Students' attitude and sleep pattern during school closure following COVID-19 pandemic quarantine: a web-based survey in south of Iran

Different sleep patterns during the COVID-19 pandemic: association with mood, exercise and light exposure

The aim was to evaluate the sleep-wake cycle pattern, mood, perceived stress and some behaviors, such as physical exercise and exposure to natural light of college students during the COVID-19 pandemic. This is a cross-sectional study conducted between June and August 2020 using an electronic form provided by Google. The sample consisted of undergraduate students aged between 18 and 30 years old and residents of the northeast region of Brazil. The students generally had sleepiness and poor sleep quality, high levels of anxiety, mild to moderate depressive symptoms and moderate perceived stress. Some of these aspects were worse in women. The college students showed three sleep patterns: one group had good sleep quality without excessive daytime sleepiness; another group had poor sleep quality, but no excessive daytime sleepiness; and a third group had high daytime sleepiness, and less expressive sleep quality impairment. Greater exposure to sunlight and practicing physical exercise predominated in individuals with better sleep quality, suggesting that they are protective factors. In addition, excessive daytime sleepiness and poor sleep quality were separately associated with higher anxiety, depression and stress perception levels, proving to be important aspects for care in order to favor mental health during the pandemic. In conclusion, it is suggested that the COVID-19 pandemic affected the sleep of college students in a heterogeneous way. The differentiated sleep patterns are associated with exposure to natural light and exercising.

Stress and sleep quality in medical students: a cross-sectional study from Vietnam

Background

The COVID-19 pandemic has resulted in significant global social and economic disruptions, as well as changes in personal attitude and behavior. The purpose of this research is to assess the sleep quality and stress levels of medical students.

Method

Data was collected from medical students over the course of a month in 2021. A total of 4,677 students at the University of Medicine Pham Ngoc Thach were invited to complete an anonymous web-based survey, which included the Pittsburgh Sleep Quality Questionnaire Index (PSQI) for measuring sleep quality and the COVID-19 Student Stress Questionnaire (CSSQ) for evaluating stress.

Results

A total of 1,502 students participated in our survey. More than half of the participants exhibited poor quality of sleep as indicated by their PSQI score. Many students reported going to bed after midnight and spending time on their smartphones. Among the students surveyed, 21.84% experienced low levels of stress (CSSQ ≤6), 63.38% had mild stress (7 ≤ CSSQ score ≤ 14), 14.78% reported high levels of stress (CSSQ >14).

Conclusion

This study showed a high prevalence of poor sleep quality in the surveyed students, which could be attributed to changes in their behavior following the COVID-19 outbreak. Mild stress was also frequently observed, and it may be related to sleep disorders in this population. These important findings provide valuable insights for making recommendations, including lifestyle modifications to improve sleep quality.

The effect of background audio and audiovisual stimuli on students' autonomic responses during and after an experimental academic examination

BACKGROUND

Due to the Covid-19 pandemic lockdown during the online-distant education period, certain students tended to combine their courses and homework with TV or social media news or other media content, such as classical music, including a wealth of audio and audiovisual stimuli. As the audio and audiovisual stimuli existing in a learning environment may affect students' autonomic nervous system (ANS) responses negatively, the present study aimed to monitor the impact of background TV, classical music, and silence on students' ANS activity represented by heart rate (HR), heart rate variability (HRV), blood volume amplitude (BVA), and skin conductance level (SCL) during and after an experimental academic examination.

METHOD

Seventy-six students were randomly allocated to background TV, classical music, or silence groups. The experiment with repeated measures design consisted of four consecutive periods: baseline, anticipation, challenge, and recovery, lasting 4 min each.

RESULTS

Within-subject analyses indicated significant HRV decrement only in the background TV group. Regardless of the experimental groups, HR and SCL increased while BVA decreased during the task. In addition, the between-subject analysis showed that the background TV group experienced significantly larger changes in HR and HRV parameters compared to the other experimental groups relative to their respective baseline measurements.

CONCLUSIONS

Based on these results, we concluded that relative to classical music and silence, background TV, including audiovisual and verbal stimuli, extant in a learning environment might raise students' sympathetic activity. Further, classical music, without lyrics, may suppress the withdrawal of vagal activity and elevate the autonomic regulation capacity during the academic reading comprehension task. HRV is a more valid and reliable indicator of students' autonomic responses during a challenging academic task.

The impact of the COVID-19 pandemic on adolescent sleep behavior

Restorative sleep is a fundamental component of adolescent wellbeing, and the COVID-19 pandemic presented both challenges and opportunities for adolescents' sleep. In this review, we synthesize emergent themes from the growing scientific evidence for the impact of the pandemic on adolescent sleep behavior across different stages of the pandemic and in different locations around the world. We also highlight the ways in which COVID-19 shaped sleep patterns among college students-a subgroup of adolescents transitioning to emerging adulthood that were particularly impacted by the shift to remote learning. Finally, we discuss variations in the impact according to several potential moderating factors in adolescents' lives and point to areas that require additional longitudinal research.

