School closure and management practices during coronavirus outbreaks including COVID-19: a rapid systematic review

Students' perceptions and experiences of remote learning amid covid-19 pandemic in Ghana

Background

The COVID-19 pandemic had a significant impact on students, instructors, and educational organisations all around the world. Remote learning was an emergency response by most universities in Ghana during this pandemic to ensure the continuation of their academic calendar. Conducting this study among Ghanaian undergraduate students is crucial because factors like socioeconomic status, technological resources, and individual learning preferences can significantly impact their experience and the perception of remote learning, which may differ from studies conducted elsewhere.

Objective

To determine the perceptions and experiences of remote learning among allied health sciences students during the COVID-19 pandemic.

Methods

This cross-sectional study involved 218 second, third, and final year Allied Health Sciences students in the University of Ghana. A questionnaire was used to obtain data concerning health professions students' perception and experience of remote learning. The readiness of students in respect to the emergency remote learning, attitudes towards remote learning, perception of remote learning, satisfaction, and the level of anxiety was calculated using mean and mean percentages. Kruskal-Wallis test was used to analyse differences between programmes of study and the perceptions and experiences of remote learning.

Results

One hundred and fifteen (53.1%) of the participants had moderate perceptions of independence and responsibility in their learning experiences while 80 (36.7%) students reported that their satisfaction levels regarding remote learning was high. Seventy-seven (38.4%) students reported that they had a burden of anxiety. There was no statistically significant difference between anxiety level and programme of study.

Conclusion

Ghana Allied Health Sciences students had positive perceptions and experiences towards remote learning. They could adapt to the new teaching method with appropriate technology integration. Despite a number of students who were anxious about using remote learning. Adequate support towards transitioning into the use of technology may be a good consideration.

Asthma control associated with anxiety and depression in asthmatic children following post-acute COVID-19

BACKGROUND

Poor asthma control may adversely affect mental health. Our study investigates the correlation between inadequate asthma control, exhaled nitric oxide (FENO) levels, and anxiety and depression among pediatric asthma patients with COVID-19.

METHODS

This prospective case-control study enrolled 520 asthmatic children (8-15 years), including 336 patients diagnosed with COVID-19 after rapid antigen testing at home and 184 age-matched asthmatic patients without COVID-19 infection. FENO and spirometry were performed 1 month after COVID-19 infection. Scores for Child Anxiety-Related Disorders (SCARED) and depression screen derived from Patient Health Questionnaire-9 (PHQ-9) to assess their mental health status. Childhood asthma control test (C-ACT), FENO levels, and spirometry were correlated with the SCARED and PHQ-9 questionnaires.

RESULTS

SCARED subscales, including generalized anxiety disorder, social anxiety disorder, school avoidance, and depression scores from PHQ-9, exhibited a significant increase in asthmatic patients diagnosed with COVID-19 (p < .05). Among asthmatic children with SARS-CoV-2 infection, the poor asthma control group exhibited the highest SCARED and PHQ-9 measurements (p < .01). Multiple linear regression analysis indicated that reduced C-ACT scores and elevated FENO levels in asthmatic children with COVID-19 were significant risk factors for both anxiety and depression scores (p < .05). Lower C-ACT scales were associated with high scores of SCARED (r = -0.471) and PHQ-9 (r = -0.329) in asthmatic children (p < .001).

CONCLUSIONS

The current study emphasizes the need for healthcare professionals to closely monitor asthma control in asthmatic children to prevent heightened risks of depression and anxiety during the ongoing COVID-19 pandemic.

Inequitable Changes in School Connectedness During the Ongoing COVID-19 Pandemic in a Cohort of Canadian Adolescents

BACKGROUND

We examined whether subgroups of adolescents experienced disparate changes in school connectedness-a robust predictor of multiple health outcomes-from before the COVID-19 pandemic to the first full school year following pandemic onset.

METHODS

We used 2 waves of prospective survey data from 7178 students attending 41 Canadian secondary schools that participated during the 2019-2020 (T1; pre-COVID-19 onset) and 2020-2021 (T2; ongoing pandemic) school years. Fixed effects analyses tested differences in school connectedness changes by gender, race, bullying victimization, socioeconomic position, and school learning mode.

RESULTS

Relatively greater declines in school connectedness were reported by students that identified as females, were bullied, perceived their family to be less financially comfortable than their classmates, and attended schools in lower income areas. Marginally greater school connectedness declines resulted among students attending schools that were fully online at T2 than those at schools using a blended model.

CONCLUSION

Results point to disparate school connectedness declines during the pandemic, which may exacerbate pre-existing health inequities by gender and socioeconomic position, and among bullied youth.

IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY

Effective strategies to improve school climates for equity denied groups are critical for pandemic recovery and preparedness for future related events.

Cultural and social attitudes towards COVID-19 vaccination and factors associated with vaccine acceptance in adults across the globe: A systematic review

OBJECTIVES

To identify and synthesise evidence on cultural and social attitudes towards coronavirus disease 2019 (COVID-19) vaccination and factors associated with vaccine acceptance in the adult population.

DESIGN

Systematic review.

DATA SOURCES

Six electronic databases were searched (CINAHL, Coronavirus Research Database, Embase, MEDLINE, Nursing and Allied Health Database, and Web of Science Core Collection). Additional studies were identified through Google Scholar and hand searching the reference lists of all studies included in the review.

METHOD

The searches were conducted to identify all relevant studies published in English, from December 2019 to December 2021. The Critical Appraisal Skills Programme (CASP) and Appraisal tool for Cross-Sectional Studies (AXIS tool) were used to critically appraise the quality of included studies. Data were extracted and synthesised narratively.

RESULTS

1260 records were identified, of which 38 studies were included in the review. Low COVID-19 vaccination acceptance rates were found among young people, females, non-medical students, and even some healthcare workers, which were associated with misinformation obtained through social media platforms, unknown side effects, questionable conspiracy theories, and doubts about efficacy and safety. Higher COVID-19 vaccination acceptance rates were due to recommendations from healthcare professionals and government sources, and the perceived increased risk of contracting COVID-19.

CONCLUSION

COVID-19 vaccine acceptance varies across the globe. To increase the acceptance rate of the COVID-19 vaccine, public health education programmes should be promoted effectively and target specifically the groups who are most hesitant to receive the vaccine such as young people, females, and non-medical students. Vaccine hesitancy among healthcare workers can affect vaccination rates as the majority of the population views them as a trustworthy source for vaccine-related knowledge. Staff training is important to enhance their confidence and communication skills in providing information about COVID-19 vaccination to combat the misunderstanding of the public and encourage vaccine uptake.

PROSPERO REGISTRATION NUMBER

CRD42021248016.

Understanding the Complexities of Student Learning Progress in Texas: A Study of COVID-19 and Rural vs. Non-Rural Districts

In this study, we investigate the impact of COVID-19 on academic achievement in Texas public schools. Demographic and Grade 5 STAAR test data were collected from 1155 public school districts for 2018-2019 and 2020-2021. Multiple regression was adopted to analyze the differences between rural and non-rural districts, as well as the impact of demographic characteristics on students' achievement. The results reveal significant differences in demographic characteristics between the two academic years, with non-rural districts exhibiting a greater decline in academic achievement than rural districts. Additionally, the findings suggest that higher teacher salaries correlate with better academic performance across various subjects and that English learners require additional support to acquire content knowledge and skills. We further confirm that the COVID-19 pandemic has disrupted the academic learning experience of Texas students, with rural districts displaying more resilience than non-rural districts.

