Analysis of Gender-Dependent Personal Protective Behaviors in a National Sample: Polish Adolescents' COVID-19 Experience (PLACE-19) Study

A Cross-Sectional Examination of Missed Infection Control Practices Among Nurses in the Jordanian Hospitals

BACKGROUND

Missed infection control practices may negatively impact quality healthcare and patient safety in acute health care settings. Hence, more research is urgently needed especially in Arab countries. To investigate the elements and reasons of missed infection control activities among nurses in Jordan. The sociodemographic correlates with missed infection control activities were also examined.

METHODS

A cross sectional design was utilized in this study. A convenience sample of 960 nurses from seven hospitals in the North of Jordan was used. The Missed Nursing Care Infection Prevention and Control (MNCIPC) Survey was employed to collect the data. Data were analyzed using descriptive inferential, and multivariate regression analysis.

FINDINGS

The majority of the participants worked as registered nurses (78.4%). The highest missed infection control activities were: screening new admissions for Multi Resistant Organisms (MRO), wearing gloves for both preparing and administration of all antibiotics, and informing staff and visitors for the need for transmission-based precautions (when managing a patient with a MRO). The least missed infection control activities reported by nurses were performing hand hygiene after touching patients, and before drug administration. The reasons of missed infection control measures most frequently reported by nurses were: urgent patient situation, followed by inadequate number of clerical staff, and unexpected rise in patient volume and or acuity.

CONCLUSION

This research suggests that interventions to reduce missed infection control measures should focus on the education and training of nursing staff as well as a adopting nurse: patient ratio in managing nursing workload, which should not exceed 1:4.

Willingness to be vaccinated, preventative behaviors, and social contact patterns during the COVID-19 pandemic among US college students

Objective: To assess the frequency of preventative COVID-19 behaviors and vaccination willingness among United States (US) college and university students during the COVID-19 pandemic. Participants: Participants (N = 653) were ≥18 years old and students at institutions for higher education in the US in March 2020. Methods: Students self-reported preventative behaviors, willingness to be vaccinated, and social contact patterns during four waves of online surveys from May-August 2020. Results: Student engagement in preventative behaviors was generally high. The majority of students intended to be vaccinated (81.5%). Overall, there were no significant differences in the proportion adopting preventative behaviors or in willingness to be vaccinated by sex or geographic location. The most common reason for willingness to get vaccinated was wanting to contribute to ending COVID-19 outbreaks (44.7%). Conclusions: Early in the pandemic, college students primarily reported willingness to vaccinate and adherence to preventative behaviors. Outreach strategies are needed to continue this momentum.

Influence of gender identity on the adoption of religious-spiritual, preventive and emotion-focused coping strategies during the COVID-19 pandemic in Pakistan

BACKGROUND

Academic research has highlighted the gendered impacts and amplifications of gender disparities of COVID-19. Traditionally, Pakistan is a patriarchal society, where it is a parenthood norm to socialize specific gender social roles.

OBJECTIVES

The current research asserts that these normative gender roles may influence individuals throughout their life course, even during the COVID-19 pandemic. Therefore, the present study explored the influence of gender identity in adopting different coping strategies such as religious-spiritual, preventive, emotion-focused and non-constructive coping against the COVID-19 pandemic.

METHODS

Due to the lockdown in various areas of Pakistan, data were collected through an online questionnaire using Qualtrics. In a cross-sectional study, 955 respondents completed responses. Factors analysis and reliability analysis were run to ensure the scales' reliability, validity and robustness for different coping strategies. Multivariate linear regression analysis was used to find model fitness.

CONCLUSIONS

For theoretical explanation, the current study used social role theory that argues that each gender benefits differently from distinct coping behaviours. The findings highlighted that women were more likely to adopt most coping strategies, with the most significant difference in religious-spiritual coping and preventative coping strategies even in the presence of control variables such as level of education, household monthly income, family structure, marital status and family size. There was no gender difference in adopting non-constructive strategies. The empirical evidence suggested that females might be at an increased risk of stress due to the burden of unbalanced household-based social norms and care responsibilities. The current research also expanded the base of coping to religious-spiritual coping, emotion-focused coping and non-constructive coping.

Age-based spatial disparities of COVID-19 incidence rates in the United States counties

COVID-19 incidence disparities have been documented in the literature, but the different driving factors among age groups have yet to be explicitly explained. This study proposes a community-based COVID-19 spatial disparity model, considering different levels of geographic units (individual and community), various contextual variables, multiple COVID-19 outcomes, and different geographic contextual elements. The model assumes the existence of age nonstationarity effects on health determinants, suggesting that health effects of contextual variables vary among place and age groups. Based on this conceptual model and theory, the study selected 62 county-level variables for 1,748 U.S. counties during the pandemic, and created an Adjustable COVID-19 Potential Exposure Index (ACOVIDPEI) using principal component analysis (PCA). The validation was done with 71,521,009 COVID-19 patients in the U.S. from January 2020 through June 2022, with high incidence rates shifting from the Midwest, South Carolina, North Carolina, Arizona, and Tennessee to the West and East coasts. This study corroborates the age nonstationarity effect of health determinants on COVID-19 exposures. These results empirically identify the geographic disparities of COVID-19 incidence rates among age groups and provide the evidentiary guide for targeting pandemic recovery, mitigation, and preparedness in communities.

Community practices of face mask use and associated knowledge and attitude in a Malaysian town during the COVID-19 pandemic

Objectives

Among the vital measures to effectively curb the incidence of COVID-19 is the use of face masks. Little is known about what people understand and how they perceive and use face masks. This study aimed to determine the community's knowledge, attitude, and practice on the correct use of face masks.

Design

A cross-sectional study.

Setting

The study was carried out in Seremban 2, Malaysia using a self-administered questionnaire adapted from validated questionnaires of two previous studies.

Participants

Through opportunistic sampling, three hundred and ninety-two literate adults (above 18) residing in Seremban 2, Malaysia, participated in this study.

Main outcome measure

Knowledge, attitude, and practice scores were assessed among the participants.

Results

Three hundred seventy (94.4%) respondents demonstrated satisfactory knowledge. A satisfactory attitude score was achieved by 349 (89%) respondents, while 281 (71.7%) achieved a satisfactory practice score. Better knowledge was significantly associated with college or university education (p=0.028). Female gender (p=0.011) and college or university education (p=0.043) were significantly associated with better practice (p<0.05). Significant but weak to fair correlations between knowledge, attitude and practice were observed.

Conclusion

Overall, there was satisfactory knowledge, attitude, and practice of face mask use among the Seremban 2 adult population in Malaysia. However, future public health education targeted toward the use of face masks requires more emphasis on proper usage and disposal to translate good knowledge into a good attitude and practice of face mask use to ensure the effectiveness in curbing the spread of infection.

Funding

None declared.

Reducing face touching through haptic feedback: A treatment evaluation against fomite-mediated self-infection

Fomite-mediated self-infection via face touching is an understudied transmission pathway for infectious diseases. We evaluated the effect of computer-mediated vibrotactile cues (presented through experimental bracelets located on one or both hands of the participant) on the frequency of face touching among eight healthy adults in the community. We conducted a treatment evaluation totaling over 25,000 min of video observation. The treatment was evaluated through a multiple-treatment design and hierarchical linear modeling. The one-bracelet intervention did not produce significantly lower levels of face touching across both hands, whereas the two-bracelet intervention did result in significantly lower face touching. The effect increased over repeated presentations of the two-bracelet intervention, with the second implementation producing, on average, 31 fewer face-touching percentual points relative to baseline levels. Dependent on the dynamics of fomite-mediated self-infection via face touching, treatment effects could be of public health significance. The implications for research and practice are discussed.

To what extent do young chinese elites comply with COVID-19 prevention and control measures?

BACKGROUND

During the COVID-19 pandemic, it is vital for individuals to comply with the government's prevention and control measures. This study aims to explore determinants of college students' compliance behaviour during the COVID-19 pandemic.

METHODS

This study conducted an online survey among 3,122 individuals aged 18 and above from March to November 2022 in China. Individuals' compliance behaviour was divided into protective behaviour (that includes wearing a mask, maintaining a physical distance, and getting vaccinated) and restrictive behaviour (that includes offering health codes and a nucleic acid test certificate). Individuals' compliance motivation was divided into calculated motivation (including the fear of being infected, the fear of being published, and previous experience of pandemic prevention) and normative motivation (including the sense of social responsibility and trust in government). We defined young people aged between 18 and 24 with a college degree as young elites, and constructed ordinary least squares linear regression to compare their compliance behaviour with young people without a college degree (young non-elites), and non-young people with a college degree (non-young elites).

RESULTS

Almost three years after the outbreak of the pandemic, Chinese individuals retained a high degree of compliance with COVID-19 prevention and control policies, particularly with respect to the provision of health codes. Young elites were more compliant with getting vaccinated, wearing a mask, providing health codes and testing results than their counterparts. The sense of social responsibility and trust in government were the major drivers of young elites' compliance behaviour during the pandemic. Young elites who were male, had a rural "hukou", and were not a member of the China Communist Party were more compliant with COVID-19 prevention and control measures.

CONCLUSION

This study found that young elites in China had high policy compliance during the COVID-19 pandemic. These young elites' compliance behaviour was driven by their sense of social responsibility and trust in government rather than the fear of being infected and the fear of being punished as a result of violating the regulations. We suggest that in the context of managing health crises, in stead of introducing punitive measures to enforce citizens to comply with the management measures, promoting citizens' sense of social responsibility and building a trusting relationship with citizens contrite to the enhancement of citizens' policy compliance.