Roadmap to recovery: Implemented and attitude toward school reopening strategies during the COVID-19 pandemic, a scoping review

The novel coronavirus disease 2019 (COVID-19) has had various financial and life impacts on the world's population. Schools' regular activity and function during the pandemic require balancing the repercussions of suspending in-person education versus health threats. Furthermore, children are one of the prominent victims of the restricted quarantine strategies' effects, which may make them vulnerable to various mental health problems. In this study, we reviewed previously reported strategies and roadmaps regarding the reopening of schools during the COVID-19 pandemic. The following databases were searched from October to December 2021, via multi-step search strategies for "COVID-19," "coronavirus," "school reopening," "roadmaps," "reopening," and "reopening strategies": Google Scholar, PubMed, Scopus, and Web of Science. A total of five papers with roadmaps focusing on reopening schools were included in this study. Fundamental issues and principles of these reviewed roadmaps were: 1) protecting the high-risk students and staff physically and mentally, 2) accelerating the vaccination of essential workers, staff, parents, and students, and 3) improving the COVID-19 testing capacity. Roadmaps for the reopening of the schools should describe some phases and steps for their strategies. Current roadmaps have not mentioned any phases and timelines for this process. Describing some health metrics in the roadmaps for progressing to the next step or returning to the previous ones is also necessary for all roadmaps and should be considered in further studies.

Sedentary Behaviour and Physical Activity Levels during Second Period of Lockdown in Chilean’s Schoolchildren: How Bad Is It?

Objective. The objective of this study was to compare the levels of sedentary behaviour and physical activity in relation to sociodemographic variables of Chilean schoolchildren before and during the COVID-19 pandemic. Methods. This retrospective study considered a non-random sample of 83 boys and 232 girls, and their respective parents, who attended public schools (n = 119) and private schools (n = 196) in Chile. A self-report instrument was applied that included sociodemographic variables, sedentary behaviour (SB), and physical activity (PA) in the second period of the pandemic in 2021. Results. The main results show that pre-pandemic SB had significant differences when compared between sexes, except for television time. During the pandemic, there was no significant difference in television time or telephone time. There were no significant differences by sex before and during the pandemic. When comparing the SB scores, video game time in boys decreased (p < 0.001), as did video game time in girls (p < 0.001), and computer time in boys (p < 0.001) and girls (p < 0.001). Telephone time increased in boys (p < 0.001) and girls (p < 0.001), as did television time (p < 0.001). Likewise, PA increased in boys (Δ + 9.51min) and girls (Δ + 3.54 min) during the pandemic (p < 0.001). Conclusions. Both PA and SB underwent changes according to sex before and during the second period of the COVID-19 pandemic in Chilean schoolchildren.

Longitudinal relationship between quality of life and negative life events among adolescents during COVID-19 pandemic: a cross-lagged panel analysis

BACKGROUND

The negative association of quality of life (QoL) and negative life evens (NLEs) among adolescents has been proved by cross-sectional studies, without exploring sex differences. This study aimed to explore the longitudinal associations between QoL and NLEs among adolescents during novel coronavirus disease 2019 (COVID-19) pandemic and whether there are sex or age differences.

METHODS

A stratified cluster sampling was used to select 1421 students in primary school and middle school in Chongqing, China. From November 2020 (T0) to December 2021 (T2), the Adolescent Self-Rating Life Events Checklist and the Adolescent Quality of Life Scale were used to collect 3 waves of data. The correlations between study variables were conducted by the Pearson correlation analyses. The direction and strength of the longitudinal associations were analyzed using cross-lagged panel analyses.

RESULTS

Results showed significant changes in both variables during COVID-19 pandemic (P < 0.001). Cross-sectional analyses showed stable negative correlations between NLEs and QoL stratified by sex or by age (P < 0.001). Sex and age differences in longitudinal relationships were shown by cross-lagged panel analyses. For males, NLEs had a short-term bi-directional association with QoL [βA-D = -(0.091-0.340), P < 0.05]; for females, QoL had a short-term correlation with NLEs [βA = -0.119), βC = -0.109), P < 0.001]. In the youngest age group, NLEs had a short-term bi-directional correlation with QoL [βA-D = -(0.098-0.428), P < 0.05]. There was a short-term association between total QoL and NLEs among students except the 14∼15 year group [βA = -(0.071-0.149), βC = -(0.086-0.119), P < 0.05], the long-term association between total QoL and NLEs was only significant in adolescents aged 14∼15 years (βE = -0.132, P < 0.05). The strength of NLEs was slightly higher than that of total QoL, but lower than that of QoL in each dimension.

CONCLUSION

There were negative longitudinal relationships between NLEs and QoL during COVID-19 pandemic, and the strength of the associations varied across sex or age. Strengthening QoL in different dimensions may be a promising way to reduce NLEs during the pandemic among adolescents, and interventions should be tailored according different sex and ages.

Association between quarantine and sleep disturbance in Hong Kong adults: The mediating role of COVID-19 mental impact and distress

BACKGROUND

COVID-19 quarantine has been associated with increased sleep problems and prolonged psychological responses to the pandemic could mediate this relationship. The present study attempted to examine the mediating role of COVID-19 mental impact and distress between quarantine and sleep disturbance.