Current state of COVID-19 in children: 4 years on

Children have been disproportionately affected by the COVID-19 pandemic. Despite evidence of a very low risk of severe disease, children were subjected to extensive lockdown, restriction and mitigation measures, including school closures, to control the rapid spread of SARS-CoV-2 in most parts of the world. In this review we summarise the UK experience of COVID-19 in children four years into the largest and longest pandemic of this century. We address the risks of SARS-CoV-2 infection, immunity, transmission, severity and outcomes in children. We also assess the implementation, uptake, effectiveness and impact of COVID-19 vaccination, as well as the emergence, evolution and near disappearance of PIMS-TS (paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2) and current understanding of long COVID in children. This review consolidates current knowledge on childhood COVID-19 and emphasises the importance of continued research and the need for research-driven public health actions and policy decisions, especially in the context of new variants and future vaccines.

Cognitive and Relational Processes Associated to Mental Health in Italian High School Students during COVID-19 and Russian-Ukrainian War Outbreaks

The negative impact of the COVID-19 pandemic on mental health has been widely demonstrated; however, few studies have investigated the psychological processes involved in this impact, including core beliefs violation, meaning-making disruption, interpersonal support, or one's relational functioning. This study explored the mental health of 215 Italian adolescents during the COVID-19 pandemic and the subsequent outbreak of the Russian-Ukrainian war. By administering a set of questionnaires, several cognitive and emotional variables were investigated, including core belief violation, meaning attribution to the pandemic and war, attachment, and emotion regulation, social media addiction, and relationships with significant others and teachers. We conducted some descriptive, mean difference, correlational, and predictive analyses that revealed a significant association between core belief violation caused by war and pandemic, ability to integrate war and pandemic within personal meaning universe, the relational support received, and mental health. The relationship with teachers during these challenging periods improved significantly according to the respondents' opinion, becoming both more authoritative and empathic. This study offers insights into what cognitive and relational processes are useful to intervene on to reduce the distress of adolescents who are facing significant moments of crisis due to events that challenge their cognitive and emotional balance.

Regional variations in vaccination against COVID-19 in Germany

Vaccination willingness against COVID-19 is generally perceived as low. Moreover, there is large heterogeneity across and within countries. As a whole, Germany has average vaccination rates compared to other industrialized countries. However, vaccination rates in the 16 different German federal states differ by more than 20 percentage points. We describe variation in vaccination rates on the level of the 400 German counties using data on all vaccinations carried out until December 2022. Around 52-72% of that variation can be explained by regional differences in demographic characteristics, housing, education and political party preferences. We find indications that the remaining part may be due to differences in soft factors such as risk aversion, trust in the German government, trust in science, and beliefs in conspiracy theories regarding the origins of the Corona virus. We conclude that improving the trust in science and the fight against conspiracy theories may possibly be effective tools to improve vaccination rates and effectively fight pandemics.

The perceived challenges to online learning during the COVID-19 pandemic: A nationwide study of K-12 parental perspectives (Arab and other parents) in Qatar

This study aimed to explore self-reported challenges Arab and other parents encountered during the sudden shift to online teaching and learning due to the COVID-19 pandemic. The researchers investigated the likely effect of demographic and contextual factors on the perceived challenges reported by parents. To achieve the study's objectives, the researchers utilized a mixed-method design involving a random sample of students' parents (Arab and other parents) in public and private schools in Qatar. The study's sample consisted of 2781 parents who responded to the online survey and 25 parents who participated in online semi-structured interview. The results derived from this study identified several challenges like lack of social interaction with schoolteachers, lack of motivation among children to participate in online classes and complete their homework, and dealing with the technical problems encountered during the online learning experience. The results further disclosed differences between Arab and other parents regarding the technologies and devices used during online teaching and learning. Finally, the results revealed differences between schools that do not organize additional activities in the curriculum compared to those that organize such activities. The study recommends home-school communication in order to empower parents and train them on how to manage effective learning at home and deal with children's learning behaviors. The study proposes developing parents' technical skills for online earning and the provision of material support for parents. Finally, it is important to raise a flag calling for revisiting the current curriculum to enrich children's schooling experiences and strengthen the bonds with their schools.

Workplace interventions to reduce the risk of SARS-CoV-2 infection outside of healthcare settings

BACKGROUND

Although many people infected with SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) experience no or mild symptoms, some individuals can develop severe illness and may die, particularly older people and those with underlying medical problems. Providing evidence-based interventions to prevent SARS-CoV-2 infection has become more urgent with the potential psychological toll imposed by the coronavirus disease 2019 (COVID-19) pandemic. Controlling exposures to occupational hazards is the fundamental method of protecting workers. When it comes to the transmission of viruses, workplaces should first consider control measures that can potentially have the most significant impact. According to the hierarchy of controls, one should first consider elimination (and substitution), then engineering controls, administrative controls, and lastly, personal protective equipment. This is the first update of a Cochrane review published 6 May 2022, with one new study added.

OBJECTIVES

To assess the benefits and harms of interventions in non-healthcare-related workplaces aimed at reducing the risk of SARS-CoV-2 infection compared to other interventions or no intervention.

SEARCH METHODS

We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Web of Science Core Collections, Cochrane COVID-19 Study Register, World Health Organization (WHO) COVID-19 Global literature on coronavirus disease, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform, and medRxiv to 13 April 2023.

SELECTION CRITERIA

We included randomised controlled trials (RCTs) and non-randomised studies of interventions. We included adult workers, both those who come into close contact with clients or customers (e.g. public-facing employees, such as cashiers or taxi drivers), and those who do not, but who could be infected by coworkers. We excluded studies involving healthcare workers. We included any intervention to prevent or reduce workers' exposure to SARS-CoV-2 in the workplace, defining categories of intervention according to the hierarchy of hazard controls (i.e. elimination; engineering controls; administrative controls; personal protective equipment).

DATA COLLECTION AND ANALYSIS

We used standard Cochrane methods. Our primary outcomes were incidence rate of SARS-CoV-2 infection (or other respiratory viruses), SARS-CoV-2-related mortality, adverse events, and absenteeism from work. Our secondary outcomes were all-cause mortality, quality of life, hospitalisation, and uptake, acceptability, or adherence to strategies. We used the Cochrane RoB 2 tool to assess risk of bias, and GRADE methods to evaluate the certainty of evidence for each outcome.

MAIN RESULTS

We identified 2 studies including a total of 16,014 participants. Elimination-of-exposure interventions We included one study examining an intervention that focused on elimination of hazards, which was an open-label, cluster-randomised, non-inferiority trial, conducted in England in 2021. The study compared standard 10-day self-isolation after contact with an infected person to a new strategy of daily rapid antigen testing and staying at work if the test is negative (test-based attendance). The trialists hypothesised that this would lead to a similar rate of infections, but lower COVID-related absence. Staff (N = 11,798) working at 76 schools were assigned to standard isolation, and staff (N = 12,229) working at 86 schools were assigned to the test-based attendance strategy. The results between test-based attendance and standard 10-day self-isolation were inconclusive for the rate of symptomatic polymerase chain reaction (PCR)-positive SARS-CoV-2 infection (rate ratio (RR) 1.28, 95% confidence interval (CI) 0.74 to 2.21; 1 study; very low-certainty evidence). The results between test-based attendance and standard 10-day self-isolation were inconclusive for the rate of any PCR-positive SARS-CoV-2 infection (RR 1.35, 95% CI 0.82 to 2.21; 1 study; very low-certainty evidence). COVID-related absenteeism rates were 3704 absence days in 566,502 days-at-risk (6.5 per 1000 working days) in the control group and 2932 per 539,805 days-at-risk (5.4 per 1000 working days) in the intervention group (RR 0.83, 95% CI 0.55 to 1.25). We downgraded the certainty of the evidence to low due to imprecision. Uptake of the intervention was 71% in the intervention group, but not reported for the control intervention. The trial did not measure our other outcomes of SARS-CoV-2-related mortality, adverse events, all-cause mortality, quality of life, or hospitalisation. We found seven ongoing studies using elimination-of-hazard strategies, six RCTs and one non-randomised trial. Administrative control interventions We found one ongoing RCT that aims to evaluate the efficacy of the Bacillus Calmette-Guérin (BCG) vaccine in preventing COVID-19 infection and reducing disease severity. Combinations of eligible interventions We included one non-randomised study examining a combination of elimination of hazards, administrative controls, and personal protective equipment. The study was conducted in two large retail companies in Italy in 2020. The study compared a safety operating protocol, measurement of body temperature and oxygen saturation upon entry, and a SARS-CoV-2 test strategy with a minimum activity protocol. Both groups received protective equipment. All employees working at the companies during the study period were included: 1987 in the intervention company and 1798 in the control company. The study did not report an outcome of interest for this systematic review. Other intervention categories We did not find any studies in this category.

