COVID-19-related prejudice toward Asian medical students: A consequence of SARS-CoV-2 fears in Poland

Knowledge and Practice of Precautions and Prevention of COVID-19 Among Adolescents in Umuahia, Nigeria: A Cross-Sectional Study

Background The coronavirus disease 2019 (COVID-19) pandemic has posed significant challenges worldwide, particularly in developing countries with limited healthcare resources. Among the various demographics, adolescents represent a crucial group in understanding and curbing the spread of the virus. Aim This research aims to assess the level of knowledge and practice of COVID-19 prevention measures among adolescents in a developing country. Methodology This study's descriptive cross-sectional study design was appropriate for capturing a snapshot of adolescents' understanding of COVID-19 in Umuahia, Abia State, Nigeria, a developing country. The study's participants were secondary school students in Umuahia's urban and rural secondary schools, aged 10-19. Fisher's formula was used to calculate the sample size. A multistage systematic sampling method was used to select 424 participants. Data were gathered using a self-administered questionnaire. The Statistical Package for the Social Sciences (SPSS) software version 25 (IBM SPSS Statistics, Armonk, NY) was used to handle and evaluate the data that had been obtained. Results All the respondents were aware of COVID-19, primarily informed through social media and television (TV). It is concerning that less than half correctly identify the disease as caused by a virus (46.9%), with some falsely attributing it to bacteria (31.1%) or fungi (15.6%). While the majority of respondents knew about the existence of COVID-19 vaccines, only 63.4% were aware that there was no definitive cure for the disease. The most worrying finding was the limited awareness and practice of recommended precautions to prevent the spread of COVID-19. Handwashing with soap and water, social distancing, and using hand sanitizers were the most frequently recognized precautions. However, even these were poorly practiced, with less than 30% of the respondents following them regularly. It was also noted that misconceptions about precautions exist, including unusual practices such as regularly drinking hot water or eating bitter kola/pepperfruit. Also, the most prominent reason for refusal among the respondents for COVID-19 vaccines was parental refusal, accounting for 57.5% of negative responses. Conclusion The study's findings underscore the urgent need for tailored, accessible, and effective health education strategies to improve adolescents' understanding and adoption of COVID-19 preventive measures in the region.

Beyond COVID-19: the impact of recent pandemics on medical students and their education: a scoping review

INTRODUCTION

Over the past two years, coronavirus disease (COVID-19) has greatly altered medical student education as well as daily life. Medical schools across the world were disrupted and had to immediately adapt the educational experience to the online environment in order to continue the delivery of quality medical education. However, COVID-19 was not the only recent pandemic. This posed the question, were similar disruptions and adaptations also seen in recent past pandemics such as Severe Acute Respiratory Syndrome (SARS) or Middle East Respiratory Syndrome (MERS) that could have prepared medical educators for COVID-19? This scoping review investigated the educational and personal impact of recent pandemics on medical students.

METHODS

This review followed the PRISMA-ScR guidelines for scoping reviews. Nine databases including PubMed, ERIC, and EMBASE were systematically searched using keywords and subject headings related to medical students and SARS, H1N1, MERS, Ebola, Zika, and COVID-19. Studies were limited to research studies published between 2000 and 2020 and in English. Based on exclusion and inclusion criteria, all studies were independently screened by two reviewers first by the title/abstract and then via full text. Data were extracted from the included studies and analyzed qualitatively using thematic analysis.

RESULTS

A total of 174 studies fit the criteria. Seven major themes emerged from those studies: educational adaptations and online modifications, knowledge and attitudes of students, mental wellness of students, student involvement and use of telehealth, student vaccination, physical wellness of students, and stigma.

CONCLUSION

This review provided insights into how medical students were affected by recent pandemics and their perceptions of pivoting to online education, mental health, and knowledge of the diseases. Additionally, this review showcases the various educational adaptations that emerged uniquely during the COVID-19 pandemic, such as telehealth services or video conferencing tools, that can be utilized in a post-pandemic environment.

COVID-19 health information trust and prejudicial attitudes predict healthcare disruptions in the first year of COVID-19 among people living with HIV

Cross-sectional studies have reported that people living with HIV experienced disruptions to social relationships and healthcare during the first year of the COVID-19 pandemic. Furthermore, individuals with less trust in public health sources of COVID-19 information as well as those who held greater COVID-19 prejudicial attitudes experienced greater healthcare disruptions in the early months of COVID-19. To examine changes in trust and prejudicial attitudes in relation to healthcare disruptions during the first year of COVID-19, we followed a closed cohort of 115 men and 26 women ages 18 to 36 living with HIV over the first year of the COVID-19 pandemic. Findings confirmed that a majority of individuals continued to experience disruptions to their social relationships and healthcare over the course of the first year of COVID-19. In addition, trust in COVID-19 information from the CDC and state health department diminished over the year as did COVID-19 prejudicial attitudes. Regression models showed that lower trust in the CDC and health department and greater prejudicial attitudes toward COVID-19 early in the pandemic predicted greater healthcare disruptions over the year. In addition, greater trust in the CDC and health department early in COVID-19 predicted better antiretroviral therapy adherence later in the year. Results support an urgent need to regain and sustain trust in public health authorities among vulnerable populations.

Stigma and health inequality experienced by ethnic minorities during the COVID-19 pandemic in a Chinese community: an implication to health policymakers

Introduction

Ethnic minorities are considered one of the most vulnerable groups during the COVID-19 pandemic. However, the explanatory pathway of how their disadvantaged experiences during epidemics are related to the embedded and longstanding stigmas against them and how these embedded stigmas can affect their resilience in disease outbreaks are not well understood. This study investigated the experiences of ethnic minorities in the COVID-19 pandemic, and how their experiences were related to the embedded stigma toward them.

Methods

This study adopted a qualitative approach, interviewed 25 individuals (13 women and 12 men) from ethnic minority groups residing in Hong Kong from August 2021 to February 2022 in a semi-structured format. Thematic analysis was conducted to analyze the data.

Results

The participants were isolated and stereotyped as infectious during the COVID-19 pandemic at community and institutional levels. Their experiences did not occur suddenly during the pandemic but were embedded in the longstanding segregation and negative stereotypes toward ethnic minorities in different aspects of life before the pandemic. These negative stereotypes affected their resilience in living and coping with the pandemic.

Conclusion

The participants' experiences during the COVID-19 pandemic were mostly disadvantageous and predominantly initiated by the mainstream stigmatization toward them by the local Chinese residents and government. Their disadvantaged experiences in the pandemic should be traced to the embedded social systems, imposing structural disparities for ethnic minorities when accessing social and medical resources during a pandemic. Because of the preexisting stigmatization and social seclusion of ethnic minorities in Hong Kong, the participants experienced health inequality, which stemmed from social inequality and the power differential between them and the Chinese locals. The disadvantaged situation of the participants negatively affected their resilience to the pandemic. To enable ethnic minorities better cope with future epidemics, merely providing assistance to them during an epidemic is barely adequate, but a more supportive and inclusive social system should be established for them in the long run.

Racially minoritized people’s experiences of racism during COVID-19 in Australia: A qualitative study

OBJECTIVE

Drawing from a broader study exploring how New South Wales community members from racially minoritized backgrounds experienced living through a pandemic, this paper reports specifically on experiences of racism during the COVID-19 pandemic in 2020.

METHODS

Using an in-depth, qualitative interpretive approach, 11 semi-structured interviews and one focus group hosting three participants (n=14) were held via an online videoconferencing platform from September to December 2020. Inductive thematic analysis was undertaken using QRS NVivo as a data management tool.

RESULTS

Racism was heightened during the pandemic and experienced in various ways by racially minoritized peoples in New South Wales. All participants in this research cited experiences of racism that impacted their wellbeing during COVID-19. These experiences are represented by the following four themes: experiencing racism is common; how racisms are experienced; increased fear of racism during COVID-19; and ways of coping with racisms.

