Mental health consequences of COVID-19 media coverage: the need for effective crisis communication practices

The dangers of having only one pandemic exit strategy

BACKGROUND

When it comes to pandemic response, preparation can be the key. Between 2020 and 2024, the fast-paced development of COVID-19-often compounded by pubic policies' failures to reflect the latest reality and the public's divergent reactions to the pandemic and the policies-means that society should prepare for exit strategies that can reflect the reality of the pandemic and the interests of the people. Yet oftentimes societies only have one exit strategy with limited scope. This paper investigates the dangers of having only one pandemic exit strategy for pandemics like COVID-19.

METHODS

Analyses were based on a review of the literature on COVID-19 exit strategies and our own research. The PubMed literature search focused on two concepts-"COVID-19″ and "exit strategy"-and was limited to peer-reviewed papers published between 2020 and 2024 in English.

RESULTS

A total of 31 articles were included in the final review. Analyses showed that existing studies on COVID-19 exit strategies often focused on using the modelling method to gauge one exit strategy. Exit strategies were often discussed in the context of implementing, easing, or lifting specific pharmaceutical or non-pharmaceutical interventions. Staged and country-wide coordinated exit strategies were also discussed in the literature, both of which were often deemed as comparatively rigorous options compared to single or stand-alone exit strategies. Drawing on the overall development of COVID-19 and our own research, we presented and discussed the importance of having multiple exit strategies that are considerate of all possible pandemic trajectories, diverse interests of the public, and the communication challenges officials might face in introducing or implementing pandemic policies.

CONCLUSION

This paper underscored the importance of having multiple exit strategies for societies to prepare for pandemics. The insights of this study can help inform health policies so that they can more comprehensively and compassionately protect the needs and wants of the "public" in public health, particularly in grave times like COVID-19.

A longitudinal study of risk and protective factors for symptoms of adjustment disorder during the COVID-19 pandemic

Background: The COVID-19 pandemic caused multiple stressors that may lead to symptoms of adjustment disorder.Objective: We longitudinally examined relationships between risk and protective factors, pandemic-related stressors and symptoms of adjustment disorder during the COVID-19 pandemic, as well as whether these relationships differed by the time of assessment.Method: The European Society for Traumatic Stress Studies (ESTSS) ADJUST Study included N = 15,169 participants aged 18 years and above. Participants from 11 European countries were recruited and screened three times at 6-month intervals from June 2020 to January 2022. Associations between risk and protective factors (e.g. gender), stressors (e.g. fear of infection), and symptoms of adjustment disorder (AjD, ADNM-8) and their interaction with time of assessment were examined using mixed linear regression.Results: The following predictors were significantly associated with higher AjD symptom levels: female or diverse gender; older age; pandemic-related news consumption >30 min a day; a current or previous mental health disorder; trauma exposure before or during the pandemic; a good, satisfactory or poor health status (vs. very good); burden related to governmental crisis management and communication; fear of infection; restricted social contact; work-related problems; restricted activity; and difficult housing conditions. The following predictors were associated with lower AjD levels: self-employment or retirement; working in healthcare; and face-to-face contact ≥ once a week with loved ones or friends. The effects of the following predictors on AjD symptoms differed by the time of assessment in the course of the pandemic: a current or previous mental disorder; burden related to governmental crisis management; income reduction; and a current trauma exposure.Conclusions: We identified risk factors and stressors predicting AjD symptom levels at different stages of the pandemic. For some predictors, the effects on mental health may change at different stages of a pandemic.

Influence of social media on psychological health of youth during COVID-19 pandemic

Context

Medical undergraduates, being away from their institutes due to the lockdown, are at a greater risk of being affected by the negative news, which may easily instill fear and panic among them. Therefore, the present study was planned with the objective to study the effects of media exposure on the psychological health of undergraduate medical students at a tertiary health institute.

Aim

To assess the psychological effects of social media/media use and coping mechanisms adopted during the COVID-19 pandemic.

Settings and Design

Tertiary care teaching Institute and Cross-sectional study.

Material and Methods

It is a cross-sectional observational study performed among (under graduate) UG students, which was assessed using a pre-tested questionnaire including the pre-validated DASS-21 scale.

Statistical Analysis

Data collected was entered in MS Excel. Descriptive statistics and correlation of the study variables were analyzed while controlling for demographics using Epi-info software version 7.2.2.

Results

It was observed that around one-fifth of the participants have moderate depression, followed by mild 10.97%; one-fifth of the participants have moderate levels of anxiety 20.41% followed by extremely severe anxiety 13.27% and about two-thirds of the study participants having no stress 64.29% followed by mild stress 14.80% and moderate stress 9.69%.

Conclusion

There was a significant psychological impact of the use of social media among young populations, particularly anxiety, stress, and depression with exposure to negative news and reports on social media platforms.

Where should "Humans" be in "One Health"? Lessons from COVID-19 for One Health

The culling of animals that are infected, or suspected to be infected, with COVID-19 has fuelled outcry. What might have contributed to the ongoing debates and discussions about animal rights protection amid global health crises is the lack of a unified understanding and internationally agreed-upon definition of "One Health". The term One Health is often utilised to describe the imperative to protect the health of humans, animals, and plants, along with the overarching ecosystem in an increasingly connected and globalized world. However, to date, there is a dearth of research on how to balance public health decisions that could impact all key stakeholders under the umbrella of One Health, particularly in contexts where human suffering has been immense. To shed light on the issue, this paper discusses whether One Health means "human-centred connected health" in a largely human-dominated planet, particularly amid crises like COVID-19. The insights of this study could help policymakers make more informed decisions that could effectively and efficiently protect human health while balancing the health and well-being of the rest of the inhabitants of our shared planet Earth.

The mediating role of coping styles in the relationship between fear of COVID-19 and mental health problems: a cross-sectional study among nurses

Fear of being infected by coronavirus disease 2019 (COVID-19) could trigger mental health problems among nurses at the frontline. In such a situation, coping strategies are needed to deal with the imminent threat. The purpose of this study was to test the mediating effects of coping on relationships of fear of COVID-19 with anxiety, depression and post-traumatic syndrome among nurses who were in contact with COVID-19 patients. A cross-sectional and correlational research design was used to recruit a sample of 278 nurses who treated COVID-19 patients in four government referral hospitals in Indonesia. A bootstrap resampling procedure was used to test the significance of the total and specific indirect effects of coping on relationships of Fear of COVID-19 with anxiety, depression and post-traumatic syndrome. The nurses reported moderate levels of fear of COVID-19, considerable anxiety and depression, and a moderate level of coping. We found coping to be significantly negatively correlated with the reported levels of anxiety, depression and post-traumatic syndrome (p < 0.001). Coping mediated relationships of fear of COVID-19 on depression, anxiety and post-traumatic syndrome after controlling for relevant confounders for each dependent variable. This shows that enacting coping mechanisms is important to achieve an adaptive effect on nurses' mental health. Proper assessments and interventions should be tailored and implemented for nurses who have contact with COVID-19 patients to facilitate their use of coping strategies when needed in stressful situations.

Effectiveness of massage and range of motion exercises on muscle strength and intensive care unit-acquired weakness in Iranian patients with COVID-19: a randomized parallel-controlled trial

BACKGROUND

Muscle weakness is prevalent in intensive care patients. This study focused on comparing the effects of massage and range of motion (ROM) exercises on muscle strength and intensive care unit-acquired weakness (ICU-AW) among patients with coronavirus disease 2019 (COVID-19).

METHODS

This study was a randomized clinical trial that recruited patients (n=45) with COVID-19 admitted to the ICU and divided them into three groups (ROM exercises, massage, and control). We evaluated muscle strength and ICU-AW in the arms and legs using a hand dynamometer. The Medical Research Council sum score was determined before and after the intervention.

RESULTS

The study findings were that 0%, 20%, and 100% of the participants in the ROM exercises, massage, and control groups had ICU-AW on the 7th day of ICU admission. The ROM exercise group had greater muscle strength in the hands and legs than the massage and control groups, and the massage group had greater muscle strength than the control group.

CONCLUSIONS

Massage and ROM exercises could improve muscle strength and reduce ICU-AW in COVID-19 patients admitted to the ICU.

Bioinformatics reveals diagnostic potential of cuproptosis-related genes in the pathogenesis of sepsis

Background

Multiple modes of cell death occur during the development of sepsis. Among these patterns, cuproptosis has recently been identified as a regulated form of cell death. However, its impact on the onset and progression of sepsis remains unclear.

Method

We screened a dataset of gene expression profiles from patients with sepsis using the GEO database. Survival analysis was performed to analyze the relationship between cuproptosis-related genes (CRGs) and prognosis. Hub genes were identified through univariate Cox regression analysis. The diagnostic value of hub genes in sepsis was tested in both training sets (GSE65682) and validation sets (GSE134347). To examine the association between hub genes and immune cells, single-sample gene set enrichment analysis (ssGSEA) and Pearson correlation analysis were employed. Additionally, the CRGs were validated in a septic mouse model using real-time quantitative PCR (qRT-PCR) and immunohistochemistry (IHC).