AUTHORS' CONCLUSIONS

We are uncertain whether a test-based attendance policy affects rates of PCR-positive SARS-CoV-2 infection (any infection; symptomatic infection) compared to standard 10-day self-isolation amongst school and college staff. A test-based attendance policy may result in little to no difference in absenteeism rates compared to standard 10-day self-isolation. The non-randomised study included in our updated search did not report any outcome of interest for this Cochrane review. As a large part of the population is exposed in the case of a pandemic, an apparently small relative effect that would not be worthwhile from the individual perspective may still affect many people, and thus become an important absolute effect from the enterprise or societal perspective. The included RCT did not report on any of our other primary outcomes (i.e. SARS-CoV-2-related mortality and adverse events). We identified no completed studies on any other interventions specified in this review; however, eight eligible studies are ongoing. More controlled studies are needed on testing and isolation strategies, and working from home, as these have important implications for work organisations.

Effects of online education on prosthetics orthotics education during COVID-19

BACKGROUND

It is obvious that educational activities were affected globally due to the pandemic.

OBJECTIVE

This study was planned to examine the effects of online education on undergraduate degree (UD) and associate degree (AD) Orthotics and Prosthesis education in the COVID-19 pandemic.

STUDY DESIGN

A crossectional online survey.

METHOD

The Google Forms questionnaire was delivered to students of Orthotics and Prosthesis in the level of undergraduate degree and AD and academicians conducted in the study. Next, the participants were reviewed regarding their knowledge about devices used for online education and related technical problems. A 5-point Likert-type questionnaire with 18 questions that was developed specifically for this study was applied to examine their views on online education.

RESULTS

The study included 472 participants who had a mean age of 21.30 ± 0.22 years. Among the participants, 262 were AD students (55.5%). Approximately 82% of the participants were used their mobile phones for connection. The connection problems, and inappropriateness of online education in applied course, preference of online education for theoretical courses, insufficiency of digital course materials, failure to access education easily, insufficiency of online examinations for measurement and evaluation, and preference of homework over online education were stated by 79%, 88.3%, 41.9%, 54.5%, 70.1%, 41.7%, and 42.8% of the participants, respectively.

CONCLUSION

Both academicians and students experienced connection problems, and applied courses were not suitable for online education. Motivation to attend the courses was low in online education, relevant workload increased, online examinations were not sufficient for measurement and evaluation, and studies were more unplanned. It is necessary to switch to formal education after the pandemic.

WhatsApp as a Tool in Blended Learning in Dental Education

Background and Objective

Dental education is unique, with clinical/practical learning much different from other professionals. In dentistry, students are exposed much earlier in their curriculum to patients, performing procedures under direct/indirect supervision. Hence, the present review attempted to assess the standing position of dentistry in blended learning worldwide.

Materials and Methods

E-learning modality was at its primitive stage as food for thought among educational task force committees, with only a handful of developed and developing countries equipped with it. During this pandemic, "WhatsApp" became a savior, as it was a widely used educational device among dental teachers and students. Furthermore, it was easily applicable in places where there was difficulty in obtaining regular internet bandwidth, especially in remote/rural areas. It is noteworthy that blended learning/e-learning, when complemented with the conventional teaching method, upskill critical thinking and problem-solving capabilities. Blended learning or virtual reality education should be made feasible without disparity, worldwide. Mind training, both students and staff in hybrid e-learning, is the need of the hour not only to keep pace with digitalized dentistry but to prepare the students to face real-world situations.

Conclusion

The sustainability of dental education should be rethought by dental schools with "Complimented Digital learning" wherever feasible, not only to cope with current trends but also to face unforeseen future challenges.

An epidemiological modeling framework to inform institutional-level response to infectious disease outbreaks: a Covid-19 case study

Institutions have an enhanced ability to implement tailored mitigation measures during infectious disease outbreaks. However, macro-level predictive models are inefficient for guiding institutional decision-making due to uncertainty in local-level model input parameters. We present an institutional-level modeling toolkit used to inform prediction, resource procurement and allocation, and policy implementation at Clemson University throughout the Covid-19 pandemic. Through incorporating real-time estimation of disease surveillance and epidemiological measures based on institutional data, we argue this approach helps minimize uncertainties in input parameters presented in the broader literature and increases prediction accuracy. We demonstrate this through case studies at Clemson and other university settings during the Omicron BA.1 and BA.4/BA.5 variant surges. The input parameters of our toolkit are easily adaptable to other institutional settings during future health emergencies. This methodological approach has potential to improve public health response through increasing the capability of institutions to make data-informed decisions that better prioritize the health and safety of their communities while minimizing operational disruptions.

Seroprevalence of antibodies against SARS-CoV-2 in the school community in Campo Grande, state of Mato Grosso do Sul, Brazil, October 2021-November 2022

Introduction

With the reopening of schools during the coronavirus disease 2019 (COVID-19) pandemic, it was imperative to understand the role of students and education professionals in the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this paper, we determined the seroprevalence of the SARS-CoV-2 anti-nucleocapsid antibodies in the school community in Campo Grande, the capital and most populous city of the state of Mato Grosso do Sul (Brazil) and evaluated its association with sex, school level, and school type.

Materials and methods

The survey was carried out in 20 public and private schools in the urban region of Campo Grande using the TR DPP® COVID-19 immunoglobulin M/immunoglobulin G (IgM/IgG) kit from the Immunobiological Technology Institute (Bio-Manguinhos, Rio de Janeiro, Brazil). Testing was carried out in three periods: from October to December 2021; from March to July 2022; and from August to November 2022. The participants were students aged 6-17 years enrolled in primary or secondary schools and professionals of different ages and roles.

Results

During the first testing period, 162 participants were seropositive for the IgM and/or IgG anti-nucleocapsid SARS-CoV-2 antibodies, with an estimated seroprevalence of 19.6% using Bayesian multilevel regression. In the second period, 251 participants were seropositive (estimated seroprevalence, 34.6%), while in the third period, 393 participants were seroconverted (estimated seroprevalence, 56.7%). In 2022, there was an increase in the seroconversion rate compared to that in 2021. The most frequently described acute manifestations in the three periods were fever, headache, sore throat, and runny nose. In terms of the demographic profile, there was no predominance of seropositivity between the sexes, although women represented approximately 70% of the study population. There were also no differences between students and school staff.

Discussion

The results made it possible to evaluate the extent of SARS-CoV-2 transmission in the school community through immunity developed against the virus, in addition to providing information about COVID-19 symptoms in children, adolescents, and adults.

