A short questionnaire to assess changes in lifestyle-related behaviour during COVID 19 pandemic

Score of fear of COVID-19 and physical activity level are related to the habitual consumption of dietary supplements

The measures implemented to contain the COVID-19 pandemic resulted in both behavioral and lifestyle changes. The "Changes in Lifestyle-Related Behavior" instrument was developed to assess lifestyle-related behaviors in the Indian population. However, considering current knowledge, this instrument was not adapted for the Brazilian population. In addition, the relationship between fear of COVID-19 and consumption of dietary supplements has not yet been evaluated. Thus, we aimed to investigate the relationship between the use of dietary supplements with lifestyle behavior and the fear of COVID-19, as well as assess the psychometric properties of the Brazilian version of the "Changes in Lifestyle-Related Behavior" instrument. An online questionnaire assessed sociodemographic, occupational, anthropometric, physical activity (International Physical Activity Questionnaire-short form), fear of COVID-19, and lifestyle behavior data from 416 Brazilian adults (237 females; 18-60y). Mann-Whitney, Chi-square test, exploratory, and confirmatory analyses were applied. Exploratory and confirmatory analyses showed a satisfactory adequacy level of the questionnaire (CMIN/DF = 2.689; Cronbach's α = 0.60) with 5 domains ('Bad eating behavior'; 'Healthy eating'; 'Sleep quality'; 'Interest in cooking'; 'Number of portions and meals'). Lower fear of COVID-19 scores and higher levels of physical activity were found in participants who reported previous dietary supplement intake during the pandemic; in addition, the group that did not ingest dietary supplements reported greater changes in stress and anxiety levels during the pandemic (p<0.05). The intake of dietary supplements before the pandemic was associated with greater energy expenditure and better coping with the fear of COVID-19 during the pandemic. Additionally, the Changes in Lifestyle-Related Behavior tool can be used to assess lifestyle-related variables during the pandemic.

Influences of public health emergency and social isolation on older adults' wellbeing: evidence from a longitudinal study

Previous research has identified social isolation as a significant detriment to the wellbeing of older adults. However, studies that consider endogenous issues are scarce. The present paper examines the impact of the recent exogenous shock, the COVID-19 pandemic on the wellbeing of the older adult population using a longitudinal dataset from China for the period 2016-2020. The results of this study indicate that the life satisfaction of Chinese older adults was negatively affected, e particularly in regions where social distancing measures were more strictly enforced. Declines in physical and mental health were found to be attributable to declines in life satisfaction. Those who experienced greater exposure to the pandemic were more likely to suffer from chronic disease, illness, and insomnia, and many found it challenging to complete tasks during the lockdown. Furthermore, heterogeneity estimation shows that these effects are stronger among the rural older adult, females, those without a spouse, and those with less education.

Healthcare Providers' Adherence to COVID-19 Prevention and Control Practices in Health Records and Information Management, Ghana

Background

The impact of contracting coronavirus on healthcare providers (HCPs) affects their ability to combat the infection. The virus can be transmitted through droplets from sneezing, coughing, and yelling, making it essential for HCPs to plan ahead when dealing with patients with respiratory symptoms. The need to assess healthcare providers' perceived adherence to COVID-19 Prevention and Control Practices (PCP) in Health Records and Information Management is vital for optimizing healthcare operations and ensuring the safety of both patients and providers. This study assesses healthcare providers' perceived adherence to COVID-19 PCP in Health Records and Information Management. Subjects and Method. A cross-sectional survey was conducted to collect data from 1268 HCPs working in eight randomly selected hospitals across five regions in Ghana. The survey was carried out from May 15, 2022, to August 13, 2022. Simple random sampling was used to choose these eight facilities from a total of 204 hospitals. Within each facility, HCPs from various departments were selected using simple random sampling. The EpiInfo 7 software's StatCalc tool was used to choose a total sample size of 1268 from an estimated 4482 HCP-PR from the eight hospitals. Compliance with COVID-19 PCP was assessed using a 3-point scale, ranging from one (Yes always) to three (No). Cronbach's alpha reliability coefficient was used to examine the statistical reliability of the variables in the dataset. Cronbach's alpha was 0.73 overall, suggesting strong reliability. Bartlett's test for equal variances was used for comparative analysis of health facility and overall mean COVID-19 PCP in different areas of health facilities. IBM SPSS (version 23) statistical software was used for the data analysis process.

Results

A total of 1268 HCP-PR participated in the survey, resulting in a 99.6% response rate. Findings reveal that 760 healthcare professionals who handle patients' records (HCP-PR), constituting 60%, consistently followed COVID-19 protocols in the registration and clinic preparation zones. Another 390 individuals (30.7%) adhered to these protocols occasionally, while 119 (9.4%) failed to comply. Similarly, in the filing area, 739 respondents (58.3%) consistently adhered to COVID-19 protocols, 358 (28.3%) occasionally did so, and 170 (13.4%) did not follow the protocols at all. Regarding handling health records cautiously, 540 participants (42.5%) always did, 448 (35.3%) did so sometimes, and 280 (22.2%) neglected these precautions. Additionally, 520 respondents (41.0%) consistently followed COVID-19 precautions when handling computers and other equipment, 393 (31.0%) did so occasionally, and 355 (28.0%) did not adhere to these precautions.

Conclusion

The majority of respondents showed good compliance with COVID-19 protocol in the registration and clinic preparation areas. However, in the filing area, just over four out of every seven respondents consistently adhered to COVID-19 PCP. Additionally, four out of every seven participants did not comply with COVID-19 PCP when handling patients' records. Analysis reveals diverse adherence to COVID-19 PCP, and statistical tests show variable performance, highlighting standout health facilities.

Unveiling the lockdown effects: exploring behavior, dietary habits and weight changes in rural Egypt during COVID-19 lockdown: a cross-sectional retrospective study

BACKGROUND

The COVID-19 lockdown significantly impacted dietary habits and body weights globally, particularly in Egypt, where 57.03% of the population resides in rural areas, despite lack of information. The study examines the impact of COVID-19 lockdown on the weight changes of the rural Egyptian population through behavioral, physical, and dietary changes.

METHODS

A cross-sectional online survey using Microsoft Forms was distributed in Delta regions in Egypt. The questionnaire used a modified version of the validated 14- items PREDIMED MedDiet Adherence Screener (MEDAS). The first part of the questionnaire addressed sociodemographic variables whereas the second one included questions related to dietary, behavioral and weight changes of participants. These changes were statistically tested for significance in relation to BMI, gender, home living, current job and family history of obesity.

RESULTS

A total of 306 participated in the study (70% females, 13% obese, 95% living with family, 56% university students, and 36% with family history of obesity). Obese showed a significant increase in sweet intake whereas underweight and normal weight people displayed a significant decrease in eating desire. Both females and males showed significant increase in consumption of fruits and vegetables with significant decrease in soft drink. However, women showed a significant decrease in sport activity relative to men. Participants living with family showed an increase in sweet intake while those living alone explored an increase in meal frequency. Employers revealed a significant decrease in sport activities and people with family history of obesity reported more sleeping times than those without family history of obesity.

CONCLUSION

During Covid-19 quarantine, Egyptians' eating habits improved, but daily routines were disrupted. Raising awareness about obesity and providing guidance on maintaining activity, energy, and mood is crucial for future quarantine situations.

Impact of the COVID-19 pandemic on child malnutrition in Selangor, Malaysia: A pilot study

BACKGROUND

Child malnutrition risk factors are globally recognized, but the specific impact of the COVID-19 pandemic on the prevalence of child malnutrition, considering socioeconomic burdens and changes in family lifestyles, remains underexplored. This study aims to identify the significance of COVID-19-related factors in relation to the prevalence of child malnutrition in Selangor, Malaysia.

METHODS

Purposive sampling was employed in this pilot study to select the households with under-5 children and, a structured questionnaire was developed to gather data. Chi-squared tests, logistic regression modelling and World Health Organisation AnthroPlus software-based visualization were used for analyses.

RESULTS

The present study's findings indicate that demographic and social factors, including 'Citizenship,' 'Type of House,' 'Number of Earning Members,' 'Father's Highest Educational Level,' and 'Number of Children in a Family,' have a statistically significant association with Wasting. Additionally, the mother's 'Highest Educational Level' is found to be linked to underweight prevalence. Within COVID-19 factors, "COVID-19 Impact on Employment/Business" demonstrated significance for both stunting and wasting. Multivariate analysis revealed disparities in childhood malnutrition by gender, age, and factors such as "COVID-19 impact on children's physical activity" and "COVID-19 impact on children's decrease in health over the last two weeks."