METHODS

The present study recruited 438 adults (109 with quarantine experience) in Hong Kong via an online survey between August and October 2021. The respondents completed a self-report questionnaire on quarantine, Mental Impact and Distress Scale: COVID-19 (MIDc), and Pittsburgh Sleep Quality Index (PSQI). The MIDc was treated as a latent mediator and continuous PSQI factor and poor sleep quality (PSQI score > 5) were the study outcomes. We evaluated the direct and indirect effects of quarantine on sleep disturbance via MIDc using structural equation modeling. Analyses were adjusted for gender, age, education level, knowing confirmed COVID-19 cases, COVID-19 frontline work, and primary income source of the family.

RESULTS

More than half (62.8%) of the sample reported poor sleep quality. Quarantine was associated with significantly higher levels of MIDc and sleep disturbance (Cohen d = 0.23 - 0.43, p < 0.05). In the structural equation model, the MIDc mediated the relationship between quarantine and sleep disturbance (αβ = 0.152, 95% CI = 0.071 to 0.235). Quarantine significantly increased the proportion of poor sleep quality by 10.7% (95% CI = 0.050 to 0.171) indirectly via MIDc.

CONCLUSIONS

The results provide empirical support to the mediating role of the MIDc as psychological responses in the relationship between quarantine and sleep disturbance.

Necrotizing autoimmune myositis following coronavirus disease 2019 infection: a case report

BACKGROUND

Severe acute respiratory syndrome coronavirus 2 may be associated with late-onset necrotizing myositis, mimicking autoimmune inflammatory myositis; however, the exact underlying pathogenesis of severe acute respiratory syndrome coronavirus 2-induced myositis is still unclear.

CASE PRESENTATION

Herein, we report a rare case of necrotizing autoimmune myositis in a 67-year-old middle eastern male following coronavirus disease 2019 infection, who presented with muscle weakness. The patient had positive anti-NXP2. The diagnosis of necrotizing autoimmune myositis was made according to muscle weakness, increased liver enzymes, electromyography and nerve conduction velocity results, and muscle biopsy. The patient underwent a full malignancy evaluation, which was unremarkable, and was discharged in relatively well condition with a daily dose of 1 mg/kg prednisolone and azathioprine 150 mg (2 mg/kg).

CONCLUSION

Our report highlights the already known possible protracted sequence of coronavirus disease 2019 infection and the potential for delayed-onset necrotizing myositis.

Effects of the COVID-19 pandemic on sleep health among Middle Eastern and North African (MENA) populations: a systematic review of the literature

OBJECTIVES

This study sought to conduct a systematic review of the literature on the impact of the COVID-19 pandemic on sleep health among Middle Eastern and North African (MENA) populations, understudied geographic regions including with regards to sleep health.

SETTING

A systematic literature search of studies published from inception to 27 March 2022 was conducted on multiple databases using developed keywords.

PARTICIPANTS

Studies were included if they (1) investigated one or more aspects/dimensions of sleep health as an outcome (eg, sleep duration, sleep quality, sleep problems); (2) measured the impact of a COVID-19 pandemic-related domain (eg, impact of quarantine, work from home, lifestyle changes); (3) focused on at least one MENA region population; (4) were peer-reviewed; (5) included ≥100 participants; (6) were written in English and (7) had full-text article publicly available.

PRIMARY AND SECONDARY OUTCOMES MEASURED

Primary outcomes were sleep duration, sleep quality and sleep problems.

RESULTS

In line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 164 studies were included for data extraction. The Newcastle-Ottawa scale for cross-sectional studies was used to assess the quality of the studies. Overall, the COVID-19 pandemic significantly impacted sleep duration, sleep quality and presence and severity of sleep disorders in MENA populations, including adults, children, students, healthcare workers and people with chronic illnesses. The directionality and strength of associations, as well as the determinants of sleep health, varied by subpopulations.

CONCLUSIONS

Longitudinal studies are needed to understand the longer-term impact of the COVID-19 pandemic on the sleep health of MENA populations. Sleep health interventions and policy measures should be tailored to the need of each subpopulation.

PROSPERO REGISTRATION NUMBER

CRD42022321128.

A spatiotemporal analysis of the impact of the COVID-19 outbreak on noise pollution in Tehran, Iran

Noise pollution is one of the non-natural hazards in cities. Long-term exposure to this kind of pollution has severe destructive effects on human health, including mental illness, stress, anxiety, hormonal disorders, hypertension and therefore also cardiovascular disease. One of the primary sources of noise pollution in cities is transportation. The COVID-19 outbreak caused a significant change in the pattern of transportation in cities of Iran. In this article, we studied the spatial and temporal patterns of noise pollution levels in Tehran before and after the outbreak of this disease. An overall analysis from one year before until one year after the outbreak, which showed that noise pollution in residential areas of Tehran had increased by 7% over this period. In contrast, it had diminished by about 2% in the same period in the city centre and around Tehran's Grand Bazaar. Apart from these changes, we observed no specific pattern in other city areas. However, a monthly data analysis based on the t-test, the results show that the early months of the virus outbreak were associated with a significant pollution reduction. However, this reduction in noise pollution was not sustained; instead a gradual increase in pollution occurred over the following months. In the months towards the end of the period analysed, noise pollution increased to a level even higher than before the outbreak. This increase can be attributed to the gradual reopening of businesses or people ignoring the prevailing conditions.