Parental Experiences of Distance Learning in Families with and without an Adolescent with ADHD/ASD: A Large Qualitative Survey Study

One of the greatest COVID-19-related challenges for children and their families was managing distance learning due to school closures. We also know from previous research that families with a child with a neurodevelopmental disorder such as ADHD or ASD were struggling more than others but also experienced some positive effects. However, few qualitative studies have been conducted. The present study therefore aimed to investigate parental experiences of the negative and positive effects of distance learning during the COVID-19 pandemic in a large sample of families with an adolescent with ADHD and/or ASD and a matched comparison group (n = 682). Data were collected through open-ended questions as part of a larger survey study. Five main themes with different sub-themes were identified for both negative and positive effects: (1) Teaching, (2) Social, (3) Support, (4) Child factors, and (5) Home environment. In addition, the main theme "Technical problems" was identified for negative effects. Families with a child with ADHD/ASD reported negative effects related to "Child factors" and "Support" more frequently than the controls, as well as negative effects related to some aspects of "Teaching" and "Technical problems". Regarding positive effects, significant group differences were primarily found for the theme "Child factors". These findings are discussed both in terms of how to best prepare for possible future pandemics, but also of how to best provide educational support for children with ADHD and/or ASD when schools are open.

Educational inclusion and satisfaction of families of students with intellectual disabilities: a bibliometric study

This bibliometric study scrutinizes the corpus of scientific output within the Web of Science pertaining to familial satisfaction among parents raising children with intellectual disabilities, focusing specifically on the milieu of educational inclusion. The analysis discerns a discernible ascension in scholarly interest in this domain, encapsulating 77 papers emanating from 75 journals, incorporating an aggregate of 3,497 cited references. Our investigation delineated 354 researchers across 39 nations, underscoring the transnational purview of this scholarly endeavor. The United States emerged as the pre-eminent contributor, with Canada and the United Kingdom following suit. Collaboration on an international scale was notably led by the US, with the UK and Australia trailing in tandem. Prominent institutions were identified for their scholarly output; the University of Kansas led with four papers, followed closely by Monash University, University of California Los Angeles, and University of California Riverside, each contributing three papers. Of particular note, the University of Kansas accrued 250 global citations (TGCS). A total of 75 journals were encompassed in this study. The Journal of Intellectual Disability Research emerged as the vanguard with four published papers, closely trailed by Child Care Health and Development and Exceptional Children. Notably, the latter boasted the highest impact factor (JCR = 4.09; Q1). In summation, this review proffers a meticulous and expansive overview of extant scholarship concerning the experiences of families rearing children with disabilities within the inclusive education framework.

Who acquires infection from whom? A sensitivity analysis of transmission dynamics during the early phase of the COVID-19 pandemic in Belgium

Age-related heterogeneity in a host population, whether due to how individuals mix and contact each other, the nature of host-pathogen interactions defining epidemiological parameters, or demographics, is crucial in studying infectious disease dynamics. Compartmental models represent a popular approach to address the problem, dividing the population of interest into a discrete and finite number of states depending on, for example, individuals' age and stage of infection. We study the corresponding linearised system whose operator, in the context of a discrete-time model, equates to a square matrix known as the next generation matrix. Performing formal perturbation analysis of the entries of the aforementioned matrix, we derive indices to quantify the age-specific variation of its dominant eigenvalue (i.e., the reproduction number) and explore the relevant epidemiological information we can derive from the eigenstructure of the matrix. The resulting method enables the assessment of the impact of age-related population heterogeneity on virus transmission. In particular, starting from an age-structured SEIR model, we demonstrate the use of this approach for COVID-19 dynamics in Belgium. We analyse the early stages of the SARS-CoV-2 spread, with particular attention to the pre-pandemic framework and the lockdown lifting phase initiated as of May 2020. Our results, influenced by our assumption on age-specific susceptibility and infectiousness, support the hypothesis that transmission was only influenced to a small extent by children in the age group [0,18) and adults over 60 years of age during the early phases of the pandemic and up to the end of July 2020.

Linking undergraduates' future work self and employability: a moderated mediation model

BACKGROUND

The career intentions of students play a crucial role in shaping the growth of the hospitality and tourism industry. Previous research underlines the significance of future work self in predicting outcomes related to one's career. However, there is limited knowledge regarding the precise ways, timing, and conditions under which the future work self of undergraduate students can enhance their employability.

METHODS

This paper aims to address the existing research gap by employing career construction theory and self-determination theory to propose a moderated mediation model-i.e., career exploration serves as a mediator and job market knowledge functions as a moderator in the relationship between future work self and employability. We conducted two independent studies (i.e., an experimental study and a time-lagged field study) to test the proposed model. Specifically, in Study 1 we employed an experimental research design to recruit 61 students majoring in tourism management to participate. They were randomly assigned to two scenarios (future work self: high vs. low), and we manipulated different levels of future work self by means of scenario descriptions. In Study 2, we used the time-lagged research design to collect data via submitting questionnaires among 253 Chinese undergraduates who majored in hospitality and tourism at a university in the middle area of China.

RESULTS

The results indicate a positive correlation between undergraduates' future work self and their employability. Furthermore, this relationship is mediated by a mediator of career exploration. It is important to note that this mediating relationship is also contingent upon the moderator variable of undergraduates' job market knowledge when considering the impact of career exploration on employability.

CONCLUSION

The findings contribute to enriching the current understanding of the positive effects of future work self on undergraduates' desirable outcomes in employability.

Evidence linking COVID-19 and the health/well-being of children and adolescents: an umbrella review

BACKGROUND

Experiences during childhood and adolescence have enduring impacts on physical and mental well-being, overall quality of life, and socioeconomic status throughout one's lifetime. This underscores the importance of prioritizing the health of children and adolescents to establish an impactful healthcare system that benefits both individuals and society. It is crucial for healthcare providers and policymakers to examine the relationship between COVID-19 and the health of children and adolescents, as this understanding will guide the creation of interventions and policies for the long-term management of the virus.

METHODS

In this umbrella review (PROSPERO ID: CRD42023401106), systematic reviews were identified from the Cochrane Database of Systematic Reviews; EMBASE (OvidSP); and MEDLINE (OvidSP) from December 2019 to February 2023. Pairwise and single-arm meta-analyses were extracted from the included systematic reviews. The methodological quality appraisal was completed using the AMSTAR-2 tool. Single-arm meta-analyses were re-presented under six domains associated with COVID-19 condition. Pairwise meta-analyses were classified into five domains according to the evidence classification criteria. Rosenberg's FSN was calculated for both binary and continuous measures.

RESULTS

We identified 1551 single-arm and 301 pairwise meta-analyses from 124 systematic reviews that met our predefined criteria for inclusion. The focus of the meta-analytical evidence was predominantly on the physical outcomes of COVID-19, encompassing both single-arm and pairwise study designs. However, the quality of evidence and methodological rigor were suboptimal. Based on the evidence gathered from single-arm meta-analyses, we constructed an illustrative representation of the disease severity, clinical manifestations, laboratory and radiological findings, treatments, and outcomes from 2020 to 2022. Additionally, we discovered 17 instances of strong or highly suggestive pairwise meta-analytical evidence concerning long-COVID, pediatric comorbidity, COVID-19 vaccines, mental health, and depression.

CONCLUSIONS

The findings of our study advocate for the implementation of surveillance systems to track health consequences associated with COVID-19 and the establishment of multidisciplinary collaborative rehabilitation programs for affected younger populations. In future research endeavors, it is important to prioritize the investigation of non-physical outcomes to bridge the gap between research findings and clinical application in this field.