CONCLUSIONS

Racism was heightened during the pandemic and generated fear and anxiety that prevented racially minoritized peoples from participating in everyday life.

IMPLICATIONS FOR PUBLIC HEALTH

Messaging from broader public platforms must be harnessed to stop the spread of moral panic so that during times of pandemic, public health strategies need only confirmation, not creation.

Experience of Ethnic Discrimination, Anxiety, Perceived Risk of COVID-19, and Social Support among Polish and International Students during the Pandemic

BACKGROUND

Our research aimed to assess the experiences of ethnic discrimination among students in Poland (Polish and international) during the COVID-19 pandemic. We also tested the prevalence of anxiety symptoms and their relationship with perceived COVID-19 risk, the severity of discrimination, and social support.

METHODS

The data from Polish (n = 481) and international university students (n = 105) were collected online (November-January 2020). Participants completed measures of ethnic discrimination (GEDS), anxiety scale (GAD-7), COVID-19 risk perception index, and perceived social support scale (MSPSS) questionnaires.

RESULTS

The results showed that international students reported being much more discriminated than Polish students during the first year of the COVID-19 pandemic. Contrary to our expectation, a higher risk of anxiety disorders (GAD) was observed in 42% of Polish students compared to 31% of international students. The predictors of higher anxiety symptoms among both groups were the perceived risk of COVID-19 and the greater severity of ethnic discrimination. In both groups, the perceived social support had a protective role in anxiety symptomatology.

CONCLUSIONS

The high prevalence of discrimination, especially among international students, simultaneously with high symptoms of anxiety, requires vigorous action involving preventive measures and psychological support.

Experiences of COVID-19-Related Stigma: A Qualitative Study on Nurses Caring for Patients With COVID-19

BACKGROUND

Healthcare workers caring for patients with Coronavirus Disease 2019 (COVID-19) have been a primary target of stigmatization and discrimination during the COVID-19 outbreak. Thus, there is an urgent need to develop a support system for Asian healthcare workers who care for patients with COVID-19.

PURPOSE

This study was designed to understand the characteristics of COVID-19-related stigma experienced by nurses caring for patients with COVID-19.

METHODS

A qualitative content analysis methodology was used. This study was conducted between April 2020 and March 2021. The participants were 10 female registered nurses working at three medical facilities that accepted patients with COVID-19. The data included specific narratives on the instances of stigma experienced when caring for patients with COVID-19, including connected situations and ideas. The data were collected using focus group interviews with three or four participants in each group. Data analysis was conducted based on the inductive qualitative analysis approach of Krippendorff.

RESULTS

The content analysis identified two categories and seven subcategories of stigma experienced by clinical nurses. The category "directly experienced prejudice and discrimination" included the subcategories "being avoided," "being treated as dirty," "discrimination toward family members," and "others prying." The category "self-imposed coping behavior" included the subcategories "keeping oneself apart," "feeling guilty," and "nondisclosure."

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

The participants internalized their experiences of stigma, as Japanese culture emphasizes keeping such things to oneself. Therefore, there is an urgent need to strengthen the support system for nurses who care for patients with COVID-19. This study addressed the problem of the stigmatization of these nurses and their families by others as well as their colleagues. The main findings were that stigma was directly experienced as discrimination and prejudice and often resulted in self-imposed coping behavior. The major implication of these findings is the need to establish systematic, active, and ongoing organizational support programs for nurses who are discriminated against because of COVID-19-related stigma.

The scar that takes time to heal: A systematic review of COVID-19-related stigma targets, antecedents, and outcomes

COVID-19, as a crucial public health crisis, has affected our lives in nearly every aspect. Besides its major health threats, COVID-19 brings severe secondary impacts, one of which is the rise of social stigma. Although numerous studies have examined the antecedents and outcomes of COVID-19-related stigma, we still lack a systematic understanding of who is being stigmatized during the COVID-19 pandemic, what exacerbates COVID-19-related stigma, and what impacts COVID-19-related stigma has on victims. Therefore, this review aims to provide a systematic overview of COVID-19-related stigma. With 93 papers conducted with 126,371 individuals in more than 150 countries and territories spanning five continents, we identify three targets that have received the most research: Chinese/Asian people, (suspected) patients and survivors, and healthcare workers. Furthermore, we find that for each stigma target, characteristics of the stigmatized, stigmatizer, and context contribute to COVID-19-related stigma and that this stigma negatively influences victims' health and non-health outcomes. We call for future research to provide a more integrative, balanced, and rigorous picture of COVID-19-related stigma via conducting research on neglected topics (e.g., contextual factors that contribute to stigma toward HCWs) and stigma interventions and using a longitudinal design. In practice, we urge governments and institutions (e.g., ministries of public health, hospitals) to pay close attention to stigma issues and to promote safe and inclusive societies.

Spread of misinformation during COVID-19: The case of Mauritius

As COVID-19 continues to spread rapidly across the globe, it is imperative to regulate the content of information such that people have access to accurate information. Nevertheless, there is the fear that governments are abusing legislation to limit freedom of expression and that the pandemic is simply being used as an excuse to further obstruct free speech. As such, it is through the lens of human rights that this research critically examines the approaches undertaken by the Mauritian authorities to deal with misinformation during COVID-19. To achieve this research objective, the related laws on misinformation are critically assessed and a comparative analysis is caried out of international responses to misinformation during COVID-19. It has been noted that the law alone is not sufficient to deal with misinformation, and media literacy among citizens is also essential in this endeavour.

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

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

Health System- and Patient-Related Factors Associated with COVID-19 Mortality among Hospitalized Patients in Limpopo Province of South Africa’s Public Hospitals

South Africa has recorded the highest COVID-19 morbidity and mortality compared to other African regions. Several authors have linked the least amount of death in African countries with under-reporting due to poor health systems and patients’ health-seeking behaviors, making the use of clinical audits more relevant for establishing the root causes of health problems, and improving quality patient care outcomes. Clinical audits, such as mortality audits, have a significant role in improving quality health care services, but very little is documented about the outcomes of the audits. Therefore, the study sought to determine the health care system and patient-related factors associated with COVID-19 mortality by reviewing the COVID-19 inpatient mortality audit narration reports. This was a retrospective qualitative research approach of all hospitalized COVID-19 patients, resulting in death between the first and second COVID-19 pandemic waves. Thematic analysis employed inductive coding to identify themes from mortality audits from all 41 public hospitals in Limpopo Province, South Africa. Four themes with seventeen sub-themes emerged: sub-standard emergency medical care provided, referral system inefficiencies contributed to delays in access to health care services, the advanced age of patients with known and unknown comorbidities, and poor management of medical supplies and equipment, as a health system and patient-related factors that contributed to the high mortality of COVID-19 patients. There is a need to routinely conduct clinical audits to identify clinical challenges and make recommendations for health promotion, risk communication, and community engagement. We recommend reviewing and expanding the scope of practice for health-care providers during epidemics and pandemics that include aspects such as task-shifting.

Impact of mild COVID-19 on balance function in young adults, a prospective observational study

Balance is of essential importance in human life. The aim of the study is to examine the incidence of balance impairments in young adults who have recovered from mild COVID-19. The study involved 100 subjects, divided into two groups: the study group (50 individuals) comprised subjects who had recovered from mild COVID-19, and the control group (50 individuals) consisted of healthy subjects matched for gender and age. Balance was assessed using a force platform and clinical tests such as: timed up and go test, 15-s step test, sit-to-stand test and 6-min walk test. The assessment on the platform showed greater balance impairments in the trials with eyes closed; more specifically, compared to the controls, in trials with double-leg support the subjects from the study group acquired significantly higher scores in X average (lateral coordinates) (p < 0.05), Path length, V average (average Centre of Foot Pressure Velocity) (p < 0.05) and Area circular (p < 0.01), with even more significant results in trials with single-leg support in X average (p < 0.001), Y average (anterior–posterior coordinates) (p < 0.001) and Path length (p = 0.004). Higher scores in the timed up and go test were found in the study group (p = 0.013). The control group had higher scores in the remaining tests. The current findings show that mild COVID-19 may lead to balance impairments in young adults. Statistically significant differences in balance were found between the subjects in the study group and the healthy controls. Further studies in this area should take into account more age groups, and patients recovered from severe COVID-19, and should investigate long-term consequences of COVID-19 reflected by balance problems.