Results

In sepsis, most CRGs were upregulated, with only DLD and MTF1 downregulated. High expression of three genes (GLE, LIAS, and PDHB) was associated with better prognosis, but only two hub genes (LIAS, PDHB) reached statistical significance. The receiver operating characteristic (ROC) analysis for diagnosing sepsis showed LIAS had a range of 0.793-0.906, while PDHB achieved values of 0.882 and 0.975 in the training and validation sets, respectively. ssGSEA analysis revealed a lower number of immune cells in the sepsis group, and there was a correlation between immune cell population and CRGs (LIAS, PDHB). Analysis in the septic mouse model demonstrated no significant difference in mRNA expression levels and IHC staining between LIAS and PDHB in heart and liver tissues, but up-regulation was observed in lung tissues. Furthermore, the mRNA expression levels and IHC staining of LIAS and PDHB were down-regulated in renal tissues.

Conclusions

Cuproptosis is emerging as a significant factor in the development of sepsis. LIAS and PDHB, identified as potential diagnostic biomarkers for cuproptosis-associated sepsis, are believed to play crucial roles in the initiation and progression of cuproptosis-induced sepsis.

Factors influencing psychological concerns about COVID-19 in South Korea: direct and indirect damage during the early stages of pandemic

BACKGROUND

COVID-19 pandemic has led to psychological concerns, the distribution of which across populations may differ depending on whether pandemic-related damage is direct or indirect. This study aims to investigate concerns associated with direct and indirect damage according to population characteristics, and identify relatively vulnerable groups that are particularly affected by concerns.

METHOD

This cross-sectional study used data from the 2020 Korea Community Health Survey, which collected data based on a complex sampling design. A total of 208,106 responses from individuals aged ≥ 19 were collected via in-person interviews. The items related to COVID-19 concerns were measured by Likert scales ranging from 1 to 5 and categorized into two types: direct concerns, which pertained to infection or death, and indirect concerns, which pertained to criticism, vulnerability, and economic damage, through factor analysis. We compared the means and effect size of direct concerns, indirect concerns, and overall concerns using weighted mean, ANOVA, and multiple regression analysis.

RESULTS

Exploratory and confirmatory factor analyses supported a two-factor structure for psychological concerns about COVID-19 (CFI = 0.99, TLI = 0.97, SRMR = 0.02, RMSEA = 0.06), which were divided into direct and indirect concerns. Mean scores were 3.62 for direct concerns and 4.07 for indirect concerns. Direct concerns were higher in females (B = .26); the elderly (B = .15); those diagnosed with hypertension or diabetes (B = .04; B = .06); those with few assistants during quarantine (B = .15); and those whose neighbors responded inappropriately to COVID-19 (B = .07). Indirect concerns were lower among the elderly (B = -.04), and higher among young; married (B = .25); pink- or blue-collar workers (B = .08; B = .06); and those who felt that the city responded inappropriately to COVID-19 (B = .02).

CONCLUSION

The prevalence of concerns regarding direct and indirect damage caused by the COVID-19 pandemic differed according to population characteristics. Some factors had a marked influence on direct and indirect concerns. Our findings could inform psychological interventions and policies for future pandemics. Customized interventions are needed to prevent negative psychological concerns and improve mental health.

COVID-19 Preparedness, Stressors, and Data-Driven Solutions for Healthcare Workers at a Regional Rural-Urban Hospital System: A Longitudinal Total Worker Health® Study

BACKGROUND

During the COVID-19 pandemic in the United States, healthcare workers were devastated by the insufficient preparedness to respond to their patients' and personal health needs. A gap exists in resources to prevent or reduce acute and long-term healthcare worker mental illnesses resulting from COVID-19 frontline response.

METHODS

We performed an exploratory, mixed methods, longitudinal study of healthcare workers at a regional rural-urban hospital system in the Midwest United States during the COVID-19 response (4 timepoints, 2020). Using the Total Worker Health® (TWH) participatory needs assessment approach, self-identified frontline COVID-19 workers participated in a survey including Health-Related Quality of Life, Impact of Event Scale, and a modified version of the American Nursing Association COVID-19 survey; and a hospital timeline tracked system-level activities.

FINDINGS

Response rate at Timepoint (T)1 was 21.7% (N = 39) and of those, 14 (36%) completed all four surveys. From T1 to T4, the rate of COVID-19 patients steadily increased, staff exceeded the threshold for post-traumatic stress disorder at T1 and T4; staff reported not enough rest or sleep 50% of the month, T1-T4. Helpfulness of family support increased but community support decreased, T1-T4. Concerns with performing new tasks increased; the challenges related to lack of protective equipment and negative media decreased. Workers wanted to be involved in decision-making, desired timely communication, and needed adequate physical, environmental, and psychological supports.

CONCLUSIONS/APPLICATIONS FOR PRACTICE

Utilization of a TWH® strategy for describing health needs, hospital response, and multi-level staff suggestions to workplace health solutions during the COVID-19 pandemic identified evidence-based health promotion interventions in a hospital system.

A synthesis of evidence for policy from behavioural science during COVID-19

Scientific evidence regularly guides policy decisions1, with behavioural science increasingly part of this process2. In April 2020, an influential paper3 proposed 19 policy recommendations ('claims') detailing how evidence from behavioural science could contribute to efforts to reduce impacts and end the COVID-19 pandemic. Here we assess 747 pandemic-related research articles that empirically investigated those claims. We report the scale of evidence and whether evidence supports them to indicate applicability for policymaking. Two independent teams, involving 72 reviewers, found evidence for 18 of 19 claims, with both teams finding evidence supporting 16 (89%) of those 18 claims. The strongest evidence supported claims that anticipated culture, polarization and misinformation would be associated with policy effectiveness. Claims suggesting trusted leaders and positive social norms increased adherence to behavioural interventions also had strong empirical support, as did appealing to social consensus or bipartisan agreement. Targeted language in messaging yielded mixed effects and there were no effects for highlighting individual benefits or protecting others. No available evidence existed to assess any distinct differences in effects between using the terms 'physical distancing' and 'social distancing'. Analysis of 463 papers containing data showed generally large samples; 418 involved human participants with a mean of 16,848 (median of 1,699). That statistical power underscored improved suitability of behavioural science research for informing policy decisions. Furthermore, by implementing a standardized approach to evidence selection and synthesis, we amplify broader implications for advancing scientific evidence in policy formulation and prioritization.

Navigating the infodemic: A qualitative study of university students' information strategies during the COVID-19 pandemic

Objectives

We aimed to study the strategies which university students developed for vetting information during the COVID-19 pandemic and associated infodemic.

Methods

We conducted semi-structured interviews with 34 students, using a piloted topic guide which explored several areas of pandemic experiences, including students' use of media. Transcripts were analysed inductively following the thematic approach. Higher order themes were finalised following a coding exercise undertaken by two of the authors.

Results

Participants were acutely aware of misinformation during the pandemic. They rated legacy news media (print and broadcast media with pre-Internet origins) higher than social media for reliable information about the pandemic. However, strikingly, not all legacy media were automatically trusted and not all social media were uniformly distrusted. Participants identified a set of mechanisms for establishing whether a piece of information was truthful and accurate. These mechanisms had four main focal points: (1) the source, (2) the message, (3) individual media literacy and (4) the trustworthiness of others. Despite possessing a critical awareness of misinformation, participants avoided posting anything in relation to the pandemic for fear of becoming the target of online abuse.

Conclusions

In addition to underscoring the role of media literacy, our research foregrounds the need to attend to the importance of fostering media confidence. We define media confidence as the ability of digital media users to challenge and interrogate questionable or inaccurate information safe in the knowledge that there are adequate regulatory mechanisms in place to curb abuse, trolling and intimidation.

The impact of COVID-19 on clinical research: the PIPPRA and MEDRA experience

Background

Coronavirus disease 2019 (COVID-19) has had a significant impact on clinical research. This paper aims to provide an insight into how the COVID-19 pandemic, associated public health restrictions and international guidance on the conduct of clinical research impacted two clinical rheumatology research trials - the Physiotherapist-led Intervention to Promote Physical Activity in Rheumatoid Arthritis (PIPPRA) and the MEDiterranean diet in Rheumatoid Arthritis (MEDRA) projects.

Methods

The March 2019 public health restrictions imposed to mitigate the risk of COVID-19 occurred at a time when PIPPRA was in the process of delivering assessment and intervention on a face-to-face basis (n=48) and MEDRA had commenced recruitment. Participants in PIPPRA and MEDRA had a diagnosis of rheumatoid arthritis, with some being immunosuppressed and thus at a higher risk for COVID-19. The decision-making processes of both trials is outlined to demonstrate the required amendments to continue in the context of the COVID-19 pandemic.

Results

Amendments to PIPPRA and MEDRA trial protocols were agreed and received ethical and funder approval. Both trials switched from a face-to-face delivery to a telehealth using online platforms. The PIPPRA study was paused for five months (April-August 2020), resulting in n=33 (60%) negative deviations from assessment protocol. MEDRA switched from face-to-face to online recruitment with 20% (n=35/44) negative deviations in recruitment. Of the n=18 participants who consented to participating in a face-to-face trial, just n=2 (11%) opted to engage with telehealth delivery of the intervention. MEDRA assessment and intervention deviations were 100% as no sessions were completed as planned in 2020.

Conclusions

The COVID-19 pandemic has severely impacted the PIPPRA and MEDRA clinical trials. Moving face-to-face clinical research to telehealth delivery may not be the panacea it is purported to be. Our experiences may be of benefit to researchers, clinicians, and funders in seeking to continue clinical research during a global pandemic.

Automated breast tumor ultrasound image segmentation with hybrid UNet and classification using fine-tuned CNN model

Introduction

Breast cancer stands as the second most deadly form of cancer among women worldwide. Early diagnosis and treatment can significantly mitigate mortality rates.

