributing to weight gain., Methods: This is a cross-sectional study involving 1,016 participants and employed a mixed-methods approach to gather data on dietary habits, physical activity levels, and psychological indicators. Statistical analyses, including binary logistic regression, were conducted to identify independent risk factors associated with weight gain during the quarantine period., Results: Approximately 36.4% of participants reported experiencing weight gain, with a notable prevalence among younger age groups. Increased consumption of sweets, pasta, and fried foods, coupled with reduced intake of water, vegetables, and fruits, were associated with weight gain. Furthermore, a decline in physical activity levels and elevated scores of anxiety and depression were observed among individuals who reported weight gain. Binary logistic regression highlighted snack frequency, fried food consumption, and pasta intake as significant independent risk factors for weight gain., Conclusion: The results underscore the importance of understanding the complex impacts of lockdowns on lifestyle habits and mental health to guide future interventions, which are necessary to mitigate adverse health consequences and promote healthy lifestyles in the post-pandemic period.

Objective: In the context of the Omicron-induced lockdown in Shanghai, this paper investigated the appeals for assistance by citizens on Weibo, aiming to understand their principal challenges and immediate needs., Methods: This paper collected Weibo posts ( N = 1040) containing the keyword "Shanghai Anti-epidemic Help" during the citywide lockdown. The online help requests from Shanghai citizens were analyzed across 7 dimensions, including the help sought, level of urgency, help recipient, the intended beneficiary of the help, expression, position, and emotion., Results: The study found that the most common requests for assistance were related to social isolation, specifically in the areas of home and community (34.81%), isolation (10.86%), and personal freedom (7.31%). Of all help requests, 11.83% were deemed very urgent. Most of the Weibo posts sent out a plea for help to Internet users (56.06%), primarily requesting help for themselves (26.25%) or their families (27.60%)., Conclusions: The study found that personal freedom, food, and medical care were the most frequently sought help from the public, and most of the public's positions and emotions were pessimistic. The relevant findings revealed the public's needs and status during the city closure, providing a reference for emergency preparedness in public health events or emergencies.

Background: Suicide is a leading cause of death in children. The COVID-19 pandemic might change the characteristics, causes (medical, suicidal, accidental, and other non-medical), and outcomes of pediatric OHCA. This study aimed to investigate the impact of pediatric OHCA in age, location, and quarantine-related movement restriction subgroups., Methods: Combining the nationwide OHCA registry with the emergency medical service transportation database, we created a database with detailed information on 7657 non-neonatal, pediatric OHCA cases., Results: The pandemic period did not significantly alter neurologically favorable 1-month survival compared to pre-pandemic 4 years (95% confidence interval 0.73-1.00). However, the survival rate significantly decreased in the following subgroups of OHCA: school-age (0.62-0.96), outside of school or home (0.52-0.96), and cases where no quarantine-related movement restrictions were applied (0.68-0.97). There was a prominent increase in the proportion of suicide-related OHCA in these subgroups: from 30.3 to 38.1% (1.22-1.64), from 10.2 to 15.9% (1.21-2.28), and from 12.5 to 17.8% (1.30-1.77), respectively., Conclusion: The COVID-19 pandemic did not significantly alter neurologically favorable 1-month survival. However, it led to worsened survival in subgroups with higher suicide attempt rates. Prevention of suicide is likely essential in the assurance of children's lives during the pandemic., Impact: This cohort study found that during the 2020/2021 pandemic, neurologically favorable survival decreased in school-age out-of-hospital cardiac arrest (OHCA) cases, those not subject to quarantine-related movement restrictions, and those in locations outside of school or home. Within these three subgroups, there was a notable rise in OHCA cases related to suicide, historically known to be more challenging to manage successfully. However, survival rates for overall OHCA and medically related OHCA cases remained unchanged throughout the pandemic. Preventive measures for suicide attempts may be necessary to improve the overall survival of pediatric OHCA during the pandemic., Competing Interests: Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/disclosure-of-interest/ and declare: no support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous three; no other relationships or activities that could appear to have influenced the submitted work., (© 2024. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.)

Background: Studies have reported an increase in mental health disorders during the perinatal period as a result of the COVID-19 pandemic and the quarantine restrictions imposed. The effects of untreated maternal mental health have an adverse impact on the mother, the development of the baby, and the family system. Determinants of health, recent natural disasters, and disparities in perinatal care that impact perinatal women in Puerto Rico place them at a higher risk of mental health difficulties., Aim: It is therefore, of extreme importance, to evaluate the effect that the COVID-19 pandemic has had on this vulnerable population., Design: This is a cross-sectional observational study that interviewed 100 women in the perinatal period during the COVID-19 lockdown measures in Puerto Rico. Participants completed the Spanish version of the COVID-19 Perinatal Experiences (COPE-IS) questionnaire and assessments of clinical depression (PHQ-9) and anxiety (GAD-7)., Results: The prevalence of moderate to severe risk of depression in this sample is 14%, while 17% showed clinical signs of anxiety. Concerns about social impact and the quarantine mandate were the most common stressors reported. Additionally, our sample reported concerns about the impact the pandemic would have on future employment and finances., Conclusion: Perinatal women showed significantly higher prevalence of depression and anxiety during the COVID -19 pandemic when compared to the mental health prevalence of the general population pre-pandemic in Puerto Rico. The concerns identified during the pandemic provide information on the importance of a biopsychosocial approach to perinatal mental health care.

LGBTQ communities around the world entered the COVID-19 pandemic with generally high rates of poor mental health and faced additional challenges including stigma, discrimination, and barriers to care. This study sample was drawn from a survey of 3135 LGBTQ adults residing in Australia during the pandemic. Regression analysis was used to explore individual differences in psychological distress and perceived change in mental wellbeing since the onset of the pandemic as well as the impact of lockdowns, by taking advantage of a natural experiment comparing the states that experienced more extensive lockdowns (Victoria and New South Wales) to the rest of Australia. The burden of mental health was found to vary across gender, sexual orientation, age, and area of residence. While no impact of lockdowns on psychological distress was observed, participants living in the states of Victoria (β = -0.15; 95% CI = -0.23, -0.07) and New South Wales (β = -0.13; 95% CI = -0.21, -0.05) self-reported a more negative impact of the pandemic on their mental wellbeing compared to the rest of the country. The findings suggest that the COVID-19 pandemic had a negative impact on the mental wellbeing of LGBTQ populations, particularly among those who experienced extensive lockdowns and highlight the need for increased efforts to enable access to mental health supports during times of crisis.

The global health emergency of COVID-19 in early 2020 placed much of the population under quarantine. Interstitial Lung Disease in childhood (chILD) was recommended to be a pediatric clinically extremely vulnerable (CEV) group in April 2020 for shielding due to the unknown health consequences of COVID-19 in children with chronic respiratory conditions. This qualitative longitudinal research study explores how chILD parents in the UK experienced COVID-19 lockdown from over two interview time points. Participants (n = 8) were recruited from chILD patient organizations and online communities. Interview one focused on the period between January 2020 to July 2020, gaining personal insight into respondent's experience of lockdowns, which included questions on support systems and media coverage of COVID-19. The second interview enquired how respondents managed further UK lockdowns between September 2020 and May 2021. The main themes were uncertainty and adaptation. Respondents described how they navigated the UK lockdowns and undertook various risk management strategies for pandemic isolation. Once these were established, routine and positive family bonding was reported, along with a reluctant acceptance of the COVID-19 virus and continued shielding. As new COVID-19 information emerged, risk management strategies changed or remained for some respondents, bringing a feeling of living with COVID-19 as a "new normal". (Understanding the unique insights people with rare diseases such as chILD face during a global pandemic adds to policy and healthcare literature. Recommendations include further study of caregiver traits and resilience, essential facets of positive pandemic adaptation., (© 2024 The Author(s). Pediatric Pulmonology published by Wiley Periodicals LLC.)