Association between Compliance with COVID-19 Restrictions and the Risk of SARS-CoV-2 Infection in Poland

During the coronavirus disease 19 (COVID-19) pandemic it has become very important to comply with preventive measures. We aimed to assess compliance with applicable restrictions and to explore the links between the level of compliance and the risk of COVID-19. This cross-sectional study included Polish adults who were asked to complete a validated questionnaire. The study period was from 1 November 2020 to 31 January 2021 and a computer-assisted web interview method was chosen to perform the survey. The study involved 562 women and 539 men. COVID-19 was reported in 11.26% of participants. A good level of compliance with the sanitary restrictions was reported for 38.87% of participants, an average level of compliance for 47.96%, and a low level of compliance for 13.17%. A reduced risk of COVID-19 was associated with the following preventive measures: regular use of protective masks, social and physical distancing in public places, regular use of hand sanitizers with high ethanol content, and the use of disposable gloves in public places. Our survey revealed satisfactory public compliance with the pandemic restrictions. Sanitary and epidemiologic measures to prevent the pandemic were shown to be adequate and effective.

Perceived barriers and facilitators for adhering to COVID-19 preventive measures in Chile: a qualitative study in three large cities

BACKGROUND

Globally, it has been reported that different social determinants of health -structural, sociodemographic, economic, living conditions and cultural factors- may affect opportunities to adhere to prevention measures against SARS-CoV-2. The objective of this study was to explore the perceptions around barriers and facilitators for adherence to COVID-19 prevention measures among the adult population residing in three large cities in Chile from a social determinants of health perspective.

METHODS

Qualitative paradigm, multiple case-study design. Online semi-structured interviews were conducted with men and women aged 18 and over from different socioeconomic groups residing in three large cities. For participant recruitment and selection, purposive contacts were made based on community and social media networks, followed by snowball sampling. Saturation was reached at 61 participants, after which a thematic analysis was carried out with the support of AtlasTi software. The Ethics Committee of the Universidad del Desarrollo in Chile approved this study.

RESULTS

The main perceived barriers to adherence to COVID-19 preventive measures are linked to structural social determinants of health such as income, occupation, gender, access to basic supplies, and housing. Perceived facilitators are the fear of contagion and the incorporation of measures into daily habits. The social communication of preventive measures by health authorities is perceived as punitive, affecting adherence once the fear of contagion decreased in the country. It is also perceived that the recommended preventive measures are disconnected from communities' cultural practices and people´s identity, as well as affected by gender inequities and socioeconomic conditions that stakeholders in the country do not sufficiently address.

CONCLUSION

Study findings suggest that adherence to preventive measures, such as social distancing, mask use, and hand washing, could be promoted through their incorporation into the daily life habits of people and communities. These measures should consider the structural social determinants that generate multiple barriers to adherence, like poverty, occupational risks, and overcrowding. Socio-cultural dimensions of health and everyday risks need further understanding among the different communities in the country, allowing for differences in viewpoints and practices based on gender, age, place, and social identity.

Greater knowledge about COVID-19, more negative emotions. Research in adult Poles after 2nd and 5th waves of the pandemic

Introduction: The study investigated the dynamics of cognitive and emotional representation of COVID-19 in adult Poles, following the second (2021) and the fifth (2022) wave of the pandemic. Material and methods: The study involved a total of 303 subjects (N = 198 in Survey 1 in 2021, and N = 105 in Survey 2 in 2022). The following measures were used: a questionnaire covering demographic data and general opinions about COVID-19 as well as the Revised Illness Perception Questionnaire (IPQ-R). Results: After the fifth wave, significantly more respondents were convinced that COVID-19 was a real and dangerous disease. Cognitive deficits were more commonly recognised among symptoms of the viremia. Vaccination against COVID-19 was recognised as an essential preventive measure. Both surveys showed that COVID-19 representation was characterised by negative emotions and low sense of illness coherence. However, there was increased belief that the disease can be controlled through medical interventions. The age of the respondents in Survey 1 and Survey 2 was differently related to beliefs about COVID-19. Conclusions: 1. After 2.5 years of the pandemic, the awareness of Poles about the causes, symptoms and methods of preventing the disease has increased. 2. Failure to vaccinate against COVID-19 has been identified as a significant cause of viremia. 3. Negative emotions and a sense of serious consequences were predominant in both Surveys, but after the fifth wave of the pandemic the scores reflect increased perception of the chronic nature of the disease and belief that the illness can be treated with medication, whereas the sense of personal control was found to decrease. 4. After the fifth wave of the pandemic, older age corresponded to increased belief in the relevance of some preventive measures, and to greater awareness of the viral origin, increased belief in the feasibility of controlling the disease through one's behaviours and a greater sense of illness coherence. 5. The intensification of negative emotions related to the pandemic can be treated as a predictor of the increase in adjustment disorders and risk of mental health deterioration among adult Poles in the following years. Keywords: cognitive and emotional representation of illness, COVID-19 pandemic, Polish adults

The gendered dimensions of the anti-mask and anti-lockdown movement on social media

This paper examines the anti-mask and anti-lockdown online movement in connection to the COVID-19 pandemic. To combat the spread of the coronavirus, health officials around the world urged and/or mandated citizens to wear facemasks and adopt physical distancing measures. These health policies and guidelines have become highly politicized in some parts of the world, often discussed in association with freedom of choice and independence. We downloaded references to the anti-mask and anti-lockdown social media posts using 24 search terms. From a total of 4209 social media posts, the researchers manually filtered the explicit visual and textual content that is related to discussions of different genders. We used multimodal discourse analysis (MDM) which analyzes diverse modes of communicative texts and images and focuses on appeals to emotions and reasoning. Using the MDM approach, we analysed posts taken from Facebook and Instagram from active anti-mask and anti-lockdown users, and we identified three main discourses around the gendered discussion of the anti-mask movement including hypermasculine, sexist and pejorative portrayals of "Karen", and appropriating freedom and feminism discourses. A better understanding of how social media users evoke gendered discourses to spread anti-mask and anti-lockdown messages can help researchers identify differing reactions toward pandemic measures.

Gender differences in health protective behaviours and its implications for COVID-19 pandemic in Taiwan: a population-based study

Introduction

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection produces more severe symptoms and a higher mortality in men than in women. The role of biological sex in the immune response to SARS-CoV-2 is believed to explain this sex disparity. However, the contribution of gender factors that influence health protective behaviors and therefore health outcomes, remains poorly explored.

Methods

We assessed the contributions of gender in attitudes towards the COVID-19 pandemic, using a hypothetical influenza pandemic data from the 2019 Taiwan Social Change Survey. Participants were selected through a stratified, three-stage probability proportional-to-size sampling from across the nation, to fill in questionnaires that asked about their perception of the hypothetical pandemic, and intention to adopt health protective behaviors.

Results

A total of 1,990 participants (median age = 45·92 years, 49% were women) were included. Significant gender disparities (p < .001) were observed. The risk perception of pandemic (OR = 1·28, 95% CI [1·21 − 1·35], p < .001), older age (OR = 1·06, 95% CI [1·05 − 1·07], p < .001), female gender (OR = 1·18, 95% CI [1·09-1·27], p < .001), higher education (OR = 1·10, 95% CI [1·06 − 1·13], p < .001), and larger family size (OR = 1·09, 95% CI [1·06 − 1·15], p < .001) were positively associated with health protective behaviors. The risk perception of pandemic (OR = 1·25, 95% CI [1·15 − 1·36]), higher education (OR = 1·07, 95% CI [1·02 − 1·13], p < .05), being married (OR = 1·17, 95% CI [1·01–1·36, p < .05), and larger family size (OR = 1·33, 95% CI [1·25 − 1·42], p < .001), were positively associated with intention to receive a vaccine. However, female gender was negatively associated with intention to receive a vaccine (OR = 0·85, 95% CI [0·75 − 0·90], p < ·01) and to comply with contact-tracing (OR = 0·95, 95% CI [0·90 − 1·00], p < .05) compared to men. Living with children was also negatively associated with intention to receive vaccines (OR = 0·77, 95% CI [0·66 − 0·90], p < .001).

Conclusion

This study unveils gender differences in risk perception, health protective behaviors, vaccine hesitancy, and compliance with contact-tracing using a hypothetical viral pandemic. Gender-specific health education raising awareness of health protective behaviors may be beneficial to prevent future pandemics.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14288-1.

Motivations and Limits for COVID-19 Policy Compliance in Germany and Switzerland

BACKGROUND

In contrast to neighboring countries, German and Swiss authorities refrained from general curfews during the first pandemic wave in spring 2020, calling for solidarity and personal responsibility instead. Using a qualitative methodology, this study aims to explore why people in Germany and Switzerland were motivated to comply with policy measures during the first wave of the coronavirus disease 2019 (COVID-19) pandemic, and what factors hindered or limited their motivation. While quantitative surveys can measure the level of compliance, or broadly ask what motives people had for compliance, we here strive to explain why and how these motives lead to compliance.

METHODS

This publication has been made possible by the joint work of the members of the "Solidarity in times of pandemics" (SolPan) research commons. Seventy-seven semi-structured qualitative interviews were conducted with members of the general public in Germany (n = 46) and the German-speaking part of Switzerland (n = 31) in April 2020. Interviews were transcribed and analyzed following a grounded theory approach.

RESULTS

Three themes were identified that summarize factors contributing to compliant or noncompliant behavior. (1) Social cohesion was, on the one hand, an important motivator for compliance, but at the same time related to conflicting needs, illustrating the limits of compliance. (2) Consequences were considered on both the individual level (eg, consequences of individual infection) and societal level (eg, the societal and economic consequences of restrictions). (3) While for some participants following the rules was perceived as a matter of principle, others stressed the importance of making their own risk assessment, which was often associated with with a need for evidence on the effectiveness and reasons behind measures.

CONCLUSION

A variety of motives contribute to COVID-19 related compliance. Authorities should seek to address these multi-faceted aspects to support motivation for compliance in a large proportion of the population.