Literacy and Mental Health of Portuguese Higher Education Students and Their Use of Health Promotion Strategies during Confinement in the COVID-19 Pandemic

The pandemic of COVID-19 caused significant changes in economies and societies with a major impact on the entire education process. However, these changes did not invalidate a constant effort of adaptation. This cross-sectional, descriptive, and correlational study used an online questionnaire administered to students from various study cycles at higher education institutions in Portugal, with the aim of exploring the influence of literacy and mental health on the use of mental health promotion strategies during COVID-19 confinement. A total of 329 students from higher education institutions participated in this study, mostly from the age group 18-24 years (n = 272; 82.7%) and female (n = 265, 80.5%). The most mentioned health promotion strategies during this period included studying (n = 170; 51.7%); physical activities (n = 151, 45.9%); social networking (n = 124, 37.7%); cooking activities (n = 120, 36.5%); and listening to music (n = 118, 35.9%). Academic success is self-reported, and it is weakly correlated with the MHI5 (r = 0.103, p = 0.063). Students in the pre-graduate programs studied more during the times of the pandemic and used this activity as a mental-health-promoting strategy with a statistically significant difference (p = 0.033). Although it was difficult to improve health literacy related to COVID-19 in such a short period of time, there was a very strong motivation to access, understand, evaluate, communicate, synthesize, and apply information and knowledge to maintain mental health through self-care using health promotion strategies.

A Turf-Based Feature Selection Technique for Predicting Factors Affecting Human Health during Pandemic

Worldwide, COVID-19 is a highly contagious epidemic that has affected various fields. Using Artificial Intelligence (AI) and particular feature selection approaches, this study evaluates the aspects affecting the health of students throughout the COVID-19 lockdown time. The research presented in this paper plays a vital role in indicating the factor affecting the health of students during the lockdown in the COVID-19 pandemic. The research presented in this article investigates COVID-19’s impact on student health using feature selections. The Filter feature selection technique is used in the presented work to statistically analyze all the features in the dataset, and for better accuracy. ReliefF (TuRF) filter feature selection is tuned and utilized in such a way that it helps to identify the factors affecting students’ health from a benchmark dataset of students studying during COVID-19. Random Forest (RF), Gradient Boosted Decision Trees (GBDT), Support Vector Machine (SVM), and 2- layer Neural Network (NN), helps in identifying the most critical indicators for rapid intervention. Results of the approach presented in the paper identified that the students who maintained their weight and kept themselves busy in health activities in the pandemic, such student’s remained healthy through this pandemic and study from home in a positive manner. The results suggest that the 2- layer NN machine-learning algorithm showed better accuracy (90%) to predict the factors affecting on health issues of students during COVID-19 lockdown time.

Effects of the COVID-19 pandemic on sleep quality in children and adolescents: A systematic review and meta-analysis

We synthesise the literature on the potential influence of the COVID-19 pandemic on sleep quality in children and adolescents. The search identified studies that examined the relationship between sleep quality and disorders during the COVID-19 pandemic. It began in May 2021 and has had two updates with the last in January 2022. The databases used were LILACS, PubMed, and EMBASE. Random effects models were performed to explore heterogeneity between studies. Data were presented as continuous variables (mean value and standard deviation) to perform a meta-analysis. Twenty-nine studies from 16 countries were identified: Nine had children and eight had adolescents. The overall quality of the studies ranged from high (27.6%) to medium (65.5%) and low (6.9%). Eight studies were eligible for meta-analysis. There was an increase in sleep duration during the pandemic when compared with the previous period 0.33 (95%CI -0.07; 0.60) (p < 0.001) and late bedtime 0.78 (95%CI -0.33; 1.22) (p < 0.001). A trend toward reduced sleep efficiency was also detected 0.54 (95%CI -0.75; -0.33) p = 0.20. Parents' reports of increased use of screen media/electronic devices were associated with worse sleep quality. The results suggest an influence of the pandemic on sleep characteristics such as increased sleep duration, late bedtimes, and poor sleep quality. These alterations were related to changes in family routines during this period.

Changes in Child Discipline Strategies in Iran During the Outbreak of COVID-19

During the prolonged COVID-19 pandemic, anxiety and depression were common among caregivers and parents more prone to adopt harsh disciplinary techniques when angry or stressed. The purpose of this study was to investigate if there are any differences in parents' disciplinary strategies following social distancing efforts during the COVID-19 pandemic. An online questionnaire was completed by a convenience sample of parents (N = 605) and mothers (n = 533; 88.1%) aged 37.80 years old (SD = 5.66; range = 20-59) who lived with children aged 6-12 years in Iran during the COVID-19 pandemic. Iran's Multiple Indicator Demographic and Health Survey questionnaire was used to gauge child discipline. There was an increase in shaking (1.8%), shouting and yelling (15.5%). The findings of this study serve as a reminder to researchers and government officials that child abuse and violence are more likely to occur during stressful times and provide the scientific foundation for the development of tailored psychological treatment.