Purpose

The study aims to classify breast ultrasound images into benign and malignant tumors. This approach involves segmenting the breast's region of interest (ROI) employing an optimized UNet architecture and classifying the ROIs through an optimized shallow CNN model utilizing an ablation study.

Method

Several image processing techniques are utilized to improve image quality by removing text, artifacts, and speckle noise, and statistical analysis is done to check the enhanced image quality is satisfactory. With the processed dataset, the segmentation of breast tumor ROI is carried out, optimizing the UNet model through an ablation study where the architectural configuration and hyperparameters are altered. After obtaining the tumor ROIs from the fine-tuned UNet model (RKO-UNet), an optimized CNN model is employed to classify the tumor into benign and malignant classes. To enhance the CNN model's performance, an ablation study is conducted, coupled with the integration of an attention unit. The model's performance is further assessed by classifying breast cancer with mammogram images.

Result

The proposed classification model (RKONet-13) results in an accuracy of 98.41 %. The performance of the proposed model is further compared with five transfer learning models for both pre-segmented and post-segmented datasets. K-fold cross-validation is done to assess the proposed RKONet-13 model's performance stability. Furthermore, the performance of the proposed model is compared with previous literature, where the proposed model outperforms existing methods, demonstrating its effectiveness in breast cancer diagnosis. Lastly, the model demonstrates its robustness for breast cancer classification, delivering an exceptional performance of 96.21 % on a mammogram dataset.

Conclusion

The efficacy of this study relies on image pre-processing, segmentation with hybrid attention UNet, and classification with fine-tuned robust CNN model. This comprehensive approach aims to determine an effective technique for detecting breast cancer within ultrasound images.

An Analysis of Crisis Communication Delivered by the Chief Health Officer During the COVID-19 Pandemic in Queensland, Australia

During the first year of the COVID-19 pandemic, the state of Queensland, Australia, had relative success in containing viral transmission, presenting a unique case for potential insights into effective crisis management. Limited research exists into the communication style and effectiveness of Chief Health Officers (CHOs) throughout pandemic scenarios. Using an adapted Crisis Emergency and Risk Communication (CERC) framework based on 12 themes which indirectly assess domains of trust, credibility, transparency, and accountability. A content analysis of 107 press conferences dating from January 30th to December 24th, 2020 was conducted to analyze crisis communication style delivered by the Queensland CHO and guest speakers. Our analysis found that most communication aligned with the CERC framework, suggesting that adherence to CERC themes in crisis communication may have played an important role in the state's success. However, areas which were lacking included themes relating to efforts to address, search and gather knowledge. Analysis also revealed that some CERC themes overlapped or were missing, thus triggering the development of a modified framework to provide a more succinct coding model. Our findings demonstrate the importance communication plays in successful crisis management and the modified framework can be applied to analyze communication at national and sub-national levels.

Prevalence of fear of COVID-19, depression, and anxiety among undergraduate students during remote classes

BACKGROUND

During the coronavirus disease 2019 (COVID-19) pandemic, undergraduate students were exposed to symptoms of psychological suffering during remote classes. Therefore, it is important to investigate the factors that may be generated and be related to such outcomes.

OBJECTIVE

To investigate the association between fear of COVID-19, depression, anxiety, and related factors in undergraduate students during remote classes.

METHODS

This cross-sectional study included 218 undergraduate students (60.6% women and 39.4% men). Students answered a self-administered online questionnaire designed to gather personal information, pandemic exposure, physical activity level, fear of COVID-19 using the 'Fear of COVID-19 Scale', symptoms of depression using the Patient Health Questionnaire-9, and anxiety using General Anxiety Disorder-7.

RESULTS

Undergraduate students had a high prevalence of depression and anxiety (83.0% and 76.1%, respectively) but a low prevalence of fear of COVID-19 (28.9%) during remote classes. Multivariate analysis revealed that women who reported health status as neither good nor bad and who had lost a family member from COVID-19 had the highest levels of fear. For depression and anxiety, the main related factors found were female gender, bad health status, insufficiently active, and complete adherence to the restriction measures.

CONCLUSION

These findings may be used to develop actions to manage symptoms of anxiety and depression among students, with interventions through physical activity programmes to improve mental health.

Risk factors of peripheral venous catheter-related complication and infection in children with bronchopneumonia

OBJECTIVE

To investigate the risk factors associated with the peripheral venous catheter-related complication and infection in children with bronchopneumonia.

METHODS

A total of 185 patients were divided into case group (n = 114) and control group (n = 71) according to the presence of catheter-related infection and complications related to indwelling needle. We performed a multivariate logistic regression analysis to explore the risk factors associated with the infection.

RESULTS

Age was divided into 4 categories (0 < age ≤ 1, 1 < age ≤ 3, 3 < age ≤ 6, age > 6). The case group had a higher percentage of patients with 0 < age ≤ 1 than the control group (21% vs. 9.7%) and the age distribution was significant different between the two groups (P = 0.045). The case group had a longer retention time than the control group (≥ 3 days: 56% vs. 35%, P < 0.001). The results of binary logistics regression analysis revealed that the indwelling time and indwelling site were the factors that influenced the complications or bacterial infection. Among the three indwelling sites, the hand is more prone to infection and indwelling needle-related complications than the head (OR: 2.541, 95% CI 1.032 to 6.254, P = 0.042). The longer the indwelling time, the more likely the infection and indwelling needle related complications (OR: 2.646, 95% CI 1.759 to 3.979, P< 0.001).

CONCLUSION

Indwelling time and indwelling site are the influencing factors of complications or bacterial infection, which should be paid more attention to prevent the catheter-related infection in children with bronchophenumonia.

Development and validation of the Post-Pandemic Fear of Viral Disease scale and its relationship with general anxiety disorder: a cross-sectional survey from Pakistan

BACKGROUND

Given the worldwide reach of COVID-19, media coverage has amplified the psychological and social effects of this pandemic causing a widespread fear. Despite substantial research on the short-term psychological impact of COVID-19, its long-term consequences on mental health remain relatively unexplored. This research aims to develop and validate a Post-Pandemic Fear of Viral Disease (PPFVD) scale and to see its relationship with general anxiety disorder among the Pakistani population.

METHODS

A cross-sectional online-based survey was conducted with 457 respondents in August and September 2022. We adopted the modified fear of coronavirus scale (FCV-19 S) consisting of seven items and the Generalized Anxiety Disorder (GAD) questionnaire to measure anxiety disorder. Confirmatory factor analysis was applied using the maximum likelihood estimation method. Scale dimensions and item reliability were tested for their validity and goodness of fit. SPSS and AMOS were used for data management and analyses.

RESULTS

All inter-item correlations were found to be significant and ranged between 0.30 and 0.70. The value of Cronbach's alpha was 0.887, indicating good reliability. Corrected item-total correlations ranged between 0.632 and 0.754. Factor loadings ranged from 0.664 to 0.810, indicating a good internal consistency. Overall, these results clearly demonstrate that the one-factor solution model for PPFVD presents a good fit to the data. The composite reliability (CR = 0.747) was also good.

CONCLUSIONS

The COVID-19 pandemic has negatively affected the mental health of people globally. This measurement scale can be trusted and used to test the PPFVD in the post-pandemic situation. Prospective research might validate this instrument in newly emerging scenarios and test it with diverse ethnic groups.

E-learning enhancement through educational data mining with Covid-19 outbreak period in backdrop: A review

E-learning is fast becoming an integral part of the teaching- learning process, particularly after the outbreak of Covid-19 pandemic. Educational institutions across the globe are striving to enhance their e-learning instructional mechanism in accordance with the aspirations of present-day students who are widely using numerous technological tools - computers, tablets, mobiles, and Internet for educational purposes. In the wake of the evident incorporation of e-learning into the educational process, research related to the application of Educational Data Mining (EDM) techniques for enhancing e-learning systems has gained significance in recent times. The various data mining techniques applied by researchers to study hidden trends or patterns in educational data can provide valuable insights for educational institutions in terms of making the learning process adaptive to student needs. The insights can help the institutions achieve their ultimate goal of improving student academic performance in technology-assisted learning systems of the modern world. This review paper aims to comprehend EDM's role in enhancing e-learning environments with reference to commonly-used techniques, along with student performance prediction, the impact of Covid-19 pandemic on e-learning and priority e-learning focus areas in the future.

Exposure to negative foreign COVID-19 news predicts lower support for immigration policy in China

We present a framework for studying the spillover effect of negative foreign COVID-19 news on attitudes towards immigration. Our framework proposes that exposure to negative COVID-19 news from foreign countries can activate negative associations with foreigners, reduce positive attitudes towards them, and increase perceived threat, ultimately leading to decreased support for immigration. We conducted three studies to test this framework. Study 1 found that exposure to negative COVID-19 news about a foreign country increased negative valence associations with that country. Study 2 showed that exposure to more negative COVID-19 news about foreign countries was associated with lower acceptance of immigration policies in real life. Study 3 replicated the spillover effect of negative news exposure using a scenario manipulation. The effects of negative news exposure on immigration policy acceptance in both Studies 2 and 3 were mediated by changes in foreigner attitudes and intergroup threat. Our results demonstrate the important spillover effect of negative foreign COVID-19 news exposure on immigration attitudes and highlight the association perspective as a foundation for understanding attitude changes during the COVID-19 pandemic.