COVID-19 reopening of China in the context of the highly transmissible Omicron variant has resulted in an unprecedented wave of infections, placing significant strain on healthcare systems and giving rise to a range of psychological responses, including perceptions of the pandemic's threat, emotional reactions, and prosocial intentions amid moral conflicts over medical resource scarcity and evolving public health responses. This study employed a comprehensive approach integrating surveys, behavioral experiments, and agent-based modeling (ABM) to examine these psychological impacts of COVID-19 reopening. A total of 1,675 participants from 34 Chinese provinces completed the surveys, with 587 also undertaking the reversal-learning task. The measures employed were primarily designed to assess perceptions of COVID-19 infection risk and medical resources, negative affect, and prosocial intentions in moral conflicts. Results found that the perception of infection risk and associated negative affects remained elevated until the pandemic decline. However, prosocial intentions initially increased, but subsequently decreased. Moreover, the influence of perceived public medical resources and negative affect on prosocial intentions is mediated by distinct pathways. ABM suggested that anxiety might accelerate the pandemic but increase overall fatalities through prosocial actions, while public medical resources perceptions might shape the pandemic by influencing healthcare-seeking behaviors. These findings underscore the crucial role of psychological factors in pandemic management, alongside physical aspects, providing a scientific foundation for future responses., Competing Interests: Declaration of competing interest We declare no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background/objectives: Home isolation measures during the COVID-19 lockdown periods may have influenced individuals' lifestyles. The COVEAT study aimed to identify differences in children's and their parents' dietary behavior, children's body weight and parental body mass index (BMI) between two lockdown periods implemented in Greece., Methods: In total, 61 participants (children 2-18 years and their parents) completed questionnaires about their lifestyle, body weight and height, and family socio-demographic data, during both lockdown periods (LDs) implemented in Greece (LD1 in March-May 2020; LD2 in December 2020-January 2021)., Results: No significant differences in parents' BMI and fluctuations in children's/adolescents' body weight and BMI were observed in LD2 compared to LD1. Regarding dietary behavior, in LD2 fewer parents were found to have dinner and prepared home meals and more families reported to order fast food. Furthermore, a significant decrease in the consumption of fresh and prepacked juices and an increase in fast-food consumption were observed for children/adolescents in LD2 compared to LD1., Conclusions: The findings of the COVEAT study indicate that each lockdown period had a different impact on children's/adolescents' and their parents' dietary behavior, with less favorable changes observed in LD2, suggesting that the implementation of additional lockdowns may have had a negative impact on individuals' lifestyles.

Background: With the COVID-19 emergency, the provision of healthcare had to be reorganized. Community Health Services for Families of Trieste adopted new methods to ensure continuity of care and the maintenance of the Standards and Good Practices of the Baby Friendly Initiative of UNICEF for the Birth Care Pathway. The aim of the study was to identify the perceived needs of women, couples, caregivers, and health professionals during the COVID-19 pandemic and evaluate new healthcare strategies, identifying weaknesses and strengths, and future developments., Methods: This was an exploratory qualitative study, using online Focus Groups (FGs) with mothers, fathers, pregnant couples, grandparents, peer breastfeeding support mothers' groups, and healthcare professionals (HCPs). The sample was purposeful, selected through the district healthcare network. After obtaining participants' consent, FGs were recorded and fully transcribed. Transcripts underwent deductive and inductive categorical analysis using Nvivo12 software., Results: Ten FGs were conducted with 86 participants. Situations of increased vulnerability were reported by women who experienced significant levels of loneliness during pregnancy, childbirth, and the first months of their child's life. Regarding healthcare pathways, inconsistencies in the information provided by healthcare services emerged, due to the lack of clear national guidelines for managing childbirth during the pandemic. A controversial healthcare practice was the widespread exclusion of partners from antenatal care, prenatal diagnostics, labour, delivery, and postnatal care. After a period of uncertainty and fear experienced by families and HCPs, significant improvements in the organisation of community and hospital services were described. This was aided by telemedicine, which re-established a sense of care and connection. Positive aspects of the lockdown included a major presence of fathers who could work from home, share daily life with their partners, and take care of their children., Conclusions: The COVID-19 emergency has reshaped the provision of healthcare, even in the field of childbirth. Innovative methods have proven to effectively address new needs resulting from physical and social distancing. These strategies could promote sustainable organisational approaches for managing childbirth care. Our results highlighted how policies and practices for future healthcare emergencies could ensure adherence to best practices and promote patient's rights., Competing Interests: Declarations. Ethics approval and consent to participate: The study was submitted and approved by the Friuli Venezia Giulia Regional Ethics Committee (CEUR- prot. n. 16724 del 20.05.2020). This included the approval of the Data Protection Office and GDPR adherence of the online web app. Before the commencement of the FGs, participants were provided with the privacy information form and signed the informed consent. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background and Objectives: Coronavirus disease 2019 (COVID-19) negatively influenced resident well-being in nursing homes (NHs). We examine perceptions and experiences of U.S. NH staff during the COVID-19 pandemic regarding resident well-being., Research Design and Methods: We sampled 68 NHs (out of 13,423) in strata defined by quality ratings, urban/rural location, and whether they served a resident population of <70% White. We enrolled 10 NHs and interviewed 11 nursing staff (8 certified nursing assistants/aides, 3 registered or licensed practical/vocational nurses), 12 managerial staff (4 administrators, 8 directors of nursing), and 5 infection preventionists. Thematic analysis identified themes related to challenges of quarantine/isolation, attempted solutions, and lessons learned concerning resident well-being., Results: Nursing home managerial, infection prevention, and nursing staff described how COVID-19 policies contributed to increased resident loneliness and declines in physical and cognitive well-being. Solutions/strategies employed across the United States and in low- and high-quality NHs included proactive mental health support, resident-centered family visitation, increased communication and care planning with families and efforts to maintain resident normalcy., Discussion and Implications: Strategies to mitigate and alleviate concerns with resident well-being were both structural and made via staff choices. NH leadership needs to proactively plan how to adapt processes and structures that prioritize resident well-being along with resident care in times of crisis. Research is needed to outline the planning, implementation, and recommendations required to operationalize these strategies into practice. Determining the most effective ways to implement these structural changes within NH practices and workflows is critical to ensure that staff have sufficient time to spend with residents., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Gerontological Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background: COVID-19 has posed a significant global threat to public health due to its high contagion risk and lack of effective treatment. While quarantine measures have been crucial in controlling the virus' spread, they have also contributed to negative impacts on individuals' mental health. Music listening has emerged as a potential coping mechanism, yet it remains unclear whether mental well-being varies across music preferences., Objective: This study examined individuals' music-listening preferences in the context of COVID-19 quarantine and assessed the mediation pathways linking 5 types of music to mental health levels, mediated by perceived social connectedness as well as sense of security., Methods: A web-based survey was conducted among people with quarantine experience in September 2022, in mainland China. A total of 712 valid questionnaires were returned and 596 samples were finally included in our study for mediation analysis., Results: The results revealed that the vast majority (596/623, 96%) of respondents had music-listening experiences during the COVID-19 quarantine, with pop music emerging as the most popular preference among respondents, while quyi was the least listened-to genre. Additionally, listening to music across 5 different genres appeared as a significant parameter indirectly linked to mental health through perceived social connectedness. Specifically, engaging with quyi was associated with higher levels of perceived social connectedness and sense of security, which in turn correlated with improved mental well-being. Conversely, individuals listening to jazz reported lower social connectedness and sense of security, which was subsequently linked to increased mental health problems. The potential reasons for these findings and implications are discussed., Conclusions: This study significantly contributes to the understanding of the mechanisms behind music-listening preferences in stressful environments. Specifically, our findings highlight the mediating roles of perceived social connectedness and sense of security in the relationship between music preferences and mental health outcomes during the quarantine period. These insights provide valuable guidance for developing interventions that use music to enhance mental health, thereby broadening the scope of studies on environmental stimuli and their impact on mental well-being., (© Xuechang Xian, Xiaoran Zhang, Danhe Zheng, Yanlin Wang. Originally published in JMIR Formative Research (https://formative.jmir.org).)