Estimation of the Reproductive Number Trend of the Novel Coronavirus "COVID-19" in Southern Iran from July to November 2020

Background

Effective measures to control COVID-19 should be based on an understanding of its epidemiological pattern and the evaluation of its prevalence in the community. This study aimed to examine the reproductive number (R) of COVID-19 and its trend in Fars Province in southern Iran.

Methods

In this ecological study, the R trend was examined from July to November 2020. Data were collected from the daily reports of Shiraz University of Medical Sciences. R is the product of three components, namely the number of infection-producing contacts per unit time, the probability of transmission per contact, and the contagiousness period. Incidence and prevalence rates were used to calculate R. The R value was calculated in Microsoft Excel 2016.

Results

The first and second peaks of COVID-19 were observed on July 6^th and November 22^nd, respectively. The median and mean of R were 1.42 and 1.41, respectively. The highest and lowest values of R were observed on October 20^th (2.60) and September 1^st (0.46), respectively. The values of R had a slightly decreasing trend in the second half of July and November than the first half. In the second half of August and September, an increasing trend was observed than the first half. There was not much change in the second half of October.

Conclusion

The highest value of R was related to the dates when there was a higher probability of exposure to the virus, including public holidays and different occasions on which the probability of people's participation in ceremonies, communities, and gatherings was higher.

Effect of Screen Time on Physical and Mental Health and Eating Habits During COVID-19 Lockdown in Lebanon

OBJECTIVE

This study aimed to explore whether screen time and the screen type impacted various health aspects of children, including physical activity (PA), sleep quality, and eating habits. Additionally, we investigated whether children's eating behavior while using electronic devices affects their physical and mental health.

METHODS

We conducted an online survey asking for screen use (duration, type, and purpose), PA, eating habits, sleep problems, and level of depression. The participants were children between the ages of 3 and 7 years, and the survey was answered by the participants' parents from March 3 to March 20, 2021.

RESULTS

A screen time of ≥2 h in children was associated with various clinical characteristics, such as body mass index (BMI), sleep problems, depression, decreased PA, and unusual eating habits. Children's food eating behavior while using electronic devices was predicted by a total screen time ≥2 h, smartphone screen time ≥2 h, sleep problems, owning electronic devices, and eating unhealthy food.

CONCLUSION

There was an interplay among children's PAs, eating behaviors, depression, sleep problems, and screen time in this pandemic era. Therefore, guiding children on the correct use of electronic devices and helping them eat healthy are paramount during this COVID-19 pandemic.

Disrupted Sleep During a Pandemic

The COVID-19 pandemic affected sleep in several people. Though most of the studies argued that age, gender, employment, finances, responsibilities, and exposure to sunlight governed sleep-wake schedule and sleep disturbances, there is also scientific evidence to suggest that these issues could have aroused because of the infiltration of the central nervous system (CNS) by SARS-CoV-2. Sleep disturbances must be addressed during the pandemic as sleep disturbances and systemic inflammation run in a vicious cycle; quality of sleep and timing of vaccination can influence the immune response to vaccination and subjects having obstructive sleep apnea (OSA) are at higher risk for having SARS-CoV-2 infection-related complications.

Social and environmental effects of the COVID-19 pandemic on children

OBJECTIVE

This study aimed to review the literature, summarizing the existing evidence on the effects of the pandemic on children, adolescents and parents, with an emphasis on the psychological, emotional, and sleep quality consequences.

SOURCE OF DATA

Empirical studies identified in the following databases: MEDLINE, ISI Web of Knowledge/Web of Science, and preprint servers.

SYNTHESIS OF DATA

The findings point to a wide range of consequences for children and adolescents resulting from the COVID-19 pandemic, which mainly includes an increase in depressive mood symptoms. There is also an increase in anxiety symptoms, suicidal ideation, as well as potential delays in language and motor development resulting from deprivation of social interaction and the closing of schools. These effects are more severe due to previous neuropsychiatric conditions. For parents, there is an increase in anxiety, depressive and post-traumatic symptoms, which are more accentuated in those who suffered socioeconomic damage due to the pandemic. There was an important increase in situations of violence towards children by parents and caregivers during the pandemic. Also, changes in routine and fear of the pandemic have negatively impacted sleep quality, globally.

CONCLUSIONS

It is noteworthy that most studies published to date used a cross-sectional design and applied online screening questionnaires. The few studies with a longitudinal design suggest that these changes may have been transitory and more prevalent at the beginning of the pandemic.