Association between Nutritional Behaviours and Acne-Related Quality of Life in a Population of Polish Male Adolescents

Acne vulgaris is diagnosed in the majority of adolescents, decreasing their quality of life, while the diet may influence its aetiology in a gender-dependent manner. The aim of the study was to analyse associations between nutritional behaviours and acne-related quality of life in a population of Polish male adolescents. The study was conducted on a population of Polish secondary school adolescents (a studied sample of 925 adolescents), while the random quota sampling procedure of secondary schools was applied. To assess acne-related quality of life, the Acne Quality of Life (AQoL) Scale and Acne Disability Questionnaire (ADQ) were applied, while the Social Quality of Life (SOCQOL) Score and Cardiff Acne Disability Index (CADI) were calculated. To assess the diet, an Acne-specific Food Frequency Questionnaire (Acne-FFQ) was applied. Neither for the ADQ results, nor for the CADI calculated on the basis of ADQ, was there an association with dietary intake (p > 0.05). The results of the SOCQOL Score (calculated on the basis of AQoL) were positively correlated with the intake of fish (p = 0.0085; R = 0.1144), salty snacks (p = 0.0495; R = 0.0854), and non-chocolate confectionary (p = 0.0078; R = 0.1156). In a group of respondents declaring any acne-related quality of life problems in AQoL, while compared with those declaring no such problems, higher intakes of dairy beverages other than milk (p = 0.0063), white bread (p < 0.0001), other white cereal products (p < 0.0001), fast foods (p = 0.0006), salty snacks (p < 0.0001), chocolate confectionary (p < 0.0001), and other confectionary (p < 0.0001), but lower intake of wholegrain bread (p = 0.0084) were observed. It may be concluded that acne-related quality of life is associated with dietary intake in a population of Polish male adolescents. In the studied population, the most prominent influencing factors were salty snacks and non-chocolate confectionary, with both of them having a proacnegenic effect.

Effects of Micro Architectural Environmental Interventions on Handwashing Compliance of Adolescents: A School-Based Intervention Trial

PURPOSE

Aimed to explore more practical interventions for handwashing compliance (HWC) and protect the minor' health with the pandemic background, this study tested whether micro architectural interventions would promote HWC of adolescents through active experience.

BACKGROUND

Despite the well-documented benefits of handwashing (HW), low compliance is common among adolescents. HW space in schools has always been treated as attached spaces of little matter, which is unfavorable to public health. According to environment behavior perspective, personal motivation of HWC may be motivated by active environment.

METHOD

A school-based investigation and a 30-week environmental behavior experiment were conducted when students returned to school after the COVID-19 pandemic closure in 2020 in China to evaluate the effects of active environment interventions selected by previous survey on promoting adolescents' HW rate. Digital infrared counters were used to unobtrusively document their behavior.

RESULTS

Results in summer revealed a positive effect on all intervention groups. The effects of combined interventions were higher than the effect of any single intervention. However, HW rates of all groups declined sharply in the coldest month and the between-group differences decreased. Significant correlations were found between HW rates and satisfaction with the intervention schemes.

CONCLUSIONS

Findings suggest that architectural environmental intervention may potentially be a positive, friendly, and one-time investment mean to expand the HWC intervention scope from passive policies to positive experience, and HW space design for adolescents should be treated as a public health strategy.

A systematic review and meta-analysis on the preventive behaviors in response to the COVID-19 pandemic among children and adolescents

Purpose

The purpose of this review was to synthesize the empirical evidence of relevant studies related to preventive behaviors in response to the COVID-19 pandemic among children and adolescents. Further to this, we aimed to identify the demographic, psychological, and social and environmental correlates of such behaviors.

Methods

Following PRISMA guidelines, eligible literature was identified by searching seven databases (PsycINFO, PubMed, MEDLINE, EMBASE, Cochrane Library, PROSPERO registry platform, and ClinicalTrials.gov website) and reference list of included studies and relevant review papers from 1^st Jan 2020 to 28^th Feb 2021. The standardized mean difference and correlation coefficients r were extracted to estimate the effect sizes. Analyses were conducted using R software.

Results

Of the 35,271 original papers, 23 eligible studies were included in the qualitative synthesis and all these studies were of moderate-to-high quality, of which 17 studies were further included into the quantitative analysis. Children and adolescents (6–20 yrs.) showed a poorer practice of COVID-19 preventive behaviors compared to younger adults (21–59 yrs.) with a small-to-medium effect size (SMD = -.25, 95%CI = -.41 to -.09). For the demographic correlates, children and adolescents’ COVID-19 preventive practice was found to be significantly associated with gender (r = .14, 95%CI = .10 to .18), while not with age (r = -.02, 95%CI = -.14 to .10). Narratively, knowledge was found to be consistently and significantly correlated. For the psychological correlates, small-to-medium overall effects were identified for the association with attitudes (r = .26, 95%CI = .21 to .31) and perceived severity (r = .16, 95%CI = .01 to .30). For the family and social correlates, a non-significant association was identified between family economic status and COVID-19 preventive behaviors (r = .004, 95%CI = -.12 to .12).

Conclusions

Interventions and relevant policies of promoting children and adolescent’s preventive measures should be a priority. Further, empirical studies identifying the demographic, psychological, and family and social correlates of children and adolescents’ preventive behaviors are needed.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13585-z.

Analysis of Self-Regulation of Eating Behaviors within Polish Adolescents' COVID-19 Experience (PLACE-19) Study

The self-regulation of eating behaviors (suppression of behavioral short-term impulse to consume food products in the interest of pursuing long-term weight goals), has been an important determinant for adopting a healthy lifestyle in the period of the COVID-19 pandemic in adults, but there have been no such studies conducted in the population of adolescents in this period. The aim of the presented study is to analyze self-regulation of eating behaviors in the population-based sample of Polish adolescents within the Polish Adolescents’ COVID-19 Experience (PLACE-19) Study. The Self-Regulation of Eating Behavior Questionnaire (SREBQ) was used to assess self-regulation of eating behaviors in the studied population of 1126 Polish adolescents (818 females and 308 males), aged 15−20, recruited based on a random quota sampling within a national sample. Based on the screening questions of the SREBQ, 145 individuals were excluded from the analysis. The participants of the study were categorized based on their gender, body mass index, body mass index change during the COVID-19 pandemic, and food products declared as tempting. The major factors associated with SREBQ score were body mass index change and tempting food products. The respondents losing weight during the COVID-19 pandemic were characterized by a higher SREBQ score than those maintaining stable body mass or gaining weight (3.4 vs. 3.2 vs. 3.2; p = 0.0001). The respondents declaring both sweet and salty food products as tempting were characterized by a lower SREBQ score than those declaring only sweet, only salty, or declaring no tempting products (3.2 vs. 3.4 vs. 3.4 vs. 3.4; p < 0.0001). The major factors associated with SREBQ categories were gender, body mass index change, and tempting food products. A higher share of respondents characterized by a high self-regulation of eating behaviors was observed for males than for females (27.4% vs. 18.8%; p = 0.0142); for respondents losing weight during the COVID-19 pandemic than for respondents gaining weight (25.9% vs. 15.5%; p = 0.0423); as well as for respondents declaring no tempting products than those declaring both sweet and salty food products (38.3% vs. 18.2%; p < 0.0001). It was concluded that the self-regulation of eating behaviors in adolescents is closely associated with food products perceived as tempting by them, as well as with gender. During the COVID-19 pandemic, the low self-regulation of eating behaviors was a significant determinant of the body mass gain. Taking this into account, female adolescents characterized by a low self-regulation of eating behaviors especially should be subjected to a dedicated intervention program to prevent overweight and obesity.

Mini Review: Co-Existing Diseases and COVID-19—A One Way Ticket?

Background and aims. Many patients with SARS-CoV-2 virus infection have various comorbidities. Their presence in the background of coronavirus has a tendency to worsen the course of the disease and increase the risk of unfavorable outcomes. Understanding the interactions between SARS-CoV-2 and the most common comorbidities is key to the successful management of these patients. Methods. We systematically searched Medline, Springer and Elsevier databases and accessed the full text on SARS-CoV-2 virus infection and the following conditions: cardiovascular, renal, immunosuppression, metabolic disorder and hematological in order to prepare a narrative review on this topic. Results. Patients with underlying cardiovascular diseases are more likely to suffer from severe forms of COVID-19. Cardiovascular diseases were also noted as the most frequent comorbidities among coronavirus patients. Metabolic syndrome and its components have been identified as the second most common comorbidity among fatal cases of COVID-19. Infected patients with acute kidney injury also show a higher mortality rate among the others. Immunocompromised patients, such as organ recipients and cancer and hematologic patients, develop more severe forms of COVID-19 and are at higher risk of admission to ICUs and requiring mechanical ventilation. Higher mortality rates among those patients have also been observed. Conclusions. Based on recent studies, patients with co-existing diseases are at higher risk for severe courses of COVID-19 virus infection and unfavorable outcomes. Cardiovascular diseases, metabolic syndrome and immunosuppressive and kidney diseases in the presence of coronavirus may lead to longer and more aggressive treatment in the ICU and increased mortality rate.

Factors Predicting Practices in Prevention of COVID-19 and Impacts among Population in Chiang Mai, Thailand

Background and objectives: The pandemic of COVID-19 is a global concern requiring urgent and effective action. However, the data on prevention practices and the impact of COVID-19 among the Thai population have not been clearly described. This study aimed to examine the knowledge, attitudes, perception, practices, and factors predicting practices in the prevention of COVID-19 and to study the impact of COVID-19 on people’s livelihoods. Materials and Methods: A cross-sectional study was performed between April and November 2020. A questionnaire eliciting demographic data and information on knowledge, attitudes, perception, prevention practices, and impact of COVID-19 was given to 500 people who lived in Chiang Mai, and 480 usable questionnaires were returned, for a response rate of 96.0%. Data were analyzed using descriptive statistics and multivariate linear regression. Results: Less than half of the participants had a high level of knowledge (45.4%) about COVID-19. Most of them had a high level of attitudes (95.6%), perception (72.1%), and prevention practices (90.4%). Female (β = 0.11, p = 0.006), patient status (β = 0.17, p < 0.001), knowledge (β = −0.10, p = 0.020), attitudes (β = 0.37, p < 0.001), and perception (β = 0.21, p < 0.001) about COVID-19 prevention were the predicting factors for overall prevention practices (R2 = 0.288). Most participants perceived the overall impact of COVID-19 at moderate and high levels (47.1 and 37.8%, respectively). The highest impact was an economic burden, followed by psychological, social, and physical impacts. Conclusions: Policymakers should enhance attitudes and perception about COVID-19 prevention to improve the COVID-19 prevention practices. This may help to reduce the new cases of COVID-19 and may result in reducing the impact of COVID-19 on people’s livelihoods.