CONCLUSIONS

This study identified COVID-19 factors alongside sociodemographic variables with statistically significant relationships impacting childhood malnutrition in Selangor, Malaysia. The results underscored the substantial influence of the COVID-19 pandemic on child malnutrition prevalence. Decision-makers at family and community levels can benefit by considering these factors in their actions. However, the study's limitation lay in its dataset, urging larger-scale analyses to explore further sub-categories of the examined variables.

The application of innovative ecosystems to build resilient communities in response to major public health events

In recent years, major public health events have had a significant and far-reaching impact on communities. As a response, there has been an increasing interest in enhancing community resilience through innovative ecosystems that involve diverse stakeholders with varying needs and demands. This study investigates the application of innovative ecosystems to improve community resilience in the face of major public health events by utilizing a sequential game approach to balance the interests of government, community, and residents. Subsequently, a comprehensive questionnaire survey was conducted among key stakeholders to ascertain their objectives, requirements and concerns for the innovation ecosystem based on the analysis results of the game model. The reliability and effectiveness of the proposed research method were verified through the analysis and verification of the sequence game model and questionnaire survey results. Finally, according to our analysis results, we propose countermeasures for promoting innovative ecosystems to improve community resilience. The research results indicate that the successful implementation of innovative ecosystems requires consideration of the different needs of stakeholders such as government officials, community members, and residents. Combining these perspectives can effectively promote such systems while enhancing the community's resilience to major public health events.

Have Incidence and Severity of Craniomaxillofacial Fractures Changed Since SARS-CoV-2?

BACKGROUND

An increase in severity and a decrease in incidence of craniomaxillofacial fractures (CMFs) were identified during the first several months of the SARS-CoV-2 pandemic. It is unclear if these changes have persisted in the current timeframe.

PURPOSE

The investigators hypothesize that the incidence and severity of CMF will not return to baseline prepandemic (control) levels as the pandemic stabilizes and becomes endemic.

STUDY DESIGN, SETTING, SAMPLE

This retrospective cohort study enrolled subjects who presented to Harborview Medical Center a Level 1 trauma center for the evaluation and management of CMF. Inclusion criteria were 1) Presentation timeline 2018 through 2022, 2) CMF identified by the 10th International Classification of Disease. Exclusion criteria were: 1) Undocumented etiology of facial fracture and 2) inadequate/unclear documentation otherwise.

PREDICTOR/EXPOSURE/INDEPENDENT VARIABLE

The predictor variable was year of injury relating to the start of the pandemic. The groups were the prepandemic (2018, 2019) and postpandemic (2020, 2021. 2022).

MAIN OUTCOME VARIABLES

The primary outcome variable was the CMF diagnosis identified using the corresponding International Classification of Disease, 10th Edition codes. The secondary outcome variables were mechanism of injury and injury severity.

COVARIATES

The covariates were age, sex, race/ethnicity, admission status, alcohol intoxication, toxicology screen, reimbursement source, abuse reported, and abuse investigated.

ANALYSES

Univariate and bivariate analyses were performed with statistical significance at P < .05.

RESULTS

The sample was composed of 5203 subjects. The annual volumes of subjects presenting with CMF were consistent over the study period (2018, 2019, 2020, 2021, 2022 n = 1018, 963, 1020, 1062, 1140, respectively). The incidence of Hispanics increased (2018, 2019, 2020, 2021, 2022: 11.1, 9.6, 12.2, 13.9, 13.2% (P < .05)) as did firearm CMF injuries (2018, 2019, 2020, 2021, 2022: 4.13, 4.98, 4.71, 7.16, 6.75% (P < .05)). The Injury Severity Score and Abbreviated Injury Scale were both lower postpandemic compared to prepandemic; mean Injury Severity Score post [18.27 ± 12.46] versus pre [19.25 ± 12.89] (P < .05), mean Abbreviated Injury Scale post [2.94 ± 1.15] versus pre [3.04 ± 1.14] (P < .05).

CONCLUSIONS AND RELEVANCE

While the severity of CMF decreased postpandemic, Hispanic and firearm CMF increased. The overall CMF incidence remained the same. The significant rise in firearm injuries warrants further study.

Healthy lifestyle behaviors and risk of cardiovascular diseases among nursing faculty during COVID-19 Pandemic

OBJECTIVE

Cardiovascular diseases are the first ranked cause of death worldwide. Adhering to health promoting lifestyle behaviors will maintain an individual's cardiovascular health and decrease the risk of cardiovascular diseases.

METHODS

In this descriptive study, 150 nursing faculty were surveyed via a non-probability (purposive) sampling method to assess their adherence to health promoting lifestyle in order to know the risk of cardiovascular diseases. The Arabic version of Health-Promoting Lifestyle Profile II (HPLP-II) was used to achieve this goal.

RESULTS

Seventy-two nursing faculty completed the survey. The results indicated that the study sample had moderate level of health promotion based on Health-Promoting Lifestyle Profile II.

CONCLUSION

Nursing faculty are at risk of developing cardiovascular diseases based on their health promoting lifestyle behaviors as they scored low level of "health responsibility", "physical activity", and "stress management ". Encouraging healthy behaviors is recommended to prevent chronic diseases such as cardiovascular diseases.

The Triple "S" Impact of COVID-19: Nationwide Evidence of the Impact of the Stress Associated With Restrictive Measures on Substance Use, Sleep, and Social Connectedness in Qatar

OBJECTIVES

Countries worldwide implemented social and movement restrictions to contain the spread of coronavirus disease 2019 (COVID-19). Unfortunately, such restrictions have adversely impacted people's lifestyles. The goal of this study was to assess the impact of COVID-19-related restrictive measures on substance use, sleep, and social connectedness in Qatar's population.

METHODS

A web-based survey was conducted between January 2021 and February 2021 targeting adults ≥18 years of age who were residing in Qatar between March and August 2020.

RESULTS

A total of 1408 participants completed the survey. Of tobacco users in our sample, 36% reported increased tobacco use since the start of home confinement, while 41.6% of alcohol users reported decreased alcohol use. Concerning sleep, 46.1% reported an increase in average sleep duration per day (0.77 h mean increase, 95% CI: 0.66-0.88, P<0.001), and a third of participants reported poorer sleep quality. Of the participants, 39.6% felt socially disconnected. Perceived stress was found to be an independent predictor for increased use of tobacco, deterioration in sleep quality, and increased sleep duration during home confinement.

CONCLUSIONS

Restrictive measures related to COVID-19 resulted in both positive and negative impacts on the lifestyle of Qatar's population. Emphasis should be placed on encouraging people to adopt healthy strategies for coping with various stressors that arise during future home confinement measures. It is also necessary to address the persistence of adverse consequences in the postpandemic era.

Effects of COVID-19 Stress on Healing Behavior in Residential Spaces

This study aims to analyze the effects of COVID-19 stress on healing behavior in residential spaces. Based on the results, the study further examines the residential space as a healing environment according to space use behavior in the post-COVID era. A survey including 2101 Korean people was conducted. The COVID Stress Scale for Korean People (CSSK) was used to identify COVID-19 stress. In addition, using a literature review on healing environment factors and behavioral changes after the pandemic, survey questions were developed to assess changes in healing behavior. A frequency analysis was conducted for sociodemographic factors, and the relationship between COVID stress factors and healing behavior factors in residential spaces was examined using factor and correlation analyses. Multiple regression analysis was conducted to verify the effects of COVID stress factors on changes in healing behavior. The results revealed that COVID stress affected healing behavior in residential spaces; however, there were differences in healing behavior depending on the COVID stress factors. Fear of being infected positively affected infection prevention behavior in homes. Anger towards others negatively affected the establishment of elements that support various activities in the residential spaces and furniture arrangement. Stress from social distancing difficulties affected healing behavior in residential spaces but was not related to infection prevention behavior. Residential spaces can serve as healing spaces when people are provided with various spatial factors that support diverse types of behavior during a pandemic crisis.

Implications for Health Management Through an Analysis of Changes in Life Patterns of Generation Z College Students Experiencing the COVID-19 Pandemic: A Qualitative Study

Purpose

This study examines the radical changes in the everyday life patterns of Gen Z college students and their health-related perceptions in the online era.

Patients and Methods

Twelve Korean college students in their 20s attending online classes were included in this study. Online video interviews were conducted between September 2021 and January 2022, and content analysis was performed on the one-on-one interview transcripts.

Results

Four main categories and ten subcategories were derived from the data analysis: (1) living in a mobile world, (2) new lifestyle transcending time and space and adaptation to the change, (3) expansion of the meaning of health, and (4) interest in health and health management.