Lived experiences of Asian Canadians encountering discrimination during the COVID-19 pandemic: a qualitative interview study

BACKGROUND

Asian Canadians have experienced increased cases of racialized discrimination after the first emergence of SARS-CoV-2 in China. This study examined how the COVID-19 pandemic has affected Asian Canadians' sense of safety and belonging in their Canadian (i.e., geographical) communities.

METHODS

We applied a qualitative description study design in which semistructured interviews were conducted from Mar. 23 to May 27, 2021. Purposive and snowball sampling methods were used to recruit Asian Canadians diverse in region, gender and age. Interviews were conducted through Zoom videoconference or telephone, and independent qualitative thematic analysis in duplicate was used to derive primary themes and subthemes.

RESULTS

Thirty-two Asian Canadians (median age 35 [interquartile range 24-46] yr, 56% female, 44% East Asian) participated in the study. We identified 5 predominant themes associated with how the COVID-19 pandemic affected the participants' sense of security and belonging to their communities: relation between socioeconomic status (SES) and exposure to discrimination (i.e., how SES insulates or exposes individuals to increased discrimination); politics, media and the COVID-19 pandemic (i.e., the key role that politicians and media played in enabling spread of discrimination against and fear of Asian people); effect of discrimination on mental and social health (i.e., people's ability to interact and form meaningful relationships with others); coping with the impact of discrimination (i.e., the way people appraise and move forward in identity-threatening situations); and implications for sense of safety and sense of belonging (i.e., people feeling unable to safely use public spaces in person, including the need to remain alert in anticipation of harm, leading to distress and exhaustion).

INTERPRETATION

During the COVID-19 pandemic, Asian Canadians in our study felt unsafe owing to the uncertain, unexpected and unpredictable nature of discrimination, but also felt a strong sense of belonging to Canadian society and felt well connected to their Asian Canadian communities. Future work should seek to explore the influence of social media on treatment of and attitudes toward Asian Canadians.

Stigma, Uncertainty, and Coping at the Time of COVID-19 Pandemic Amid Health Care Professionals: How Far Have We Gone?

Stigma and uncertainty are noticed in global pandemics. Their impacts on health care providers tend to persist notably during and after the outbreaks. Our objective was to assess stigma, uncertainty, and coping among health care providers through an online survey using the Discrimination and Stigma Scale Version 12 (DISC-12) modified version to assess stigma related to treating COVID-19, the Intolerance of Uncertainty Scale, and the Brief Resilient Coping Scale (BRCS). Of the respondents (n = 65), 63.1% treated patients with COVID-19, and 21.5% worked in isolation hospitals. Physicians who treated patients with COVID-19 had significantly higher scores in all DISC subscales: unfair treatment (8.73 ± 6.39, p = 0.001), stopping self from doing things (2.05 ± 1.41, p = 0.019), overcoming stigma (1.17 ± 0.80, p = 0.035), and positive treatment (1.90 ± 1.65, p = 0.005). Unfair treatment was negatively correlated with BRCS (r = -0.279, p = 0.024). On the other hand, physicians who did not treat patients with COVID-19 had significantly higher BRCS scores. We concluded that frontline physicians experienced greater stigma associated with lower resilient coping strategies.

Telenutrition: Changes in Professional Practice and in the Nutritional Assessments of Italian Dietitian Nutritionists in the COVID-19 Era

The COVID-19 pandemic has brought about various restrictions around the world, and its impact on healthcare has been enormous: RDNs have had to shift from in-person interactions with clients to telenutrition consultations, encountering obstacles. We designed the first survey to investigate the changes in RDN practices related to telenutrition provision after the onset of the pandemic through an online survey in Italy. Four hundred and thirty-six responses were analyzed. Before the pandemic, only 16% of Italian RDNs provided telenutrition; this percentage increased significantly up to 63% (p < 0.001). Among patients, the lack of interest in accessing telenutrition (30.9%) and the Internet (16.7%) were the most frequently reported barriers. Among RDNs, one of the main obstacles was their inability to conduct nutritional evaluation or monitoring activities (24.4%). Our survey indicated that increased adoption of telenutrition can be a valid, safe alternative to face-to-face visits. Telenutrition was mainly used by young RDNs (20−39 years) with fewer years of professional experience (0−20 years) and master’s degrees. Remote nutrition can enable RDNs to maintain normal workloads and provide patients with uninterrupted access to nutritional healthcare. It is important that RDNs using telemedicine resources possess the ability to provide high-quality, efficient, and secure services using evidence-based guidance.

Choices of Specialties and Training Sites among Taiwanese Physicians Graduating from Polish Medical Schools

Taiwanese students who graduated from Polish medical schools (P-IMGs) accounted for the second-largest group of international medical graduates in Taiwan. In 2009, domestic medical students in Taiwan staged mass demonstrations against P-IMG’s exemption from the qualifying test before the licensing exam. Although medical circles in Taiwan might still hold prejudices against P-IMGs, little is known about their career development. This study will analyze P-IMGs’ choices of specialties and training sites from 2000 to 2020 using data from the membership section of the Taiwan Medical Journal, the monthly official publication of the Taiwan Medical Association. Of 372 P-IMGs, 34.2% chose internal medicine and 17.1% surgery. Although academic medical centers offered 76% of all available trainee positions in a year, only 49.3% of P-IMGs received training there. By contrast, 20.9% of P-IMGs were trained at nonmetropolitan hospitals that altogether accounted for only 5.8% of trainee positions. In conclusion, P-IMGs had their residency training at less favorable specialties and sites. Their long-term career development deserves further study.

Influencing Factors on College Students' Willingness to Spread Internet Public Opinion: Analysis Based on COVID-19 Data in China

Following COVID-19 outbreak, Internet public opinion has tended to proliferate. From a theoretical perspective, however, the spread law of Internet public opinion in major epidemic prevention and control may provide optimization strategies on how best to channel Internet public opinion. Specifically, this article aims at exploring key factors affecting our theoretical understanding on the spread of Internet public opinion on a major epidemic situation amongst college students. A questionnaire survey on college students was conducted via online research data collection platform located in Changsha, China, amassing three hundred and nineteen valid questionnaires. Smart PLS was applied to verify a theoretical model vis-à-vis the reliability and validity of the measuring instrument. Results show that adult attachment and social motivation have significant positive influences on the consciousness of social participation. Evidently, adult attachment, emotional orientation and risk perception also have significant positive influences on emotional motivation. Emotional motivation plays a mediating role in the relationship between affective disposition and dissemination willingness. Additionally, social motivation, consciousness of social participation and emotional motivation significantly influence one's dissemination willingness in a positive way. The consciousness of social participation plays a mediating role in the relationship between social motivation and dissemination willingness. Social motivation plays a moderating role in the relationship between risk perception and dissemination willingness. Altogether, theoretical rationalization to enhance understanding and guide the initiation and spread of Internet public opinion of major public health emergencies accurately has now been provided by this work.