Objectives: This study aimed to investigate the experiences of healthcare workers in long-term care facilities (LTCFs) during cohort quarantine for the COVID-19 pandemic in South Korea., Design: A qualitative study using thematic analysis., Setting and Participants: Ten workers from two LTCFs that underwent cohort quarantine due to COVID-19 in South Korea, including direct-care staff and administrators., Methods: In-depth, semi-structured interviews were conducted from 23 April to 7 May 2021. Data were analysed using Braun and Clarke's thematic analysis approach., Results: Five main themes emerged: (1) adapting to unprecedented infection control measures; (2) enduring prolonged cohort quarantine situation; (3) confronting social stigma and discrimination; (4) developing organisational resilience; and (5) recognising the need for systemic support., Conclusions: This study provides insights into the multifaceted experiences of LTCF workers during the COVID-19 quarantine. The findings suggest the need for enhanced infection control training, mental health support, and systemic changes to better prepare LTCFs for any future pandemic., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.)

Background: The lockdown due to the COVID-19 pandemic, imposed in many countries in 2021, led to social isolation and the interruption of many activities that were useful in stimulating cognition. The impact of these changes has been particularly severe in older subjects with cognitive impairment., Methods: The present study aimed to investigate the effects of lockdown on Alzheimer's disease patients (in cognition, behavior, and autonomy) and on their caregivers (in emotions, burden, and quality of life). We created a questionnaire and performed an extensive semi-structured telephone interview with each caregiver. The main outcomes were (1) changes in cognitive and behavioral symptoms and autonomy levels in the patients and (2) effects on caregivers' emotions, burden, and quality of life., Results: The lockdown severely impaired patients' cognition and independence and worsened behavioral and psychological symptoms of dementia. These effects contributed to increasing caregivers' burden and stress levels, with a significant perceived deterioration in quality of life among caregivers with higher education levels ( p = 0.047)., Conclusions: This study might contribute to our understanding of the impact of lockdown on Alzheimer's disease patients and their caregivers, to guide future public health interventions aimed at preventing and/or reducing the consequences of similar extraordinary events in frail subjects.

Background: The implementation of COVID-19 lockdown measures had immediate and delayed psychological effects. From March 27, 2022, to June 1, 2022, the Shanghai government enforced a city-wide lockdown that affected 25 million residents. During this period, mental health services were predominantly provided through digital platforms. However, limited knowledge exists regarding the general population's intention to use mental health services during this time., Objective: This study aimed to assess the intention of Shanghai residents to use mental health services during the 2022 Shanghai lockdown and identify factors associated with the intention to use mobile mental health services., Methods: An online survey was distributed from April 29 to June 1, 2022, using a purposive sampling approach across 16 districts in Shanghai. Eligible participants were adults over 18 years of age who were physically present in Shanghai during the lockdown. Multivariable logistic regression was used to estimate the associations between demographic factors, lockdown-related stressors and experiences, physical and mental health status, and study outcomes-mobile mental health service use intention (mobile applications and WeChat Mini Programs [Tencent Holdings Limited])., Results: The analytical sample comprised 3230 respondents, among whom 29.7% (weighted percentage; n=1030) screened positive for depression or anxiety based on the 9-item Patient Health Questionnaire or the 7-item Generalized Anxiety Disorder Scale. Less than one-fourth of the respondents (24.4%, n=914) expressed an intention to use any form of mental health services, with mobile mental health service being the most considered option (19.3%, n=728). Only 10.9% (n=440) used digital mental health services during the lockdown. Factors associated with increased odds of mobile mental health service use intention included being female, being employed, being a permanent resident, experiencing COVID-19-related stressors (such as loss of income, food insecurity, and potentially traumatic experiences), and having social and financial support. Individuals with moderate or severe anxiety, as well as those with comorbid anxiety and depression, demonstrated a higher intention to use mobile mental health services. However, individuals with depression alone did not exhibit a significantly higher intention compared with those without common mental disorders., Conclusions: Despite a high prevalence of common mental disorders among Shanghai residents, less than one-fourth of the study respondents expressed an intention to use any form of mental health services during the lockdown. Mobile apps or WeChat Mini Programs were the most considered mental health service formats. The study provided insights for developing more person-centered mobile mental health services to meet the diverse needs of different populations., (©Lingzi Luo, Gen Li, Weiming Tang, Dan Wu, Brian Hall. Originally published in JMIR Formative Research (https://formative.jmir.org), 02.12.2024.)

Objectives: We explore the experiences of people with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (pwME/CFS) during the first UK COVID-19 lockdown period. We specifically probe perceived commonalities and departures in experience between government- and health-imposed lockdowns, application of coping strategies for social isolation, and predictions for inclusion of the chronically ill in post-pandemic society., Methods and Measures: Thirty semi-structured interviews were conducted in pwME/CFS between June - July, 2020. Responses were qualitatively analysed using an experiential, thematic framework., Results: While participants reported enhancements in digital accessibility during lockdown, they perceived this as an unintentional benefit from changes designed to cater universally. Similarly, their expectation was that the general population's limited experience of restriction would not engender greater understanding for those who would continue to experience health-imposed lockdowns, post-pandemic. Participants described numerous strategies for coping with restriction and isolation, developed during prior health-imposed lockdowns and applied to this novel circumstance, highlighting the presence of acceptance and resilience in the sample., Conclusions: Our findings suggest that future work may fruitfully examine whether our participant's predictions for post-pandemic societal inclusion have been met, and how resilience and acceptance might be developed and nurtured in chronically ill populations through times of adversity.

The study examined whether caregiver worry of COVID-19 infection and co-existence difficulty differentially predicted child mental health and wellbeing during the lockdown in two culturally different countries that were severely affected by the pandemic: the UK and Turkey. Co-existence difficulty is the hardship experienced by family members living all together in the same house at the same time during the lockdown period. Participants were 1849 caregivers of children between 5- and 12-years old living in the UK ( n = 995) and Turkey ( n = 854), who completed an electronic survey distributed via social networks during the initial phase of the COVID-19 lockdown (July and August 2020). Caregivers completed a set of questionnaires on child and family wellbeing and on whether the child's internalizing and externalizing symptoms changed during the lockdown as compared to before. Worry of COVID-19 infection was higher amongst caregivers in the Turkish sample and was associated with higher levels of child internalizing symptoms during the lockdown in the Turkish sample, however there were no statistically significant differences in the size of the impact of worry of infection on the children's internalizing symptoms between the two countries. Co-existence difficulty independently predicted increase in children's internalizing and externalizing symptoms during the lockdown in both samples. Families in the UK experienced a higher level of difficulty with co-existence compared to the families living in Turkey but the magnitude of the impact of co-existence difficulty on children's outcomes between the two samples was not significantly different.The findings suggest that public health strategies should aim to reduce social anxiety and invest in the development of programs aimed at supporting families to overcome the challenges of co-existence during times of public health crisis., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This study estimates the association between emergency department (ED) visits for mental health disorders (MHDs) and the health context of the COVID-19 pandemic in the French region of Nouvelle-Aquitaine. This retrospective study took place between 2018 and 2021 using ED data. We defined the main exposure according to five periods: "Pre-pandemic (reference)", "First lockdown", "Second lockdown", "Third lockdown", and "Pandemic out-of-lockdown." We constructed the daily indicators for each MHD-related ED visit based on medical diagnoses. We described and then modeled the daily time series using generalized additive models with a quasi-Poisson regression. The analysis included 5,693,341 ED visits of which MHDs accounted for 4%. We observed a decline in ED use for most indicators, particularly during the first lockdown. Models revealed a statistically significant relative increase in ED visits for almost all MHDs during the first lockdown; for anxiety and child psychiatric disorders during the second lockdown; and only for child psychiatric disorders during the pandemic out-of-lockdown period. The public health crisis and lockdowns associated with the COVID-19 pandemic have been important sources of stress that could partially explain the deterioration of MHD indicators, thus leading to new public health concerns (notably among the youngest age group). Mental health is a major determinant of overall health and should therefore be considered in the management of crises that may require similar responses in the future., (Copyright © 2024 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