Conclusion

Gen Z college students have quickly adapted to the convenience of a non-face-to-face lifestyle, and their perceptions about health and methods of health management have also changed accordingly. Correspondingly, for the new generation of university students, providing customized health care that reflects the lifestyle of using mobile devices and includes self-management areas is necessary.

COVID-19 impacts on non-work travel patterns: A place-based investigation using smartphone mobility data

The COVID-19 pandemic has brought unprecedented changes to our mobility. It has not only changed our work-related travel patterns but also impacted leisure and other utilitarian activities. Non-work-related trips tend to be more seriously affected by the neighborhood/contextual factors such as socioeconomic status (SES), and destination accessibility, and COVID-19 impact on non-work trips may not be equal across different neighborhood SES. This study compares non-work-related travel patterns between the pre- and during COVID-19 pandemic in the City of El Paso, Texas. By utilizing smartphone mobility data, we captured the visitation data for major non-work destinations such as restaurants, supermarkets, drinking places, religious organizations, and parks. We used Census block groups (n = 424) within the city and divided them into low- and high-income neighborhoods based on the citywide median. Overall, the total frequency of visitations and the distances traveled to visit these non-work destinations were influenced by the COVID-19 pandemic. However, significant variations existed in their visitation patterns by the type of non-work destinations. While the overall COVID-19 effects on non-work activities were evident, its effects on the travel patterns to each destination were not equal by neighborhood SES. We also found that COVID-19 had differently influenced non-work activities between high- and low-income block groups. Our findings suggest that the COVID-19 pandemic may exacerbate neighborhood-level inequalities in non-work trips. Thus, safe and affordable transportation options together with compact and walkable community development appear imperative to support daily travel needs for various utilitarian and leisure purposes, especially in low-income neighborhoods.

Seasonal variation in food security, lifestyle, nutritional status and its associated factors of the urban poor adolescents in Kuala Lumpur, Malaysia: research protocol of a prospective cohort study

BACKGROUND

Climate change, obesity and undernutrition have now become a worldwide syndemic that threatens most people's health and natural systems in the twenty-first century. Adolescent malnutrition appears to be a matter of concern in Malaysia, and this is particularly relevant among the urban poor population. Mounting evidence points to the fact that underlying factors of malnutrition are subject to climate variability and profoundly affect nutritional outcomes. Hence, it is interesting to examine seasonal variation in nutritional status and its associated factors of urban poor adolescents in Malaysia.

METHODS

This is a prospective cohort study following urban poor adolescents aged 10-17 years living in low-cost high-rise flats in Kuala Lumpur, Malaysia, across two monsoon seasons. The baseline assessment will be conducted during the onset of the Northeast Monsoon and followed up during Southwest Monsoon. Climate data will be collected by obtaining the climatological data (rainfall, temperature, and relative humidity) from Malaysia Meteorological Department. Geospatial data for food accessibility and availability, and also built (recreational facilities) environments, will be analyzed using the QGIS 3.4 Madeira software. Information on socio-demographic data, food security, lifestyle (diet and physical activity), and neighbourhood environment (food and built environment) will be collected using a self-administrative questionnaire. Anthropometric measurements, including weight, height, and waist circumference, will be conducted following WHO standardized protocol. WHO Anthro Plus was used to determine the height-for-age (HAZ) and BMI-for-age (BAZ). Anaemic status through biochemical analyses will be taken using HemoCue 201+® haemoglobinometer.

DISCUSSION

The study will provide insights into the seasonal effects in nutritional status and its associated factors of urban poor adolescents. These findings can be useful for relevant stakeholders, including policymakers and the government sector, in seizing context-specific strategies and policy opportunities that are seasonally sensitive, effective, and sustainable in addressing multiple challenges to combat all forms of malnutrition, especially among urban poor communities.

TRIAL REGISTRATION

The protocol for this review has not been registered.

COVID-19-related anxiety trajectories in children, young people and adults with rheumatic diseases

Objectives

Uncertainty regarding the risk of coronavirus disease 2019 (COVID-19), its complications and the safety of immunosuppressive therapies may drive anxiety among adults and parents of children and young people (CYP) with rheumatic diseases. This study explored trajectories of COVID-related anxiety in adults and parents of CYP with rheumatic diseases.

Methods

Adults and parents of CYP participating in the international COVID-19 European Patient Registry were included in the current study if they had enrolled in the 4 weeks following 24 March 2020. COVID-related anxiety scores (0-10) were collected weekly for up to 28 weeks.Group-based trajectory models explored COVID-related anxiety clusters in adult and parent populations, with optimal models chosen based on model fit, parsimony and clinical plausibility. Demographic, clinical and COVID-19 mitigation behaviours were compared between identified clusters using univariable statistics.

Results

In 498 parents of CYP and 2640 adults, four common trajectory groups of COVID-related anxiety were identified in each cohort: persistent extreme anxiety (32% and 17%), persistent high anxiety (43% and 41%), improving high anxiety (25% and 32%) and improving moderate anxiety (11% and 10%), respectively. Few characteristics distinguished the clusters in the parent cohort. Higher and more persistent anxiety clusters in the adult cohort were associated with higher levels of respiratory comorbidities, use of immunosuppressive therapies, older age and greater self-isolation.

Conclusions

COVID-19-related anxiety in the rheumatic disease community was high and persistent during the COVID-19 pandemic, with four common patterns identified. In the adult cohort, higher COVID-related anxiety was related to perceived risk factors for COVID-19 morbidity and mortality.

Satisfaction With Governmental Risk Communication Both Increases and Decreases COVID-19 Mitigation Behaviours

Objectives: Over 3 years of the COVID-19 pandemic, and intense societal and governmental response, a wealth of research has examined risk perceptions and public risk mitigation behaviours. The vast majority of this inquiry has focused on health risks. Nevertheless, as a "total social fact" influencing nearly every aspect of quotidian life, the pandemic engenders a wide range of risk perceptions. Methods: Via a survey (N = 4,206) of representative samples of the general public in five European countries (Germany, Norway, Sweden, Switzerland, United Kingdom), we explore perceptions of a range of personal/public health, economic, and societal risks. We also investigate the effects of perceptions of official governmental risk communication in one's country on risk perceptions and risk mitigation behaviours. Results: Structural equation modelling reveals that whilst perceptions of effective risk communication directly increase behaviours that mitigate COVID-19 health risks, these same perceptions indirectly decrease behaviour frequency via a mediated relationship with societal risk perceptions. Conclusion: The findings highlight the import of governmental authorities analysing and communicating about the range of risk perceptions citizens might have about a "total social fact" such as COVID-19.

Dietary habits, lifestyle changes, and glycemic control in patients with type 2 diabetes mellitus during coronavirus disease 2019 (COVID-19): A cross-sectional study in Egypt

BACKGROUND

The coronavirus disease 2019 (COVID-19) lockdown had a significant effect on people's lifestyles and dietary habits resulting in a possible negative health impact, particularly for patients with type-2 diabetes mellitus (T2DM). The objective of the study was to assess the changes in dietary habits and lifestyle and how these relate to glycemic control in patients with type 2 diabetes (T2D), who attended Zagazig Diabetes Clinic, Sharkia Governorate, Egypt, during the COVID-19 pandemic.

MATERIALS AND METHODS

A total of 402 patients with T2D were included in this cross-sectional study. A semistructured questionnaire was used to collect information on socioeconomic status, dietary habits, lifestyle changes, and previous medical history. Weight and height were also measured, and hemoglobin A1C levels before and after lockdown were compared. Data analysis was performed using the SPSS. To determine statistical significance, Chi-square test was used for categorical variables whereas, paired t-test or McN-Nemar test, as appropriate, was used to compare change in HbA1c before and after lockdown. Ordinal logistic regression was used to determine factors associated with weight change, whereas binary logistic regression was used to determine factors related with glycemic control.

RESULTS

During the COVID-19 pandemic, 43.8% of the studied groups consumed more than their usual diet with an increase in fruits, vegetables, and immunity-boosting food; 57% depended on home-cooked food, 48.3% did not practice exercise. About 57% reported to have gained weight, 70.9% suffered from mental stress, and 66.7% reported inadequate sleep. Collectively, there was a statistically significant decrease in the percentage of good glycemic control in the studied groups (28.1% vs. 15.9%) before and after the COVID-19 lockdown, respectively (P < 0.001). Weight gain, physical inactivity, mental stress, and inadequate sleep were significantly associated with poor glycemic control.

CONCLUSION

COVID-19 pandemic has had a negative impact on the lifestyle and dietary habits of the studied groups. Therefore, it is very important to ensure better diabetes management in this critical period.