A narrative review into the impact of COVID-19 pandemic on senior high school adolescent mental health

Problem

High school teenagers are facing significant challenges during the COVID‐19 pandemic. Teenagers are at risk of experiencing physical, mental, and social health problems due to the COVID‐19 pandemic. This narrative review aims to explore the impact of COVID‐19 on the emergence of mental health problems in high school adolescents.

Methods

This study employed a narrative review method. We conducted a systematic search using PRISMA on three databases: Medline, PubMed, and ScienceDirect. A total of 40 articles met the inclusion and exclusion criteria set based on the research objectives.

Findings

The study uncovered that high school adolescents had an increased risk of experiencing mental health problems, namely psychological distress, worry, loneliness, anxiety, depression, traumatic symptoms, other psychological disorders, suicide risk, sleep disorders, and psychosocial functioning. Anxiety, depression, and psychological stress were the most discussed mental health problems among high school adolescents during the COVID‐19 pandemic.

Conclusions

There is a need for efforts to identify health problems and intervene in mental health problems early in high school adolescents. Schools, mental health workers, and the government (e.g., policy stakeholders) need to implement the recommendations given as a follow‐up effort for mental health services for high school youth.

Prevalence of anxiety, depression, stress, and perceived stress and their relation with resilience during the COVID-19 pandemic, a cross-sectional study

Background and aims

Home quarantine and physical distancing at the time of coronavirus disease 2019 (COVID-19) had a severe effect on the mental health of the populations. Resilience has been reported previously to be a protective factor against anxiety, stress, and depression. This study evaluates the prevalence and severity of depression, anxiety, stress, and perceived stress and their relation with resilience associated with the COVID-19 pandemic among a sample of the general population in Southern Iran.

Methods

In this cross-sectional web-based survey, from April 12 to May 13, 2020, stress, anxiety, depression, perceived stress, and resilience were measured using the Persian version of Depression Anxiety and Stress Scale (DASS-21), Perceived Stress Scale (PSS-14), and Connor-Davidson Resilience Scale (CD-RISC). Statistical analyses were carried out using the IBM Statistical Package for Social Sciences. Mean ± standard deviation (SD) and frequencies were used to describe demographic data. Independent sample t-test, Spearman correlation, and the Pearson correlation coefficient were performed to examine anxiety, depression, stress, and resilience.

Results

Among a total of 538 participants, the overall prevalence of moderate-to-extremely severe depression, anxiety, and stress was found to be 26.1%, 33.2%, and 5.8%, respectively. The overall median PSS and resilience score were 30 and 70, respectively. There was a significant association between higher age and perceived stress. Male and high income were related to higher resilience scores. Perceived stress positively correlates with resilience, whereas depression significantly correlates with anxiety and stress. Individuals with underlying disease demonstrated significantly higher scores for depression and anxiety. Also, perceived stress had a significant but weak, positive correlation with age and the number of quarantine days.

Conclusion

The occurring COVID-19 pandemic could be the culprit of psychological distress, anxiety, and depression of large population quantities. Our results showed a subordinate overall resilience in the general Iranian population during the COVID-19 pandemic.

Learning Methods During School Closure and Its Correlation With Anxiety and Health Behavior of Thai Students

BACKGROUND

The sequential waves of epidemic spread of COVID-19 in Thailand have caused periodic closures of schools, and exposed students to different learning methods that require multiple adjustment strategies. This study aimed to examine how different learning methods may correlate with anxiety and health behavior (e.g., physical activity, active play, screen time, sleep) of primary and secondary school students in Thailand.

METHODS

Thailand Report Card (TRC) Data (2021) was employed. The sample of the TRC was drawn by multi-stages random sampling stratified by region, district, urban/rural, school size, sex, and age to ensure national representativeness. A total of 6,078 Thai primary (64%) and secondary (36%) school students were included in the analysis.

RESULTS

About two-thirds (66.4%) of the sample experienced a shift from traditional classroom to fully online learning, 6.9% experienced partial online instruction, 23.6% received handouts or written assignments, and 3.1% resumed traditional classroom learning. Compared to fully online learning, students who experienced traditional classroom (onsite) teaching were 37.8% less likely to report moderate-to severe anxiety (OR 0.6; p-value 0.021). There was no significant correlation between school closure-induced anxiety with overall physical activity (PA) and active play, but anxiety was significantly associated with screen time and sleep duration. Receiving handouts/written assignments only as the learning method was significantly correlated with PA, but two methods (handouts and onsite/traditional classroom) was significantly correlated with active play. Students who experienced classroom learning were also more likely to comply with recommended durations of screen time and sleep.

CONCLUSION

Although online learning was probably the most convenient choice during COVID-19 containment measures in Thailand, this method did not provide sufficient opportunity for PA and play. Online learning also encouraged an excessive use of screen media, and disrupted sleeping patterns. Online learning also pressured Thai students to make various adjustments in their daily routines that may have further aggravated anxiety.