Relationship Between Freshmen's Psychological Health and Family Economic Status in Chinese Universities: A Latent Profile Analysis

Purpose

With the rapid social changes, psychological health problems among freshmen in universities have become increasingly serious. Many researchers have studied the psychological health status of college freshmen using quantitative methods. However, most researchers have studied the psychological health of college freshmen by treating variables as the central concept and analysis unit, which has limitations on the variable-centered research method. Therefore, this study aims to explore the impact of family economic status and demographic variables on the psychological health of college freshmen, as well as the potential types of psychological health among college freshmen.

Methods

Based on the SCL-90 and the self-evaluation of the family economic status of college freshmen, latent profile analysis (LPA) was used to analyze the psychological health of 1497 college freshmen selected through a whole-group sampling method. Freshmen completed the questionnaire from October 18 to October 20, 2022. Then, multinomial logistic regression analysis and variance analysis were conducted using SPSS 25.0 to analyze the impact of family economic status and demographic variables on different psychological health subtypes of college freshmen from a university in Eastern China.

Results

There is obvious heterogeneity in the psychological health of college freshmen, which can be divided into three groups: psychological health group (69.54%), psychological distress group (24.65%), and psychological risk group (5.81%). The latent categories of psychological health among college freshmen differ by gender and family economic status. The psychological health status of female students is significantly better than that of male students. In addition, the lower the self-evaluation of family economic status of college freshmen, the lower their psychological health level.

Conclusion

Three categories of mental health exist for college freshmen, with significant group heterogeneity. Gender and family economic status significantly influenced mental health outcomes with female students faring better. The study's significance lies in providing useful recommendations for educational administrators and developing targeted interventions for college freshmen. Given the practical realities of mental health education efforts, personalized strategies that utilize peer support, counseling, and psychological services can be adopted to assist freshmen in acclimating to university life and maintaining mental wellness. The findings suggest considering the role of family economic status and gender in promoting mental health and the need for further research to develop comprehensive and effective interventions.

The Role of Social Support and Socioeconomic Factors in the Prediction of Depression among First-Year Undergraduate Students

Aim

This study was devoted to determining the role of social support and socioeconomic factors in predicting students' depression.

Methods

In this cross-sectional study, all first-year undergraduate students in the Shahrekord University of Medical Sciences, Iran, during the 2019-2020 academic year were included via the census method. Data collection tools include a researcher-made checklist about demographic and socioeconomic status, a standard questionnaire of perceived social support, and Beck's depression questionnaire. Smoothly clipped absolute deviation (SCAD) linear regression was used to model the role of social support and socioeconomic factors in predicting depression.

Results

Out of the 220 first-year undergraduate students, 174 (79.1%) were female, and 176 (80.0%) were single. The mean ± SD of depression score among the first-year undergraduate students was 10.56 ± 5.19, and the mean ± SD of social support score was 48.86 ± 5.46. The mean score of depression was significantly higher in female students than in males (11.09 versus 8.59, P = 0.001) but was not statistically significant in different categories of age (P = 0.70), marital status (P = 0.37), ethnicity (P = 0.10), parents' education, and the other demographic variables. Pearson's correlation showed an inverse and significant correlation between depression and social support (R = -0.20, P = 0.003). The mean score of depression was at the highest level for students of public health and environmental health majors and was the lowest for students of laboratory sciences, which was statistically significant (P < 0.001). After adjusting the other variables, SCAD regression showed that social support plays a key role in depression prediction, and increasing social support leads to a decrease in depression score.

Conclusion

Considering the existence of an inverse and significant correlation between depression and social support, any intervention to promote social support for first-year undergraduate students may decrease depression.

How Do Women React to the COVID-19 Pandemic Period? Relationship Between Ego-Resiliency, Anxiety, Alcohol Consumption and Aggression Among Polish Women

Purpose

There are many reports in the literature on the impact of the COVID-19 pandemic on mental health, including the condition of women. Most of these studies refer to a single time point, while there is a lack of studies controlling for selected parameters during different periods of the pandemic. This work aimed to determine the role of ego-resiliency in women's adaptation to the COVID-19 pandemic.

Patients and Methods

The survey was conducted in two stages - all via online forms. A total of 762 Polish women took part in the overall project. The scales used in the study were the Ego-resiliency scale (ER89-R12), Generalized Anxiety Disorder 7 Scale (GAD-7), Alcohol Use Disorders Identification Test (AUDIT), and Buss-Perry Aggression Questionnaire (BPAQ). Statistical analysis was performed using Statistica 13.3.

Results

Women participating in the second study had significantly lower scores on ego-resilience and its components compared to the first study. In the first research, ego-resiliency and optimal regulation were statistically significantly correlated with anxiety, alcohol consumption, generalised aggression, verbal aggression and hostility, while openness to life experiences was correlated with alcohol consumption and hostility. The second part of the project highlighted new significant correlations between ego-resiliency and optimal regulation and physical aggression and anger, but a non-significant correlation of these variables with alcohol consumption. The effect of openness to life experiences on alcohol consumption and anxiety, evident in the first study, was no longer present in the second part of the study.

Conclusion

The lack of a significant effect of openness to life experience on alcohol consumption, lower ego-resiliency and optimal regulation scores are observed in the second part of the research, which might be an expression of adaptation to the COVID-19 pandemic. Ego-resiliency is a protective factor against aggression, while optimal regulation against anxiety among Polish women.

Media-Induced War Trauma Amid Conflicts in Ukraine

War could be traumatic. War trauma could often lead to severe and sustained health consequences on people's physical and psychological health. War trauma is often prevalent in people who either participated in the war or lived near conflict zones, such as military professionals, refugees, and health workers. Advances in information and communication technologies, such as the speed, scale, and scope at which people worldwide could be exposed to the near-time happenings of the war, mean that an unprecedented number of people could face media-induced war trauma. Different from war experienced in person, which could be limited in scope and intensity, media-induced war trauma can be substantially more extensive and comprehensive-news reports on the war often cover all aspects and angles possible, possibly paired with disturbing, if not demoralizing, images, repeatedly 24/7. Although media-induced war trauma could have a profound influence on people's mental health, particularly factoring in the compounding challenges caused by the pandemic, there is a dearth of research in the literature. To shed light on this issue, in this article, we aim to examine the implications of media-induced war trauma on people's health and well-being. Furthermore, we discuss the duties and responsibilities of the media industry amid and beyond the current conflicts in Ukraine.

Gender and Racial/Ethnic Disparities in Undergraduate and Graduate Students' Mental Health and Treatment Use Amid the COVID-19 Pandemic

The COVID-19 pandemic has negatively impacted numerous people?s mental health and created new barriers to services. To address the unknown effects of the pandemic on accessibility and equality issues in mental health care, this study aimed to investigate gender and racial/ethnic disparities in mental health and treatment use in undergraduate and graduate students amid the COVID-19 pandemic. The study was conducted based on a largescale online survey (N = 1,415) administered during the weeks following a pandemic-related university-wide campus closure in March 2020. We focused on the gender and racial disparities in current internalizing symptomatology and treatment use. Our results showed that in the initial period of the pandemic, students identified as cis women (p < .001), non-binary/genderqueer (p < .001), or Hispanic/Latinx (p = .002) reported higher internalizing problem severity (aggregated from depression, generalized anxiety, intolerance of uncertainty, and COVID-19-related stress symptoms) compared to their privileged counterparts. Additionally, Asian (p < .001) and multiracial students (p = .002) reported less treatment use than White students while controlling for internalizing problem severity. Further, internalizing problem severity was associated with increased treatment use only in cisgender, non-Hispanic/Latinx White students (pcis man = 0.040, pcis woman < 0.001). However, this relationship was negative in cis-gender Asian students (pcis man = 0.025, pcis woman = 0.016) and nonsignificant in other marginalized demographic groups. The findings revealed unique mental health challenges faced by different demographic groups and served as a call that specific actions to enhance mental health equity, such as continued mental health support for students with marginalized gender identities, additional COVID-related mental and practical support for Hispanic/Latinx students and promotion of mental health awareness, access, and trust in non-White, especially Asian, students are desperately needed.

COVID-19 vaccination willingness in peri-urban Tanzanian communities: Towards contextualising and moving beyond the individual perspective

With only 5.1% of the population fully vaccinated against COVID-19, Tanzania has one of the lowest vaccination rates in the world and after two years of changing policies regarding the disease, the country struggles to get its vaccination campaign on the rails. In this study, we identify the determinants of COVID-19 vaccination willingness in two villages of the Mvomero district in Eastern Tanzania. Based on survey data, we performed univariate analyses to assess differences in vaccination intention for various social groups, and built a four-dimensional multivariate ordered logistic regression model that comprises respondents' personal and socioeconomic characteristics, the channels through which they get their information, their attitudes and perceptions towards COVID-19, and their social network embeddedness. Only 37.0% of the respondents indicated that they would be willing to get vaccinated against COVID-19. Vaccination willingness differed significantly according to gender, age, educational attainment and religion; with men, the elderly, people with post-secondary education and Catholics and Muslims more likely to accept a vaccine. Predictors of vaccination willingness were gender, age, social media and informal contacts as information sources, perceived effectiveness of the vaccine and of alternative medicine, fear of side effects, a general dislike of vaccines, and the proportion of vaccinated people and the highest value of trust in international organisations in one's network. Although people's attitudes and perceptions have the largest share of the explanatory value, our model shows that all four of our model's building blocks were imperative in explaining vaccination willingness. Therefore, our paper presents a compelling case for the inclusion of respondents' social embeddedness as a common dimension for exploratory models of vaccination willingness.