COVID-19 pandemic caused several lockdowns in most countries, enclosing together perpetrators and victims of intimate partner violence (IPV). Our study investigates psychological mechanisms associated with IPV. We supposed that stress provoked by the pandemic, as well as adhering to authoritarian beliefs will be a predictor of IPV. Using an online questionnaire, 1,659 individuals indicated whether they had been victim or witnessed IPV at home and filled a perceived stress scale, anxiety, depression, and aggressiveness scales. They were also asked to fill an authoritarianism scale, how they cope with the lockdown situations, and some demographical information. We found that individuals who were victims or witnesses of IPV during the COVID-19 lockdowns tended to have more difficulty isolating at home or to hold stronger authoritarian beliefs. Importantly, the association between authoritarian beliefs and IPV was moderated by perceived stress, suggesting that individuals who hold authoritarian views may be more affected by stress, which could increase the risk of experiencing or witnessing IPV. IPV incidents during the pandemic lockdowns may be partially explained by perceived stress, which is amplified by authoritarian attitudes. Further discussions on the causes of IPV and interventions are suggested., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the authorship and/or publication of this article.

Background: Government mandated quarantine outside the home was implemented to mitigate COVID-19 in some countries. Individual studies report that this can result in psychological distress. Investigating levels of distress and associated risk factors across different settings would inform public health models of care during future pandemics. However, no previous systematic reviews have been conducted on the topic. Therefore, we systematically reviewed international research on the prevalence and risk factors of psychological distress within supervised quarantine facilities during the COVID-19 pandemic., Methods: A systematic review of the literature was conducted using Medline, Psychological and Behavioural Sciences, Psych Info, Cochrane databases and Google Scholar from January 2020 until June 2023. Relevant quantitative studies published in English were included., Results: 13 studies (pooled participants n = 4366) were included in this review. The prevalence of psychological distress varied widely across the included studies (depression 4%-63%; anxiety 4%-100%; stress 1%-68%). Associated risk factors identified were also heterogeneous between studies and facilities., Conclusion: In future pandemics, the benefits of infection mitigation need to be weighed against the risk of psychological distress. Models of care utilising specifically designed facilities, with greater freedoms, increased comfort and ease of access to mental health services may limit psychological distress., Competing Interests: DisclosureThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Two of the authors are authors included in two of the included studies.13,32

Aim: The aim of this study was to examine the impact of the COVID-19 pandemic and non-pharmacological interventions, with a particular focus on the subjective experiences of pupils in relation to the measures, the extent to which quarantine and illness with COVID-19 influenced their perception of the disease, the protective measures taken and the groups that were particularly affected., Methods: From November 2021 to February 2022, a written survey of tenth grade pupils from all nine secondary municipal schools in the city of Witten, Germany was conducted. Descriptive statistics were used to analyze and evaluate the data., Results: 98.3% of the pupils present in class (n=649) were included in the survey. Of the study population, 12.9% stated that they had already had COVID-19 and 43.6% had been quarantined. 27.3% of the pupils reported that mask-wearing was not easy for them, while 65.2% found wearing a mask easy. Furthermore, 33.4% reported that distance learning had negatively impacted their well-being, and 6.9% of the pupils reported that they had experienced more violence during the pandemic. Fear of COVID-19 was reported by 10% of the pupils, and was less frequently reported if pupils had already been infected with COVID-19 or had been quarantined. 75.7% reported no fear of COVID-19., Conclusion: The COVID-19 pandemic and the non-pharmacological measures to address it presented significant challenges and were a substantial burden on the pupils. The present study shows that the pandemic and/or the measures had a negative impact on the pupils. It is imperative to critically examine the measures, particularly in relation to vulnerable groups such as gender-diverse or socio-economically disadvantaged pupils. Education that is needs-based and target group-oriented can facilitate increased acceptance and perceptions of safety of implemented measures among pupils., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

It is assumed that increases in Covid-19 cases are caused by people not adhering to advised individual transmission-reducing behaviours. Upon the implementation of restrictions, the hypothesis is that those individuals will change their behaviour. We aimed to retrospectively explore adherence to physical distancing before and after restrictions (e.g., lockdowns) were implemented in a region of Scotland. We assessed adherence, intention, and self-efficacy to physical distancing in a series of cross-sectional telephone surveys of a representative sample of adults in Scotland. We included data from before regional restrictions and after restrictions and examined whether regions with and without restrictions differed in adherence. A total of 1724 Scottish adults (675 men, M age = 52.79 years, SD = 17.92) participated (879 (51.0%) pre-restriction, 466 (27.0%) from a restricted region). ANOVA showed that none of the main effects (for region or time) nor the interaction effect were significant. There was a main effect of time on self-efficacy, such that self-efficacy was lower post-restriction measures (M = 4.13, SD = 0.81) compared to pre-restriction time (M = 4.22, SD = 0.79). There was no evidence that adherence was weaker before restrictions were implemented in regions with higher case rates. Nor was there evidence that imposing restrictions increased adherence. In a future pandemic, it is advisable to assess behaviour and beliefs about Covid-19, risk, and behaviours on an ongoing basis and to use that as indicators of the need for intervention even before cases rates start to go up., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society of Behavioral Medicine.)

This paper analyses the relationship between working from home (WFH) and mental well-being at different stages during the first two critical years of the COVID-19 pandemic, when governments repeatedly imposed lockdowns and enacted WFH mandates to contain the spread of the virus. Using data from a representative survey conducted at four different time periods in 2020 (first lockdown, subsequent gradual reopening), 2021 (further lockdown) and 2022 (restrictions widely lifted) in the 27 EU member states, it examines the changing role of several mediators over time: work-family conflict, family-work conflict, stability, resilience, isolation, the importance of different support networks, workload, physical risk of contracting COVID-19 at work and housing conditions. For the first lockdown, it also differentiates by previous WFH experience, in terms of WFH novices and experienced WFH workers. It likewise differentiates by gender, in order to take the potential gendered nature of COVID-19 measures into account. The results point to several important mediators: for those who work from home, less family-work conflict and isolation, but greater stability, resilience, network support from family and friends, and superior housing conditions were associated with better mental well-being. The relevance of mediators was specific to certain stages of the pandemic. Stability was the most important mediator during the first lockdown. Work-family conflict and family-work conflict were only relevant during the first lockdown, while resilience and isolation mattered especially towards the end of the pandemic. Unlike established WFH workers, WFH novices had an advantage during the first lockdown, benefiting from lower family-work conflict and more helpful networks of family and friends. Our results differ by gender: for females who undertook WFH, important mediators were work-family conflict and family-work conflict. Both were related to adjustments they had to make in work and non-work hours in response to the enforced closure of schools and childcare facilities. For males who undertook WFH, support from networks of family and friends was an important mediator during the first lockdown., Competing Interests: The author has declared that no competing interests exist., (Copyright: © 2024 Sandra M. Leitner. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objective: We aimed to explore conversations about mental health difficulties by Reddit users who posted within college subreddits during the COVID-19 pandemic. Participants: Data were collected from the subreddits of 22 California campuses, representing 113,579 anonymous members. Using the following search terms, we retrieved 577 posts (ie, 268 original posts and 309 replies): COVID, Coronavirus, Quarantine, Pandemic, Anxiety, Anxious, Depressed, Depression, Overwhelmed, Stress, and Stressed. Methods: We used inductive, thematic data analysis to explore themes within posts and replies dated from 3/16/2020 to 3/16/2021. Results: We identified the following themes: 1) the COVID-19 pandemic has negatively impacted engagement with learning; 2) remote learning has exacerbated students' mental health difficulties; and 3) students provide and receive social support online. Conclusions: These findings have implications that are particularly relevant as campuses are faced with continuous decisions related to repopulation.