Political beliefs and the acceptance of the SARS-CoV-2 pandemic restrictions. The case of Poland

We investigated the relationships between political beliefs regarding two aspects of the right-left distinction (cultural and economic) and the acceptance of the pandemic restrictions using variable-centred and person-centred approaches. The community sample consisted of 305 participants. Four groups of the restrictions were considered. Religious fundamentalism predicted positively the acceptance of the restrictions associated with the limitations of labour rights and those limiting civil rights without a direct impact on safety. Anti-welfare negatively predicted the acceptance of the restrictions regarding social distancing and those limiting civil rights and increasing safety. These associations were discussed in relation to basic needs and values which motivate persons who endorse right-wing or left-wing political views. The latent profile analysis revealed three profiles of political beliefs, which were termed "Conservative Statists," "Liberal Laissez-fairists," and "Conservative Laissez-fairists." The profiles differed in terms of acceptance of the pandemic restrictions, and the patterns of these relationships were different for particular groups of restrictions.

Impact of infectious disease epidemics on xenophobia: a systematic review

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Xenophobia has a significant impact on the health of international migrants.

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During an infectious disease outbreak, stigma and prejudice are highly pronounced.

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Migrants, often seen as disease carriers, are socially rejected during epidemics.

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Ensure an equal treatment and healthcare assistance for migrants is imperative.

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Educational interventions are urgently needed to prevent xenophobic tendencies.

Background Globally, xenophobia towards out-groups is frequently increased in times of economic and political instability, such as in infectious disease outbreaks. This systematic review aims to: (1) assess the xenophobic attitudes and behaviors towards migrants during disease outbreaks; and (2) identify adverse health outcomes linked to xenophobia. Methods We searched nine scientific databases to identify studies measuring xenophobic tendencies towards international migrants during disease outbreaks and evaluated the resulting adverse health effects. Results Eighteen articles were included in the review. The findings were grouped into: (1) xenophobia-related outcomes, including social exclusion, out-group avoidance, support for exclusionary health policies, othering, and germ aversion; and (2) mental health problems, such as anxiety and fear. Depending on the disease outbreak, different migrant populations were negatively affected, particularly Asians, Africans, and Latino people. Factors such as perceived vulnerability to disease, disgust sensitivity, medical mistrust individualism, collectivism, disease salience, social representation of disease and beliefs in different origins of disease were associated with xenophobia. Conclusions Overall, migrants can be a vulnerable population frequently blamed for spreading disease, promoting irrational fear, worry and stigma in various forms, thus leading to health inequities worldwide. It is urgent that societies adopt effective support strategies to combat xenophobia and structural forms of discrimination against migrants.

Homemade food, alcohol, and body weight: Change in eating habits in young individuals at the time of COVID-19 Lockdown

BACKGROUND

The 2019 coronavirus disease (COVID-19) lockdown has caused significant changes in everyday life. This study evaluated the effect of the COVID-19 quarantine on dietary and alcohol consumption habits and body weight of Italian university students.

MATERIALS AND METHODS

An online cross-sectional survey was carried out among university students than 18 years in July 2020. The online self-administered questionnaire included demographic and anthropometric data (reported weight and height), weight, and dietary habits changes during of the COVID-19 lockdown.

RESULTS

A total of 520 respondents have been included in the study. A total of 393 (~76%) were female, 3.8% was obese, and the mean age was 23 ± 4 years. Numerous students reported a change in their eating habits during the lockdown with an increase in consumption of chocolate (40%), ice cream, and desserts (34%), but most of all an increase of homemade bread and pasta (60%), pizza (47%), and homemade sweets (55%). The students also reported an increase of vegetables, fresh fruit, legumes, eggs, and coffee, but also of processed meat, fried foods, cheeses, butter, and sweet beverage, and a reduction in alcohol intake. The weight gain was observed in 43.8%, and males have greater weight gain than females (57% vs. 46%, respectively; P = 0.04). A greater increase in body weight was observed in obese as compared to those with normal weight (77% vs. 44%, respectively; P < 0.001).

CONCLUSIONS

Our data highlighted the need for dietary guidelines to prevent weight gain during the period of self-isolation, especially targeting those with overweight and obesity.

COVID-19 vaccinations: The unknowns, challenges, and hopes

The entire world has been suffering from the coronavirus disease 2019 (COVID‐19) pandemic since March 11, 2020. More than a year later, the COVID‐19 vaccination brought hope to control this viral pandemic. Here, we review the unknowns of the COVID‐19 vaccination, such as its longevity, asymptomatic spread, long‐term side effects, and its efficacy on immunocompromised patients. In addition, we discuss challenges associated with the COVID‐19 vaccination, such as the global access and distribution of vaccine doses, adherence to hygiene guidelines after vaccination, the emergence of novel severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) variants, and vaccine resistance. Despite all these challenges and the fact that the end of the COVID‐19 pandemic is still unclear, vaccines have brought great hope for the world, with several reports indicating a significant decline in the risk of COVID19‐related infection and hospitalizations.

1.

Vaccination plays a pivotal role in reducing the death toll of the COVID‐19 infection.

2.

The immunity provided by vaccines is still disputable leading to some challenges like the asymptomatic spread; therefore, staying strict to hygiene guidelines is necessary.

3.

Hence, COVID‐19 vaccines' related long‐term side effects are still unknown; cautions should be taken when injected to various individuals of the community.

4.

COVID‐19 vaccines' effectiveness are strongly related to their effect on emergent COVID‐19 variants, but until now approved vaccines can still show some protective effects against new variants.

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.

Pandemic-related racial discrimination and its health impact among non-Indigenous racially minoritized peoples in high-income contexts: a systematic review

This study aims to review articles reporting the perspectives and experiences of pandemic-related discrimination among racially minoritized peoples in high-income contexts. We searched online databases (Medline, EMBASE, PsycINFO, Web of Science, and ProQuest) for peer-reviewed articles published between January 2002 and October 2020. Eligible studies reported either quantitative or qualitative accounts of pandemic-related discrimination from the perspectives of racially minoritized peoples in high-income contexts. Two authors screened 30% of titles/abstracts, and all full-text articles. Each article included for extraction underwent a quality assessment by two reviewers. Data were extracted and categorized thematically using NVivo 12, followed by a secondary analysis informed by critical race theory. Of the 1289 articles screened, 16 articles from five countries met the inclusion criteria. Racial discrimination is heightened during pandemic periods, due to the social association of specific racial groups with pandemic diseases including COVID-19, SARS (Asian), H1N1 (Hispanic) and Ebola (African). Fear based responses to racially minoritized peoples during pandemic periods included verbal/physical abuse, hypersurveillance, and avoidance, often occurring in public spaces. Pandemic-related racism had subsequent impacts on mental health and health care accessibility. Various coping strategies, including community support, avoidance, and problem solving, were documented in response to racial discrimination. Racialized discrimination and violence is a serious threat to the health and wellbeing of racially minoritized peoples, particularly due to its increase during pandemic periods. Racism must be recognized as a public health issue, and efforts to address its increased impact in pandemic contexts should be made, including ensuring that adequate representation of racially minoritized groups is present in policy, planning, and implementation.

Priming COVID-19 salience increases prejudice and discriminatory intent against Asians and Hispanics

Mounting reports in the media suggest that the COVID-19 pandemic has intensified prejudice and discrimination against racial/ethnic minorities, especially Asians. Existing research has focused on discrimination against Asians and is primarily based on self-reported incidents or nonrepresentative samples. We investigate the extent to which COVID-19 has fueled prejudice and discrimination against multiple racial/ethnic minority groups in the United States by examining nationally representative survey data with an embedded vignette experiment about roommate selection (collected in August 2020; n = 5,000). We find that priming COVID-19 salience has an immediate, statistically significant impact: compared to the control group, respondents in the treatment group exhibited increased prejudice and discriminatory intent against East Asian, South Asian, and Hispanic hypothetical room-seekers. The treatment effect is more pronounced in increasing extreme negative attitudes toward the three minority groups than decreasing extreme positive attitudes toward them. This is partly due to the treatment increasing the proportion of respondents who perceive these minority groups as extremely culturally incompatible (Asians and Hispanics) and extremely irresponsible (Asians). Sociopolitical factors did not moderate the treatment effects on attitudes toward Asians, but prior social contact with Hispanics mitigated prejudices against them. These findings suggest that COVID-19-fueled prejudice and discrimination have not been limited to East Asians but are part of a broader phenomenon that has affected Asians generally and Hispanics as well.