Associations between depression, fear of COVID-19 infection and students' self-care measures used during the first wave of the pandemic

BACKGROUND

COVID-19 lockdown resulted in the closure of schools with associated problems. The aim of this study was to determine the associations between depression, fear of contracting COVID-19 infection and the use of self-care measures by college students during the first wave of the COVID-19 pandemic.

METHODS

This was a cross-sectional study that collected data from undergraduate and postgraduate college students 18 years and older from 152 countries between June and December 2020. Study participants were recruited through crowdsourcing using various social media platforms including Facebook, Twitter, and Instagram, WhatsApp groups and emails to participants in the collaborators' networks. The dependent variables were fear of contracting COVID-19 and depression while the independent variable was students' self-care measures. Multivariable logistic regression models were conducted to assess the associations between the dependent and independent variables.

RESULTS

Of the 2840 respondents, 1305 (46.0%) had fears of contracting COVID-19 and 599 (21.1%) reported depression. The most common self-care measures were phone calls with friends/family (60.1%) and video chat (52.8%). Learning a new skill was significantly associated with higher odds of fear of contracting COVID-19 (AOR = 1.669) and lower odds of having depression (AOR = 0.684). Talking to friends/family through video chat (AOR = 0.809) was significantly associated with lower odds of feeling depressed while spending time with pets (AOR = 1.470) and taking breaks from the news/social media (AOR = 1.242) were significantly associated with higher odds of feeling depressed. Students from lower middle-income countries (AOR = 0.330) had significantly lower odds of feeling depressed than students from low-income countries.

CONCLUSION

Self-care strategies involving social interactions were associated with less depression. Coping strategies with more cognitive demands may significantly reduce the risk of fear of COVID-19. Special attention needs to be given to students in low-income countries who have higher odds of depression during the pandemic than students from other countries.

Spillover effects of the COVID-19 pandemic on attitudes to influenza and childhood vaccines

The current study sought to determine whether public perceptions of other vaccines and diseases than COVID-19 have been impacted by the COVID-19 pandemic. We longitudinally examined whether there had been a change from before the COVID-19 pandemic to during the pandemic in: (a) influenza vaccination behaviour and intentions; (b) the perceived benefit of childhood vaccines and influenza vaccines; (c) the perceived safety of childhood vaccines and influenza vaccines; (d) the perceived severity of measles and influenza; and (e) trust in healthcare professionals in two samples of Finnish adults (N = 205 in Study 1 and N = 197 in Study 2). The findings showed that during the pandemic, more people than before had received or wanted to receive the influenza vaccine. The respondents also believed that influenza was more dangerous during the pandemic and that vaccinations were safer and more beneficial. On the other hand, for childhood vaccines only perceived safety increased. Finally, in one of the studies, people had more confidence in medical professionals during the pandemic than they had before. Together, these findings imply a spillover of the COVID-19 pandemic on how people view other vaccines and illnesses.

Effects of tourism and eco-innovation on environmental quality in selected ASEAN countries

Environmental issues have gained the attention of regulators and researchers worldwide. This present study empirically examines the validation of the environmental Kuznets curve (EKC) in the selected ASEAN economies for the period 1995-2018 in the presence of eco-innovations and tourism. This study assesses the short-run and long-run relationship between carbon dioxide emission, tourism, eco-innovations, and economic growth in ASEAN countries. To fulfil the objectives of the study, Westerlund and Edgerton (Oxf Bull Econ Stat 70:665-704, 2008) and Banerjee and Carrion-i-Silvestre (J Time Ser Anal 38:610-636, 2017) co-integration analysis have been applied to estimate the co-integration among variables because cross-sectional dependence (CSD) and slope heterogeneity was present. The short-run and the long-run empirical estimation have been done through cross-sectional auto distributive lag model. The findings provide evidence that an inverted U-shape nexus exists between carbon (CO2) emissions and economic growth in the ASEAN countries, a validation of EKC. Eco-innovations and tourism are found to be the factors that mitigate CO2 emissions. AMG and CCEMG results also confirm the robustness of short-run and long-run results. The findings of the study suggest that governments in ASEAN countries should promote tourism and eco-innovations (i.e., research and development) to mitigate CO2 emission, which poses serious threats to environmental sustainability. Also, tourism and eco-innovations are the drivers of economic growth, and growth reconciles with environmental sustainability in the selected ASEAN countries. This study provides guidelines to the policymakers while formulating the regulations related to environmental degradation.

Effects of tourism and eco-innovation on environmental quality in selected ASEAN countries

Environmental issues have gained the attention of regulators and researchers worldwide. This present study empirically examines the validation of the environmental Kuznets curve (EKC) in the selected ASEAN economies for the period 1995-2018 in the presence of eco-innovations and tourism. This study assesses the short-run and long-run relationship between carbon dioxide emission, tourism, eco-innovations, and economic growth in ASEAN countries. To fulfil the objectives of the study, Westerlund and Edgerton (Oxf Bull Econ Stat 70:665-704, 2008) and Banerjee and Carrion-i-Silvestre (J Time Ser Anal 38:610-636, 2017) co-integration analysis have been applied to estimate the co-integration among variables because cross-sectional dependence (CSD) and slope heterogeneity was present. The short-run and the long-run empirical estimation have been done through cross-sectional auto distributive lag model. The findings provide evidence that an inverted U-shape nexus exists between carbon (CO2) emissions and economic growth in the ASEAN countries, a validation of EKC. Eco-innovations and tourism are found to be the factors that mitigate CO2 emissions. AMG and CCEMG results also confirm the robustness of short-run and long-run results. The findings of the study suggest that governments in ASEAN countries should promote tourism and eco-innovations (i.e., research and development) to mitigate CO2 emission, which poses serious threats to environmental sustainability. Also, tourism and eco-innovations are the drivers of economic growth, and growth reconciles with environmental sustainability in the selected ASEAN countries. This study provides guidelines to the policymakers while formulating the regulations related to environmental degradation.

The relationship between COVID-19 fear levels and healthy lifestyle behaviors of elderly individuals: a cross-sectional study

BACKGROUND

It is known that fear of COVID-19 is associated with many lifestyle behaviours including delays in access to healthcare services and smoking status. However, the relationship between healthy lifestyle behaviours and fear of COVID-19 in older individuals remains unclear. Therefore, there is a need for research that examines the relationship between healthy lifestyle behaviours and fear of COVID-19 in elderly individuals. The purpose of this study is to investigate the relationship between the COVID-19 fear levels of elderly individuals and their healthy lifestyle behaviours.

METHODS

This cross-sectional study was carried out with individuals at or over the age of 65 registered at a public health centre located in eastern Turkey (N = 494). Data collection tools included a form for descriptive variables and two scales, the Fear of COVID-19 Scale (FCV-19 S) and the Healthy Lifestyle Behaviours Scale-II (HLSBS-II). Descriptive statistics, independent-samples t-test, ANOVA, correlation analyses, and hierarchical linear regression analyses were used in the analysis of the data.

RESULTS

The mean HLSBS-II and FCV-19 S scores of the participants were 127.61 ± 24.76 and 20.96 ± 7.29, respectively. While fear of COVID-19 alone, as indicated by the FCV-19 S score, explained 2.4% of the total variance in healthy lifestyle behaviours, fear of COVID-19, having a university degree, and high economic status together explained 7.5% of the total variance in healthy lifestyle behaviours indicated by scores on the HLSBS-II.

CONCLUSIONS

The results of this study showed that fear of COVID-19 and healthy lifestyle behaviours were dynamics that are positively related, albeit to a small extent, to each other for elderly individuals. Additionally, it was revealed that elderly individuals have moderate levels of fear of COVID-19 and healthy lifestyle behaviours.

Exploring experiences with stressors and coping resources among Dutch socioeconomic groups during the COVID-19 pandemic

The COVID-19 crisis impacts populations globally. This impact seems to differ for groups with low- and high-socioeconomic status (SES). We conducted a qualitative study in the Netherlands using a salutogenic perspective to examine experiences with stressors and coping resources during the pandemic among both SES groups to gain insight on how to promote the health and well-being of these groups. We conducted 10 focus group discussions and 20 interviews to explore the experiences, including resources and stressors, of respondents from low- (N = 37) and high-SES (N = 38) groups (25-55 years, Dutch speaking). We analyzed the findings at individual, community, and national levels. The results show that coping depends on government-imposed measures and the way individuals handle these measures; restriction to the home context with positive and negative consequences for work and leisure; psychological negative consequences and resourcefulness; and social effects related to unity (e.g. social cohesion or support) and division (including polarization). Respondents with lower SES expressed more problems with COVID-19 measures and experienced more social impact in their neighborhood than those with higher SES. Where low-SES groups especially mentioned the effects of staying at home on family life, high-SES groups mentioned effects on work life. At last, psychological consequences seem to differ somewhat across SES groups. Recommendations include consistent government-imposed measures and government communication, support for home schooling children, and strengthening the social fabric of neighborhoods.

It was the best of times, it was the worst of times: a tale of two cities-Beijing and Shanghai-why the divergent COVID-19 control outcomes?