Gender Difference in Psychological, Cognitive, and Behavioral Patterns Among University Students During COVID-19: A Machine Learning Approach

The COVID-19 pandemic affects all population segments and is especially detrimental to university students because social interaction is critical for a rewarding campus life and valuable learning experiences. In particular, with the suspension of in-person activities and the adoption of virtual teaching modalities, university students face drastic changes in their physical activities, academic careers, and mental health. Our study applies a machine learning approach to explore the gender differences among U.S. university students in response to the global pandemic. Leveraging a proprietary survey dataset collected from 322 U.S. university students, we employ association rule mining (ARM) techniques to identify and compare psychological, cognitive, and behavioral patterns among male and female participants. To formulate our task under the conventional ARM framework, we model each unique question-answer pair of the survey questionnaire as a market basket item. Consequently, each participant's survey report is analogous to a customer's transaction on a collection of items. Our findings suggest that significant differences exist between the two gender groups in psychological distress and coping strategies. In addition, the two groups exhibit minor differences in cognitive patterns and consistent preventive behaviors. The identified gender differences could help professional institutions to facilitate customized advising or counseling for males and females in periods of unprecedented challenges.

The Impact of the COVID-19 Pandemic on Food Consumption Behavior: Based on the Perspective of Accounting Data of Chinese Food Enterprises and Economic Theory

Since the outbreak of the COVID-19 pandemic, the rapid spread of COVID-19 around the world has become one of the main focuses of concern in almost every country, and governments have taken numerous measures to prevent/mitigate the spread of the disease. As an essential social determinant, COVID-19 has significantly impacted consumers' food consumption behavior and healthy eating habits/behaviors. The purpose of this study is to analyze the impact of COVID-19 on food consumption behavior, and the main goal was to assess the possible problems (such as food waste and weight gain) caused by changes in food consumption behavior during the pandemic. Based on the accounting data of Chinese enterprises found in the China Stock Market and Accounting Research (CSMAR) database, this study uses economic theory and the translog function to conduct an average partial effect (APE) analysis of the pandemic, and finds that the COVID-19 pandemic has increased Chinese people's overall food consumption, and the consumption of food from large food enterprises has increased even more (APE = 0.11 vs. APE = 0.31). This study suggests that food waste and weight gain in the Chinese population may be more severe during the pandemic, and it is necessary to enhance food management and weight management through multiple pathways.

Body Mass and Emotional Eating: Emotional Eater Questionnaire (EEQ) in the Polish Adolescents' COVID-19 Experience (PLACE-19) Study

Stress caused by the Coronavirus Disease 2019 (COVID-19) pandemic may lead to emotional eating which may have a negative impact on the weight status. This study aimed to analyze the association between emotional eating and body mass, as well as changes in body mass during the COVID-19 pandemic, within the Polish Adolescents’ COVID-19 Experience (PLACE-19) Study. A total of 1126 Polish adolescents, aged 15–20, were included. A random quota sampling was performed within a national sample, and emotional eating was assessed using Emotional Eater Questionnaire (EEQ). Based on the declared height and weight before and during the pandemic, the respondents were categorized according to their body mass (malnourished, normal weight, overweight, obese) and changes in body mass during the COVID-19 pandemic (lost weight, no body mass change, gained weight). Higher EEQ scores were achieved by female respondents compared with males (p < 0.0001), respondents who stated that they gained weight during the pandemic compared with those who stated either weight loss or no body mass change (p < 0.0001), and overweight and obese respondents compared with those who had normal weight and who were malnourished (p < 0.0001). A higher share of emotional eaters and very emotional eaters was found among female respondents, respondents stating weight gain during the pandemic, and overweight and obese respondents, compared with the other ones (p < 0.0001). Based on the findings, it may be concluded that among Polish adolescents gender, body mass, and body mass change during the COVID-19 pandemic are the major determinants of emotional eating behaviors and that female individuals, obese individuals, and those gaining weight are especially vulnerable to emotional eating behaviors. The results of the study suggest that the issue of emotional eating should be addressed in general public health policy and appropriate education should be provided to vulnerable groups such as female and obese adolescents.

Family caregiving during the COVID-19 pandemic: factors associated with anxiety and depression of carers for community-dwelling older adults in Hong Kong

Background

The COVID-19 pandemic disrupts the daily routine and increases the caregiving load of the family carers of older adults. This study examined how the pandemic may impact mental health and investigated the prevalence of anxiety and depressive symptoms in family carers of older people.

Methods

Two hundred and thirty-six family carers of older adults participated in this cross-sectional survey study. Outcome measures included their symptoms of anxiety and depression, pandemic-related psychosocial factors, external factors, and the practice of preventive behaviours.

Results

Caseness prevalence of anxiety and depression among family carers was 25 and 56% respectively. Working carers were more depressed than non-working, while younger carers reported more anxiety and depression symptoms than older. Hand hygiene and getting drugs from the hospital positively predicted depression while healthy lifestyle negatively predicted depression. These variables, together with perceived risk and severity and the worry of getting infected, predicted anxiety.

Conclusions

The prevalence of mental health symptoms was alarming. Telemedicine practice, including online pharmaceutical services and the Internet Hospital plus Drug Delivery platform, could be a solution in alleviating the burden and worry of infection of family carers. Tailored-made interventions by age and working status of the family carers are recommended.

Impact of the COVID-19 pandemic on the experience and mental health of university students studying in Canada and the UK: a cross-sectional study

OBJECTIVES

To explore the impact of the COVID-19 pandemic on the experiences and mental health of university students.

DESIGN

A cross-sectional study consisting of an electronic survey about students' experiences and concerns during the pandemic and the associated impact. In addition to the quantitative analysis, free-text responses were extracted and analysed using a framework technique.

SETTING

Queen's University in Canada and the University of Oxford in the UK.

PARTICIPANTS

Undergraduate students at Queen's University and first-year undergraduate students at the University of Oxford were invited to complete the COVID-19 supplement survey. This study included data from 3013 Queen's students as the primary focus and 339 Oxford students as a secondary comparison.

RESULTS

Females at Queen's reported greater adherence to government recommendations to prevent the spread of COVID-19 (91.3% vs 86.7%, χ² p<0.01) and were more likely to self-isolate (63.9% vs 57.0%, χ² p<0.01) than males. A similar trend was seen among Oxford students. Students' concerns were wide ranging including those related to their learning experience, finances and future academic and career prospects. 78.9% of Queen's students and 50.4% of first-year Oxford students reported worries about the long-term impact on their academic and job prospects. A sizeable proportion of students also reported that the pandemic negatively impacted their plans to continue at university (29.4% of Queen's, 14.2% of Oxford) and disrupted activities important to their mental well-being. Key themes identified in the qualitative component included the negative impacts of social isolation, challenging academic changes and disruption to support services and means of coping.

CONCLUSIONS

Overall, findings underscore the importance of addressing areas of student concern and the aspects of student life negatively impacted by the pandemic in order to maintain student well-being and support a successful university experience.

Secondary household transmission of SARS-CoV-2 among children and adolescents: Clinical and epidemiological aspects

OBJECTIVE

To evaluate the secondary attack rate (SAR) in children and adolescents, contacts of essential activities workers who were infected by SARS-CoV-2; and to describe associated clinical and epidemiological data.

METHODS

A cross-sectional study conducted in children and adolescents aged 5 to 19 years of age, that were household contacts of parents and other relatives who were infected by SARS-CoV-2 in the city of Goiânia, Central Brazil, from March to October 2020. Sociodemographic and clinical data were collected from all participants. Nasopharyngeal and oropharyngeal swabs were collected and tested for SARS-CoV-2 RNA using real-time reverse transcription polymerase chain reaction (RT-PCR). Factors associated with SARS-CoV-2 infection and SAR were analyzed using Poisson regression.

RESULTS

A total of 267 children and adolescents were investigated. The prevalence of SARS-CoV-2 RNA by the real-time RT-PCR test and/or the presence of COVID-19 associated symptoms (anosmia/ageusia and flu syndrome) was 25.1% (95.0% Confidence Interval [95.0% CI] = 20.3-30.6). More than half (55.1%) of the participants had sygns and symptoms. The most prevalent signs and symptoms in positive individuals were nasal congestion (62.7%), headache (55.2%), cough (50.8%), myalgia (47.8%), runny nose (47.8%), and anosmia (47.8%). The Poisson model showed that the following signs or symptoms were associated with SARS-CoV-2 infection: fever, nasal congestion, decreased appetite, nausea, anosmia, and ageusia. Families that had more than one infected adult, in addition to the index case, presented greater transmissibility to children and adolescents.

CONCLUSIONS

Our results contribute to the hypothesis that children and adolescents are not important sources of transmission of SARS-CoV-2 in the home environment during a period of social distancing and school closure; even though they are susceptible to infection in the household (around ¼ of our study population).

Childhood Handwashing Habit Formation and Later COVID-19 Preventive Practices: A Cohort Study

OBJECTIVE

This study identified developmental patterns of handwashing habit formation during childhood and examined their associations with later COVID-19 preventive practices.

METHODS

We used data from the Taiwan Birth Cohort Study, which included 11,254 adolescents with complete data on childhood handwashing behavior and age-15 COVID-19 survey items. Bias-adjusted 3-step latent class analysis was used to test study hypotheses.