In the wake of epidemics, quarantine measures are typically recommended by health authorities or governments to help control the spread of the disease. Compared with mandatory quarantine, voluntary quarantine offers individuals the liberty to decide whether to isolate themselves in case of infection exposure, driven by their personal assessment of the trade-off between economic loss and health risks as well as their own sense of social responsibility and concern for public health. To better understand self-motivated health behavior choices under these factors, here we incorporate voluntary quarantine into an endemic disease model - the susceptible-infected-susceptible (SIS) model - and perform comprehensive agent-based simulations to characterize the resulting behavior-disease interactions in structured populations. We quantify the conditions under which voluntary quarantine will be an effective intervention measure to mitigate disease burden. Furthermore, we demonstrate how individual decision-making factors, including the level of temptation to refrain from quarantine and the degree of social compassion, impact compliance levels of voluntary quarantines and the consequent collective disease mitigation efforts. We find that successful disease control requires either a sufficiently low level of temptation or a sufficiently high degree of social compassion, such that even complete containment of the epidemic is attainable. In addition to well-mixed populations, we have also analyzed other more realistic social networks of contacts, including spatial lattices, small-world networks, and real social networks. Our work offers new insights into the fundamental social dilemma aspect of disease control through non-pharmaceutical interventions, such as voluntary quarantine and isolation, where the collective outcome of individual decision-making is crucial., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objectives: Mpox continues to spread in China, and stakeholders' experiences may help inform prevention and control strategies., Study Design: Qualitative study., Methods: A qualitative study across 14 Chinese cities recruited stakeholders from Centers for Disease Control and Prevention (CDCs), community-based organizations (CBOs), and hospitals involved in curbing mpox. Semi-structured interviews were conducted by telephone and analyzed using Colaizzi's phenomenological method., Results: 15 CBOs workers, 14 CDCs staff, and 13 healthcare workers were recruited. Three theme categories were identified: "Efforts to curb mpox epidemic", including CDCs' epidemic management and health education, hospitals' diagnosis, treatment, and care, CBOs' counseling, publicity, and referrals. "Challenges to curb mpox epidemic", including negative impacts of hospital-based quarantine, lack of specific antiviral drugs, gay identity disclosure concerns, psychological problems, contact tracing difficulties, and inadequate communication and collaboration. "Recommendations for curbing mpox epidemic", including prioritizing supervised home-based quarantine, incorporating HIV-related indicators into hospital quarantine criteria, reducing the cost of hospital quarantine, accelerating the development of vaccines and drugs, enhancing patient privacy protection, psychological training for stakeholders, establishing a task force that comprises personnel who are experienced in contact tracing and strengthening communication and collaboration., Conclusions: Effective control of mpox spread requires strengthening collaboration with CBOs and community healthcare centers (CHCs) and working out a flexible and contextualized mechanism. It also needs to reinforce patient privacy protection and integrate stigma reduction into strategies. Additionally, it is important to include HIV-related indicators in the quarantine evaluation and provide psychological training for stakeholders to help them manage their mental health and improve counseling skills., (Copyright © 2024 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)

Background: The COVID-19 pandemic triggered a worldwide socio-sanitary crisis, continuing to impact societies worldwide. With many school systems shifted to online education, the current study presents a unique opportunity to investigate relevant phenomena related to serious health issues during the schooling and later in life, cyberbullying and bullying. This study began just before the COVID-19 lockdown was declared and resumed 5 months later allowing to explore 2 main objectives: first, to explore whether cyberbullying increased during the lockdown, and second, to analyze transitions from to time of bullying and cyberbullying., Methods: The participants included 792 students from sixth and seventh years of Primary Education (Mean age  = 10.81, SD = 0.85) in Ecuador. This is a quantitative longitudinal study. Cyberbullying and bullying scales were used for data collection before the lockdown in January and February 2020 (T1), and after 5 months of lockdown, at the end of the same academic year in July 2020 (T2). Descriptive, comparative and predictive analyses, a latent transition analysis was used to identify latent status of cyberbullying and bullying behavior at T1 and T2., Results: The results revealed a significant increase of cyberbullying after 5 months of the lockdown. Interestingly, only a small percentage of students who were uninvolved in cyberbullying and bullying in T1 remained uninvolved in T2., Conclusions: The discussion explores the dynamics of cyberbullying involvement and examines changes in the roles and groups of bullying and cyberbullying after 5 months of lockdown. The political- and school-related implications of these findings are thoroughly discussed., (© 2024 The Author(s). Journal of School Health published by Wiley Periodicals LLC on behalf of American School Health Association.)

Objectives: The psychological effects of the COVID-19 pandemic have been shown to include anxiety. However, the association between demographic and physiological factors in COVID-19-associated anxiety symptoms is poorly understood. Therefore, the present cross-sectional study was conducted to examine anxiety symptoms and associated factors among patients with the SARS-CoV-2 Omicron variant during the quarantine period in Shanghai., Methods: The study was conducted between April 16, 2022, and May 21, 2022, at Fangcang Shelter Hospital in Shanghai, China. Data were collected using an anonymous online questionnaire. Demographic characteristics, respiratory symptoms, vaccine dose, comorbidities (such as hypertension and diabetes), type of work, and mental health symptoms were evaluated. Logistic regression was used to examine the relationship between anxiety symptoms and risk factors. Stratified analyses were performed to investigate potential interactions., Results: A total of 2132 patients with confirmed Omicron variant SARS-CoV-2 infection were enrolled. The results demonstrated that female gender (OR = 1.47, 95% CI = 1.11-1.94), nonmanual labor (OR = 1.62, 95% CI = 1.25-2.09), respiratory symptoms (OR = 3.19, 95% CI = 2.30-4.43), and having other comorbidities (OR = 1.65, 95% = 1.09-2.50) were positively associated with anxiety symptoms. A significant interaction was found between gender and (a) nonmanual labor (OR = 1.54, 95% = 1.29-1.85), (b) respiratory symptoms (OR = 2.06, 95% = 1.72- 2.48), and (c) comorbidities (OR = 1.57, 95% = 1.16-2.12), such that the relationship with anxiety symptoms was stronger in women compared to men. There were also significant interactions between age group and (a) nonmanual labor (stronger in those ages >46) and (b) respiratory symptoms (stronger in those ages 36-45) regarding the association with anxiety symptoms., Conclusions: Alleviation of respiratory symptoms, addressing comorbidities, and implementation of both psychological and psychopharmacological treatments may help reduce anxiety symptoms following infection with the SARS-CoV-2 Omicron variant in mainland China., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Bangladesh suffered a severe COVID-19 wave from June to August 2021, which forced the government to impose emergency nationwide lockdown measures for three months with discontinuities. The sudden lockdown strongly affected the dietary preferences, financial circumstances, and social interactions of citizens., Methods: In this comprehensive study, we collected sociodemographic information as well as data on food purchase and consumption behaviors from 1,350 adults in Bangladesh during the weeks of enforced confinement. The association between the sociodemographic factors (viz., gender, age, education status, income, occupation, and household size) and food purchase and consumption behaviors were determined by conducting bivariate and multivariate logistic regression models reporting as odds ratios., Results: The descriptive result reveals that 49.63% of the participants experienced wage reductions, with many people enduring reductions of up to 75%; 12.22% lost their jobs. Besides, a decline in the frequency of shopping was observed by 35.04%; and 24.52% avoided outdoor shopping during the pandemic period. Additionally, 28.74% of participants purchased less overall, while 19.48% purchased significantly fewer items per trip compared to the pre-pandemic period. The multivariate analysis shows a prominent increase in online grocery shopping (OR: 4.03, 95% CI: 2.38-6.83, p < 0.001) and meal delivery services (OR = 5.19, 95% CI = 3.21-7.17, p < 0.001) among higher educated individuals compared to the individuals having no institutional education. The personnel having formal jobs purchased 2.34 times more from online grocery sites (95% CI = 0.34-4.08, p = 0.003) compared to the unemployed one. In contrast, a notable increase in panic buying and stockpiling was observed, driven by scarcity and escalating prices of essential food items. The frequency of meals with families, active engagement in meal preparation, and the exploration of novel recipes also increased notably., Conclusions: The consumption of takeaway food and inter-meal snacks increased significantly with the education level of individuals. These findings highlighted that a prolonged pandemic could magnify economic vulnerability in Bangladesh., (© 2024. The Author(s).)