Impact of the COVID-19 pandemic on the mental and physical health and overall wellbeing of university students in Portugal

Throughout the pandemic of COVID-19 caused by SARS-CoV-2, university students were considered a vulnerable risk group for mental health impairment and wellbeing deterioration. This study aimed at evaluating the pandemic's impact on the physical and mental health and wellbeing among students of a Portuguese university. This cross-sectional study included 913 participants and ran from June to October 2020. Data collected included sociodemographics, three mental health self-report questionnaires (Depression Anxiety Stress Scale, Eating Disorder Examination Questionnaire and Brief COPE) and lifestyle practices (eating and sleeping patterns, media, and entertainment habits) during the first months of the pandemic, which included a 72-day full national lockdown. Descriptive and correlational statistical analysis were conducted. Students' food habits changed during the pandemic, namely on the consumption of snacks and fast food and, overall, less balanced meals became more prevalent. Additionally, almost 70% of the students reported Body Mass Index changes, while 59% went through sleep pattern changes-these were more pronounced in women and younger students. Over half (67%) of the inquirees exhibited an increase in their stress, depression, and generalized anxiety symptoms. Also, the study demonstrates that students' lifestyles trended negatively during the pandemic and highlights how important regular psychological, health monitoring and emotional support is, amongst this somehow overlooked population throughout the pandemic. Universities should provide support to overcome challenges in future stressful situations. This study might have an impact on how universities and higher education systems approach their students in terms of mental and physical health monitoring and promotion in future situations, non-related with COVID. Moreover, it has a large sample of students well characterized in terms of mental and physical health, which might be of interest for future comparison with other worldwide group of students throughout stressful situations, such as tragic events, wars, pandemics.

Evaluation Study on the Use of Non-Contact Prevention and Protection Products in the Context of COVID-19: A Comprehensive Evaluation Method from AHP and Entropy Weight Method

In the post-epidemic era, there is an endless supply of epidemic prevention products that cover a wide range of public areas. The introduction of such products has eased the tense pattern of virus proliferation in the context of the epidemic, and effectively demonstrated the initiatives implemented by the Chinese people in response to the outbreak. This paper therefore begins with the study of contactless epidemic prevention products, which appear in a form that meets the needs of contemporary society and offers a new mode of living to it. It enriches the measures for epidemic prevention and control. By obtaining satisfaction ratings from the user community, the performance of such products can be understood in time to provide a substantial basis for the subsequent upgrading and optimization or transformation of such products. This study uses the KJ method and questionnaires to construct an index system for contactless epidemic prevention products, grasp users' needs for epidemic prevention products in real time, classify and identify such products, and select such products as epidemic prevention smart security gates, medical delivery robots, infrared handheld thermometers, thermographic body temperature screening, contactless inductive lift buttons, and contactless medical vending machines. The questionnaire was designed with four dimensions: safety, intelligence, aesthetics and economy. A sample size of 262 was collected through the distribution of questionnaires. We used AHP and entropy weighting methods for the comprehensive evaluation; AHP basically tells us how satisfied most users are with this type of product. The use of the entropy weighting method can achieve objectivity in the weighting process. Combining the two approaches helps to improve the scientific nature of the weighting of the evaluation indexes for contactless and epidemic-proof products. It is clear from the AHP analysis that, firstly, there are differences in the perceptions of the performance of this type of product between different age groups. Secondly, the user group rated the perceived performance of the product presented as high (Bn>0.200), which users can subjectively and directly perceive. Next, the perceived future sustainable economic development of this product category is low (Bn≤0.200), and users place low importance on its economic aspects as an objective additional condition. The entropy method of analysis shows that, under reasonable government control of the market for intelligent products, the safety, intelligence and aesthetic effects of these products are significant (Cm≤0.100); further, the economic presentation of these products has yet to be optimized and upgraded (Cm>0.100).

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

OBJECTIVES

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

SETTING

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

PARTICIPANTS

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

PRIMARY AND SECONDARY OUTCOMES MEASURED

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

RESULTS

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

CONCLUSIONS

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

PROSPERO REGISTRATION NUMBER

CRD42022321128.

Impact of the first COVID-19 lockdown on body weight: A combined systematic review and a meta-analysis

The coronavirus disease 2019 (COVID-19) and the imposed lockdowns in order to control the pandemic, had undoubtedly influenced the lifestyle of millions of people worldwide. The period of confinement, which was characterized by seizing most business activities and allowing only for e-classes at schools and universities, leading also to a lower physical activity, could have affected eating behaviors of people of all ages. In this study we aimed to investigate the impact of the first lockdown period (March-May 2020) on body weight (BW) and on body mass index (BMI) in both adults and adolescents (>16 years old). A systematic literature search was conducted in PubMed®, Scopus®, Web of Science® and EMBASE® databases and 36 observational (35 cross-sectional and one cohort) studies were included. BW and BMI changes after/during the lockdown period were examined. BW was stated as increased in a significant part of the individuals (11.1-72.4%), although a range of 7.2-51.4% of individuals reported weight loss. A significant higher BW was observed with a weighted mean between-group difference (WMD) 1.57 (95% CI 1.01 to 2.14) in the post-lockdown period compared to the before lockdown time and higher BMI, 0.31 WMD (95% CI, 0.17 to 0.45) was identified before the lockdown period. At variance with general trends, one study in older adults (>60 years old) notably reported a significant BW loss, suggesting a higher risk for lockdown-induced weight loss and potentially malnutrition in the elderly population. Overall increments in BW are an alarming effect of lockdown during the COVID-19 pandemic, leading to potential higher incidence of overweight, obesity and related health-risks as well as other noncommunicable diseases. Further studies are needed to assess potential group-specific impacts, with particular regard to weight gain in younger people and risk of weight loss, malnutrition and sarcopenia in older adults.

Gender, loneliness and happiness

We analyse a measure of loneliness from a representative sample of German individuals interviewed in both 2017 and at the beginning of the COVID-19 pandemic in 2020. Both men and women felt lonelier during the COVID-19 pandemic than they did in 2017. The pandemic more than doubled the gender loneliness gap: women were lonelier than men in 2017, and the 2017-2020 rise in loneliness was far larger for women. This rise is mirrored in life-satisfaction scores. Men's life satisfaction changed only little between 2017 and 2020; yet that of women fell dramatically, and sufficiently so to produce a female penalty in life satisfaction. We estimate that almost all of this female penalty is explained by the disproportionate rise in loneliness for women during the COVID-19 pandemic.

Association between the Health Belief Model, Exercise, and Nutrition Behaviors during the COVID-19 Pandemic

INTRODUCTION

The COVID-19 pandemic has affected our nation's health further than the infection it causes. Physical activity levels and dietary intake have suffered while individuals grapple with the changes in behavior to reduce viral transmission. With unique nuances regarding the access to physical activity and nutrition during the pandemic, the constructs of Health Belief Model (HBM) may present themselves differently in nutrition and exercise behaviors compared to precautions implemented to reduce viral transmission studied in previous research. The purpose of this study was to investigate the extent of exercise and nutritional behavior change during the COVID-19 pandemic and explain the reason for and extent of this change using HBM constructs (perceived susceptibility, severity, benefit of action, and barriers to action).

METHODS

This study used a cross-sectional design to collect 206 surveys. This survey collected information on self-reported exercise and nutrition changes during the pandemic and self-reported levels of the HBM constructs.

RESULTS

Findings showed individuals with medium or high exercise behavior change had greater odds of increased HBM score than individuals with little to no exercise behavior change (OR = 1.117, 95% CI: 1.020-1.223, SE: 0.0464, p = 0.0175). There was no association between nutritional behavior change and HBM score (OR = 1.011, 95% CI: 0.895-1.142, p = 08646).

CONCLUSION

Individuals who reported a more drastic change in either exercise had greater odds of increased feelings of perceived susceptibility and severity related to COVID-19 and decreased perceived benefits and increased barriers to exercise. This relationship was not found regarding nutrition behavior change. These results encourage public health practitioners to understand how an individual's perceived feelings about a threat may affect exercise and nutritional behaviors.