Prejudicial beliefs and COVID-19 disruptions among sexual minority men living with and not living with HIV in a high SARS-CoV-2 prevalence area

The COVID-19 pandemic has had profound health and social impacts. COVID-19 also affords opportunities to study the emergence of prejudice as a factor in taking protective actions. This study investigated the association of COVID-19 concerns, prejudicial beliefs, and personal actions that involve life disruptions among people not living with and people living with HIV. 338 Black/African American men not living with HIV who reported male sex partners and 148 Black/African American men living with HIV who reported male sex partners completed a confidential survey that measured COVID-19 concern, COVID-19 prejudice, and personal action and institutionally imposed COVID-19 disruptions. Participants reported having experienced multiple social and healthcare disruptions stemming from COVID-19, including reductions in social contacts, canceling medical appointments, and inability to access medications. Mediation analyses demonstrated that COVID-19 concerns and COVID-19 prejudice were associated with personal action disruptions, indicating that these social processes are important for understanding how individuals modified their lives in response to COVID-19. It is imperative that public health efforts combat COVID-19 prejudice as these beliefs undermine investments in developing healthcare infrastructure to address COVID-19 prevention.

The Effects of COVID-19 on the Eating Habits of Children and Adolescents in Italy: A Pilot Survey Study

Nutrition during childhood and adolescence is very important for growth and can have long-term health implications. The COVID-19 lockdown caused significant changes in everyday life, including in children and adolescents. This study evaluated the effects of the first COVID-19 lockdown on eating habits and body weight in children and adolescents. An online cross-sectional survey was carried out among the parents of children (5-9 years) and adolescents (10-14 years) living in Italy. The online self-administered questionnaire included demographic and anthropometric data (reported weight and height) weight and dietary habit changes during the COVID-19 lockdown in Italy (March to June 2020). A total of 439 participants were included. We found a change in eating habits with an increase in consumption of sweet packaged snacks (34%) and processed meat (25%), as well as bread, pizza and bakery products (47%). We also found an increase in vegetable, fresh fruit and legume intake (19%), and a reduction in sweet beverage and candy intake. A total of 59.7% of the participants reported body weight gain, with adolescents gaining more than children (67% vs. 55%, p = 0.010, respectively). In children, body weight gain was associated with a change in body height and increased consumption of dairy products and sweet packaged snacks, while in adolescents it was associated with an increased intake of comfort foods and processed meat. Our data highlighted the need to carefully monitor eating behaviors to avoid the establishment of unhealthy eating habits and prevent obesity in children and adolescents during periods of self-isolation.

A Bibliometric Review of Research on International Students' Mental Health: Science Mapping of the Literature from 1957 to 2020

The mental health of university students is not only a predominant topic for psychology and education researchers but also a source of interest for policymakers and various stakeholders. Although there has been a lot of research on higher education students’ mental health, we have little understanding on the mental health of international students (MHIS). Despite their distinctive characteristics compared to native students, the mental health issues of international students only started receiving attention very recently. So far, the literature on this topic lacks a comprehensive overview of its sub-topic and trending issues. By using bibliometric analysis, this research aims to fulfil this gap and provide a review of the extant literature about MHIS. Specifically, this study aims to (i) draw the growth trajectory and geographic distribution of the literature on MHIS; (ii) identify the documents and authors that have the greatest impact, generally and locally, within the major topic clusters of the literature on MHIS; and (iii) identify the most researched keywords in the literature on MHIS over time. The results have shown that academic documents about international students’ mental health are increasing in number and becoming more extensive content-wise. The research’s findings provide implications for stakeholders and identifies some prominent research avenues for the future.

SARS-CoV-2 among migrants and forcibly displaced populations: A rapid systematic review

The economic and health consequences of the COVID-19 pandemic pose a particular threat to vulnerable groups, such as migrants, particularly forcibly displaced populations. The aim of this review is (i) to synthesize the evidence on risk of infection and transmission among migrants, refugees, asylum seekers and internally displaced populations, and (ii) the effect of lockdown measures on these populations. We searched MEDLINE and WOS, preprint servers, and pertinent websites between 1st December 2019 and 26th June 2020. The included studies showed a high heterogeneity in study design, population, outcome and quality. The incidence risk of SARS-CoV-2 varied from 0•12% to 2•08% in non-outbreak settings and from 5•64% to 21•15% in outbreak settings. Migrants showed a lower hospitalization rate compared to non-migrants. Negative impacts on mental health due to lockdown measures were found across respective studies. However, findings show a tenuous and heterogeneous data situation, showing the need for more robust and comparative study designs.

COVID 19 related perceived discrimination in medical settings, March and April 2020

Global spread of a disease causes fear that can lead to discrimination against the people infected with the disease. On December 2019, COVID-19 emerged in Wuhan, China, and has spread throughout the world. In this descriptive and analytic study Perceived discrimination of the patients admitted to COVID-19 wards was measured in medical settings. Data was collected of 176 patients discharged in March and April 2020. Discrimination scale was used to collect data in medical settings. Overall mean score of the scale was 11.51 ± 3.883 indicating low level of perceived discrimination. The highest level of discrimination belonged to refusal of physicians and nurses to physically examine the patients (0.992 ± 3.49). Low level of perceived discrimination was reported in this study, which necessitated taking useful measures to identify discrimination, determines causes and prevent discriminatory behaviors in medical settings to improve the hospitalization experience and disease outcomes.

Causes of anxiety among teachers giving face-to-face lessons after the reopening of schools during the COVID-19 pandemic: a cross-sectional study

BACKGROUND

Coronavirus infections are spreading rapidly worldwide, and primary and middle schools are closed in many countries. After the state of emergency was lifted in Japan, schools have reopened, and teachers are conducting face-to-face classes while maintaining safety precautions. This study aimed to assess the factors contributing to infection-related anxiety and educational anxiety among teachers conducting face-to-face classes during the COVID-19 pandemic after schools reopened.

METHODS

This questionnaire-based cross-sectional study was conducted with 263 primary and middle school teachers in the Shinagawa area of Tokyo (October 10-30, 2020). The questionnaire assessed the type of school (primary or middle school), sex, age, and factors contributing to infection-related anxiety and educational anxiety that arose from the pandemic. The levels of anxiety and the factors contributing to anxiety were assessed using a 5-point Likert scale ranging from 1 (not at all) to 5 (very anxious).

RESULTS

In an analysis of the data of 237 participants excluding the missing data, many teachers reported feeling infection- and education-related anxiety. A majority of the participants were women (n = 152, 64.1%), and the mean age of the participants was 39.8 ± 11.3 years. A stepwise multiple regression analysis identified six factors for infection-related anxiety as significant (R² = 0.61, p < 0.001). Among these variables, the largest partial regression coefficient value was reported for the following reason: "I feel anxious because we cannot ensure the safety of teachers themselves or of their families" (β = 0.37, p < 0.001). For educational anxiety, four of six reasons were identified as significant (R² = 0.64, p < 0.001). Among these, "anxiety about the students' home situations" (β = 0.41, p < 0.001) and "delay in education (students' side)" (β = 0.27, p < 0.001) had stronger associations with anxiety compared to the others.

CONCLUSION

In-person education during the COVID-19 pandemic has caused teachers to experience anxiety. This report provides useful information by highlighting the reasons for infection-related anxiety and educational anxiety that teachers experience in face-to-face classes during a pandemic. Even if the coverage of a COVID-19 vaccine becomes widespread worldwide, we will still be combating COVID-19 infections for at least a few years. Given concerns regarding such infections, to ensure students' right to education, it is essential to understand why teachers feel anxious and to determine appropriate measures to decrease such anxiety.