Coronavirus disease 2019 (COVID-19) both creates and complicates public health challenges. Yet, the pandemic also provides a unique lens for dissecting complex issues in global health that could benefit society in the long run. In this article, we discuss the underlying reasons that can help explain the divergent COVID-19 control outcomes between Beijing and Shanghai-two advanced metropolises that are similar in their municipal capacity, administrative capability and pandemic strategy. We hope insights from this investigation contribute to the development of disease prevention systems, such as context-specific and data-driven public health strategies that could yield optimal pandemic control outcomes with minimal unintended consequences, both amid and beyond COVID-19.

COVID-19, Mental Health, and Chronic Illnesses: A Syndemic Perspective

BACKGROUND

The COVID-19 pandemic is an epidemiological and psychological crisis; what it does to the body is quite well known by now, and more research is underway, but the syndemic impact of COVID-19 and mental health on underlying chronic illnesses among the general population is not completely understood.

METHODS

We carried out a literature review to identify the potential impact of COVID-19 and related mental health issues on underlying comorbidities that could affect the overall health of the population.

RESULTS

Many available studies have highlighted the impact of COVID-19 on mental health only, but how complex their interaction is in patients with comorbidities and COVID-19, the absolute risks, and how they connect with the interrelated risks in the general population, remain unknown. The COVID-19 pandemic can be recognized as a syndemic due to; synergistic interactions among different diseases and other health conditions, increasing overall illness burden, emergence, spread, and interactions between infectious zoonotic diseases leading to new infectious zoonotic diseases; this is together with social and health interactions leading to increased risks in vulnerable populations and exacerbating clustering of multiple diseases.

CONCLUSION

There is a need to develop evidence to support appropriate and effective interventions for the overall improvement of health and psychosocial wellbeing of at-risk populations during this pandemic. The syndemic framework is an important framework that can be used to investigate and examine the potential benefits and impact of codesigning COVID-19/non-communicable diseases (NCDs)/mental health programming services which can tackle these epidemics concurrently.

The relationship between transmission misinformation, COVID-19 stress and satisfaction with life among adults

The perplexing evolution of the COVID-19 pandemic has had a significant effect on the spiritual lives of Vietnamese people in general, and particularly adults. The objective of this study was to ascertain the link between adult satisfaction with life and COVID-19 stress in Vietnam and investigate if COVID-19 transmission disinformation modifies the effect of COVID-19 stress on adult satisfaction with life. A total of 435 Vietnamese adults were enrolled online to finish answering, including the Satisfaction with Life Scale (SL), the COVID-19 Stress Scale (CS), and the COVID-19 Transmission Misinformation Scale (CTMS), consisting of 350 females and 85 males. Correlation, regression, and basic mediation analyses were used to dissociate the data. According to the findings of our study, there is a difference in gender in satisfaction with life. Females have a greater degree of satisfaction with life than males. Significant differences exist between relatives of direct and indirect COVID-19 transmission misinformation workers. People who had relatives who were frontline medical staff had higher COVID-19 Transmission Misinformation than others. There is a positive correlation between satisfaction with life and COVID-19 spreading disinformation, but it can have adverse effects on persons' physical health. Additionally, COVID-19 transmission misinformation has a role in the relationship between COVID-19 stress and adult life satisfaction. Individuals are more likely to access misinformation about COVID-19 transmission, which results in enhanced life satisfaction. During the COVID-19 epidemic, adults in Vietnam should be aware of the damaging consequences of COVID-19 transmission misinformation on their stress levels. Stress may significantly influence not just one's mental health but also other aspects of one's life. Clinicians should be aware of COVID-19 transmission misinformation and stress, which affect psychological treatment.

Parental survey of the sleep patterns and screen time in US school children during the first 6 months of the COVID-19 pandemic

BACKGROUND

This study compared sleep duration, screen exposure and sleep quality in school-aged children before COVID-19 to that during school closures and again when schools re-opened in fall 2020.

METHODS

Cross-sectional anonymous, online survey of parents of children 5-13 years old. Questions elicited information about sleep timing and quality, screen time, and schooling at three distinct periods: before the pandemic, when schools first closed and then re-opened in the fall.

RESULTS

Respondents described 101 children who were an average of 8.5 years old and 51% male. In lockdown, children slept 25 min more (95%CI 00:13-00:38) due to later wake times (75 min, 95% CI 0:57-1:34) with later bedtimes (29 min, 95%CI 0:00-0:58). When schools re-opened, sleep duration returned to pre-pandemic levels, but sleep onset and offset times remained later. Despite more sleep, sleep quality and habits (e.g. bedtime refusal) worsened during lockdown and did not normalize in fall 2020. During lockdown, screen time increased in 65% of all children, and 96% of those in private schools. When schools reopened, 78% of children in hybrid/virtual learning had more than 4 h of screen exposure daily. Less screen time was associated with twofold higher odds of better sleep (OR 2.66, 95%CI 1.15-6.14).

CONCLUSIONS

Although school-aged children had more total sleep when schools were closed, sleep quality and habits worsened. Upon return to school, sleep times and quality did not normalize and were linked to screen time.

Did Depression, Schizophrenia, and Alcohol Use Increase During the COVID-19 Pandemic Even in Low-Risk Regions? An Analysis of the 2017-2020 National Health Insurance Data in Tottori Prefecture

Background

This study aimed to determine whether the COVID-19 pandemic increased the number of medical consultations for depression, schizophrenia, and alcohol dependence in low-risk regions.

Methods

National Health Insurance enrolments from March 2017 to March 2021 in Tottori Prefecture, Japan, where there were minimal COVID-19 cases in 2020, were included in this study. The all-cause mortality and proportion of National Health Insurance members with depression, schizophrenia, and alcohol dependence in the financial years (FY) 2017, 2018, 2019, and 2020 were calculated. The proportion in FY 2020 was compared with the average proportion from FY2017 to FY2019 and the proportion in FY2019.

Results

The all-cause mortality for men aged 80-99 years and women aged 70-89 years decreased in FY2020. The proportion of men aged 20-29 years with depression increased to 4.1% in FY2020 compared with 3.0% in FY2019, while the proportion of women aged 20-29 years with depression was 4.4% in FY2017, 4.8% in FY2018, 4.8% in FY2019, and 5.5% in FY2020, confirming an increasing trend from before the COVID-19 pandemic. The proportion of men aged 30-39 years and 60-69 years with schizophrenia increased and that of women aged 40-49 years, 60-69 years, and 90-99 years with schizophrenia also increased, even before the pandemic. The proportion of people with alcohol use disorder has not changed significantly since FY2017.

Conclusion

The pandemic has led to an increased proportion of men aged 20-29 years with depression, even in low-risk regions.

Development of inferiority-compensation scale among high school students

An increasing number of high school students are inflicted by different degrees of mental disorders in learning, such as moodiness, learning difficulties, test anxiety, difficulty coping with frustration, etc., which are one of the factors leading to the inferiority of students. In the present study, the initial scale of inferiority compensation for high school students was developed through literature searching, expert evaluation, interviews, and an open scale. 1187 high school students were tested in different periods, after deleting an invalid 83 scales, including 461 copies of valid scale of exploratory factor analysis in the first stage and 643 copies of valid scale of confirmatory factor analysis in the second stage. The results showed that the inferiority compensation scale for high school students consisted of two sub-scale: self-compensation and others-compensation, ach two were composed of five dimensions including academic performance, physical fitness, social communication, appearance, and self-esteem. Confirmatory factor analysis showed that the total scale and the two sub-scale all had good structural validity (RMSEA≤0.08; CFI&IFI ≥ 0.9), and the combined reliability and values (such as the correlation coefficient of each dimension) of the two sub-scale were within the ideal range. With good reliability and validity (Cronbacα&KMO ≥ 0.90), and meeting the requirements of psychometrics, the scale can be used in the relevant research and practice of inferiority compensation for high school students.

Protecting public's wellbeing against COVID-19 infodemic: The role of trust in information sources and rapid dissemination and transparency of information over time

Objectives

This study examined how trust in the information about COVID-19 from social media and official media as well as how the information was disseminated affect public's wellbeing directly and indirectly through perceived safety over time.

Methods

Two online surveys were conducted in China, with the first survey (Time1, N = 22,718) being at the early stage of the pandemic outbreak and the second one (Time 2, N = 2,901) two and a half years later during the zero-COVID policy lockdown period. Key measured variables include trust in official media and social media, perceived rapid dissemination and transparency of COVID-19-related information, perceived safety, and emotional responses toward the pandemic. Data analysis includes descriptive statistical analysis, independent samples t-test, Pearson correlations, and structural equation modeling.

Results

Trust in official media, perceived rapid dissemination and transparency of COVID-19-related information, perceived safety, as well as positive emotional response toward COVID-19 increased over time, while trust in social media and depressive response decreased over time. Trust in social media and official media played different roles in affecting public's wellbeing over time. Trust in social media was positively associated with depressive emotions and negatively associated with positive emotion directly and indirectly through decreased perceived safety at Time 1. However, the negative effect of trust in social media on public's wellbeing was largely decreased at Time 2. In contrast, trust in official media was linked to reduced depressive response and increased positive response directly and indirectly through perceived safety at both times. Rapid dissemination and transparency of COVID-19 information contributed to enhanced trust in official media at both times.

Conclusion

The findings highlight the important role of fostering public trust in official media through rapid dissemination and transparency of information in mitigating the negative impact of COVID-19 infodemic on public's wellbeing over time.