Gender-Specific Effect of Couple-Based Intervention on Behavioral and Psychological Outcomes of Older Adults with Type 2 Diabetes during the COVID-19 Partial Lockdown in Guangzhou, China

This study aimed to evaluate the gender-specific effect of a couple-based intervention on the management behaviors and mental well-being of community-dwelling older adults with type 2 diabetes mellitus during the COVID-19 partial lockdown in Guangzhou. Out of 207 participants involved in a prior randomized controlled trial (Trial no. ChiCTR1900027137), 156 (75%) completed the COVID-19 survey. Gendered differences in management behaviors and depressive symptoms between the couple-based intervention group and the patient-only control group were compared by distance to the high-risk areas cross-sectionally and longitudinally using random intercept models. Cross-sectionally, female patients of the intervention group had more positive behavior change scores (β = 1.53, p = 0.002) and fewer depressive symptoms (β = −1.34, p = 0.02) than the control group. Over time, female patients lived closer to the high-risk areas (<5 km) and showed decreasing depressive symptoms (β = −4.48, p = 0.008) in the intervention group vs. the control group. No statistically significant between-group difference was found for males. Females tended to benefit more from the coupled-based intervention than males did, particularly among these closer to the high-risk areas. Chronic disease management can be better sustained with active spousal engagement.

Food insecurity and eating habits of Lebanese children aged 5–11 years during the COVID-19 pandemic and the socioeconomic crisis: a national study

Background

Food insecurity is the lack of access to nutritious healthy food due to economic and financial insufficiencies. Food insecurity is expected to be higher during these difficult times in Lebanon, which is facing many financial, political, economic and health debates. The present study aims to find the prevalence of food insecurity among Lebanese children during the COVID-19 pandemic and its correlates.

Methods

This cross-sectional study enrolled 4001 participants from all Lebanese governorates (March–April 2022). The Ministry of Education and Higher Education randomly disseminated the link to parents of children aged between 5 and 11 years from public and private schools.

Results

The results showed that 1505 (37.6%) and 1497 (37.4%) had moderate and severe food insecurity. A significantly higher percentage of families with severe food insecurity was reported by fathers compared to mothers. In addition, participants who reported a bad overall health status of their children had a severe food insecurity. Moreover, those with a severe food insecurity had their children’s daily snacking habit between meals decreased, with a decreased quantity of meals, intake of vegetables/fruits, the intake of balanced diet, junk food, sugar-sweetened beverages, consumption of sweets/candies/chocolate, consumption of unhealthy food, intake of immunity-boosting food, intake of nutrition supplements, participation in the house chores, number of sleeping hours and sleep quality, as well as stress/anxiety decreased. Finally, a higher mean financial burden was seen in families with severe food insecurity compared to the other groups.

Conclusion

The current study found a high prevalence of moderate to severe food insecurity among Lebanese children during the COVID-19 pandemic. Food insecurity should be seriously discussed in Lebanon due to its rapid development in the middle of all the crises facing the country in order to avoid short and long term consequences on human’s health.

Changes in Doctor-Patient Relationships in China during COVID-19: A Text Mining Analysis

Doctor-patient relationships (DPRs) in China have been straining. With the emergence of the COVID-19 pandemic, the relationships and interactions between patients and doctors are changing. This study investigated how patients' attitudes toward physicians changed during the pandemic and what factors were associated with these changes, leading to insights for improving management in the healthcare sector. This paper collected 58,600 comments regarding Chinese doctors from three regions from the online health platform Good Doctors Online (haodf.com, accessed on 13 October 2022). These comments were analyzed using text mining techniques, such as sentiment and word frequency analyses. The results showed improvements in DPRs after the pandemic, and the degree of improvement was related to the extent to which a location was affected. The findings also suggest that administrative services in the healthcare sector need further improvement. Based on these results, we summarize relevant recommendations at the end of this paper.

Seating Behaviour of Students before and after the COVID-19 Pandemic: Findings from Occupancy Monitoring with PIR Sensors at the UCL Bartlett Library

Since the first case of COVID-19 was confirmed in China, social and physical distancing has been promoted worldwide as an effective community mitigation strategy. However, our understanding remains limited regarding how students would resume their activities and use of libraries when the restrictions to manage the spread of coronavirus were lifted. Understanding students' seating behaviour in libraries is required to guarantee that the libraries meet the needs and preferences of students and promote students' health and well-being and satisfaction with the library. This paper aims to explore the changes in the use of study spaces before and after the pandemic. Occupancy data from the UCL Bartlett Library collected at 10-min intervals from motion sensors located underneath desks was used to assess the occupancy within the library and which was then compared to characteristics of the space. This study revealed that the COVID-19 pandemic significantly impacted students' use of the library as well as how much time they spent there. While seats with a good combination of daylight, outdoor view and privacy were in most demand before the pandemic, distance from other students seems to be the priority after the pandemic. Students' seating preferences appear to be also influenced by the position of desk dividers after COVID-19. Future research should focus on assessing and proposing new seating arrangements and developing strategies to promote students' satisfaction with libraries in response to changes in students' seating behaviours.

Has the COVID-19 pandemic changed food waste perception and behavior? Evidence from Italian consumers

Food waste represents a multi-sectoral issue and influences the economy, society and environment. Considering that over 50% of food waste is generated from household consumption, the issue has been included among the 17 Sustainable Development Goals, with the aim of halving its quantity by 2030. However, the COVID-19 pandemic imposed several variations in the agri-food industry in terms of food manufacturing, storage and distribution, changing at the same time food access, food consumption and food waste behavior. The present paper, through an online-based questionnaire among 831 respondents from Italy and the application of the cumulative logit model, investigates consumer behavior after the lockdown with reference to unpredictable lifestyles, improvements in smart food delivery and never-experienced time management. Results illustrate that always-at-home consumers (forced to stay at home 24 h a day) are more likely to perceive food waste and reduce its amount, whereas discontinuous smart working makes food purchase, preparation and consumption activities even more stressful and complex. Furthermore, smart food delivery tends to increase consumers' awareness of meals, improving buying decisions and indirectly reducing food waste generation. The unjustifiable prevalence of household food waste represents a major barrier to the achievement of food security, health insurance and hunger reduction, but also the most promising entry point to stress in the achievement of private and public benefits. Thus, the active role of education among young generations must be enhanced.

Pandemic Policy and Life Satisfaction in Europe

We use data from the COME-HERE longitudinal survey collected by the University of Luxembourg to assess the effects of the policy responses to the COVID-19 pandemic on life satisfaction in France, Germany, Italy, Spain and Sweden over the course of 2020. Policy responses are measured by the Stringency Index and the Economic Support Index from the Blavatnik School of Government. Stringency is systematically associated with lower life satisfaction, controlling for the intensity of the pandemic itself. This stringency effect is larger for women, those with weak ties to the labor market, and in richer households. The effect of the Economic Support is never statistically different from zero.

COVID ‐19 Behavioral Questionnaire ( CoBQ ): Comparing the pandemic’s impact on health behavior in three US states

Background

The COVID‐19 pandemic impacted daily routines for a majority of the population, with implications for their health behaviors. Racial and ethnic minorities have been disproportionately impacted by COVID‐19. The novel COVID‐19 Behavioral Questionnaire (CoBQ) was developed in Fall 2020 to provide a means to measure the impact of the COVID‐19 pandemic on the United States population. The study utilized behavioral domains to determine which demographic groups reported that they were made the most vulnerable during Fall‐Winter 2020–2021 of the pandemic.

Objectives

The study aimed to further validate and test the CoBQ in varied US regions and compare the scores obtained from three states, California, Ohio, and Illinois.

Methods

A prospective, multi‐site survey‐based study was designed to further validate and test the 17‐item CoBQ in varied populations. Respondents included patients on routine visits at each pharmacy or clinical site who agreed to complete the survey online via Qualtrics. Data analyses included descriptive statistics, psychometric testing, and comparison of groups using Analysis of Variance.

Results

Completed surveys (n = 507) between October 2021 and March 2021 were analyzed. Respondents were mostly female, white, and had some college education. The CoBQ showed improved reliability compared with previous testing and strong construct validity through factor analysis. Overall scores were similar between three states. The most impacted groups included those who reported within the 18–49 age group, a yearly household income <$50 000, or education up to high school.

Conclusions

The CoBQ is the first validated tool to measure the negative impact of the COVID‐19 pandemic on health behaviors. Results could serve as a baseline to address the most vulnerable patient groups and support identified behavioral needs during a similar pandemic situation.

Perceived severity of COVID-19, social support, and pandemic-related stress associated with lifestyle changes among undergraduate students in Indonesia

Introduction:

COVID-19 affects lifestyles, including those of undergraduate students who are one of the most vulnerable populations. This study aimed to describe changes in lifestyle-related behaviors and assess the correlation between the perceived risk of COVID-19, social support, perceived stress, and lifestyle changes among undergraduate students during the pandemic.

Design and methods:

A total of 547 students from 32 provinces in Indonesia completed online questionnaires comprising four measures: perceived risk of COVID-19, the Lifestyle-related Behavior Questionnaire, the Multidimensional Scale of Perceived Social Support, and the Pandemic-related Perceived Stress Scale.