Health equity in pediatrics: Current concepts for the care of children in the 21st century (Dis Mon)

This is an analysis of important aspects of health equity in caring for children and adolescents written by a multidisciplinary team from different medical centers. In this discussion for clinicians, we look at definitions of pediatric health equity and the enormous impact of social determinants of health in this area. Factors involved with pediatric healthcare disparities that are considered include race, ethnicity, gender, age, poverty, socioeconomic status, LGBT status, living in rural communities, housing instability, food insecurity, access to transportation, availability of healthcare professionals, the status of education, and employment as well as immigration. Additional issues involved with health equity in pediatrics that are reviewed will include the impact of the COVID-19 pandemic, behavioral health concepts, and the negative health effects of climate change. Recommendations that are presented include reflection of one's own attitudes on as well as an understanding of these topics, consideration of the role of various healthcare providers (i.e., community health workers, peer health navigators, others), the impact of behavioral health integration, and the need for well-conceived curricula as well as multi-faceted training programs in pediatric health equity at the undergraduate and postgraduate medical education levels. Furthermore, ongoing research in pediatric health equity is needed to scrutinize current concepts and stimulate the development of ideas with an ever-greater positive influence on the health of our beloved children. Clinicians caring for children can serve as champions for the optimal health of children and their families; in addition, these healthcare professionals are uniquely positioned in their daily work to understand the drivers of health inequities and to be advocates for optimal health equity in the 21st century for all children and adolescents.

Changes in self-reported health and wellbeing outcomes in 36,951 primary school children from 2014 to 2022 in Wales: an analysis using annual survey data

Introduction

This study examines the changes in childhood self-reported health and wellbeing between 2014 and 2022.

Methods

An annual survey delivered by HAPPEN-Wales, in collaboration with 500 primary schools, captured self-reported data on physical health, dietary habits, mental health, and overall wellbeing for children aged 8-11 years.

Results

The findings reveal a decline in physical health between 2014 and 2022, as evidenced by reduced abilities in swimming and cycling. For example, 68% of children (95%CI: 67%-69%) reported being able to swim 25m in 2022, compared to 85% (95% CI: 83%-87%) in 2018. Additionally, unhealthy eating habits, such as decreased fruit and vegetable consumption and increased consumption of sugary snacks, have become more prevalent. Mental health issues, including emotional and behavioural difficulties, have also increased, with emotional difficulties affecting 13%-15% of children in 2017-2018 and now impacting 29% of children in 2021-2022. Moreover, indicators of wellbeing, autonomy, and competence have declined.

Discussion

Importantly, this trend of declining health and wellbeing predates the onset of the Covid-19 pandemic, suggesting that it is not solely attributed to the pandemic's effects. The health of primary school children has been on a declining trajectory since 2018/2019 and has continued to decline through the COVID recovery period. The study suggests that these trends are unlikely to improve without targeted intervention and policy focus.

Emotional experiences and study motivation among Italian university students during the second wave of COVID-19

Objective: This study aimed to investigate the relationships between emotional experiences and study motivation in a group of nonworking and never-infected university students, during the second wave of the COVID-19 pandemic. Participants: Participants (N = 353; aged M = 21.5; SD = 2.8) were mostly female (76.2%) Italian university students. Methods: They completed an online assessment that included self-report measures of fear during the second wave of the COVID-19 pandemic, intolerance of uncertainty, optimism, and study motivation. Results: Our findings showed that older students were more optimistic than younger students. Besides, fear of COVID-19, intolerance of uncertainty, and pessimism predicted worse study motivation. Conclusions: Greater psychological support should be reserved for younger students to prevent emotional experiences that might affect the learning goal.

Prolonged School Closure and Pediatric Respiratory Hospitalization: The Silver Lining of the COVID-19 Pandemic

Objective. This is a single-center retrospective cohort study that aimed to quantitatively assess the association between prolonged school closure (>2 weeks) and pediatric respiratory hospitalization during the COVID-19 pandemic. Methods. Subjects included 1243 patients presenting to Children's Hospital of Michigan during the winters of 2019, 2020, and 2021. The primary outcome measures were total respiratory hospitalizations and respiratory diagnoses. Results. Data was analyzed using a 2-sample z-test for proportions. We found that pediatric patients in the setting of prolonged school closure had significantly fewer hospitalizations in 2020 compared to 2019 (9% vs 47%; P < .001) and 2021 (9% vs 45%; P < .001). There were decreases in bronchiolitis, asthma/reactive airway disease (RAD), and pneumonia hospitalizations compared to 2019 and 2021. Conclusions. Our study showed that during prolonged school closure, there was a significant decrease in pediatric respiratory hospitalization. As such, it should be considered when creating a pandemic response strategy.

SARS-CoV-2 trends in Italy, Germany and Portugal and school opening during the period of Omicron variant dominance: A quasi experimental study in the EuCARE project

OBJECTIVES

We investigated the impact of school reopening on SARS-CoV-2 transmission in Italy, Germany, and Portugal in autumn 2022 when the Omicron variant was prevalent.

METHODS

A prospective international study was conducted using the case reproduction number (Rc) calculated with the time parametrization of Omicron. For Germany and Italy, staggered difference-in-differences analysis was employed to explore the causal relationship between school reopening and Rc changes, accounting for varying reopening dates. In Portugal, interrupted time series analysis was used due to simultaneous school reopenings. Multivariable models were adopted to adjust for confounders.

RESULTS

In Italy and Germany, post-reopening Rc estimates were significantly lower compared to those from regions/states that had not yet reopened at the same time points, both in the student population (overall average treatment effect for the treated subpopulation [O-ATT]: -0.80 [95% CI: -0.94;-0.66] for Italy; O-ATT-0.30 [95% CI: -0.36;-0.23] for Germany) and the adult population (O-ATT: -0.04 [95% CI: -0.07;-0.01] for Italy; O-ATT: -0.07 [95% CI: -0.11;-0.03] for Germany). In Portugal, there was a significant decreasing trend in Rc following school reopenings compared to the pre-reopening period (sustained effect: -0.03 [95% CI: -0.04; -0.03] in students; -0.02 [95% CI: -0.03; -0.02] in adults).

CONCLUSIONS

We found no evidence of a causal relationship between school reopenings in autumn 2022 and Omicron SARS-CoV-2 transmission.

Frequency and burden of disease for SARS-CoV-2 and other viral respiratory tract infections in children under the age of 2 months

OBJECTIVE

To evaluate the frequency and burden of disease of SARS-CoV-2 and other respiratory viruses in children under the age of 2 months.

METHODS

A retrospective, cross-sectional, single-center study was conducted between March 2021 and February 2022. All children under the age of 2 months and tested for SARS-CoV-2 were included. The frequency of SARS-CoV-2, of other respiratory viruses and the burden of disease caused by SARS-CoV-2 and other respiratory viruses were evaluated.

RESULTS

Seven hundred and twenty-seven children with an RT-PCR test for SARS-CoV-2 were included (mean age: 0.9 months (±0.6); boys: 57%); 514 (71%) in the emergency room and 213 (29%) in hospital. Among them, 62 (8.5%) had a positive RT-PCR test for SARS-CoV-2, more often in the Omicron period (23%) than in the Alpha period (4%). Of the 565 (78%) with a multiplex RT-PCR test for other viruses, 325 (58%) were positive. Children with a positive SARS-CoV-2 were less likely to have required respiratory support (p = 0.001), enteral nutrition (p = 0.03), or intensive care admission (p = 0.01) and had a shorter hospital stay than children with other respiratory viruses (5 days vs. 7 days, p = 0.007).

CONCLUSION

In this young population of children, SARS-CoV-2 infection was less frequent and less severe than other viral respiratory infections.