Discrimination and Sleep among Asians and Pacific Islanders Adults

STUDY OBJECTIVES

To examine the association between discrimination and sleep duration and difficulty among Asians and Pacific Islanders (APIs) in the United States, and to test nativity and ethnic identity (EI) as effect modifiers.

METHODS

This cross-sectional study of 1,765 adults from the National Epidemiology Study of Alcohol and Related Conditions III, assessed discrimination using the Experiences of Discrimination scale. Discrimimation was classified as low, moderate, and high. Regression models were used to examine self-reported sleep duration and difficulty.

RESULTS

In bivariate analyses, individuals with high discrimination had the shortest sleep and reported sleep difficulty most often. Using linear models adjusted for sociodemographic and health characteristics, moderate and high discrimination were associated with 9 minutes (standard error [SE]: 4.8, p <0.10) and 14.4 minutes (SE: 6.0, p <0.05) less sleep, respectively, relative to low discrimination. Individuals with moderate and high discrimination had higher prevalence of sleep difficulty compared to those with low discrimination (prevalence ratio [PR]: 1.51, 95% confidence interval [CI]: 1.14-1.99 and PR: 1.73, 95% CI: 1.33-2.24, respectively). Interaction effect was observed in sleep difficulty by nativity and EI, but not duration. The association between discrimination and sleep difficulty was stronger among US-born relative to foreign-born participants. Among participants with low EI, moderate and high discrimination were associated with sleep difficulty, whereas among those with high EI, only high discrimination displayed this association.

CONCLUSIONS

Discrimination is associated with sleep duration and difficulty, and varies by nativity and EI. Research is needed to improve sleep among APIs that experience discrimination.[.

Instruments to measure fear of COVID-19: a diagnostic systematic review

BACKGROUND

The COVID-19 pandemic has become a source of fear across the world. Measuring the level or significance of fear in different populations may help identify populations and areas in need of public health and education campaigns. We were interested in diagnostic tests developed to assess or diagnose COVID-19-related fear or phobia.

METHODS

We performed a systematic review of studies that examined instruments diagnosing or assessing fear or phobia of COVID-19 (PROSPERO registration: CRD42020197100). We utilized the Norwegian Institute of Public Health's Live map of covid-19 evidence, a database of pre-screened and pre-categorized studies. The Live map of covid-19 evidence identified references published since 1 December 2019 in MEDLINE, Embase, and the Centers for Disease Control and Prevention. Following biweekly searches, two researchers independently categorized all studies according to topic (seven main topics, 52 subordinate topics), population (41 available groups), study design, and publication type. For this review, we assessed for eligibility all studies that had been categorized to the topic "Experiences and perceptions, consequences; social, political, economic aspects" as of 25 September 2020, in addition to hand-searching included studies' reference lists. We meta-analyzed correlation coefficients of fear scores to the most common reference tests (self-reports of anxiety, depression, and stress), and reported additional concurrent validity to other reference tests such as specific phobias. We assessed study quality using the QUADAS-2 for the minority of studies that presented diagnostic accuracy statistics.

RESULTS

We found 18 studies that validated fear instruments. Fifteen validated the Fear of COVID-19 scale (FCV-19S). We found no studies that proposed a diagnosis of fear of COVID-19 or a threshold of significant/clinical versus non-significant/subclinical fear. Study quality was low, with the most common potential biases related to sampling strategy and un-blinded data analysis. The FSV-19S total score correlated strongly with severe phobia (r = 0.703, 95%CI 0.634-0.761) in one study, and moderately with anxiety in a meta-analysis.

CONCLUSIONS

The accuracy of the FSV-19S needs to be measured further using fear-related reference instruments, and future studies need to provide cut-off scores and normative values. Further evaluation of the remaining three instruments is required.

The Psychological and Academic Effects of Studying From the Home and Host Country During the COVID-19 Pandemic

Objective: This study explored the psychological and academic effects of studying online from the home vis-à-vis host country during the coronavirus disease 2019 (COVID-19) pandemic in the experience of international students at the University of Warsaw, Poland. Methods: A total of 357 international students from 62 countries (236 in the host country and 121 in the home country) completed an online questionnaire survey 2 months after transition to online learning. We studied students' levels of loneliness, life and academic satisfaction, acculturative stress, academic adjustment, performance, loyalty, and perceptions of the online learning experience. Results: The country-of-residence variable had no statistically significant effects on most psychological and academic variables. Significant effects were observed only for two academic variables. Specifically, students who returned to the home country found online communication with other students more contributing to their online learning experience and exhibited higher academic adjustment than students who remained in the host country. This suggests the positive influence of (peer and familial) support on online learning experience from the home country. Furthermore, a significant difference in experiencing acculturative stress occurred for students in quarantine/self-isolation in the host country, which expands prior literature on the disruptive effects of social distancing on students' mental health. Finally, this study confirmed the expected increased levels of loneliness among self-isolating students in both countries, hence extending prior results to the home- and host-country contexts. No relationship between self-isolation and students' life or academic satisfaction was found, which is explained by the specific nature of the learning-from-home experience.

Medical students as the volunteer workforce during the COVID-19 pandemic: Polish experience

In response to the COVID-19 pandemic medical students in different countries were mobilized to support healthcare systems during the emergency. This study presents the experience of 580 students of a single medical university in Poland who served as volunteers at different healthcare units during the first six months of the first case being recorded in the country (March-September 2020). The mean ± SD hours and days spent on volunteering in the studied group were 52 ± 36 h and 144 ± 126 d, respectively, the collective number of worked hours amounted to 83,460 h. Compared to other fields of study students of medicine engaged in volunteering for more hours and for more days. The main tasks performed by the surveyed group included triage, servicing call-centers for patients and working at the admission ward, hospital clinics, emergency departments and diagnostic labs. The level of fear at the beginning of volunteering was relatively low in the studied group and did not increase over the course. The majority of students received positive feedback from families, friends, patients and healthcare workers, revealed a high level of satisfaction from volunteering (also when experiencing COVID-19-related prejudice), while gaining professional experience and a sense of giving real aid were among the most frequently indicated benefits. The results of the present study demonstrate that although medical students are not essential workers in response to the COVID-19 pandemic, they can be of real assistance to healthcare systems during times of emergency, and should be considered as such in the future in case such a need arises again.

Medical students as the volunteer workforce during the COVID-19 pandemic: Polish experience

In response to the COVID-19 pandemic medical students in different countries were mobilized to support healthcare systems during the emergency. This study presents the experience of 580 students of a single medical university in Poland who served as volunteers at different healthcare units during the first six months of the first case being recorded in the country (March-September 2020). The mean ± SD hours and days spent on volunteering in the studied group were 52 ± 36 h and 144 ± 126 d, respectively, the collective number of worked hours amounted to 83,460 h. Compared to other fields of study students of medicine engaged in volunteering for more hours and for more days. The main tasks performed by the surveyed group included triage, servicing call-centers for patients and working at the admission ward, hospital clinics, emergency departments and diagnostic labs. The level of fear at the beginning of volunteering was relatively low in the studied group and did not increase over the course. The majority of students received positive feedback from families, friends, patients and healthcare workers, revealed a high level of satisfaction from volunteering (also when experiencing COVID-19-related prejudice), while gaining professional experience and a sense of giving real aid were among the most frequently indicated benefits. The results of the present study demonstrate that although medical students are not essential workers in response to the COVID-19 pandemic, they can be of real assistance to healthcare systems during times of emergency, and should be considered as such in the future in case such a need arises again.