Relationships between local school closures due to the COVID-19 and mental health problems of children, adolescents, and parents in Japan

The widespread impacts of COVID-19 have affected both child and parent mental health worldwide. This study aimed to investigate the relationship between school closures due to COVID-19 and child and parent mental health in Japan. A sample of 1,984 Japanese parents with children and adolescents aged 6-15 years participated. The parents responded to online questionnaires about their own mental health and that of their children cross-sectionally. Participants were divided into three school situations based on the past week: full school closure, partial school closure, and full school open. Results indicated that 2.02% (n = 40) of the participants were in full school closure and 5.95% (n = 118) of the participants were in partial school closure. The results indicated that, after controlling for other variables regarding the pandemic, full school closure was associated with much higher scores in both child and parent mental health problems compared to full school open. Moderately higher scores were found only for anxiety symptoms in both children and parents under partial school closure compared to where schools were fully open. Consideration of the needs of families is necessary in the context of both full and partial school closures to prevent deteriorating mental health.

Management of pleural empyema in a 12-year-old obese patient with COVID-19: a pediatric case report

BACKGROUND

With the ongoing coronavirus disease (COVID-19) pandemic, along with the development of new mutations of the virus and an increase in the number of cases among pediatrics, physicians should be aware and alerted on the atypical presentations of the disease, especially in less expected individuals.

CASE PRESENTATION

Here we present a 12-year-old obese boy (BMI = 37.5 kg/m2) who presented with empyema, which was following SARS-CoV-2 infection. The patient had no history of fever. Due to the onset of dyspnea, a chest tube was inserted for him which was later altered to a pleural drainage needle catheter.

CONCLUSION

Our case is the first report of COVID-19 presenting as empyema among pediatrics. Pleural empyema should be considered as a rare complication of COVID-19. Since there is still no guideline in the management of empyema in the context of COVID-19, delay in diagnosis and intervention may cause morbidity and mortality in children.

Multisystem Inflammatory Syndrome with Features of Atypical Kawasaki Disease during the COVID-19 Pandemic

Background

Although Kawasaki disease (KD) is the most common self-limited systemic vasculitis in pediatrics, the exact etiology of the disease, its association with other diseases, and pathogens is still unknown. In order to achieve a better understanding and management of the disease, documentation and reporting of atypical cases is justified, particularly with the growing number of children with inflammatory syndrome with clinical features simulating KD during the COVID-19 pandemic. Here, we present a case of an atypical case of KD presenting as multisystem inflammatory syndrome (MIS) during the COVID-19 pandemic. Case Presentation. The patient is a 7-year-old girl who developed fever (39°C) and erythematous multiform rash on the abdomen and along with erythema and edema on the extremities. Laboratory evaluation revealed neutrophilia and lymphopenia along with elevated C-reactive protein, erythrocyte sedimentation rate, troponin, lactate dehydrogenase, ferritin, and D-dimer. Although the patient did not fulfill the KD criteria, based on approved guidelines and approaches regarding atypical KD and multisystem inflammatory syndrome in children (MIS-C) during the COVID-19 pandemic, intravenous immunoglobulin along with aspirin was administered for the patients. The patient's symptoms resolved with an uneventful postdischarge course.

Conclusion

Early diagnosis and treatment of patients meeting full or partial criteria for KD are critical to preventing end-organ damage and other long-term complications, especially during times of public crisis and global health emergencies, such as the novel coronavirus pandemic.

Will Nothing Be the Same Again?: Changes in Lifestyle during COVID-19 Pandemic and Consequences on Mental Health

Social isolation caused by the COVID-19 pandemic has drastically affected lifestyles: from sedentary behaviors to reduced physical activity, from disrupted sleep patterns to altered dietary habits. As a consequence, serious mental and emotional responses have been registered. There was a significant decline in physical and other meaningful activities of daily living, leisure, social activity, and education. In children, collateral effects of the pandemic include inadequate nutrition with a risk of both overweight and underweight, addiction to screens, lack of schooling, and psychosocial difficulties. Older adults are frequently unable to adapt to lockdown measures and suffer from depression and cognitive complaints. Recent studies focusing on changes in lifestyle during the Covid-19 pandemic and consequences on mental health have been identified in PubMed/Medline, Scopus, Embase, and ScienceDirect. All the available literature has been retrospectively reviewed. The results of the present narrative review suggest that mental distress caused by social isolation seems to be linked not only to personality characteristics but also to several lifestyle components (sleep disruption, altered eating habits, reduced physical activity). This review aims to explore major changes in the lifestyle and quality of life and the impact of these changes on mental health, and to inform clinicians and policymakers about elements that may reduce the negative psychological effects of the quarantine period imposed during this worldwide crisis. There is an urgent need for tailored preventive, diagnostic, and therapeutic mental health interventions for the general population and for higher risk groups.

Lifestyle and eating habits before and during COVID-19 quarantine in Brazil

OBJECTIVE

To assess changes in daily habits, food choices and lifestyle of adult Brazilians before and during the COVID-19 pandemic.

DESIGN

This observational study was carried out with Brazilian adults through an online questionnaire 5 months after the social distance measures implementation. The McNemar, McNemar–Bowker and Wilcoxon tests were used to investigate differences before and during the COVID pandemic period, adopting the statistical significance of P < 0·05.