Virtual Schooling and Pediatric Mental Health During the COVID-19 Pandemic

In this single-site, retrospective, descriptive chart review and survey, we investigated changes in pediatric behavioral health needs during the COVID-19 pandemic and the relationship between virtual schooling and hospitalized children's mental health. Subjects included patients aged 6 and 18 years during the 2015 to 2019 and 2020 to 2021 school years who received inpatient mental health care. Parents of patients admitted in 2020 to 2021 were surveyed regarding their child's schooling. We additionally described and compared subjects using descriptive data, including proxies for illness severity, and assessed how these outcomes changed during the pandemic and correlated with school modality. During the pandemic, the distribution of diagnoses changed, and some markers of severity increased. Patients in exclusively virtual school had higher rates of mood and anxiety disorders and tic disorders, and lower rates of eating and disruptive behavior disorders, than patients with recent in-person school. Further study is needed regarding the impact of virtual schooling on pediatric mental health.

Parental role-modeling on 24-hour movement behaviors among preschoolers during the COVID-19 pandemic

INTRODUCTION

Little is known about the association between parents' and children's 24-h movement behaviors during the pandemic. This cross-sectional study examined the association between the 24-h movement behaviors of parents and their preschoolers and investigated sex differences in this association.

METHODS

A total of 1740 preschoolers (4.5 ± 0.8 years old, 50.3% boys) and their parents (35.4 ± 4.9 years old, 24.3% males) in China participated in this study and provided valid and complete data. Parents completed an online survey or a written questionnaire in the period between October and December 2020. Preschoolers' and parents' movement behaviors (physical activity [PA], sedentary behavior [SB], screen time, and sleep) and demographic information were reported by the parents. Generalized linear models and logistic regression models were performed.

RESULTS

Positive associations were found between parents' and preschoolers' moderate-to-vigorous intensity PA (β = 0.28; 95% confidence interval [CI]: 0.20, 0.36), total PA (β = 0.21; 95% CI: 0.17, 0.24), and sleep (β = 0.05; 95% CI: 0.03, 0.06) with no apparent sex difference. No significant association was found between parents' and preschoolers' SB or screen time. Girls were more likely to meet all three 24-h movement guidelines when their parents met them (odds ratio = 2.38; 95% CI: 1.42, 4.01), but the relationship was not significant for boys.

CONCLUSIONS

Parental role-modeling was positively associated with children's PA and sleep. This finding suggests that supporting parents' movement behaviors has the potential to promote a healthy lifestyle among preschoolers.

Technological Challenges and Solutions in Emergency Remote Teaching for Nursing: An International Cross-Sectional Survey

OBJECTIVES

With the sudden global shift to online learning modalities, this study aimed to understand the unique challenges and experiences of emergency remote teaching (ERT) in nursing education.

METHODS

We conducted a comprehensive online international cross-sectional survey to capture the current state and firsthand experiences of ERT in the nursing discipline. Our analytical methods included a combination of traditional statistical analysis, advanced natural language processing techniques, latent Dirichlet allocation using Python, and a thorough qualitative assessment of feedback from open-ended questions.

RESULTS

We received responses from 328 nursing educators from 18 different countries. The data revealed generally positive satisfaction levels, strong technological self-efficacy, and significant support from their institutions. Notably, the characteristics of professors, such as age (p = 0.02) and position (p = 0.03), influenced satisfaction levels. The ERT experience varied significantly by country, as evidenced by satisfaction (p = 0.05), delivery (p = 0.001), teacher-student interaction (p = 0.04), and willingness to use ERT in the future (p = 0.04). However, concerns were raised about the depth of content, the transition to online delivery, teacher-student interaction, and the technology gap.

CONCLUSIONS

Our findings can help advance nursing education. Nevertheless, collaborative efforts from all stakeholders are essential to address current challenges, achieve digital equity, and develop a standardized curriculum for nursing education.

Student's perspectives, satisfaction and experiences with online and classroom learning during the COVID-19 pandemic: Findings and implications on blended learning

Objectives

The coronavirus disease 2019 (COVID-19) pandemic disrupted classroom-based learning, necessitating the adoption of online learning in most universities. However, there has been a lack of information on university students' perspectives regarding online learning during the COVID-19 pandemic. This study assessed the perspectives, satisfaction and experiences with online and classroom learning among human health students at the University of Zambia.

Methods

This cross-sectional study was conducted among 737 students at the University of Zambia from October 2022 to April 2023. Data were analysed using Stata version 16.1.

Results

Of the 737 participants, 51.6% were female and 56.5% agreed that blended learning should continue even after the COVID-19 pandemic. However, 78.4% of the students believed that group discussions were more suitable in the classroom than online learning. Most students (67.1%) disagreed that they preferred online learning to classroom learning. Furthermore, 77.6% of the students disagreed that online learning gave more satisfaction than classroom learning.

Conclusions

This study found that most students recommended the continuation of blended learning after the pandemic. However, they believed that follow-up tutorials and assessments were better undertaken in physical classrooms than online learning. These findings are important in sensitising stakeholders in the education sector and governments to consider blended learning as a teaching strategy in the future. There is a need to develop and implement curricula that offer blended learning to students as well as ensure the students have the necessary facilities and equipment to support such learning.

Assessing the impact of an evidence- and consensus-based guideline for controlling SARS-CoV-2 transmission in German schools on decision-making processes: a multi-component qualitative analysis

INTRODUCTION

During the COVID-19 pandemic, decision-making on measures to reduce or prevent transmission of SARS-CoV-2 in schools was rendered difficult by a rapidly evolving and uncertain evidence base regarding their effectiveness and unintended consequences. To support decision-makers, an interdisciplinary panel of scientific experts, public health and school authorities as well as those directly affected by school measures, was convened in an unprecedented effort to develop an evidence- and consensus-based public health guideline for German schools. This study sought to assess whether and how this guideline impacted decision-making processes.

METHODS

This study comprised three components: (1) we sent inquiries according to the Freedom of Information Acts of each Federal State to ministries of education, family, and health. (2) We conducted semi-structured interviews with individuals involved in decision-making regarding school measures in two Federal States, and (3) we undertook semi-structured interviews with members of the guideline panel. The content of response letters in component 1 was analysed descriptively; data for components 2 and 3 were analysed using deductive-inductive thematic qualitative content analysis according to Kuckartz.

RESULTS

Responses to the Freedom of Information Act inquiries showed that the guideline was recognised as a relevant source of information by ministries of education in nine out of 16 Federal States and used as a reference to check existing directives for school measures in five Federal States. All participants (20 interviews) emphasised the value of the guideline given its evidence- and consensus-based development process but also noted limitations in its usability and usefulness, e.g., lack of context-specificity. It was consulted by participants who advised policy-makers (5 interviews) alongside other sources of evidence. Overall, perceptions regarding the guideline's impact were mixed.

CONCLUSIONS

Our findings suggest that the guideline was relatively well-known in Federal States' decision-making bodies and that it was considered alongside other forms of evidence in some of these. We suggest that further research to evaluate the impact of public health guidelines on (political) decision-making is warranted. Guideline development processes may need to be adapted to account for the realities of decision-making during public health emergencies and beyond.

Evaluating the Effectiveness of School Closure in COVID-19-Related Syndromes From Community-Based Syndromic Surveillance: Longitudinal Observational Study

BACKGROUND

During the COVID-19 pandemic, a school closure policy was adopted to prevent cluster transmission in schools and subsequent household transmission. However, the effectiveness of school closure is not consistent in studies conducted in different countries.

OBJECTIVE

This study aimed to explore the association between school closure and the daily standardized incidence of COVID-19-related syndromes in an outpatient syndromic surveillance system.