Lockdowns were implemented to reduce the transmission of the COVID-19 virus. However, it is unclear how severely curtailed physical interaction shapes individual behaviors that are considered vital for socioeconomic development. In this exploratory study, we investigate the behavior of college students who experienced a strict campus-wide lockdown and those who did not. Employing a combination of experimental and survey methodologies, we elicit students' behavioral variables, which are then integrated with administrative records from the university. We find that those exposed to the lockdown were more likely to trust others and be honest; however, their creativity was lower. Exposure to the lockdown was not found to significantly affect students' trustworthiness, risk preferences, or competitiveness. A follow-up study reveals that the lower creativity among students may be attributed to reduced communication frequency with friends during the lockdown, mediating the lockdown's impact. Conversely, the effects of the lockdown on trust and honesty may operate through a direct pathway, independent of changes in daily activities during the lockdown. Further analysis reveals a gender-dependent trend, with lockdowns exerting a more pronounced influence on male students than their female counterparts. These results underscore the consequences of lockdowns and advocate for enhanced support networks, emphasizing the importance of communicating with friends in similar circumstances., Competing Interests: Competing interests statement:The authors declare no competing interest.

Loneliness and associated physical and cognitive health decline among the aging population is an important medical concern, exacerbated in times of abnormal isolation like the 2020-2021 Covid-19 pandemic lockdown. In this backdrop, recent "social prescribing" based health policy initiatives such as community groups as a support structure for the aging population assumes great importance. In this paper, we evaluate and quantify the impact of such social prescribing policies in combatting loneliness and related health degeneration of the aging population in times of abnormal isolation. To this end, we conduct a natural experiment across a sample of 618 individuals aged 65 and over with varying access to community groups during the Covid-19 lockdown period. Using a random-effects, probit model to compare the differences in health outcomes of participants with access to community groups (target) with those without access (control), we find that the target group was 2.65 times less likely to suffer from loneliness as compared to the control group, along with lower incidences of reported cardiovascular and cognitive health decline. These initial findings provide preliminary support in favor of the interventional power of social prescription tools in mitigating loneliness and its consequent negative health impact on the aging population., (© 2024. The Author(s).)

Background: Locking or confinement of persons with severe mental illness has been common in Indonesia. In 2010, the Ministry of Health declared a policy that persons who were locked (pasung) should be unlocked or freed (bebas) from confinement and provided mental health services. This study is an empirical evaluation of the effectiveness of one Bebas Pasung program in Indonesia at two-year follow-up., Methods: From medical records in Soerojo Mental Hospital, Magelang, Central Java, 114 persons with severe mental illness who had been unlocked, treated, and returned to the community from four districts served by the hospital were identified. At two-year follow-up, 62 caregivers were able to be contacted and willing to participate in a study. Data were collected from hospital records about condition of the patient at time of "unlocking" and at discharge, and primary caregivers were interviewed about the previous locking and care of the patient since return, as well as experiences of caregiving., Results: We provide descriptive data concerning history of illness, reasons for locking, type of confinement, and care of the individual since return. 58% of those unlocked were men, 80% had diagnoses of schizophrenia, and mean age was 35. At follow-up, 24% of this sample had been re-locked; only 44% took medications regularly, including 33% of those re-locked and 47% of those not relocked. A majority cared for themselves, half were partially or fully productive, and the quality of life of family caregivers improved significantly since their family member was unlocked, treated, and returned home., Conclusions: This program successfully unlocked, treated, and returned to their homes persons with severe mental illness living in pasung or restraints. Findings suggest such unlocking programs need to be linked more closely to community-based mental health and rehabilitation services, maintain care of the patient, and provide a path toward recovery., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Tyas et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: There is growing evidence that the social blockade brought about by the COVID-19 pandemic has dramatically affected college students' physical activity; however, their weight management behaviors and mental health have not been fully explored, especially among healthcare students. This study aimed to assess physical activity, weight management behaviors, and mental health among healthcare students during the campus lockdown and to analyze the factors influencing physical activity., Methods: A cross-sectional survey of 1,216 healthcare students from March 24, 2022, to April 11, 2022. To collect information about students' physical activity, weight management behaviors, and mental health, they were asked to complete the Physical Activity Questionnaire-Short Form (IPAQ-SF), 11 issues related to weight management behavior, and the World Health Organization 5-Item Well-Being Index (WHO-5) questionnaire. Binary logistic regression was performed to determine the factors influencing physical activity., Results: Almost half of the participants had low levels of physical activity (45%), the mean score for weight management behavior was 39.55±6.26, and 54.6% had low levels of well-being. Healthcare students without exercise habits during the non-epidemic period reported lower levels of physical activity (OR = 1.81; 95%CI = 1.41-2.34, P<0.001). Participants with poor weight management behavior were more likely than other participants to report lower levels of physical activity (OR = 0.92; 95%CI = 0.90-0.94, P < 0.001). Likewise, the odds of being physically inactive were higher among the happier participants (OR = 0.98; 95%CI = 0.96-0.99, P = 0.031)., Conclusions: During the COVID-19 lockdown, most healthcare students in Gansu province lack physical exercise and have a low health level. Significant correlation factors for low physical activity levels were grade level, non-lockout exercise habits, weight management level, and well-being. These findings demonstrate the importance of developing targeted policies and programs encouraging physical activity among medical students., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Zhang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: The appearance of the COVID-19 virus in December 2019, quickly escalated into a global crisis, prompting the World Health Organization to recommend regional lockdowns. While effective in curbing the virus's spread, these measures have triggered intense debates on social media platforms, exposing widespread public anxiety and skepticism. The spread of fake news further fueled public unrest and negative emotions, potentially undermining the effectiveness of anti-COVID-19 policies. Exploring the narratives surrounding COVID-19 on social media immediately following the lockdown announcements presents an intriguing research avenue. The purpose of this study is to examine social media discourse to identify the topics discussed and, more importantly, to analyze differences in the focus and emotions expressed by the public in two countries (the UK and India). This is done with an analysis of a big corpus of tweets., Methods: The datasets comprised of COVID-19-related tweets in English, published between March 29th and April 11th 2020 from residents in the UK and India. Methods employed in the analysis include identification of latent topics and themes, assessment of the popularity of tweets on topic distributions, examination of the overall sentiment, and investigation of sentiment in specific topics and themes., Results: Safety measures, government responses and cooperative supports are common themes in the UK and India. Personal experiences and cooperations are top discussion for both countries. The impact on specific groups is given the least emphasis in the UK, whereas India places the least focus on discussions related to social media and news reports. Supports, discussion about the UK PM Boris Johnson and appreciation are strong topics among British popular tweets, whereas confirmed cases are discussed most among Indian popular tweets. Unpopular tweets in both countries pay the most attention to issues regarding lockdown. According to overall sentiment, positive attitudes are dominated in the UK whilst the sentiment is more neutral in India. Trust and anticipation are the most prevalent emotions in both countries. In particular, the British population felt positive about community support and volunteering, personal experiences, and government responses, while Indian people felt positive about cooperation, government responses, and coping strategies. Public health situations raise negative sentiment both in the UK and India., Conclusions: The study emphasizes the role of cultural values in crisis communication and public health policy. Individualistic societies prioritize personal freedom, requiring a balance between individual liberty and public health measures. Collectivistic societies focus on community impact, suggesting policies that could utilize community networks for public health compliance. Social media shapes public discourse during pandemics, with popular and unpopular tweets reflecting and reshaping discussions. The presence of fake news may distort topics of high public interest, necessitating authenticity confirmation by official bloggers. Understanding public concerns and popular content on social media can help authorities tailor crisis communication to improve public engagement and health measure compliance., (© 2024. The Author(s).)