Results:

Undergraduate students who lived with their families had healthier lifestyles than students who lived alone ( p = 0.007). Furthermore, The Pearson’s correlation showed a significant correlation between lifestyle changes with perceived severity ( r = 0.107; p < 0.05), social support ( r = 0.237; p < 0.001and pandemic-related stress ( r = −0.304, p < 0.001). Higher perceived severity of COVID-19 and social support were associated with a healthier lifestyle, whereas increased stress correlated with a less healthy lifestyle.

Conclusion:

Psychological factors correlated with lifestyle changes of Indonesian undergraduate students during the pandemic. Therefore, psychological aspects should be more considered by relatives and institutions to ensure healthier lifestyles of students.

Cross-cultural adaptation and validation of a questionnaire on eating habits and physical activity of university students in confinement due to coronavirus disease

OBJECTIVE

The purpose of the current study was to cross-culturally adapt and validate an online questionnaire to assess eating habits and physical activity of university students under confinement due to coronavirus disease (COVID-19).

DESIGN

Generation of a cross-sectional online survey to university students conducted during confinement due to COVID-19. The study was divided into two phases.

SETTINGS

Students, Chile.

PARTICIPANTS

Phase 1 considered the process of translation and back translation, expert panel, cultural adaptation and the generation of a pilot to validate a preliminary format of the questionnaire. In Phase 2, information from the instrument was collected from two hundred and sixty-eight university students, ages 16 to 30 years old, with a mean age of 21·6 (3·3) The major proportion of participants were female (82 %).

RESULTS

The adapted questionnaire was statistically validated in three dimensions: (A) eating habits and behaviours during quarantine, (B) perception of risk and (C) physical activity changes during the quarantine. The reliability of Cronbach's α for dimensions A, B and C was 0·59, 0·85 and 0·97, respectively. The complete questionnaire obtained 0·61 in internal consistency and 0·61 (0·58-0·67) ICC reliability. A statistically significant positive correlation matrix was observed.

CONCLUSIONS

This questionnaire is a practical tool to obtain accurate information about the relation of COVID-19 confinement on people's eating habits and physical activity. Therefore, it could contribute to establishing appropriate strategies to prevent negative effects on people's health.

The post-pandemic era: will physical distancing be a perceived way of life?

Background: This study aimed to determine whether people living in the Eastern Region of Saudi Arabia would prefer to continue the practice of physical distancing after the coronavirus disease 2019 (COVID-19) pandemic or to return to their previous way of life. Methods: This cross-sectional study was conducted from August 2020 to October 2020 in the Eastern Region of Saudi Arabia. A pre-tested questionnaire was sent electronically through social media. Data on participants' demographics and their perspectives regarding post-pandemic physical distancing were collected. The calculated sample size was 1,066; however, the total number of responses included in the analysis was 989. Results: The average age of the participants was 31.15±11.93 years. There were 435 men and 554 women in the study. Participants showed significantly high levels of disagreement with statements indicating that they were willing to use public transportation (61%), attend social gatherings (36%), and hug relatives or colleagues (40%) after the pandemic ( p<0.001); however, 43% agreed that they would spend time with family or friends ( p<0.001). The level of education was also found to be significantly related to the responses, and the level of disagreement increased as the level of education increased ( p<0.001). Conclusions: One-third of the study participants planned to continue engaging in physical distancing even after the current pandemic and if the COVID-19 related restriction will remain in place for longer, there is chance to increase in this proportion. However, it cannot be concluded whether or not this behavior will prevail in the long run, after the ease in restrictions. If so, it may greatly affect some businesses and perhaps some social norms and values as well.

The Impact of Changes in Work Arrangements During COVID-19 Pandemic on the Lifestyle of Qatar's Working Population

OBJECTIVES

To explore the impact of changing work arrangements during COVID-19 on diet, physical activity, body weight, and sleep of Qatar's working population.

METHODS

A web-based survey targeting working adults who were residing in Qatar during the period of home confinement was conducted.

RESULTS

About 47% of 1061 participants reported weight gain. Higher proportions of participants reported consuming more fatty foods (P = 0.007), more sugary foods (P = 0.001), and greater increase in screen and sitting/reclining times (P < 0.001) among the work from home (WFH) group. Participants with higher adverse dietary changes score were more likely to report weight gain in both the WFH (adjusted OR 1.38, 95% CI 1.28 to 1.49), and working regularly groups (adjusted OR, 1.31, 95% CI 1.20 to 1.43) with P < 0.001.

CONCLUSION

Qatar's working population experienced adverse lifestyle changes which were more prominent among those who shifted to WFH.

Lifestyle Variations during and after the COVID-19 Pandemic: A Cross-Sectional Study of Diet, Physical Activities, and Weight Gain among the Jordanian Adult Population

The way that COVID-19 has been handled since its inception in 2019 has had a significant impact on lifestyle-related behaviors, such as physical activities, diet, and sleep patterns. This study measures lifestyle-related behavior during the COVID-19 pandemic lockdown using a 22-item questionnaire. The responses were collected from March 2021 to September 2021. A total of four hundred and sixty-seven Jordanian participants were engaged in assessing the changes caused by the pandemic and their effect on BMI. The validity and reliability of the questionnaire were tested for 71 participants. Cronbach's alpha values for the questionnaire exceeded 0.7, demonstrating good reliability and internal consistency. The effect of each question regarding physical activity and dietary habits over the BMI difference was studied using ANOVA. The study shows that more than half of the participants reported snacking more between meals and increased their sitting and screen time, while 74% felt more stressed and anxious. BMI difference among the individuals throughout the lockdown was significantly associated with these variables. In contrast, 62% of the participants showed more awareness about their health by increasing the intake of immunity-boosting foods, and 56% of the participants showed an increase in the consumption of nutrition supplements. Females and married individuals tended to be healthier. Therefore, their BMI showed stability compared to others based on their gender and marital status. Exercise, sleep, and avoiding 'junk' food, which contributes to weight gain and COVID-19 vulnerability, are strongly recommended.

Development and validation of comprehensive evaluation tool for weight management at menopausal transition and early menopause stage

Objective:

To develop and validate a comprehensive questionnaire to evaluate risk factors, perceptions, and practices for weight management in women at menopausal transition and early menopause stage.

Methodology:

A mixed-method study was conducted in two phases. In the first phase, the questionnaire was developed by literature review and focused group discussions with the target population and experts. In the second phase, content and face validity were established by expert evaluation and cognitive interviews with the target population. The developed questionnaire was crosssectionally administered in 215 women and responses were used to determine the construct validity by factor analysis and reliability by evaluating internal consistency.

Results:

The finalized questionnaire consisted of two sections; section A included sociodemographic characteristics, anthropometric measures, and menopausal status with symptom severity, while section B contained 32-items focusing on readiness to initiate weight loss, perceptions and practices related to lifestyle behaviors, built environment, and social support. The Cronbach's α value of the questionnaire is 0.79 with good internal consistency.

Conclusion:

The developed questionnaire is a valid and reliable tool to assess weight-related risk factors, perceptions, and practices in middle-aged women, which can potentially be used by doctors and other healthcare practitioners to customize weight management advice in women at menopausal transition and early menopause.

Impact of Covid-19 on Lifestyle Related Behaviors of Nigerians

Introduction: A great threat of a novel virus – coronavirus otherwise known as COVID-19 pandemic rocked the entire world in the wake of the year 2020. The threat is so strenuous that the entire world was placed on lockdown in the matter of social restriction such as on international and national transport links, market or business transactions, school and organizational activities, and all related social and religious gatherings. This restriction might change people’s lifestyle. This study was aimed at assessing the lifestyle changes caused by the pandemic among Nigerians.

Methodology: A web based cross sectional survey was conducted using an e-questionnaire. A paired t-test, independent t-test were used to test hypothesis while mean, frequency, and percentage were used to summarize the data.

Results: Majority of the participants were male (72.1%), single (83.2%), and middle class (79.5%) of social status. There was a decrease in the habit of consuming meals routinely at regular intervals during COVID-19 (19.4% vs 25.7%). There were significant differences in eating patterns before and during COVID-19 (P<0.05). Likewise, significant differences in physical activity before and during COVID-19 were observed.

Conclusion: Some of the protocol put in place in curtailing the virus has been proven to have a positive impact on the lifestyle of Nigerians Such health benefits include but not limited to an increase in moderate exercise, increase in the consumption of healthy and reduction in the consumption of unhealthy food.