RESULTS

The rates of handwashing and mask-wearing during the pandemic were 63.8% and 93.8%, respectively. Five distinct patterns of handwashing habit formation were identified: early formation (14.89%), delayed formation (17.73%), gradual formation (42.98%), inconsistent formation (9.78%), and nonformation (14.62%). Compared with adolescents with an early formation pattern of handwashing habits, those with other patterns exhibited lower odds ratios (ORs) of handwashing during COVID-19; these ORs were 0.67 (95% confidence interval [CI], 0.49-0.85), 0.60 (95% CI, 0.44-0.77), 0.29 (95% CI, 0.08-0.49), and 0.21 (95% CI, 0.01-0.40) for those with delayed formation, gradual formation, inconsistent formation, and nonformation patterns, respectively. Moreover, relative to that of adolescents with the early formation pattern, mask-wearing was less common among adolescents with gradual formation, inconsistent formation, and nonformation patterns, with ORs of 0.54 (95% CI, 0.16-0.92), 0.50 (95% CI, 0.03-0.96), and 0.26 (95% CI, 0.00-0.65), respectively.

CONCLUSIONS

The early formation of hygienic habits is associated with higher adherence to pandemic preventive practices among adolescents. Our findings suggest that interventions to promote hygienic behaviors can start as early as age 3 through the introduction of healthy habits such as handwashing.

Hand hygiene and mask-wearing behaviors and the related factors during the COVID 19 pandemic: A cross-sectional study with secondary school students in Turkey

PURPOSE

The research was conducted to determine the hand hygiene and mask-wearing behaviors and related factors of secondary school students in the COVID-19 pandemic process.

DESIGN AND METHODS

This descriptive cross-sectional study was conducted between March 02-April 022021 with 1284 students who continued their secondary education in a province in the east of Turkey. The data were collected face-to-face through the Descriptive Characteristics Form, the Mask-Wearing Behavior Form, and the Hand Hygiene Behavior Form. Percentage, mean, t-test in independent groups, Mann Whitney U test and Multiple Regression analysis were used in the evaluation of the data. Ethical principles were observed at all stages of the study.

RESULTS

It was determined that 80.1% of the students used disposable medical masks, 62.1% of their parents chose a mask suitable for the age of the student, and 52.1% used the mask they wore all day long. It was found that 41.4% of the students washed their hands before wearing a mask, and 51.9% after wearing a mask. It was determined that there was a significant relationship between students' mask-wearing behavior and gender, and hand hygiene behavior and gender, grade level, previous training on hand-washing and mask-wearing. As a result of multiple regression analysis, it was found that gender and mother's occupation had a statistically significant effect on mask-wearing behavior, while gender and previous training on mask-wearing had a statistically significant effect on hand-washing behavior.

CONCLUSIONS/PRACTICE IMPLICATIONS

Students exhibited correct behaviors regarding hand hygiene and mask-wearing, but some misbehaviors suggest that training is necessary, especially in the COVID-19 pandemic period.

Perception of the COVID-19 Pandemic Among Members of Saudi Society: Solidarity, Humility, and Connectivity

Background and purpose The magnitude of the coronavirus disease 2019 (COVID-19) pandemic on the healthcare system, economy, education, and social networking is dreadful, the least to say. Surprisingly, and unlike previous epidemics, the impact has been universal, and even top-ranking countries with solid economies were not immune. The purpose of this study is to develop a better understanding of the Saudi community's response and reaction to the preventative measures implemented by the government to combat the COVID-19 pandemic. Methodology A cross-sectional study using a self-administered online-based questionnaire was conducted among 920 participants from March 2020 to February 2021 among the Saudi community across the Kingdom. Results Among the studied participants, the majority (60%) are always committed to washing their hands according to the Ministry of Health (MoH) instructions, and 74% indicated that they were always compliant with the sneezing etiquette outlined by the MoH. Studied participants were affected through different influencers of life aspects. Moreover, 63% of them gained new skills and behaviors during the pandemic curfew. Additionally, many studied participants assumed that "life will not return to what it used to be" as a future perception. Conclusion In conclusion, the present findings proved the importance and power of the Saudi Vision (2030) represented by the National Transformation Program on enhancing the healthcare system, facilitating access to healthcare, and integrating technology among government parties addressed during the COVID-19 pandemic.

Misinformation, Fears and Adherence to Preventive Measures during the Early Phase of COVID-19 Pandemic: A Cross-Sectional Study in Poland

The response to the pandemic requires access to accurate information and public understanding and adherence to preventive measures. This online cross-sectional study of adult Poles (n = 1337) assessed the frequency of COVID-19 preventive behaviors, fears related to the COVID-19 pandemic, and beliefs in COVID-19-related conspiracy theories during the early phase of the COVID-19 pandemic when the nationwide lockdown was imposed (April 2020). As shown, 22% of surveyed admitted not to wash their hands frequently, while 12% did not use disinfectants. These two behaviors were also less frequent in individuals with medical education. The highest levels of pandemic-related fears were associated with health loss in relatives, pandemic-induced economic crisis, and government using a pandemic to control citizens by the state. A significant share of surveyed individuals believed that the pandemic was intentional action to weaken non-Chinese economies (32%) or was deliberately induced for profits from selling vaccines (27%). Men, individuals with no children, and subjects with lower education were significantly less likely to adhere to sanitary measures (handwashing, disinfection, avoiding face touching, changes in greeting etiquette, face-covering when coughing or sneezing), and were less concerned over self and relatives' health. At the same time, men were less prone than women to the conspiracy theories related to the COVID-19 pandemic. The results indicate that adherence to sanitary measures during the pandemic can be a challenge also in developed countries, while misinformation campaigns (also concerning vaccines) have already affected the general public during the early phase of the epidemiological outbreak. The study provides observations that may be useful in the management of the public response to future epidemics.

Construction and Validation of a Brief Pandemic Fatigue Scale in the Context of the Coronavirus-19 Public Health Crisis

Objectives: The chronic restrictions to mitigate the new SARS-CoV-2 virus may result in pandemic fatigue. This study set out to develop a short, reliable, valid, and gender-invariant instrument-the Pandemic Fatigue Scale (PFS). Methods: In the first phase, 300 students responded to a pilot questionnaire that allowed the reduction and refinement of the items. In the second phase, the validity, reliability, and invariance of the scale were explored among a sample of 596 participants. Results: Factor exploratory and confirmatory analyses confirmed a robust adjustment for the bifactorial structure that explained 79,36% of the variance. The two factors identified were 1) people's demotivation in continuing to follow the recommended protective behaviors (neglect) and 2) people's boredom regarding the pandemic-related information (boredom). The pattern of relations between the Pandemic Fatigue Scale and other variables-find through correlation, mediation, and path analyses-and the gender differences-find in the ANOVA analyses-provided strong evidence of the construct validity. Moreover, the PFS was shown to be invariant regarding gender in a multigroup factor confirmatory analysis. Conclusion: The instrument can be of utility for professionals and researchers to assess pandemic fatigue, a variable that can affect the adoption of protective measure to avoid catching and spreading the virus.

Association between Food Preferences and Food Habits in a Polish Adolescents' COVID-19 Experience (PLACE-19) Study

Food preferences are among the most influential factors of food habits in the vulnerable period of adolescence; in addition, gender-dependent differences in food preferences are also observed. The aim of the present study was to analyze differences in food habits between individuals stratified based on their food preferences in a population-based sample of adolescents aged 15–20. The study was conducted within the Polish Adolescents’ COVID-19 Experience (PLACE-19) Study population in a group of 2419 secondary school students who were randomly chosen to participate in the study using a random quota sampling procedure. The food preferences were determined on the basis of a validated Food Preference Questionnaire (FPQ) (which enables assessing preference of vegetables, fruit, meat/fish, dairy, snacks, and starches), whereas food habits were determined on the basis of the Adolescents’ Food Habits Checklist (AFHC) (which enables assessing food purchase, preparation, and consumption habits). The analysis involved three homogenous clusters (‘low-preferring’, ‘hedonists’, and ‘high-preferring’), which were identified using the k-means algorithm. It was found that for a number of the assessed food purchase, preparation, and consumption habits, there were statistically significant differences between the ‘low-preferring’, ‘hedonists’, and ‘high-preferring’ clusters. Within food purchase habits, the food preference influenced frequency of buying pastries/cakes and frequency of eating takeaway meals for all the respondents, while for female respondents, it influenced also choice of desserts in restaurants, and for male respondents, it influenced choosing a low-fat lunch away from home (p < 0.05). Within food preparation habits, the food preference influenced the fat content in desserts at home, the frequency of eating at least one serving of vegetables/salad with an evening meal, the frequency of spreading butter/margarine on bread thinly, and the frequency of having cream on desserts for all the respondents; meanwhile, for female respondents, it also influenced the frequency of avoiding fried foods and the frequency of including chocolate/biscuits in their packed lunch (p < 0.05). Within food consumption habits, the food preference influenced the frequency of eating a dessert/pudding, eating at least one serving of fruit a day, eating at least one serving of vegetables/salad a day, avoiding sausages/burgers, trying to ensure they eat plenty of fruit and vegetables, and frequency of choosing fruit as a snack for all the respondents; meanwhile, for male respondents, it also influenced the frequency of eating sweet snacks and eating at least three servings of fruit most days (p < 0.05). Taking into account that some improper food habits may be typical for the specific clusters, there is an urgent need to analyze and address them for the purposes of public health and to bear in mind that some of those habits are gender-dependent.

Practice of New Normal Lifestyles, Economic and Social Disruption, and Level of Happiness Among General Public in China in the Post-COVID-19 Era

Purpose

This study aimed to investigate the impact of the COVID-19 pandemic on the practice of ‘new normal’ lifestyles, economic and social distribution, and individuals’ well-being of people in China after the country ease the lockdown restriction.