SETTING

Brazil.

PARTICIPANTS

Totally, 1368 volunteers aged 18+ years.

RESULTS

The volunteers reported a lower frequency of breakfast, morning and lunch snacks (P < 0·05) and a higher frequency of evening snacks and other meal categories during the pandemic period (P < 0·05). The results showed an increase in the consumption of bakery products, instant meals and fast food, while the consumption of vegetables and fruits decreased (P < 0·005). There was a significant increase in the frequency of consumption of alcoholic beverages (P < 0·001), but a reduction in the dose (P < 0·001), increased frequency of smoking (P = 0·007), an increase in sleep and screen time in hours and decrease in physical activity (P < 0·001).

CONCLUSIONS

It was possible to observe an increase in screen time, hours of sleep, smoking and drinking frequency. On the other hand, there was a reduction in the dose of alcoholic beverages but also in the practice of physical activity. Eating habits also changed, reducing the performance of daytime meals and increasing the performance of nighttime meals. The frequency of consumption of instant meals and fast food has increased, while consumption of fruits and vegetables has decreased.

Self-Regulation of Motivation and Confinement by COVID-19: A Study in Spanish University Students

(1) Background: confinement by COVID-19 in 2020 meant that face-to-face teaching changed to virtual teaching. The goal of this study was to test how confinement affected to self-regulation of motivation (SRM); (2) Methods: a longitudinal design was used to obtain information from 75 university students in three moments: before confinement, 20 days after confinement, and 40 days after confinement. The SRM Strategies Questionnaire and the Pittsburgh Sleep Index were used to evaluate the study variables; (3) Results: the SRM decreased as confinement progressed. Moreover, those students who had higher levels of SRM before confinement, showed worse sleep quality 20 days after. There was no interaction effect between moments and gender and between moments and work situation on any of the dimensions of the SRM. There were gender differences (women scored higher) in almost all of the SRM dimensions in the three moments, but there were no differences dependent on the work situation (i.e., only study or study and work); (4) Conclusions: the change from face-to-face classes to virtual learning decreased the SRM of university students and was related to worse sleep quality. Women showed higher levels of SRM than men, but these levels were reduced to the same extent in both genders.

Comparison of lidocaine, huffing maneuver and combination of both in prevention fentanyl induced cough before induction of anesthesia: a double-blind, prospective, randomized placebo-controlled study

BACKGROUND

Intravenous bolus injection of fentanyl has been frequently reported to be associated with cough reflex during patient anesthesia. However, the search for the most effective protocol continues. This study aimed to compare the effect of reducing cough reflex after injection of fentanyl in a fusion protocol by combining the injections of lidocaine and Huffing maneuver and comparing with a placebo control group, before anesthesia induction.

METHODS

This prospective randomized controlled trial study was performed on 400 patients who were divided into four groups of combined protocol (group 1), lidocaine group (group 2), Huffing maneuver group (group 3), and the control receiving normal saline (group 4). Then patients were injected with 2. 5 μg /kg fentanyl and monitored for 2 min regarding their cough reflex, as well as the severity.

RESULTS

In group one, 9 patients (9%), in group two, 45 patients (45%), 22 patients (22%) in group three, and in group four, 75 patients (75%), developed cough reflex following fentanyl injection. Also, 13 patients (13%) developed moderate and 4 (4%) developed severe coughs in the control group reported, while no reports of severe or moderate cough were among the intervention groups. There was a significant difference between the intervention group and the control group both in terms of the rate and severity of the fentanyl-induced cough.

CONCLUSION

By using a combination of lidocaine injection along and Huffing maneuver, better results can be obtained in reducing the frequency, and also the severity of cough followed by fentanyl injection.

TRIAL REGISTRATION

The trial was registered with IRCT.IR (09/03/2018-No. IRCT20141009019470N74 ).

The Association between Emotional Stress, Sleep Disturbance, Depression, and Burning Mouth Syndrome

INTRODUCTION

Burning mouth syndrome (BMS) is one of the challenging clinical problems not only in its diagnosis and treatment but also its concurring mental impact. This study is aimed at determining the association between psychological factors, including emotional stress, depression, anxiety, and sleep pattern among BMS patients.

METHODS

In this cross-sectional study, 19 patients with idiopathic BMS were enrolled along with a control group equivalent in age and sex, but without BMS. Questionnaires used were the Visual Analog Scale (VAS), the Pittsburgh Sleep Quality Index (PSQI), and the Depression, Anxiety, and Stress Scale (DASS-21). Demographic information was also recorded and analyzed.

RESULTS

There was a significant correlation among the two groups of BMS and non-BMS patients regarding stress, depression, and sleep disorder. The average severity of the burning score was 8.31 among the patients. Furthermore, a significant correlation was observed among mental disorders and educational level and sex, but not with age. There was also no significant correlation among the severity of the burning score with sex, education, and mental disorder.

CONCLUSION

BMS is significantly associated with psychological symptoms. This condition requires proper treatment and support because it can represent psychological or mental issues and/or have a significant effect on daily life.