Perceptions of social media challenges and benefits during the Covid-19 pandemic: Qualitative findings from a cross sectional international survey

Since the beginning of the Covid-19 pandemic in January 2020 the need for rapid information spread grew and social media became the ultimate platform for information exchange as well as a tool for connection and entertainment. With the rapid information spread along came the various public misconceptions and misinformation which consequently influenced perceptions and behaviors of the public towards the coronavirus pandemic. Thus, there was a need for identification and collation of public perceptions information to address future public health initiatives. This cross-national study aimed to examine the challenges and benefits of using social media during the Covid-19 pandemic outbreak. This study was a content analysis of the open-ended questions from a wider cross-sectional online survey conducted in Norway, UK, USA, and Australia during October/November 2020. 2368 participants out of 3474 respondents to the survey provided the open text responses included in the qualitative analysis. Thematic analysis was conducted independently by two researchers. All statements were coded to positive and negative sentiments. Three overarching themes were identified: 1. Mental health and emotional exhaustion 2. Information and misinformation; 3. Learning and inspiration.While providing a powerful mode of connection during the pandemic, social media also led to negative impact on public perceptions, including mistrust and confusion. Clarity in communications by institutions and education about credible information sources should be considered in the future. Further research is required in exploring and documenting social media narratives around COVID-19 in this and any subsequent incidents of pandemic restrictions. Understanding the public perceptions and their social narratives can support the designing of appropriate support and services for people in the future, while acknowledging the uncertainty and overwhelming impact of the pandemic that may have skewed the experiences of social media.

Crisis communication in the WHO COVID-19 press conferences: A retrospective analysis

OBJECTIVES

The objective of this study is to investigate, from a longitudinal perspective, how WHO communicated COVID-19 related information to the public through its press conferences during the first two years of the pandemic.

METHODS

The transcripts of 195 WHO COVID-19 press conferences held between January 22, 2020 and February 23, 2022 were collected. All transcripts were syntactically parsed to extract highly frequent noun chunks that were potential topics of the press conferences. First-order autoregression models were fit to identify "hot" and "cold" topics. In addition, sentiments and emotions expressed in the transcripts were analyzed using lexicon-based sentiment/emotion analyses. Mann-Kendall tests were performed to capture the possible trends of sentiments and emotions over time.

RESULTS

First, eleven "hot" topics were identified. These topics were pertinent to anti-pandemic measures, disease surveillance and development, and vaccine-related issues. Second, no significant trend was captured in sentiments. Last, significant downward trends were found in anticipation, surprise, anger, disgust, and fear. However, no significant trends were found in joy, trust, and sadness.

CONCLUSIONS

This retrospective study provided new empirical evidence on how WHO communicated issues pertaining to COVID-19 to the general public through its press conferences. With the help of the study, members of the general public, health organizations, and other stake-holders will be able to better understand the way in which WHO has responded to various critical events during the first two years of the pandemic.

Postpartum post-traumatic stress symptoms during the COVID-19 period: exposure and fear as mediating factors

Background: Post-traumatic stress symptoms (PTSS) following childbirth are common within a stressful environment and are mitigated by social support. During the COVID-19 pandemic, an increase in such symptoms has been reported. The current study aims to longitudinally model the influence of general and pandemic-specific risk and protective factors on the temporal unfolding of symptoms among postpartum women.Methods: Participants were 226 women following a liveborn, term birth during the first lockdown in Israel. Participants completed questionnaires 10 weeks (T1) and 6 months (T2) after delivery. PATH analyses included predictors of symptoms in T1: demographics, exposure to traumatic events, medical complications during delivery or pregnancy, exposure to COVID-19-related events and their subjective impact, fear of COVID-19, and social support. Predictors of symptoms in T2 were: T1 predictors, both as direct effects and mediated by T1 PTSS, as well as predictors measured again in T2.Results: Results showed the suggested model fit the data. The effect of COVID-19-related fear and subjective impact at T1 on symptoms at T2 were fully mediated by PTSS in T1, as were the effects of marriage and high social support at T1. COVID-19-related fear at T2 positively predicted symptoms at T2, while social support at T2 had the opposite effect. Medical complications during pregnancy negatively predicted symptoms in T2 only.Discussion: Persistent fear appears to be a risk factor and supports a consistent buffer in postpartum PTSS during the COVID-19 pandemic. Medical complications during pregnancy served as a protective factor, possibly due to habituation to medical settings.

Course and predictors of eating disorder symptoms, anxiety symptoms, and pandemic-related eating disorder concerns among adults with eating disorders during the first year of the COVID-19 pandemic

OBJECTIVE

The COVID-19 pandemic and public health mitigation measures have negatively impacted individuals with eating disorders (ED). We evaluated changes in and predictors of ED symptoms, pandemic-related ED concerns, and anxiety symptoms across the first 12 months of the COVID-19 pandemic among individuals with self-reported EDs in the United States (US), Sweden (SE), and the Netherlands (NL).

METHOD

Participants in the US (N = 510), SE (N = 982), and NL (N = 510) completed an online survey assessing ED symptoms (binge eating, restriction, compensatory behaviors, and anxiety about being unable to exercise), general anxiety symptoms, and pandemic-related ED concerns about accessing food, lack of structure and social support, being in a triggering environment, and food and treatment costs. In the US and NL, respondents completed surveys beginning April 2020 and continuing monthly for a year. In SE, respondents completed baseline surveys in May 2020, a six-month follow-up around December 2020, and a 12-month follow-up in May 2021.

RESULTS

Three patterns emerged: (1) a curvilinear course with the highest level of symptoms at baseline, declining through November 2020, and increasing through the rest of the year; (2) a linear declining course over time; and (3) a stable course with no changes. Worries about COVID-19 infection, lockdown, concerns about lack of structure and social support, and concerns about accessing food consistent with one's recovery meal plan predicted increases in ED symptoms.

DISCUSSION

ED symptoms tracked with pandemic-related concerns in people with EDs. Conceptualizing predictors of symptoms may inform therapy and public health resources that reduce the impact of pandemics on mental health.

PUBLIC SIGNIFICANCE

Our findings suggest that the COVID-19 pandemic had negative impacts on people with eating disorders, including amplification of mental health symptoms and stressors around peak periods of infection and COVID-19 restrictions. These findings inform medical providers, policy-makers, and community-based supports about the information and resource needs of this group to ensure efficient dissemination in future public health emergencies and during the ongoing COVID-19 pandemic.

Suicidal Ideation of Healthcare Workers During COVID-19: An Ecological Momentary Assessment

Introduction: The COVID-19 pandemic had an impact on the psychological health of healthcare workers (HCWs). Cross-sectional studies report suicidal ideation in this population during this period, but no longitudinal study has examined the evolution of these ideas over time. Objectives: To assess the evolution of suicidal ideation of HCWs during the first two waves of the COVID-19 pandemic among Quebec (Canada) HCWs and to identify the risk factors involved. Methods: A longitudinal study among Quebec (Canada) HCWs using ecological momentary assessment was conducted between May 8, 2020, and March 31, 2021 (corresponding to the second half of the first wave to the end of the second). Participants (n=865) answered weekly questions related to anxiety (GAD-7), depression (PHQ-9), suicidal ideation (PHQ-9 Q.9), exposure to COVID-19, exposure to COVID-19-related deaths, their infection status and that of their co-workers and loved ones, as well as the amount of time they spent consuming news related to COVID-19. Results: Proportion of suicidal ideation increased from May to June 2020 (second half of the first wave) peaking at 18% before declining up to March 2021. Anxiety and depression symptoms severity increased those ideations as well as having a colleague confirmed positive to COVID-19. Social support does not appear to be a protective factor for suicidal ideation. Suicidal thoughts are associated with media consumption and appear to be mediated by the presence of clinical distress expressed as depressive or anxiety states. Discussion and conclusion: Media consumption in a pandemic context is associated with anxiety and depression, the more severe states of which may express suicidal ideation. Without inferring causality relationship, it seems advisable for HCWs to limit their media exposure during a disaster such as a pandemic.

Terrorist Attacks Against COVID-19-Related Targets during the Pandemic Year 2020: A Review of 165 Incidents in the Global Terrorism Database

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic enabled a situational type of terrorism with mixed racist, anti-government, anti-science, anti-5G, and conspiracy theorist backgrounds and motives.

OBJECTIVE

The objective of this study was to identify and characterize all documented COVID-19-related terrorist attacks reported to the Global Terrorism Database (GTD) in 2020.

METHODS

The GTD was searched for all COVID-19-related terrorist attacks (aimed at patients, health care workers, and at all actors involved in pandemic containment response) that occurred world-wide in 2020. Analyses were performed on temporal factors, location, target type, attack and weapon type, attacker type, and number of casualties or hostages. Ambiguous incidents were excluded if there was doubt about whether they were exclusively acts of terrorism.

RESULTS

In total, 165 terrorist attacks were identified. With 50% of incidents, Western Europe was the most heavily hit region of the world. Nonetheless, most victims were listed in Southeast Asia (19 fatalities and seven injured). The most frequent but least lethal attack type concerned arson attacks against 5G telephone masts (105 incidents [60.9%] with only one injured). Armed assaults accounted for most fatalities, followed by assassinations. Incendiary and firearms were the most devastating weapon types.

CONCLUSION

This analysis of the GTD, which identified 165 COVID-19-related terrorist attacks in 2020, demonstrates that the COVID-19 pandemic truly resulted in new threats for COVID-19 patients, aid workers, hospitals, and testing and quarantine centers. It is anticipated that vaccination centers have become a new target of COVID-19-related terrorism in 2021 and 2022.