Influencing Factors of Public Satisfaction with COVID-19 Prevention Services Based on Structural Equation Modeling (SEM): A Study of Nanjing, China

Service satisfaction with public policies is an important component of public service quality management, which is of great significance to the improvement of public service quality. Based on an online questionnaire survey and in combination with the characteristics of public policies and services, in this study the influencing factors of residents' satisfaction with COVID-19 pandemic prevention services were analyzed with structural equation modeling. The results reveal that the data fit the model well, and all the hypotheses formulated in this study were supported. Among the factors that were found to directly affect residents' satisfaction with pandemic prevention services, perceived quality (PQ) has the greatest impact on satisfaction, followed by the disaster situation (DS) and policy expectation (PE). The observed variables that have significant impacts on the latent variables were also explored. Regarding the main findings, the residents who were seriously affected by the pandemic tended to have lower satisfaction with the policies and services provided by the government. Moreover, the improvement of PQ was found to significantly increase pandemic prevention service satisfaction (SS). Finally, the residents with a good psychological status during the pandemic were found to have higher satisfaction. According to the results, implications for the prevention and control practices of similar public health emergencies are proposed.

How to identify the most suitable questionnaires and rating scales for your clinical practice or research?

BACKGROUND

Selection of the most suitable instrument for a health outcome or exposure assessment is challenging, as there are many different instruments and their versions, most with unknown validity.

AIMS

To develop guidelines facilitating the search for the most suitable instrument.

MATERIALS AND METHODS

Based on our experience, we formalised a five-step process. The first step is the search for systematic reviews of available instruments validity in COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN), International prospective register of systematic reviews (PROSPERO), or conventional (eg, Medline and Web of Science) databases. If there is no systematic review, the clinician should look for original validation studies and assess them critically. We presented two alternatives of this assessment: qualitative using COSMIN and quantitative using our methodological framework. The latter helps to decide upon the instrument validity completeness and interpret the statistical results from original studies objectively. This process was then transformed into guidelines, which were tested by three external clinicians to select the most appropriate instrument to measure depression, occupational stress and daily fatigue.

RESULTS

The guidelines were proved to facilitate the instrument search and selection, practical and time-saving.

DISCUSSION

The guidelines assessment highlighted that clinicians should check whether the instrument that they are looking for was developed for screening or diagnosing purposes, whether it can be self-administered or not, and for which setting it was validated (academic vs clinical).

CONCLUSION

These guidelines facilitate the objective choice of the most suitable instrument in clinical practice by making the search simple, systematic and time-effective.

Impact of COVID-19 related home confinement measures on the lifestyle, body weight, and perceived glycemic control of diabetics

Background

People with Diabetes Mellitus are at high risk of encountering COVID-19 infection and are more vulnerable to the negative repercussions of this infection. In this study we aimed to explore the impact of COVID-19 related home confinement measures on physical activity, dietary habits, body weight and perceived glycemic control of adults with type 2 Diabetes Mellitus (T2DM) in Qatar.

Methods

A cross sectional web-based survey was conducted between January and February 2021 targeting adults ≥18 years with T2DM.

Results

Over 40% of the participants reported unhealthy dietary changes. We found a significant increase in the sitting/reclining, and screen times. One third of the participants reported weight gain, while one fifth reported poorer glycemic control since the start of home confinement measures. We found that reporting at least one unhealthy dietary change (p < 0.001) and being a female (p = 0.002) were significantly associated with reporting greater weight gain. Participants who reported five unhealthy dietary behaviours were more than seven times more likely to perceive poorer glycemic control during home confinement measures compared to those who did not report any unhealthy changes (OR: 7.27, 95%CI 1.60–33.5, p = 0.011).

Conclusion

Adults with T2DM experienced adverse lifestyle changes during COVID-19 related home confinement measures. Further research is needed to investigate the persistence of such changes in the post pandemic era.

•

One third of the participants reported weight gain.

•

Participants reported a significant increase in each of the sitting/reclining and screen times.

•

The perceived glycemic control varied among the participants.

Relationship between Psychological Status and Health Behaviors during the Coronavirus Disease Pandemic in Japanese Community-Dwelling Older Adults

The coronavirus disease (COVID-19) continues to be a widespread pandemic. We investigated the relationship between anxiety/stress and health behaviors during the COVID-19 pandemic in homebound Japanese older adults during January and February 2021. We surveyed 1507 community-dwelling, older Japanese adults using a self-administered questionnaire on primary attributes, including family structure, evaluation of psychological anxiety/stress, and health behaviors. Participants were divided into four anxiety/stress groups based on the frequency of experiencing anxiety/stress, and their association with health behaviors was analyzed using bivariate and multivariate analyses. Responses were received from 469 (31.1%) respondents. In the bivariate analysis, age and family structure were significantly associated with anxiety/stress (p < 0.01). The health behaviors significantly associated with anxiety/stress were walking, balanced eating habits, limited snacking, regular lifestyle, and dental visits. Logistic regression analysis was performed using the variables in the bivariate analysis that showed a significant association with anxiety/stress status as independent variables. Finally, age and dietary habits were significantly associated with anxiety/stress status. No significant associations were found between any other variables. Among older adults living in the rural areas of Japan during the COVID-19 pandemic, anxiety/stress status was significantly associated with age and dietary habits but not with other health behaviors.

Echinacea purpurea Extract Enhances Natural Killer Cell Activity In Vivo by Upregulating MHC II and Th1-type CD4+ T Cell Responses

There are a number of factors that cause immune system disruption, including infection caused by foreign antigens and decreased immunity due to excessive exercise, and public interest in improving immunity is growing. In this study, we investigate the immunomodulatory effects of Echinacea purpurea (E) extract in C57BL/6N mice that were exposed to a forced swimming exercise. There were six experimental groups as follows: wild-type, forced swimming exercise control, positive control (red ginseng, 300 mg/kg), and E (50, 100, and 200 mg/kg b.w.) groups. The mice were administered the E extract for 2 weeks. We detected chicoric acid, the active substance of E, through high-performance liquid chromatography and evaluated changes in the following laboratory values in response to forced swimming exercise using flow cytometry and ELISA: the major histocompatibility complex (MHC), CD4⁺ and CD8⁺ T cells, Th1 and Th2 cytokines, natural killer (NK) cell activity, and number of leukocytes. Oral E intake increased levels of MHC II, CD4⁺ T cells, Th1 cytokines, and NK cell activity. In addition, E treatment increased B cell proliferation, leukocyte counts, and immunoglobulin levels. Taken together, these results suggest that the chicoric acid of E can improve immune response by controlling NK cell activity, which may be a useful function for immunomodulation systems.

Psycho-social and behavioral impact of COVID-19 on middle-aged and elderly individuals: A qualitative study

BACKGROUND

COVID-19 may seem to have an impact on middle-aged and elderly people. However, not much is known about the lived experiences of middle-aged and elderly people during this pandemic. The study aims to explore psychosocial and behavioral impact of COVID-19 on the lives of these individuals.

MATERIALS AND METHODS

Three focus group discussions and seven in-depth interviews were conducted. A format to guide discussions and interviews was made to bring uniformity across groups and participants. Participants were recruited through purposive and snowball sampling techniques. Discussions were recorded and transcribed verbatim. Thematic analysis method was used to extract key conceptual themes.

RESULTS

There were 12 male and 10 female participants included, with a mean age of 62.2 years. Five subcategories identified were: Fear and anxiety, household confinement, lifestyle modification, preventive practices, and coping strategies. These sub-categories formed three major categories-psychological, social, and behavioral which ultimately led to the emergence of the main theme that is, COVID-19 effects on the life of middle-aged and older individuals.

CONCLUSION

Middle-aged and elderly people are affected in many ways due to COVID-19. Addressing the psycho-social and behavioral problems can help in the better adjustment to tide over the pandemic.

Socio-behavioural impact of COVID-19 on general population: A cross-sectional survey of one thousand seventy-nine participants across India between the first and the second wave of pandemic

BACKGROUND AND AIMS

COVID-19 is expected to have a significant impact on the socio-behavioural aspect of citizens' lives, although the effects are expected to manifest differently in different population groups. The current study was conducted to assess the socio-behavioural impact of COVID-19 among the general population across India between the first and the second wave of pandemic.

METHODS

A web-based cross-sectional study was conducted from 15th March -25th March 2021 using a pre-validated validated questionnaire upon the general population using e-survey, telephonic and face-to-face interview. The participants were recruited from the different regions of India by the purposive and snowball sampling technique following the principle of maximum diversity. Appropriate statistical tests were applied to study the association between the various sociodemographic variables and different behaviours.

RESULTS

A total of 1079 responses were analysed for the study. Almost half of the participants feared contracting the COVID-19 infection. Overall, female participants, elderly people (more than 60 years of age) and urban dwellers reported a greater fear in the survey. More than half of the participants (53.39%) reported significant difficulties due to home confinement. People have become more inclined to adopt healthy lifestyles. There are mixed responses in the area of following preventive practices.