Methods

A cross-sectional, self-administered online survey was carried out between 3 September and 15 October 2020.

Results

A total of 8393 complete responses were received from a nationwide sample. Poor sustainability in the practice of “new norm” was reported. Noteworthy disparities were observed in willingness to carry out “new normal” practices by gender, urban-rural locality, non-Han and Han Chinese and educational attainment. There was evidence of economic and social disruption associated with COVID-19 or “new normal” practices. The current mean (±standard deviation [SD]) happiness score (110.45 ± 17.55) was slightly lower than the mean happiness score before (111.12 ± 17.83) the COVID-19 pandemic (t= −9.01, p<0.001). Lower socioeconomic status and greater economic and social disruptions were associated with lower current happiness scores. Moreover, greater willingness to adapt to “new normal” practices was associated with higher levels of happiness.

Conclusion

There is a need to encourage sustainable practice of new norm post-pandemic. Segments of the public continue to experience significant economic and social effects and the post-pandemic ‘new norms’ remain at risk of leading to psychological consequences.

Lifestyle in Undergraduate Students and Demographically Matched Controls during the COVID-19 Pandemic in Spain

Few studies have used a multidimensional approach to describe lifestyle changes among undergraduate students during the COVID-19 pandemic or have included controls. This study aimed to evaluate lifestyle behaviors and mental health of undergraduate students and compare them with an age and sex-matched control group. A cross-sectional web survey using snowball sampling was conducted several months after the beginning of COVID-19 pandemic in Spain. A sample of 221 students was recruited. The main outcome was the total SMILE-C score. Students showed a better SMILE-C score than controls (79.8 + 8.1 vs. 77.2 + 8.3; p < 0.001), although these differences disappeared after controlling for covariates. While groups did not differ in the screenings of depression and alcohol abuse, students reported lower rates of anxiety (28.5% vs. 37.1%; p = 0.042). A lower number of cohabitants, poorer self-perceived health and positive screening for depression and anxiety, or for depression only were independently associated (p < 0.05) with unhealthier lifestyles in both groups. History of mental illness and financial difficulties were predictors of unhealthier lifestyles for students, whereas totally/moderate changes in substance abuse and stress management (p < 0.05) were predictors for the members of the control group. Several months after the pandemic, undergraduate students and other young adults had similar lifestyles.

Food Preferences and Food Choice Determinants in a Polish Adolescents' COVID-19 Experience (PLACE-19) Study

Food preferences are within the most important determinants of food choices; however, little is known about their complex associations, and no studies were conducted in the period of the COVID-19 pandemic. The aim of the study was to analyze the association between food preferences and food choice determinants in adolescents aged 15-20 years within the Polish Adolescents' COVID-19 Experience (PLACE-19) Study. The PLACE-19 Study included a random quota sampling conducted in the whole of Poland and covered a population-based sample of 2448 secondary school students. The food preferences were assessed using a validated Food Preference Questionnaire (FPQ), and the food choices were assessed using a validated Food Choice Questionnaire (FCQ). The statistical analysis comprised k-means clustering and linear regression adjusted for sex and age. Four homogenous clusters of respondents were defined based on the food choice motives-"healthy eaters" (health as the most important determinant of food choices), "hedonists" (convenience, sensory appeal, and price as the most important determinants), "indifferent consumers" (low significance for all determinants), and "demanding consumers" (high significance for all determinants). The preferences for all food categories differed when comparing between clusters presenting various food choice determinants (p < 0.001). The "healthy eaters" were characterized by the highest preference for vegetables; the "hedonists" preferred meat/fish, dairy, and snacks; the "demanding consumers" had a high preference for all food categories, while "indifferent consumers" had a low preference for all food categories. All preference scores were positively associated with mood, convenience, sensory appeal, natural content, and price (p < 0.05). The results confirmed the association between food preferences and food choice determinants in adolescents, as well as allowed adolescents to be clustered into segments to define various needs and motives among the identified segments. For public health purposes, it may be crucial to educate "hedonists," with a high preference for meat/fish, dairy and snacks, accompanied by convenience, sensory appeal, and price as the most important determinants of their food choices.

Knowledge and Perceptions about COVID-19 among Health Care Workers: Evidence from COVID-19 Hospitals during the Second Pandemic Wave

Health care workers (HCWs) face a higher risk of infection, since they work at the front line of COVID-19 patients' management. Misinterpretations of current scientific evidence among HCWs may impact the delivery of appropriate care to COVID-19 patients and increase the risk of SARS-CoV-2 transmission in the hospital setting. Moreover, knowledge may affect HCWs perceptions depending on their broad beliefs and past experiences. The aim of this study was to explore the knowledge and perceptions of HCWs regarding COVID-19 issues during the second wave of the pandemic. A cross-sectional survey, involving a printed questionnaire, was conducted from 21 October 2020 to 31 January 2021 in four tertiary care hospitals located at four distant geographical regions in Greece. In total, 294 HCWs participated in this study. The majority of HCWs provided precise responses regarding general knowledge, perceptions, and practices concerning the COVID-19 pandemic. However, responses on hand hygiene and antimicrobial use in HCWs with COVID-19 were mistaken. This study reveals a certain degree of misconceptions and knowledge gaps in HCWs everyday practice, especially regarding hand hygiene and antimicrobial use in COVID-19 patients.

Associations between Food Preferences, Food Approach, and Food Avoidance in a Polish Adolescents' COVID-19 Experience (PLACE-19) Study Population

Food preferences are among the strongest predictors of the food choices of adolescents. These are associated with appetitive traits (food approach and avoidance) to some extent. However, no research has been conducted so far analyzing the association between food preferences and appetitive traits of adolescents. The aim of this study was to evaluate the associations between food preferences and appetitive traits in adolescents (aged 15-20 years) within the Polish Adolescents' COVID-19 Experience (PLACE-19) Study population. The PLACE-19 Study was carried out in a population-based sample of 2448 secondary school students sampled across the country (random quota sampling). Food preferences (including the preference for vegetables, fruit, meat/fish, dairy, snacks, and starches) of the adolescents were assessed using the validated Food Preference Questionnaire (FPQ) while their appetitive traits (hunger, food responsiveness, emotional overeating, enjoyment of food, satiety responsiveness, emotional undereating, food fussiness, slowness in eating) were assessed using the validated Adult Eating Behavior Questionnaire (AEBQ). The k-means clustering was performed to identify the homogenous clusters of respondents based on their preferences, and linear regression was performed to determine the relationship between food preferences and appetitive traits with a model adjusted for sex and age. Based on their preferences, three homogenous clusters of respondents were defined: low-preferring respondents (low preference for all food categories), respondents preferring snacking foods (low preference for all food categories, except for fruit and snacks), and high-preferring respondents (high preference for all food categories). The low-preferring respondents showed the lowest values for all appetitive traits (p = 0.0008), as well as the lowest total score (p = 0.0001), except for food fussiness, for which they showed the highest value (p = 0.0008). All preference scores were positively associated with traits such as hunger, food responsiveness, enjoyment of food, and emotional under-eating, while negatively associated with food fussiness (all p < 0.05). The largest amount of variance was observed for preference for dairy (14.6%; R² = 0.146, p = 0.008) and snacks with respect to enjoyment of food (16.2%; R² = 0.162, p = 0.008), for vegetable with respect to food fussiness (22%; R² = 0.220, p = 0.008), and for meat/fish with respect to enjoyment of food (19.9%; R² = 0.199, p = 0.008) and food fussiness combined (19.1%; R² = 0.191, p = 0.008). These results support the association of food preferences with both food approach traits and food avoidance traits.

The Prevalence and Clinical Features of Skin Irritation Caused by Infection Prevention Measures During COVID-19 in the Mecca Region, Saudi Arabia

PURPOSE

Due to the COVID-19 pandemic, recommendations to prevent infection suggest increasing the frequency of handwashing and disinfection; however, these measures can have negative implications on our skin. This study aims to evaluate whether these measures correlate with new-onset skin damage or can exacerbate hand eczema among the general population.

MATERIALS AND METHODS

This was a descriptive, cross-sectional, survey-based study, including the general population of Mecca region, Saudi Arabia. To achieve the study's aim, an online questionnaire to the general population comprising 25 items was distributed via social media apps during the pandemic between October 23 and November 21, 2020. Data were automatically collected in Excel and entered into SPSS for analysis.

RESULTS

A total of 783 participants were included in this study, of whom 695 (88.8%) were female. A history of hand eczema was reported among 123 (15.7%) participants, and 270 (34.5%) had a history of atopy. During the COVID-19 pandemic, 86 (13.0%) participants noticed new-onset skin irritation, while 81 (31.3%) of the participants reported exacerbation of earlier hand allergic dermatitis. The most frequent symptoms were dryness and feeling of tightness. Additionally, most participants among both groups noticed that skin lesions appeared for less than 10 days. The frequent handwashing statistically increased following the onset of the pandemic (p=0.001), there is association between new-onset symptoms and more frequent handwashing, as well as the use of hand disinfectants, during the pandemic (p=0.001).

CONCLUSION

Our study suggests that the general population's skin was negatively affected by COVID-19 precautions, particularly those with a history of hand eczema. We recommend spreading awareness of skin protective modalities and the use of new infection prevention measures, such as regular skin moisturization for hand protection and possibly using less damaging skin disinfectants like ozonized water provided it is scientifically proven effective in disinfecting COVID-19 virus.