User profiling and role evaluation of government microbloggers in the context of public emergencies

Purpose

This study aims to profile the government microbloggers and evaluate their roles. The results can help improve the governments' response capability to public emergencies.

Design/methodology/approach

This study proposes the user profiling and role evaluation model of government microbloggers in the context of public emergencies. The indicators are designed from the four dimensions of time, content, scale and influence, and the feature labels are identified. Three different public emergencies were investigated, including the West Africa Ebola outbreak, the Middle East respiratory syndrome outbreak and the Shandong vaccine case in China.

Findings

The results found that most government microbloggers were follower responders, short-term participants, originators, occasional participants and low influencers. The role distribution of government microbloggers was highly concentrated. However, in terms of individual profiles, the role of a government microblogger varied with events.

Social implications

The findings can provide a reference for the performance assessment of the government microbloggers in the context of public emergencies and help them improve their ability to communicate with the public and respond to public emergencies.

Originality/value

By analyzing the performance of government microbloggers from the four dimensions of time, content, scale and influence, this paper fills the gap in existing literature on designing the user profiling and role evaluation model of government microbloggers in the context of public emergencies.

Technology-based interventions for health challenges older women face amid COVID-19: a systematic review protocol

BACKGROUND

Pandemics, such as COVID-19, are dangerous and socially disruptive. Though no one is immune to COVID-19, older persons often bear the brunt of its consequences. This is particularly true for older women, as they often face more pronounced health challenges relative to other segments in society, including complex care needs, insufficient care provisions, mental illness, neglect, and increased domestic abuse. To further compound the situation, because protective measures like lockdowns can result in unintended consequences, many health services older women depend on can become disrupted or discontinued amid pandemics. While technology-based interventions have the potential to provide near-time, location-free, and virtually accessible care, there is a dearth of systematic insights into this mode of care in the literature. To bridge the research gaps, this investigation aims to examine the characteristics and effectiveness of technology-based interventions that could address health challenges older women face amid COVID-19.

METHODS

A systematic review of randomized trials reporting on technology-based interventions for older women (≥65 years) during COVID-19 will be conducted. The databases of Web of Science, ScienceDirect, PubMed/MEDLINE, PsycINFO, CINAHL, and Scopus will be searched. Retrieved citations will be screened independently by at least two reviewers against the eligibility criteria. Included studies will be assessed using the Cochrane ROB-2 tool. Data will be extracted independently by the reviewers. Where possible, meta-analyses will be performed on relevant study outcomes and analysed via odds ratios on the dichotomized outcomes. Where applicable, heterogeneity will be measured using the Cochrane Q test, and publication bias will be assessed via funnel plots and Egger's regression test.

DISCUSSION

Technology has the potential to transform healthcare for the better. To help society better safeguard vulnerable populations' health and quality of life, this investigation sets out to gauge the state-of-the-art development of technology-based interventions tailored to the health challenges older women face amid COVID-19. In light of the growing prevalence of population ageing and the inevitability of infectious disease outbreaks, greater research efforts are needed to ensure the timely inception and effective implementation of technology-based health solutions for vulnerable populations like older women, amid public health crises like COVID-19 and beyond.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42020194003.

Attacks on Health Care Workers in Historical Pandemics and COVID-19

Previous pandemics have been (mis)used for (geo)political reasons, for terrorism purposes, and in times of conflict. Coronavirus disease (COVID-19) has been no exception with populist politicians challenging the relations with China, calling it the "Chinese virus," certain state actors setting up cyberterrorist actions against health care organizations in the United States and Europe, and a reported increase of violent acts against health care workers.Aside from state-driven factors, both left- and right-wing activists and anti-vaccination activists adhering to conspiracy theories are a threat for health care organizations. Furthermore, socioeconomic, religious, and cultural factors play a role in why health care is a possible target of violence. Fear of viral pathogens, fury about financial losses due to the pandemic and governmental measures such as lockdowns, anger because of mandatory quarantines, and the disruption of burial rituals are among the reasons for people to revolt against health care providers.Here, we provide a narrative review of the impact of violence against health care workers during the COVID-19 pandemic and earlier pandemics, and suggest preventive strategies.

Multi-label multi-class COVID-19 Arabic Twitter dataset with fine-grained misinformation and situational information annotations

Since the inception of the current COVID-19 pandemic, related misleading information has spread at a remarkable rate on social media, leading to serious implications for individuals and societies. Although COVID-19 looks to be ending for most places after the sharp shock of Omicron, severe new variants can emerge and cause new waves, especially if the variants can evade the insufficient immunity provided by prior infection and incomplete vaccination. Fighting the fake news that promotes vaccine hesitancy, for instance, is crucial for the success of the global vaccination programs and thus achieving herd immunity. To combat the proliferation of COVID-19-related misinformation, considerable research efforts have been and are still being dedicated to building and sharing COVID-19 misinformation detection datasets and models for Arabic and other languages. However, most of these datasets provide binary (true/false) misinformation classifications. Besides, the few studies that support multi-class misinformation classification deal with a small set of misinformation classes or mix them with situational information classes. False news stories about COVID-19 are not equal; some tend to have more sinister effects than others (e.g., fake cures and false vaccine info). This suggests that identifying the sub-type of misinformation is critical for choosing the suitable action based on their level of seriousness, ranging from assigning warning labels to the susceptible post to removing the misleading post instantly. We develop comprehensive annotation guidelines in this work that define 19 fine-grained misinformation classes. Then, we release the first Arabic COVID-19-related misinformation dataset comprising about 6.7K tweets with multi-class and multi-label misinformation annotations. In addition, we release a version of the dataset to be the first Twitter Arabic dataset annotated exclusively with six different situational information classes. Identifying situational information (e.g., caution, help-seeking) helps authorities or individuals understand the situation during emergencies. To confirm the validity of the collected data, we define three classification tasks and experiment with various machine learning and transformer-based classifiers to offer baseline results for future research. The experimental results indicate the quality and validity of the data and its suitability for constructing misinformation and situational information classification models. The results also demonstrate the superiority of AraBERT-COV19, a transformer-based model pretrained on COVID-19-related tweets, with micro-averaged F-scores of 81.6% and 78.8% for the multi-class misinformation and situational information classification tasks, respectively. Label Powerset with linear SVC achieved the best performance among the presented methods for multi-label misinformation classification with micro-averaged F-scores of 76.69%.

Lockdown in Chinese university dormitories: Significant increase in negative feelings and time perception distortion

The COVID-19 pandemic has led to a global crisis resulting in lockdowns worldwide. Studies found that these could amplify negative affects predictive of disturbances in time perception. However, all existing studies on this topic concentrated on the general population during a lockdown at home. There was no research on university students living in dormitories. This study fills a gap in the literature by investigating the affective states and awareness of the passage of time of Chinese university students during an exceptional dormitory lockdown. Using a snowball sampling approach, this web-based study recruited 225 volunteers (136 girls, 17-27 years old) during a dormitory lockdown. The online survey consisted of questions on demographic information, affective states (the Chinese version of the depression anxiety stress scales-21 (DASS-21) on depression, anxiety, and stress), and sense of the passage of time (the translated version of the assessment of passage of time over daily, weekly and yearly periods). The researchers shared the questionnaire link via the social media application WeChat. The study applied descriptive statistics and column charts to represent students' affective states and sense of the passage of time under extreme conditions and Pearson's correlation analysis to examine the impact of affective states on their sense of time. The study's results indicate that the dormitory lockdown caused a significant increase in all depression, anxiety, and stress categories of the DASS-21, as well as a distortion of the sense of time passing. However, the direction of the distortion differed from that in previous studies. Moreover, a Pearson correlation analysis showed that none of the three negative affects could be associated with students' sense of time. The findings of this study indicate an increased vulnerability of students due to the lockdown. Their emotions were strongly affected, requiring particular interventions to preserve their mental well-being. In addition, they showed a different distortion direction of time passage. Finally, they differed in the correlations between negative affect and the sense of passage of time compared to the general population in lockdown at home. This shows a need to investigate the impact of psychological states on students' routines and quality of life in emergencies. This study's scope should be expanded by incorporating additional factors pertaining to the passage of time and by integrating cross-cultural comparisons.

Burden of mental distress in the US associated with trust in media for COVID-19 information

During the COVID-19 pandemic, news and social media outlets have played a major role in dissemination of information. This analysis aimed to study the association between trust in social and traditional media and experiences of mental distress among a representative sample of US adults. Data for this study came from National Pandemic Pulse, a cross-sectional, nationally representative survey that sampled participants on the Dynata platform. Participants included 6435 adults surveyed between 15–23 December 2020. Ordinal logistic regression analyses examined the associations of trust in (i) social media, (ii) print media, (iii) broadcast TV and (iv) cable TV, for COVID-19-related information with self-reported mental distress (4-item Patient Health Questionnaire), controlling for sociodemographics and census region. Compared with those who distrusted social media, those who trusted social media had 2.09 times (95% CI = 1.84–2.37) greater adjusted odds of being in a more severe category of mental distress. In contrast, compared with those who distrusted print media, those who trusted print media had 0.80 times (95% CI = 0.69–0.93) lower adjusted odds of being in a more severe category of mental distress. No significant associations were found between mental distress and trust in broadcast or cable TV for accessing news about COVID-19. Trust in different news outlets may be associated with mental distress during public health emergencies like the COVID-19 pandemic. Future studies should explore mechanisms behind these associations, including adherence to best practices for crisis reporting among different media sources and exposure of individuals to misinformation.