Taking a lesson from the COVID-19 pandemic: Preventing the future outbreaks of viral zoonoses through a multi-faceted approach

The pandemic of the novel coronavirus disease 2019 (COVID-19) has caused a significant burden to healthcare systems, economic crisis, and public fears. It is also a lesson to be learned and a call-to-action to minimize the risk of future viral pandemics and their associated challenges. The present paper outlines selected measures (i.e., monitoring and identification of novel viral agents in animals, limitations to wildlife trade, decreasing hunting activities, changes to mink farming and meat production), the implementation of which would decrease such a risk. The role of viral surveillance systems and research exploring the virus strains associated with different animal hosts is emphasized along with the need for stricter wild trade regulations and changes to hunting activities. Finally, the paper suggests modifications to the meat production system, particularly through the introduction of cultured meat that would not only decrease the risk of exposure to novel human viral pathogens but also strengthen food security and decrease the environmental impacts of food production.

The Role of Medical Students During COVID-19 Era. A Review

BACKGROUND AND AIM OF THE WORK

Since December 2019, the world has been facing the coronavirus (COVID-19) pandemic crisis. The rapid and effortless spread of the virus has led the World Health Organization to adopt unprecedented large-scale preventive measures. Our aim is to investigate the impact of COVID-19 on the mental health of medical students, and to evaluate their awareness and aptitude for contributing to the fight against COVID-19 contagion.

METHODS

PubMed electronic database was employed for the research using the following terms: "medical students and COVID-19", "mental health of medical students and COVID-19", "knowledge of medical students and COVID-19", "preventive behavior of medical students and COVID-19".

RESULTS

Twenty-one articles were included; ten assess the knowledge of medical students on COVID-19, seven present whether they demonstrate appropriate preventive behavior according to global guidelines, seven examine the impact of the pandemic on their mental health, five examine their role on the side of trained healthcare workers. Some articles combine more than one of the above mentioned domains.

CONCLUSIONS

Medical students seem to demonstrate an adequate level of knowledge upon COVID-19 and implement proper strategies to prevent its spread. Further training is essential to improve some aspects in this field. Social media has proven to be the optimal source of information for medical students, which is incompatible with their future careers as doctors. The pandemic had a negative impact on medical students, expressed as fear regarding the virus spread; nevertheless, many have felt the need to assist healthcare systems under appropriate precautions.

How the Coronavirus Lockdown Impacts the Impoverished in India

In response to the coronavirus pandemic, several countries have imposed curfews, quarantines, and lockdowns to restrict the spread of the infection among people. India had initiated a nationwide lockdown to combat the pandemic starting from the last week of March until the end of May 2020. But, the lockdown had continued subsequently in several red zones across parts of the country for few months. However, scientists have criticized the government's abrupt lockdown since it prevented people from preparing for the worst aftermath. Besides, the curfews have blocked millions of impoverished migrant workers from leaving cities to return to their homes in distant rural villages. As a result, the destitute workers have endured enormous hardship and outright discrimination desolately leading to their added physical and mental distress, pain, suffering, and death. Most of the victims of the lockdown have belonged to the economically distressed lower social classes of the Indian caste hierarchy. This article outlines their sufferings triggered by the long drawn-out lockdown episode.

The Strategies to Support the COVID-19 Vaccination with Evidence-Based Communication and Tackling Misinformation

COVID-19 vaccinations are about to begin in various countries or are already ongoing. This is an unprecedented operation that is also met with a loud response from anti-vaccine communities-currently using all available channels to manipulate public opinion. At the same time, the strategy to educate on vaccinations, explain their mechanism of action, and build trust in science is subdued in different world parts. Such actions should go much beyond campaigns promoting the COVID-19 vaccines solely on the information provided by the health institutions and national authorities. In this paper, actions provided by independent expert groups needed to counteract the anti-vaccine propaganda and provide scientific-based information to the general public are offered. These actions encompass organizing groups continuously communicating science on COVID-19 vaccines to the general public; tracking and tackling emerging and circulating fake news; and equipping celebrities and politicians with scientific information to ensure the quality of messages they communicate, as well as public letters, and statements of support for vaccination by healthcare workers, recognized scientists, VIPs, and scientific societies; and no tolerance to false and manipulated claims on vaccination spread via traditional and social media as well as by health professionals, scientists, and academics. These activities should be promptly implemented worldwide, regardless of the current status and availability of the COVID-19 vaccine in a particular region. If we are about to control the pandemic for the sake of public benefit, it is high time to collectively speak out as academic and medical societies with support from decision-makers. Otherwise, the battle will be lost to those who stand against scientific evidence while offering no feasible solution to the problem.

The Main Sources and Potential Effects of COVID-19-Related Discrimination

The outbreak of a new coronavirus disease (COVID-19), which appeared in late 2019 and eventually resulted in the announcement of a pandemic by the World Health Organization, led to global fear and panic as well as the spread of false information and fake news from different sources. As a result, a sharp increase in prejudice, discrimination, and xenophobia against different groups of people was observed in different geographical locations. This chapter presents the psychological and social sources of stereotypes and prejudices that take forms in the COVID-19 pandemic. These sources can be located in psychosocial processes, such as (i) socially generated and reinforced fears; (ii) human responses to stress induced by certain types of stimuli; (iii) sense of helplessness based on the lack of control over reality; (iv) psychological responses reinforced by conformism (crowd psychology); and (v) the stigmatization process. The chapter also presents the main groups of increased risk of experiencing prejudice and discrimination during the COVID-19 pandemic (Asians, health-care workers, COVID-19 patients, and their relatives). Moreover, it provides a documented example of such behaviors. The groups at higher risk of more adverse effects of COVID-19 due to pre-pandemic discrimination are also discussed. Finally, initiatives taken to mitigate the discrimination associated with COVID-19 are presented, as well as the recommendations and good practices for preventing these behaviors during future outbreaks and for limiting discrimination against COVID-19 until the disease can be contained.

A Phenomenological Study on the Positive and Negative Experiences of Chinese International University Students From Hong Kong Studying in the U.K. and U.S. in the Early Stage of the COVID-19 Pandemic

Background: The COVID-19 pandemic has caused distress in students globally. The mental health of international students studying abroad has been neglected during the COVID-19 pandemic, especially Chinese students who have been unfairly targeted. Objective: To explore and document the positive and negative experiences of a group of Hong Kong Chinese international students studying in the U.K. and U.S. from an insider perspective in the early stage of the COVID-19 pandemic. Methods: The qualitative study used four 1.5-h online focus group interviews of 20 Chinese international students from Hong Kong aged 18 or older studying in universities in the United Kingdom or the United States, from 3 May to 12 May 2020. A framework approach with a semi-structured interview guide was used to reflect students' stressors, cognitive appraisals, coping, and outcomes (negative impacts and positive gains), in the early stages of COVID-19. Different strategies were used to ensure the credibility, dependability, confirmability, and transferability of the study. Transcripts were analyzed using qualitative thematic content analysis. Results: Twenty full-time international University students (60% female, 90% aged 18-25 years and 65% undergraduates) were recruited. Students reported (i) stress from personal (e.g., worries about health and academic attainment), interpersonal (e.g., perceived prejudice and lack of social support), and environmental factors (e.g., uncertainties about academic programme and unclear COVID-19-related information); (ii) significant differences in culture and cognitive appraisal in the levels of perceived susceptibility and severity; (iii) positive thinking and using alternative measures in meeting challenges, which included effective emotion and problem coping strategies, and the importance of support from family, friends and schools; and (iv) negative psychological impact (e.g., worries and stress) and positive personal growth in crisis management and gains in family relationships. Conclusions: With the rise in sinophobia and uncertain developments of the pandemic, proactive support from government and academic institutions are urgently needed to reduce stress and promote the well-being of international students, especially Chinese students in the U.K. and U.S. Clear information, public education and policies related to the pandemic, appropriate academic arrangements from universities and strong support systems play important roles in maintaining students' psychological health. Clinical Trial Registration: The study was registered with the National Institutes of Health (https://clinicaltrials.gov/, identifier: NCT04365361).