Global Temporal Patterns of Age Group and Sex Distributions of COVID-19

Since the beginning of 2020, COVID-19 has been the biggest public health crisis in the world. To help develop appropriate public health measures and deploy corresponding resources, many governments have been actively tracking COVID-19 in real time within their jurisdictions. However, one of the key unresolved issues is whether COVID-19 was distributed differently among different age groups and between the two sexes in the ongoing pandemic. The objectives of this study were to use publicly available data to investigate the relative distributions of COVID-19 cases, hospitalizations, and deaths among age groups and between the sexes throughout 2020; and to analyze temporal changes in the relative frequencies of COVID-19 for each age group and each sex. Fifteen countries reported age group and/or sex data of patients with COVID-19. Our analyses revealed that different age groups and sexes were distributed differently in COVID-19 cases, hospitalizations, and deaths. However, there were differences among countries in both their age group and sex distributions. Though there was no consistent temporal change across all countries for any age group or either sex in COVID-19 cases, hospitalizations, and deaths, several countries showed statistically significant patterns. We discuss the potential mechanisms for these observations, the limitations of this study, and the implications of our results on the management of this ongoing pandemic.

"Public Health Behaviors during the COVID-19 Pandemic in Greece and Associated Factors: A Nationwide Cross-sectional Survey"

The objective of this cross-sectional survey was to estimate the association between multiple socioeconomic, and health-related characteristics, COVID-19 related attitudes and adoption of public health preventive behaviors. A national cross-sectional survey among 1205 adults was conducted in April 2020 in Greece. Multivariable ordered logistic regression models were used to estimate the association between COVID-19 related attitudes and knowledge and adoption of preventive behaviors, controlling for socioeconomic and health-related characteristics. A total of 923 individuals fully completed the survey. Individuals who believed that the virus is out of control, is transmitted through the air, and is not similar to the common flu were more likely to adopt public health preventive behaviors more frequently, particularly wearing masks in public spaces, washing their hands, and spending fewer hours out of their homes. Uncertainty about the virus symptomatology was associated with less frequent mask-wearing and handwashing. Increased social support, frequent media use for COVID-19 updates, trust to authorities, older age, worse health status, female gender and being a healthcare professional were also associated with uptake of some preventive health behaviors. Attitudinal and socioeconomic determinants critically affect public engagement in preventive behaviors. Health policy initiatives should focus on community outreach approaches to raise awareness and to strengthen social support mechanisms by integrating multiple stakeholders.

The Influence of the COVID-19 Epidemic on Prevention and Vaccination Behaviors Among Chinese Children and Adolescents: Cross-sectional Online Survey Study

BACKGROUND

The COVID-19 epidemic and the related containment strategies may affect parental and pediatric health behaviors.

OBJECTIVE

The goal of this study was to assess the change in children's and adolescents' prevention and vaccination behaviors amid China's COVID-19 epidemic.

METHODS

We conducted a cross-sectional online survey in mid-March 2020 using proportional quota sampling in Wuhan (the epidemic epicenter) and Shanghai (a nonepicenter). Data were collected from 1655 parents with children aged 3 to 17 years. Children's and adolescents' prevention behaviors and regular vaccination behaviors before and during the epidemic were assessed. Descriptive analyses were used to investigate respondents' characteristics, public health prevention behaviors, unproven protection behaviors, and vaccination behaviors before and during the COVID-19 epidemic. Univariate analyses were performed to compare differences in outcome measures between cities and family characteristics, using chi-square tests or Fisher exact tests (if expected frequency was <5) and analyses of variance. Multivariate logistic regressions were used to identify the factors and disparities associated with prevention and vaccination behaviors.

RESULTS

Parent-reported prevention behaviors increased among children and adolescents during the COVID-19 epidemic compared with those before the epidemic. During the epidemic, 82.2% (638/776) of children or adolescents always wore masks when going out compared with 31.5% (521/1655) before the epidemic; in addition, 25.0% (414/1655) and 79.8% (1321/1655) had increased their frequency and duration of handwashing, respectively, although only 46.9% (776/1655) went out during the epidemic. Meanwhile, 56.1% (928/1655) of the families took unproven remedies against COVID-19. Parent-reported vaccination behaviors showed mixed results, with 74.8% (468/626) delaying scheduled vaccinations and 80.9% (1339/1655) planning to have their children get the influenza vaccination after the epidemic. Regarding socioeconomic status, children and adolescents from larger families and whose parents had lower education levels were less likely to improve prevention behaviors but more likely to take unproven remedies. Girls were less likely than boys to always wear a mask when going out and wash their hands.

CONCLUSIONS

Prevention behaviors and attitudes toward influenza vaccination have improved during the COVID-19 epidemic. Public health prevention measures should be continuously promoted, particularly among girls, parents with lower education levels, and larger families. Meanwhile, misinformation about COVID-19 remains a serious challenge and needs to be addressed by public health stakeholders.

Conceptualization of college students' COVID-19 related mask-wearing behaviors using the Multi-Theory Model of health behavior change

Background: Recommendations and policies, regarding the use of face coverings, have been instituted to control transmission of coronavirus disease 2019 (COVID-19). Understanding of psychosocial factors related to the use of face coverings within the context of COVID-19 is needed. This study aimed to conceptualize mask-wearing behavior among students using the Multi-theory Model (MTM) of behavior change.

Methods: In October 2020, students (n = 595) enrolled in a large public southeastern US university were recruited to participate in a cross-sectional survey, using a valid and reliable instrument. Univariate, bivariate, and multivariate techniques described mask-wearing behavior and differentiated theoretical drivers of mask-wearing between individuals compliant and non-compliant with guidelines.

Results: Compliant individuals reported significantly higher scores (P <0.05) for initiation and sustenance of mask-wearing, participatory dialogue, behavioral confidence, emotional transformation, practice for change, changes in the social environment, and significantly lower scores for disadvantage. Among multivariable models, all theoretical predictors exhibited significant relationships to their respective outcomes (initiation and sustenance). Specifically, MTM constructs explained approximately 35% of variance in initiation (R² = 0.346, F_(3,526) = 94.32, P <0.001) and 33% of variance in sustenance of mask wearing (R² = 0.328, F_(3,529) = 87.71, P <0.001) for compliant individuals. Behavioral confidence and emotional transformation exhibited the strongest relationships to initiation (ß = 0.403, P <0.001) and sustenance (ß = 0.450, P <0.001), respectively.

Conclusion: Findings suggest a need to design educational programming based on the MTM to promote mask-wearing behavior among laggards who defy face mask guidelines, recommendations, and mandates.

Differences in Adolescents' Food Habits Checklist (AFHC) Scores before and during Pandemic in a Population-Based Sample: Polish Adolescents' COVID-19 Experience (PLACE-19) Study

The COVID-19 pandemic is known to influence the dietary habits of adults, but results for adolescents in studies are ambiguous. The present work aimed to analyze the differences in the scores of the Adolescents’ Food Habits Checklist (AFHC) before and during the pandemic in the Polish Adolescents’ COVID-19 Experience (PLACE-19) Study population. The PLACE-19 Study was conducted during the pandemic among a population of 2448 students recruited from secondary schools in all regions of Poland using a random quota sampling. The participants were required to complete an AFHC consisting of 23 items pertaining to food purchase, preparation, and consumption habits. Current habits (during the pandemic) and previous habits were assessed and scored separately. The total (p = 0.001), purchase (p < 0.001), and consumption scores (p = 0.014) indicated that the AFHC scores during the pandemic were higher than before. For questions on purchase habits, a lower number of respondents reported eating in a restaurant, eating takeaway meals, having lunch away from home, or buying pastries, cakes or crisps. For questions on preparation habits, an greater number of respondents reported that they usually avoided eating fried food and tried to keep their overall sugar intake down, but fewer respondents said they tried to have low-fat desserts. For questions on consumption habits, a lower number of respondents reported that they usually ate a dessert or pudding if one were available and a larger number said they made sure to eat at least one serving of vegetables or salad a day and at least three servings of fruit most days. Based on the obtained results, it may be stated that although there was an increase in the AFHC scores during the pandemic, a similar share of respondents showed improved or worsened food habits, and a similar share changed their food habits from healthy to unhealthy and from unhealthy to healthy. At the same time, a majority of changes were associated with purchase habits, which were probably forced by lockdowns and the resultant restrictions in eating out or grocery shopping.

COVID-19 Pandemic and Remote Education Contributes to Improved Nutritional Behaviors and Increased Screen Time in a Polish Population-Based Sample of Primary School Adolescents: Diet and Activity of Youth during COVID-19 (DAY-19) Study

The Coronavirus-19 disease (COVID-19) pandemic has influenced the nutrition of individuals, including the diet followed, food availability, and food security. However, thus far, only a few studies have been published regarding the diet and activity of children and adolescents. The aim of the present study was to analyze the influence of the COVID-19 pandemic and remote education in this period on the diet and physical activity in a Polish population-based sample of primary school adolescents. In June 2020, the Diet and Activity of Youth during COVID-19 (DAY-19) Study was conducted on a population recruited based on stratified random sampling from all regions (schools sampled from counties, and counties from voivodeships). The sample consisted of a total of 1334 adolescents aged 10–16 years. The study assessed the diet and physical activity of the participants using a validated questionnaire which included questions about the period of remote education and the period before the COVID-19 pandemic. The participants were asked about the following: consumption of fruit, vegetables, soft drinks, water, French fries, and fast food; eating meals in front of the television; and the number of days they are physically active and the number of hours they spend watching television. The obtained data were analyzed by stratifying the respondents by the gender, age, size of the city and total COVID-19 morbidity in the voivodeship. It was observed that, during the pandemic and the resultant remote education, the proportion of respondents who declared the recommended intake of fruits and vegetables had increased compared to that before the pandemic—a higher proportion consumed at least three portions of fruit per day (19.0% before pandemic vs. 27.4% during pandemic; p < 0.0001), as well as three and four or more portions of vegetables per day (11.9% vs. 14.5% and 7.5% vs. 11.1%; p = 0.0004). At the same time, the proportion of respondents consuming at least three cups of water per day had increased (41.1% vs. 47.9%; p = 0.0020), whereas the proportion of respondents who never or rarely eat their meals in front of the television had decreased (35.6% vs. 28.9%; p < 0.0001), and the proportion watching television for more than 2 h a day had increased (78.3% vs. 88.4%; p < 0.0001). Based on the results, it may be concluded that, during the period of remote education due to the COVID-19 pandemic, the dietary behaviors of the studied population of Polish adolescents were more beneficial, which included a higher intake of fruit, vegetables, and water, compared to before the pandemic. In spite of the increasing screen time, including eating in front of the television, there was no reduction in the number of days the respondents were physically active.