A stressful condition such as the emergence of the coronavirus and its related lockdown measures might trigger alterations in college students' behaviors. This cross-sectional study aimed to identify the changes in college students' dietary and lifestyle behaviors during the lockdown and the effect of lockdown-related stressors on health-risk behaviors. A web-based survey was conducted among undergraduate college students in Jordan. Weight and height were reported by the students. The students' dietary and lifestyle behaviors and their changes during 1 month of the countrywide lockdown were assessed. The Perceived Stress Scale-4 was utilized to assess stress levels. Results indicated that 77.2% of the students reported weight changes. Notably, 45.9% increased their intake of unhealthy food, while and 38% opted for healthier food choices. Most students experienced alterations in physical activity (80.0%), screen time (86.2%), smoking, and sleep patterns (85.4%), with a higher tendency toward adopting health-risk behaviors. Perceptions of curfew-related stress were associated with distance learning-related stress (OR = 2.73, CI: 1.08-6.90, P = .034), and a greater change in physical activity (OR = 3.59, CI: 1.36-9.48, P = .010). Additionally, weight changes were associated with perception of other types of stressors (OR = 3.39, CI: 1.39-8.28, P = .007). Overall, there was a considerable increase in malnutrition and health-risk behaviors among students during the lockdown. Understanding students' responses to these stressful conditions and the role of stress in driving behavioral changes are crucial for developing interventions that enhance college students' adaptation to such changes and maintaining healthy dietary and lifestyle behaviors in the future., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Introduction: The COVID-19 pandemic affected adolescents' mental health diversely., Methods: Our objective was to examine the one-year change in well-being (WHO-5 well-being index) and self-esteem (Rosenberg self-esteem scale) among secondary school students affected by school lockdown (lockdown group) compared to control students unaffected by the pandemic (pre-pandemic group), utilizing data from a longitudinal survey study conducted in Hungary. We used linear mixed models stratified by sex and adjusted for family structure and family communication., Results: Two hundred twenty seven pre-pandemic (128 girls, 99 boys) and 240 lockdown (118 girls, 122 boys) students were included. Both boys' and girls' well-being declined in the pre-pandemic group but remained stable in the lockdown group. Post-hoc analyses on WHO-5 items revealed that the pre-pandemic and lockdown groups differed significantly on Item 4 (waking up feeling fresh and relaxed). Boys' self-esteem did not change over the observation period in neither groups. As for girls, self-esteem of girls during lockdown increased over the observation period, while it did not change in the pre-pandemic group. Better family communication was consistently associated with higher well-being and self-esteem scores for both sexes., Discussion: Our results suggested that students may have benefitted from altered academic circumstances due to lockdown (e.g., more sleep) and students struggling with waking up early benefitted the most from lockdown (as shown in our post hoc analysis). Additionally, our results also indicate that families should be involved in mental health promotion interventions, especially in time of adversities. This study underscores the multifaceted effects of pandemic-related factors on adolescent mental health and highlights the need to also investigate the unexpected benefits of pandemic-related restrictions to incorporate this knowledge in health promotion programs targeting the well-being of students., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Major, Falus, Árva, Eorsi, Terebessy, Tabak and Fazekas-Pongor.)

The SARS-CoV-2 pandemic had a considerable impact on both the physical and mental health of people. Resilience is a psychological characteristic reflecting the ability to overcome or adapt to difficulties such as adversity, trauma, or extremely stressful situations. People with high resilience have been shown to exhibit lower levels of anxiety, stress and depression when faced with a stressful event. Sleep is particularly sensitive to anxiety and stress. The aim of this study was to investigate the impact of COVID-19 pandemic on sleep quantity, quality, and habits, while considering resilience as a factor. A total of 1260 individuals were recruited through an online survey. The variables that were assessed were socio-demographic, sleep habits and sleep disorders history, the Athens Insomnia Scale (AIS), the 25-item version of the Connor-Davidson Resilience Scale (CD-RISC), and any work/financial consequences during the first COVID-19 lockdown. The results showed that sleep habits during the lockdown changed for many of the participants. Their sleep schedule moving towards earlier or later for 9% and 67% of them, respectively; 38% of the participants were found to suffer from insomnia, based on the AIS score. A higher score on the CD-RISC was associated with better sleep. In conclusion, our study confirmed previous studies identifying quantitative and qualitative changes in sleep during the COVID-19 lockdown. It also expanded on the previous findings by identifying the correlation between sleep and resilience during the stressful period of the COVID-19 lockdown.

Background: The global COVID-19 pandemic has highlighted critical concerns surrounding mental health. Social isolation measures, such as the quarantine of incoming travelers, are essential public health strategies for the prevention and control of infectious diseases. However, quarantine can lead to adverse psychological outcomes, including feelings of confinement, boredom, perceived scarcity of supplies and information, financial hardship, and social stigma. This study aims to assess the mental states of quarantined individuals, investigate the factors affecting their mental well-being, and examine their coping mechanisms, with the objective of providing recommendations to enhance mental health in anticipation of future outbreaks, such as Disease X., Methods: We surveyed 327 individuals in quarantine from September 22, 2020 to January 9, 2021, collecting general demographic data and information related to COVID-19. Depression and anxiety were assessed using the PHQ-9 and GAD-7 scales, respectively, while stress coping was evaluated with a simplified version of the Cope scale. We analyzed the relationships between independent variables and mental health outcomes., Results: Among the individuals undergoing entry quarantine, 27.8% reported symptoms of depression, and 20.5% reported symptoms of anxiety. Students were more likely to experience depression compared to those with permanent jobs or no occupation. Significant risk factors for both depression and anxiety included pre-existing health conditions, lack of medical insurance, concerns about shortages of daily necessities during quarantine, and high scores for "guilt and self-blame." Additionally, participants who worried about the impact of the epidemic on their studies or work, and those with high scores for "denial," were more likely to exhibit depressive symptoms. On the other hand, participants who were concerned about potential rejection or discrimination from the outside world after quarantine were more prone to anxiety symptoms., Conclusion: Attention should be paid to the negative psychological reactions of the entry quarantined personnel, especially those with pre-existing health conditions, those without medical insurance, and students studying abroad. Accurate and effective epidemic dynamic information and preventive and control measures can be provided to the public to prevent fear and stigma against quarantined personnel., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Chen, Chu, Xu, Zhou, Hu, Wang, Jin and Lv.)