METHODS

We calculated the incidence of COVID-19-related syndromes derived from a community-based syndromic surveillance system between the first week of January and the second or fourth weeks after school closure in 2021 and 2022 in Taipei City, Taiwan. The effect of school closure on the standardized incidence of COVID-19-related syndromes was evaluated by interrupted time series analysis using an autoregressive integrated moving average with a distributed lag function. The exogenous variables were changes in human mobility measured by Google COVID-19 community mobility reports. Furthermore, the models quantified the influence of different age groups and the hierarchy of medical facilities, such as clinics or community hospitals.

RESULTS

School closure was only negatively and significantly associated with the overall standardized incidence of COVID-19-related syndromes in 2021 for 2 weeks after the intervention (coefficient -1.24, 95% CI -2.40 to -0.08). However, in different age groups, school closure had a significantly negative association with the standardized incidence among people aged 13-18 years and ≥65 years for 2 weeks after the intervention in clinics in 2021. In community hospitals, school closure was significantly positively associated with the standardized incidence among people aged 19-24 years in 2021. In 2022, 2 weeks after the intervention, school closure had a significantly negative association with the standardized incidence among people aged 0-6, 7-12, and 19-24 years in community hospitals and aged >45 years in clinics. Furthermore, the standardized incidence was positively associated with movement change toward grocery and pharmacy stores in all age groups in 2022. In addition, movement changes toward residences were significantly positively associated with the standardized incidence among all age groups.

CONCLUSIONS

Overall, school closure effectively suppresses COVID-19-related syndromes in students owing to the reduction of physical contact. In addition, school closure has a spillover effect on elderly people who stay at home.

Pandemic response strategies and threshold phenomena

This paper critically evaluates the Suppression Threshold Strategy (STS) for controlling Covid-19 (C-19). STS asserts a "fundamental distinction" between suppression and mitigation strategies, reflected in very different outcomes in eventual mortality depending on whether reproductive number R is caused to fall below 1. We show that there is no real distinction based on any value of R which falls in any case from early on in an epidemic wave. We show that actual mortality outcomes lay on a continuum, correlating with suppression levels, but not exhibiting any step changes or threshold effects. We argue that an excessive focus on achieving suppression at all costs, driven by the erroneous notion that suppression is a threshold, led to a lack of information on how to trade off the effects of different specific interventions. This led many countries to continue with inappropriate intervention-packages even after it became clear that their initial goal was not going to be attained. Future pandemic planning must support the design of "Plan B", which may be quite different from "Plan A".

Psychiatric Hospitalization for Psychopathological Disorders and Self-Injurious Behaviors in Italian Children and Adolescents during COVID-19

The evidence shows that the COVID-19 pandemic dramatically increased the number of urgent psychiatric consultations for children and adolescents in hospital emergency departments (EDs). However, what needs to be further investigated are the characteristics of psychiatric hospitalization in children and adolescents admitted to the Child and Adolescent Neuropsychiatry Unit wards in EDs. Specifically, this retrospective study aimed to examine changes in (i) the number of inpatients and (ii) the distribution of psychopathological disorders and self-injurious behaviors in our Child and Adolescent Neuropsychiatry Unit ward during the COVID-19 lockdown in Italy (March-June 2020; October 2020-January 2021) compared with the same months of previous years. We found a significantly lower number of inpatients during the first four quarantine months than the first four reference months and a higher number of inpatients during the second four quarantine months than the second four reference months. Additionally, we found an increased frequency of mood disorders, non-suicidal self-injurious behavior, and suicidal ideation during the COVID-19 lockdown compared to the reference periods. Our findings underline the need to develop psychological healthcare services for future emergency periods in order to identify and treat psychological distress in children and adolescents early, reducing the risk of psychiatric hospitalization.

Policies to prevent zoonotic spillover: a systematic scoping review of evaluative evidence

BACKGROUND

Emerging infectious diseases of zoonotic origin present a critical threat to global population health. As accelerating globalisation makes epidemics and pandemics more difficult to contain, there is a need for effective preventive interventions that reduce the risk of zoonotic spillover events. Public policies can play a key role in preventing spillover events. The aim of this review is to identify and describe evaluations of public policies that target the determinants of zoonotic spillover. Our approach is informed by a One Health perspective, acknowledging the inter-connectedness of human, animal and environmental health.

METHODS

In this systematic scoping review, we searched Medline, SCOPUS, Web of Science and Global Health in May 2021 using search terms combining animal health and the animal-human interface, public policy, prevention and zoonoses. We screened titles and abstracts, extracted data and reported our process in line with PRISMA-ScR guidelines. We also searched relevant organisations' websites for evaluations published in the grey literature. All evaluations of public policies aiming to prevent zoonotic spillover events were eligible for inclusion. We summarised key data from each study, mapping policies along the spillover pathway.

RESULTS

Our review found 95 publications evaluating 111 policies. We identified 27 unique policy options including habitat protection; trade regulations; border control and quarantine procedures; farm and market biosecurity measures; public information campaigns; and vaccination programmes, as well as multi-component programmes. These were implemented by many sectors, highlighting the cross-sectoral nature of zoonotic spillover prevention. Reports emphasised the importance of surveillance data in both guiding prevention efforts and enabling policy evaluation, as well as the importance of industry and private sector actors in implementing many of these policies. Thoughtful engagement with stakeholders ranging from subsistence hunters and farmers to industrial animal agriculture operations is key for policy success in this area.

CONCLUSION

This review outlines the state of the evaluative evidence around policies to prevent zoonotic spillover in order to guide policy decision-making and focus research efforts. Since we found that most of the existing policy evaluations target 'downstream' determinants, additional research could focus on evaluating policies targeting 'upstream' determinants of zoonotic spillover, such as land use change, and policies impacting infection intensity and pathogen shedding in animal populations, such as those targeting animal welfare.

What does the biography of Duncan Forbes MBE (1873-1941), Medical Officer of Health for Brighton (1908-1938), reveal about managing pandemics?

Coronavirus disease 2019 (COVID-19) and the national lockdowns of 2020/2021 illustrate how modern public health systems are founded on empirical evidence and contemporary understanding of disease transmission. Duncan Forbes was one of the earliest sanitarians in Britain to propose and implement a new understanding of infectious disease control. Starting his early career in Manchester and Cambridge, his eventual tenure as Brighton's longest-serving medical officer of health (MOH) left an indelible mark by challenging the entrenched tradition of terminal disinfection and by devising his "Brighton methods" for the care of tubercular patients. Forbes led Brighton's public health responses during World War I and the 1918/1919 "Spanish" influenza pandemic. Forbes also strove to improve health and housing in Brighton. His views on limiting access to contraception on the grounds of eugenics are also significant. Analysis of Forbes' work then allowed a discussion of both his legacy and of the applicability of his experiences to our own in tackling COVID-19. Forbes undeniably had a great influence in shaping modern public health practice in Britain and his challenges as MOH bear many similarities, as well as stark differences, to today's experience of COVID-19.

Readiness of public schools before reopening during COVID-19 pandemic: School-based cross-sectional survey in southern Ethiopia

BACKGROUND

School closures in response to the COVID-19 impacted children's education, protection, and wellbeing. After understanding these impacts and that children were not super spreaders, countries including Ethiopia decided to reopen schools with specified preconditions. But when deciding to reopen schools, the benefits and risks across education, public health and socio-economic factors have to be evaluated. However, there was information gap on status of schools as per preconditions. Hence, this study was designed to investigate status of schools in Southern Ethiopia.