Gender Differences in Health Protective Behaviors During the COVID-19 Pandemic in Taiwan: An Empirical Study

INTRODUCTION

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection produces more severe symptoms and a higher mortality in men than in women. The role of biological sex in the immune response to SARS-CoV-2 is believed to explain this sex disparity. However, the contribution of gender factors that influence health protective behaviors and therefore health outcomes, remains poorly explored.

METHODS

We assessed the contributions of gender in attitudes towards the COVID-19 pandemic, using a hypothetical influenza pandemic data from the 2014 Taiwan Social Change Survey. Participants were selected through a stratified, three-stage probability proportional-to-size sampling from across the nation, to fill in questionnaires that asked about their perception of the hypothetical pandemic, and intention to adopt health protective behaviors.

RESULTS

A total of 1,990 participants (median age 45.92 years, 49% women) were included. Significant gender disparities (p<0.001) were observed. The risk perception of pandemic (OR=1.28, 95% CI=1.21-1.35, p<0.001), older age (1.06, 95%=1.05-1.07, p<0.001), female gender (OR = 1.18, 95% CI = 1.09□1.27, p<0.001), higher education (OR=1.10, 95% CI=1.06-1.13, p<0.001), and larger family size (OR=1.09, 95% CI=1.06-1.15, p<0.001) were positively associated with health protective behaviors. The risk perception of pandemic (OR=1.25, 95% CI=1.15-1.36), higher education (OR=1.07, 95% CI=1.02-1.13, p<0.05), being married (OR=1.17, 95% CI=1.01-1.36, p<0.05), and larger family size (OR=1.33, 95% CI=1.25-1.42, p<0.001), were positively associated with intention to receive a vaccine. However, female gender was negatively associated with intention to receive a vaccine (OR=0.85, 95% CI=0.75-0.90, p<0.01) and to comply with contact-tracing (OR=0.95, 95% CI=0.90-1.00, p<0.05) compared to men. Living with children was also negatively associated with intention to receive vaccines (OR=0.77, 95% CI=0.66-0.90, p<0.001).

CONCLUSION

This study unveils gender differences in risk perception, health protective behaviors, vaccine hesitancy, and compliance with contact-tracing using a hypothetical viral pandemic. Gender-specific health education raising awareness of health protective behaviors may be beneficial to prevent future pandemics.

Modest effects of dietary supplements during the COVID-19 pandemic: insights from 445 850 users of the COVID-19 Symptom Study app

OBJECTIVES

Dietary supplements may ameliorate SARS-CoV-2 infection, although scientific evidence to support such a role is lacking. We investigated whether users of the COVID-19 Symptom Study app who regularly took dietary supplements were less likely to test positive for SARS-CoV-2 infection.

DESIGN

App-based community survey.

SETTING

445 850 subscribers of an app that was launched to enable self-reported information related to SARS-CoV-2 infection for use in the general population in the UK (n=372 720), the USA (n=45 757) and Sweden (n=27 373).

MAIN EXPOSURE

Self-reported regular dietary supplement usage (constant use during previous 3 months) in the first waves of the pandemic up to 31 July 2020.

MAIN OUTCOME MEASURES

SARS-CoV-2 infection confirmed by viral RNA reverse transcriptase PCR test or serology test before 31 July 2020.

RESULTS

In 372 720 UK participants (175 652 supplement users and 197 068 non-users), those taking probiotics, omega-3 fatty acids, multivitamins or vitamin D had a lower risk of SARS-CoV-2 infection by 14% (95% CI (8% to 19%)), 12% (95% CI (8% to 16%)), 13% (95% CI (10% to 16%)) and 9% (95% CI (6% to 12%)), respectively, after adjusting for potential confounders. No effect was observed for those taking vitamin C, zinc or garlic supplements. On stratification by sex, age and body mass index (BMI), the protective associations in individuals taking probiotics, omega-3 fatty acids, multivitamins and vitamin D were observed in females across all ages and BMI groups, but were not seen in men. The same overall pattern of association was observed in both the US and Swedish cohorts.

CONCLUSION

In women, we observed a modest but significant association between use of probiotics, omega-3 fatty acid, multivitamin or vitamin D supplements and lower risk of testing positive for SARS-CoV-2. We found no clear benefits for men nor any effect of vitamin C, garlic or zinc. Randomised controlled trials are required to confirm these observational findings before any therapeutic recommendations can be made.

Investigating Racial Differences among Men in COVID-19 Diagnosis, and Related Psychosocial and Behavioral Factors: Data from the Michigan Men's Health Event

Extant research is growing in its ability to explain sex differences in novel coronavirus 2019 (COVID-19) diagnosis and mortality. Moving beyond comparisons based on biological sex is now warranted to capture a more nuanced picture of disparities in COVID-19 diagnosis and mortality specifically among men who are more likely to die of the illness. The objective of this study was to investigate racial disparities in COVID-19-related psychosocial, behavior and health variables among men. The present study utilizes a sample of 824 men who participated in a free health event held in a Midwestern state. Chi-square analysis showed that African American men were more likely to report an adverse impact of COVID-19 based on several factors including experiencing more COVID-19-related medical issues (χ² = 4.60 p = 0.03); higher COVID-19 diagnosis (χ² = 4.60 p = 0.02); trouble paying for food (χ² = 8.47, p = 0.00), rent (χ² = 12.26, p = 0.00), medication (χ² = 7.10 p = 0.01) and utility bills (χ² = 19.68, p = 0.00); higher fear of contracting COVID-19 (χ² = 31.19, p = 0.00); and higher rates of death of close friends and family due to COVID (χ² = 48.85, p = 0.00). Non-Hispanic white men reported more increased stress levels due to COVID-19 compared to African American men (χ² = 10.21, p = 0.01). Regression analysis showed that race was a significant predictor of self-reported COVID-19 diagnosis (OR = 2.56, p < 0.05) after controlling for demographic characteristics. The results showed that compared to non-Hispanic White men, African American men were more likely to report an adverse impact of COVID-19 based on several factors including experiencing more COVID-19-related medical issues; higher COVID-19 diagnosis; trouble paying for food, rent, medication and utility bills; higher fear of contracting COVID-19; and higher rates of death of close friends and family due to COVID. Interestingly, non-Hispanic white men reported more increased stress levels due to COVID-19 compared to African American men.

The Outbreak of the COVID-19 Pandemic and its Social Impact on Education: Were Engineering Teachers Ready to Teach Online?

The major impacts of the COVID-19 pandemic are still affecting all social dimensions. Its specific impact on education is extensive and quite evident in the adaptation from Face-to-Face (F2F) teaching to online methodologies throughout the first wave of the pandemic and the strict rules on lockdown. As lesson formats changed radically, the relevance of evaluating student on-line learning processes in university degrees throughout this period became clear. For this purpose, the perceptions of engineering students towards five specific course units forming part of engineering degree courses at the University of Burgos, Spain, were evaluated to assess the quality of the online teaching they received. Comparisons were also drawn with their perceptions of the F2F teaching of the course units prior to the outbreak of the pandemic. According to the students' perceptions, the teachers possessed the technical knowledge, the social skills, and the personal capabilities (empathy and understanding of the at times troubled situation of each student) for a very abrupt adaptation of their courses to an online methodology. The shortcomings of the online teaching were related to its particularities and each teacher's personality traits. Overall, engineering teachers appeared well prepared for a situation of these characteristics and, if similar online teaching scenarios were ever repeated, the quality of engineering teaching appears to be guaranteed.

Global Population Aging, National Development Level, and Vulnerability to the Pandemic

PURPOSE

This study examined the roles of population aging and national development level in affecting different phases of novel coronavirus disease development with a view to advancing preparedness and corresponding policy.

METHODS

Regression analysis was conducted using multisource data from the World Bank and Johns Hopkins COVID-19 Dashboard.

RESULTS

Population aging is positively associated with confirmed cases of day-10, day-20, and day-30. The positive association between population aging and death does not emerge until day-20. Countries with a higher proportion of older males face higher risks of death.. Countries with a higher proportion of males aged 70-74 years are at the highest risk of confirmed cases. National development level is not associated with confirmed cases, but developing countries face significantly higher risks of death of day-10 and day-20.

CONCLUSION

Prevention and control policies for older adults and underdeveloped areas and sex differences need to be studied.

Fear of COVID-19 in Madrid. Will patients avoid dental care?

Introduction

The objective of this research is to describe how perceived infectability, germ aversion, and fear of COVID-19 in adults in Madrid have changed from the beginning of the pandemic until the lockdown exit phase and their influence on dental care behaviour.

Materials and Methods

Some 961 participants were monitored in a study in Madrid at 2 time points: before lockdown (T0) and after completion of the total lockdown (T1). A questionnaire that included basic sociodemographic variables, the perceived vulnerability to disease scale (including perceived infectability and germ aversion), the fear of COVID-19 scale, and dental visiting behaviour after confinement for fear of COVID was administered.

Results

The participants had higher scores for infectability and germ aversion at T1 than at T0 (P < 0.01). Of those studied, 24.5% (235) of the participants would not go to the dentist for fear of COVID-19. Those who had a high perceived infectability scale score were at least 5 times more likely to not visit the dentist. Those with high COVID-19 fear were at least 6 times more likely to not visit the dentist, and those older than 60 years were 8 times more likely to not visit.

Conclusions

The population's high levels of vulnerability to infectability and perceived germ aversion associated with fear of COVID-19 and the resultant avoidance behaviour to dental care will remain until an effective drug or vaccine for SARS-CoV2 is found.