The COVID-19 lockdown affected children, especially those with autism spectrum disorder, due to the disruption in rehabilitation and educational activities. We conducted a cross-sectional study of 315 preschool-aged children, 35 of which had autism, to investigate this impact. A questionnaire was administered to explore socio-demographic status, familiar/home environment, and COVID-19 exposure. The clinical features of autistic subjects were also examined. Seven variables were considered to describe the effect of pandemic: Remote learning, Behavior changes, Home activities, Sleep habits, Night awakenings, Physical activity, Information about the virus. The lockdown had a significant impact on Remote learning, Behavior changes, and Information about the virus in participants with autism. Moreover, we found a worsening in repetitive movements, echolalia, restricted interests, and aggressive behaviors., (© 2023. The Author(s).)

Introduction: Loneliness is a pressing public mental health issue. So far, there has been a paucity of investigations focused on the individual differences modulating this subjective feeling in the face of difficult circumstances, e.g., the COVID-19 pandemic. As such, the present study aimed to investigate the role of mentalization; given that the construct comprises reflection abilities that might be particularly relevant to the pandemic's interpersonal challenges., Methods: A survey representative of the German population was conducted from May to June 2020 (N = 2503). We examined mentalization, operationalized as reflective functioning (RF) and measured using the Mentalization Questionnaire (MZQ), both as a protective factor against loneliness on its own and as a moderator of the association of social isolation with loneliness., Results: Of the overall sample, 822 (32.8 %) individuals reported social isolation. Worse RF was moderately associated with higher levels of loneliness (r = 0.433, p < .001). A linear regression model (controlling for sociodemographic characteristics and general personality pathology) confirmed this positive association, but also indicated an interaction effect of RF and social isolation in the statistical prediction of loneliness. Stratified models showed that RF was a comparatively weaker statistical predictor of loneliness among the socially isolated., Discussion: This representative population study expanded our knowledge about the factors shaping loneliness in the population. RF emerged as a potentially modifiable protective influence. Further research needs to clarify the mechanisms through which it mitigates loneliness., Limitations: The cross-sectional design does not give insight into the temporal association of RF and loneliness., Competing Interests: Declaration of competing interest The authors report no conflict of interest., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background : Groups at high risk of severe illness/death from COVID-19 (older people and those identified as clinically extremely vulnerable: CEV) experienced increased restrictions, poor mental health and loneliness during the first UK lockdown. Methods : Seventeen older adults, eight CEV adults, one parent of a CEV child, and two family carers of CEV adults, shared their experiences of the first UK lockdown through various media: written reflections, interviews, poetry, videos, photographs, and visual artwork. Results : Through a positive psychology lens, five themes were identified: experiencing loss; community and connection; finding joy, hope and optimism; adapting to change; and sense- and meaning-making. Conclusion : High-risk groups fostered wellbeing and flourishing and formed a sense of coherence in a time of great loss. Engagement with artistic, creative, and cultural activities facilitated this. The arts not only provided a creative means of collecting data but was also identified as a central thread in the findings.

To understand whether the mental health of children and young people (CYP) with and without attention-deficit/hyperactivity disorder (ADHD) and/or autism spectrum disorder (ASD) were differentially affected by COVID-19. We analysed data (n = 6507) from the Co-Space study, a UK web-based longitudinal survey. CYP with ADHD (n = 160;2.5%), ASD (n = 465;7%), and ADHD + ASD (n = 155;2.4%) were compared with a reference group (n = 5727;88%) using parent-completed questionnaires [Strengths and Difficulties Questionnaire (SDQ) & Pandemic Anxiety Scale (PAS)]. Baseline to 1-month follow-up differences were compared using linear regression models. CYP with ADHD and/or ASD had higher scores at baseline than other CYP. At follow-up, CYP with ASD showed small but significant improvements in symptoms (SDQ), compared with the reference group. CYP with ASD experienced a worsening of disease anxiety (PAS) and CYP with ADHD a deterioration in functional impairment. These findings indicate a mixed pattern of pandemic-related impact for CYP with ADHD and/or ASD., (© 2023. The Author(s).)

Objective: We aimed to estimate prevalence and incidence of stress, depression, and anxiety symptoms in Brazilians during the COVID-19 pandemic., Method: We assessed 103 (54 women, 49 men) participants online in three periods of the pandemic: March 2020 (T1), April 2020 (T2), and June 2020 (T3). Estimates of prevalence and incidence were identified when mental health scores were two standard deviations above the mean compared to normative data. Mental health indicators were measured using the Perceived Stress Scale, the Filgueiras Depression Index, and the State-Trait Anxiety Inventory - State Subscale., Results: At T1, 89% of individuals were below cut-off scores for stress, anxiety, and depression, which dropped to 35% by T3. Estimated stress prevalence was 1.9% at T1, 7.8% at T2, and 28.2% at T3. Estimated depression prevalence was 0% at T1, 23.3% at T2, and 25.2% at T3. Estimated state anxiety prevalence was 10.7% at T1, 11.7% at T2, and 45.6% at T3. Stress incidence increased by 7.8% from T1 to T2, and 23.3% from T2 to T3. Depression incidence increased by 23.3% from T1 to T2, and 15.5% from T2 to T3. Anxiety incidence increased by 9.7% from T1 to T2, and 39.8% from T2 to T3. Stress severity scores significantly increased from 16.1 ± 8.7 at T1 to 23.5 ± 8.4 at T2, and 30.3 ± 6.0 at T3. Depression severity scores significantly increased from 48.5 ± 20.5 at T1 to 64.7 ± 30.2 at T2, and 75.9 ± 26.1 at T3. Anxiety increased from 49.0 ± 13.4 at T1 to 53.5 ± 12.5 at T2 and 62.3 ± 13.4 at T3. Females had significantly higher anxiety scores than males by T3 (66.7 ± 11.8 vs. 57.4 ± 13.5)., Conclusion: Prevalence and incidence of stress, depression, and anxiety significantly increased throughout the pandemic. The largest increase in stress and anxiety occurred between T2 and T3, and between T1 and T2 for depression. Severity of stress, depression, and anxiety increased throughout the study., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The COVID-19 pandemic has brought unprecedented challenges globally, with a notable surge in gender-based violence (GBV) incidents. This descriptive, exploratory study conducted in the Golden Valley mining community in Kadoma, Mashonaland West Province, Zimbabwe, delves into the challenges faced by GBV survivors during and after the pandemic, alongside community perceptions of GBV in the post-COVID-19 era. Guided by Bronfenbrenner's Social-Ecological Model which offers insights into the various levels of influence on GBV behavior and experiences,aiding in the development of contextually relevant prevention strategies. The study used qualitative methods such as interviews and focus group discussions, there were 24 study participant classified by random and convenient sampling techniques including traditional and community leaders, gbv surviours medical personnel and male and female, community members. The research followed the COREQ guidelines to transparently document the research process and findings. The research sheds light on the multifaceted nature of GBV exacerbated by societal norms and economic instability in a low-income, masculine-dominated work culture experience in the COVID-19 period. Findings underscore the urgent need for comprehensive prevention programs, effective legislation, and community engagement to address GBV in post-pandemic communities. The research provides valuable lessons for enhancing GBV prevention efforts globally, emphasizing the significance of survivor voices and addressing root causes of GBV., (© 2024. The Author(s).)