Addressing the Covid-19 Burden on Medical Education and Training: The Role of Telemedicine and Tele-Education During and Beyond the Pandemic

Medical students are the future of sustainable health systems that are severely under pressure during COVID-19. The disruption in medical education and training has adversely impacted traditional medical education and medical students and is likely to have long-term implications beyond COVID-19. In this article, we present a comprehensive analysis of the existing structural and systemic challenges applicable to medical students and teaching/training programs and the impact of COVID-19 on medical students and education. Use of technologies such as telemedicine or remote education platforms can minimize increased mental health risks to this population. An overview of challenges during and beyond the COVID-19 pandemic are also discussed, and targeted recommendations to address acute and systemic issues in medical education and training are presented. During the transition from conventional in-person or classroom teaching to tele-delivery of educational programs, medical students have to navigate various social, economic and cultural factors which interfere with their personal and academic lives. This is especially relevant for those from vulnerable, underprivileged or minority backgrounds. Students from vulnerable backgrounds are influenced by environmental factors such as unemployment of themselves and family members, lack of or inequity in provision and access to educational technologies and remote delivery-platforms, and increased levels of mental health stressors due to prolonged isolation and self-quarantine measures. Technologies for remote education and training delivery as well as sustenance and increased delivery of general well-being and mental health services to medical students, especially to those at high-risk, are pivotal to our response to COVID-19 and beyond.

Behavioral Immune System Responses to Coronavirus: A Reinforcement Sensitivity Theory Explanation of Conformity, Warmth Toward Others and Attitudes Toward Lockdown

Behavioral immune system (BIS) describes psychological mechanisms that detect cues to infectious pathogens in the immediate environment, trigger disease-relevant responses and facilitate behavioral avoidance/escape. BIS activation elicits a perceived vulnerability to disease (PVD) which can result in conformity with social norms. However, a response to superficial cues can result in aversive responses to people that pose no actual threat, leading to an aversion to unfamiliar others, and likelihood of prejudice. Pathogen-neutralizing behaviors, therefore, have implications for social interaction as well as illness behaviors and responses to health communications. In this study, we investigate how PVD influences conformity, attitudes to other people and to lockdown regulations through the lens of the Reinforcement Sensitivity Theory (RST). RST describes personality in terms of biologically-driven approach and avoidance motivations which support personal goals. Participants from the United Kingdom public (N = 605) completed an RST personality questionnaire and then read either (a) coronavirus morbidity-mortality statistics and current United Kingdom government lifestyle regulations, (b) just the regulations (as presented in most government publicity materials), or (c) no information at all. They all completed the Perceived Vulnerability to Disease scale to assess BIS-relevant Germ Aversion and Perceived Infectability, followed by questions measuring social conformity, warmth toward others and attitudes toward lockdown measures. Significantly lower PVD scores were observed in the no-information condition, with the other conditions showing no difference. In terms of RST, approach behaviors related to goal-drive persistence work alongside fear in explaining conformity to social norms. Reward related approach behaviors partially explained warmth toward others, indicating that social rewards gained through interaction continue to be strong drivers of behavior. We found no role for RST traits in attitudes toward lockdown. Overall, coronavirus-related behavior is not driven purely by fear, but also by social and/or protection goals regulated by approach motivation. This study presents new insights into public perceptions of coronavirus and government regulated lifestyle restrictions, helping to explain social behaviors in terms of biologically driven mechanisms. Such understanding is vital if we are to successfully motivate public behavior to constrain spread of the virus.

The COVID-19 Infodemic: Infodemiology Study Analyzing Stigmatizing Search Terms

BACKGROUND

In the context of the COVID-19 infodemic, the global profusion of monikers and hashtags for COVID-19 have found their way into daily communication and contributed to a backlash against China and the Chinese people.

OBJECTIVE

This study examines public engagement in crisis communication about COVID-19 during the early epidemic stage and the practical strategy of social mobilization to mitigate the infodemic.

METHODS

We retrieved the unbiased values of the top-ranked search phrases between December 30, 2019, and July 15, 2020, which normalized the anonymized, categorized, and aggregated samples from Google Search data. This study illustrates the most-searched terms, including the official COVID-19 terms, the stigmatized terms, and other controls, to measure the collective behavioral propensities to stigmatized terms and to explore the global reaction to the COVID-19 epidemic in the real world. We calculated the ratio of the cumulative number of COVID-19 cases to the regional population as the cumulative rate (R) of a specific country or territory and calculated the Gini coefficient (G) to measure the collective heterogeneity of crowd behavior.

RESULTS

People around the world are using stigmatizing terms on Google Search, and these terms were used earlier than the official names. Many stigmatized monikers against China (eg, "Wuhan pneumonia," G=0.73; "Wuhan coronavirus," G=0.60; "China pneumonia," G=0.59; "China coronavirus," G=0.52; "Chinese coronavirus," G=0.50) had high collective heterogeneity of crowd behavior between December 30, 2019, and July 15, 2020, while the official terms "COVID-19" (G=0.44) and "SARS-CoV-2" (G=0.42) have not become de facto standard usages. Moreover, the pattern of high consistent usage was observed in 13 territories with low cumulative rates (R) between January 16 and July 15, 2020, out of 58 countries and territories that have reported confirmed cases of COVID-19. In the scientific literature, multifarious naming practices may have provoked unintended negative impacts by stigmatizing Chinese people. The World Health Organization; the United Nations Educational, Scientific and Cultural Organization; and the media initiated campaigns for fighting back against the COVID-19 infodemic with the same mission but in diverse voices.

CONCLUSIONS

Infodemiological analysis can articulate the collective propensities to stigmatized monikers across search behaviors, which may reflect the collective sentiment of backlash against China and Chinese people in the real world. The full-fledged official terms are expected to fight back against the resilience of negative perceptual bias amid the COVID-19 epidemic. Such official naming efforts against the infodemic should be met with a fair share of identification in scientific conventions and sociocultural paradigms. As an integral component of preparedness, appropriate nomenclatures should be duly assigned to the newly identified coronavirus, and social mobilization in a uniform voice is a priority for combating the next infodemic.

Combatting Against Covid-19 & Misinformation: A Systematic Review

Accompanied by false information, mass media content is hindering efforts to cope with the current outbreak. Although the World Health Organization and other concerned bodies are notified regarding misinformation, myths and rumors are highly prevalent. This paper aims to highlight the misinformation and its potential impacts during the Covid-19 by using the Systematic Review Approach. The researcher randomly selected n = 35 research articles published from 2015 to 2020, witnessing the misinformation as a major concern during previous endemics and the current Covid-19 pandemic. Myths and rumors through traditional and new media platforms cause Xenophobia, LGBT Rights violations, and psychological disorders among the masses. Despite the efforts made by the World Health Organization, much more is required to nullify the impacts of misinformation and Covid-19. Therefore, the researcher recommended improved global healthcare policies and strategies to counteract against misinformation to mitigate the impacts of Covid-19.

Emotional, Behavioral, and Psychological Impact of the COVID-19 Pandemic

The emergence of SARS-CoV-2 in December 2019 prompted consternation in many parts of the world. Due to its fast dissemination, the World Health Organization declared a pandemic in March 2020. Aiming to contain the spread of the virus, leaders of many countries restrained social movement, targeting to flatten the curve of contamination with social distancing. This review aimed to analyze how human behavior has changed throughout this period. We also approached the key components of the emotional reaction to the pandemic, how internal and external factors, such as personality traits, gender, the media, the economy and the governmental response, influence the social perception of the pandemic and the psychological outcomes of the current scenario. Moreover, we explored in depth the groups at increased risk of suffering mental health burden secondary to these circumstances. These include the healthcare professionals, elderly individuals, children, college students, black subjects, latin and LGBTQ+ communities, economically disadvantaged groups, the homeless, prisoners, the rural population and psychiatric patients. We also discussed several measures that might minimize the emotional impact derived from this scenario. It is crucial that the health authorities, the government and the population articulate to assist the vulnerable groups and promote emotional and psychological support strategies. Moreover, it is fundamental that the population is provided with accurate information concerning the COVID-19 pandemic.