CONCLUSION

People have a significant amount of fear and anxiety related to the pandemic, leading to several social and behavioural changes that might have a considerable impact on their everyday lives.

Association of Sociodemographic Parameters With Depression, Anxiety, Stress, Sleep Quality, Psychological Trauma, Mental Well-Being, and Resilience During the Second Wave of COVID-19 Pandemic: A Cross-Sectional Survey From India

Objective This study was conducted to assess the traumatic impact of the second wave of coronavirus disease 2019 (COVID-19) pandemic on depression, anxiety, stress, sleep quality, mental well-being, and resilience among the general population of India. Methods An online cross-sectional survey was conducted in May-June, 2021 via Google Forms, which included adult individuals who were willing to participate in the study. The purposive and snowball sampling technique was used to ensure the principle of maximum diversity. Standardised tools [Depression Anxiety and Stress Scale (DASS), Pittsburgh Sleep Quality Index (PSQI), Impact of Event-Revised (IES-R), Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS), and the Brief Resilience Scale (BRS)] were used to collect data. Results A total of 1,109 responses were analysed for this study. Participants of different age groups (mean age: 32.98 ±14.72 years) and different sociodemographics were enrolled. The younger population group (18-34 years) was found to be the most affected among all the age groups. The findings revealed that 44.18% showed posttraumatic stress disorder (PTSD)-like symptoms. About 48.87%, 65.56%, and 22.09% of the participants had significant depression, anxiety, and stress symptoms respectively, and 11.27% had disturbed sleep patterns. Mental well-being was found to be disturbed for 74.75% of the study population, out of which only 4.15% showed high resilience capacity. Conclusion The associated collective psychological trauma mapped out by this paper is a pandemic in itself and needs to be addressed on a scale similar to the efforts being made to curb the physical symptoms of COVID-19.

Effects of Digitalisation on Higher Education in a Sustainable Development Framework—Online Learning Challenges during the COVID-19 Pandemic

Throughout the planet, the medical challenges posed by the pandemic caused by the SARS-Cov-2/COVID-19 coronavirus have overlapped, inter alia, with the necessity to continue the academic process on every level. Romania was no exception. With the new vaccines against COVID-19, the hope of resuming face-to-face activity, considered as ‘normal’ before 2020, has emerged. In these circumstances, not at all far-fetched, certain questions have arisen, such as: should and must the online university education be completely removed? Should this form of education be continued? If so, to what extent? We have used econometric methods related to ARDL (auto regressive distributed lag models) such as pooled mean group (PMG) and mean group (MG) and used different tests for unit roots for the stationarity check of the series implied. The results show the positive effect of digitalisation on tertiary education and also the positive impact of the latter on sustainable development, as a base for future stimulation in public policies. The present study also aims to harness the university experience of these times, from some of the main Romanian university centres; the method used was a quantitative and qualitative research based on a questionnaire, which was answered by a number of 258 university teachers and 1569 students from prestigious public and private universities. The results of this analysis allowed us to conclude that most of the participants in the university educational process have adapted to the online activity, and the latter ‘saved’ the academic years 2019–2020 and, respectively, 2020–2021. The present study is useful for tertiary education institution and policymakers in terms of formulating strategies and policy recommendations to support teachers and students during any future pandemics.

Development and validation of a questionnaire to assess preventive practices against COVID-19 pandemic in the general population

Coronavirus Disease 2019 (COVID-19) pandemic has affected millions of people worldwide with far-reaching socio-economic implications in society. The adoption of preventive practices by the public remains the mainstay in reducing the spread of COVID-19 but there is a dearth of validated tools to assess such infection prevention practices related to pandemics. This study was conducted to develop and validate a questionnaire for the assessment of preventive practices against COVID-19 in the general population. It was done following a standardized protocol involving questionnaire development through literature review, focused group discussions, in-depth interviews, expert opinion, and pre-testing. This was followed by the validation of the questionnaire through a cross-sectional survey on 108 individuals from diverse backgrounds in New Delhi, India in July 2020. Exploratory factor analysis was used to evaluate construct validity. Internal consistency was assessed by Cronbach's alpha coefficient. The developed questionnaire for assessing preventive practices consists of two sections: the first section of 18 items to evaluate preventive practices and the second section of 19 items for assessing various reasons for deficiencies in the preventive practices. The first section has good content validity (CVR = 0.81 and S-CVI/Av = 0.97) and internal consistency (Cronbach's alpha coefficient 0.82). Thus, this questionnaire is a valid and reliable tool for the comprehensive assessment of preventive practices and barriers related to the COVID-19 pandemic. It will be useful in assessing the preparedness of the public and will be helpful to policymakers in designing appropriate interventions for protection against COVID-19.

Daily Associations Between Positive Emotion and Obesity-Related Behaviors and Their Interconnections Within Adolescent-Caregiver Dyads

Background Greater overall positive emotion has been linked with increased physical activity and overeating. High approach positive emotions (HAPEs), a subtype of positive emotion, are theorized to facilitate this goal-driven behavior. However, the day-to-day associations of HAPE and physical activity and overeating, including both at the individual level and within caregiver-adolescent dyads, remain unknown. Purpose We examined the independent and dyadic associations between HAPE (positive emotions that occur pregoal and motivate individuals toward approaching/acting upon that motive) and obesity-related behaviors, including physical activity and overeating, in adolescents and their primary caregivers. Methods Adolescents (N = 47) aged 11-17 and their caregivers completed demographic questions and a 7-day diary at the end of each day about daily emotion, and physical activity and overeating behaviors. Results For adolescents and their caregivers, increased day-to-day fluctuations in HAPE and greater average HAPE was associated with increases in their own daily physical activity levels. Greater average caregiver HAPE was also associated with increased overeating in caregivers. When examining interdependency within dyads, greater average caregiver HAPE was associated with greater adolescent overeating behavior. Conclusions There is evidence that HAPE is related to obesity-related health promoting behaviors and health risk behaviors in adolescence and adulthood. Future studies should further explore mechanisms underlying these associations, including within the family system.

Tools for the evaluation of the psychological impact of COVID-19: A practical guide for Family physicians and Primary Care Practitioners

The COVID-19 pandemic has affected the global population significantly and has resulted in physiological, psychological, social, and behavioral changes among the individuals. The prominent mental health effects of COVID-19 on the general and clinical populations have been well recognized. The family physicians and primary care practitioners from various disciplines are likely to encounter patients who are experiencing psychological distress manifested in the form of anxiety, depression, stress, insomnia, increased substance use, or other symptoms. This narrative review is aimed to present a bird's eye view of the psychological impact of COVID-19 on the general population and the various tools that are used to evaluate them. Besides, we intend to suggest a set of tools/questionnaires that can be used by the family physicians and primary care practitioners for generating data on the psychological impact of this pandemic.

Change in eating habits and physical activities before and during the COVID-19 pandemic in Hong Kong: a cross-sectional study via random telephone survey

BACKGROUND

Hong Kong is a densely populated city with a low incidence and mortality of coronavirus disease 2019 (COVID-19). The city imposed different levels of social distancing including, the closure of sports venues and restrictions on eateries. This inevitably affects the eating behaviour and physical activities of the population. We examined the changes in eating behavior and physical activities before and during the COVID-19 pandemic, and identified sociodemographic factors associated with the behavioral changes.

METHODS

This was a cross-sectional study via a random telephone survey of Chinese adults conducted in Hong Kong from May to June, 2020 - a period in which social distancing measures were being imposed. We measured the physical activity habits from four aspects and dietary consumption patterns from seven aspects before and during the pandemic based on the World Health Organization's guidelines and previous publications.

RESULTS

In total, 724 participants were recruited. Individuals were found to cook more frequently at home (p < 0.001) and order take-out (p < 0.001) during the COVID-19 pandemic. While no significant change in the frequency of fast food consumption was observed, we found significant increases in the frequency of eating fruits (p < 0.001) and vegetables (p = 0.004). The frequencies of walking, moderate-intensive sports, and high-intensity sports were significantly reduced (p < 0.001). We found that healthy lifestyle behaviors during the pandemic were negatively associated with participants' economic status.

CONCLUSIONS

Social distancing measures likely provided an opportunity for individuals to stay home and thus eat healthier. However, in a prolonged period of social restrictions, a lower physical activity level poses a risk to public health. Public health officials are thus advised to monitor physical health on a population-wide basis. The findings highlighted the importance of interventions tailored to individuals who have prolonged home stays - particularly for individuals in the low economic group.