METHODS

School based cross-sectional study was conducted in October 2020 in Southern Ethiopia. Sample of 430 schools were included. National school reopening guideline was used to develop checklist for assessment. Data was collected by public health experts at regional emergency operation center. Descriptive analysis was performed to summarize data.

RESULTS

A total of 430 schools were included. More than two thirds, 298 (69.3%), of schools were from rural areas while 132 (30.7%) were from urban settings. The general infection prevention and water, sanitation and hygiene (IPC-WASH) status of schools were poor and COVID-19 specific preparations were inadequate to meet national preconditions to reopen schools during the pandemic. Total score from 24 items observed ranged from 3 to 22 points with mean score of 11.75 (SD±4.02). No school scored 100% and only 41 (9.5%) scored above 75% while 216 (50.2%%) scored below half point that is 12 items.

CONCLUSION

Both the basic and COVID-19 specific IPC-WASH status of schools were inadequate to implement national school reopening preconditions and general standards. Some of strategies planned to accommodate teaching process and preconditions maximized inequalities in education. Although COVID-19 impact lessened due to vaccination and other factors, it is rational to consider fulfilling water and basic sanitation facilities to schools to prevent communicable diseases of public health importance.

Measuring unequal distribution of pandemic severity across census years, variants of concern and interventions

BACKGROUND

The COVID-19 pandemic stressed public health systems worldwide due to emergence of several highly transmissible variants of concern. Diverse and complex intervention policies deployed over the last years have shown varied effectiveness in controlling the pandemic. However, a systematic analysis and modelling of the combined effects of different viral lineages and complex intervention policies remains a challenge due to the lack of suitable measures of pandemic inequality and nonlinear effects.

METHODS

Using large-scale agent-based modelling and a high-resolution computational simulation matching census-based demographics of Australia, we carried out a systematic comparative analysis of several COVID-19 pandemic scenarios. The scenarios covered two most recent Australian census years (2016 and 2021), three variants of concern (ancestral, Delta and Omicron), and five representative intervention policies. We introduced pandemic Lorenz curves measuring an unequal distribution of the pandemic severity across local areas. We also quantified pandemic biomodality, distinguishing between urban and regional waves, and measured bifurcations in the effectiveness of interventions.

RESULTS

We quantified nonlinear effects of population heterogeneity on the pandemic severity, highlighting that (i) the population growth amplifies pandemic peaks, (ii) the changes in population size amplify the peak incidence more than the changes in density, and (iii) the pandemic severity is distributed unequally across local areas. We also examined and delineated the effects of urbanisation on the incidence bimodality, distinguishing between urban and regional pandemic waves. Finally, we quantified and examined the impact of school closures, complemented by partial interventions, and identified the conditions when inclusion of school closures may decisively control the transmission.

CONCLUSIONS

Public health response to long-lasting pandemics must be frequently reviewed and adapted to demographic changes. To control recurrent waves, mass-vaccination rollouts need to be complemented by partial NPIs. Healthcare and vaccination resources need to be prioritised towards the localities and regions with high population growth and/or high density.

Policy instruments facilitate China's COVID-19 work resumption

Governments worldwide have announced stimulus packages to remobilize the labor force after COVID-19 and therefore to cope with the COVID-19-related recession. However, it is still unclear how to facilitate large-scale work resumption. This paper aims to clarify the issue by analyzing the large-scale prefecture-level dataset of human mobility trajectory information for 320 million workers and about 500,000 policy documents in China. We model work resumption as a collective behavioral change due to configurations of capacity, motivation, and policy instruments by using qualitative comparative analysis. We find that the effectiveness of post-COVID-19 recovery stimulus varied across China depending on the fiscal and administrative capacity and the policy motivation of the prefecture. Subnational fiscal and procurement policies were more effective for the wholesale and retail sector and the hotel and catering sector, whereas the manufacturing and business services sectors required more effort regarding employment policies. Due to limited prefectural capacity and wavering policy motivation, the simultaneous adoption of fiscal, employment, and procurement policy interventions endangered post-COVID-19 work resumption. We highlight the necessity of tailored postcrisis recovery strategies based on local fiscal and administrative capacity and the sectoral structure.

The response to COVID-19 in Timor-Leste: lessons learnt

The response to the COVID-19 pandemic in Timor-Leste offers lessons that may be useful for incorporating into future responses to infectious disease outbreaks in similar resource-limited settings. In this paper, we identify nine key areas for learning from Timor-Leste's experience of the COVID-19 pandemic: (1) the importance of prior preparation for health emergencies, (2) the establishment of effective leadership and governance structures, (3) the protective impact of early border restrictions, (4) the rapid expansion of diagnostic laboratory capacity, (5) the impact of effective health communications in supporting the vaccine roll-out, (6) the opportunity to build capacity for clinical care, (7) the use of public health interventions that were found to have limited public health impact, (8) the broader effects of the pandemic and the public health response and (9) translation of lessons from COVID-19 to other public health priorities.

Determining Self-Efficacy of Nurses Who Graduated From Distance Education Because of the COVID-19 Pandemic: A Multicenter Cross-Sectional Study

BACKGROUND

The current literature states that distance education has caused a lack of professional skills, regression of existing professional skills (Kaya & Akin Isik, 2021; Kürtüncü & Kurt, 2020), a lack of self-confidence, and feelings of inadequacy among nursing students (George et al., 2020). The current study examined the professional self-efficacy of nurses who graduated from distance education because of the coronavirus disease 2019 pandemic.

METHOD

This multicenter cross-sectional study was conducted between November 2020 and June 2022 with 164 nurses who graduated from distance education in 2020-2021 from three faculties of health sciences.

RESULTS

Professional self-efficacy of the nurses was found to be above average. Male nurses and nurses who believed distance education had a negative impact on their professional skills had significantly higher professional self-efficacy. Some nurses reported that their professional theoretical knowledge was insufficient and defined the effect of distance education on their professional skills as relatively negative.

CONCLUSION

Most of the nurses expressed that distance education had a negative effect on their professional self-efficacy and working life. [J Contin Educ Nurs. 2023;54(10):480-488.].

Measuring the clustering effect of the SARS-CoV-2 transmission in a school population: a cross-sectional study in a high incidence region

Since the beginning of the pandemic, there has been a great deal of controversy regarding the role of schools in the spread of SARS-CoV-2 infection, and the relative contribution of students, teachers, and others. To quantify the clustering effect of SARS-CoV-2 infection within classes and schools considering the seroprevalence of specific antibodies among students and school staff (teachers and non-teachers) evaluated in schools located in the Northern region of Portugal. 1517 individuals (1307 students and 210 school staff) from 4 public and 2 private schools, comprising daycare to secondary levels, were evaluated. A rapid point-of-care test for SARS-CoV-2 specific IgM and IgG antibodies was performed and a questionnaire was completed providing sociodemographic and clinical information. We calculated the seroprevalence of IgM and IgG antibodies and estimated the Median Odds Ratio (OR) and 95% confidence interval (CI) to assess the clustering effect, using a multilevel (school and class) logistic regression. SARS-CoV-2 seroprevalence (IgM or IgG) was 21.8% and 23.8% (p = 0.575) in students and school staff, respectively. A total of 84 (8.6%) students and 35 (16.7%) school staff reported a previous molecular diagnosis. Among students, those who reported high-risk contacts only at school (OR = 1.13; 95% CI 0.72-1.78) had a seroprevalence similar to those without high-risk contacts; however, seroprevalence was significantly higher among those who only reported a high-risk contact outside the school (OR = 6.56; 95% CI 3.68-11.72), or in both places (OR = 7.83; 95% CI 5.14-11.93). Similar associations were found for school staff. The median OR was 1.00 (95% CI 1.00, 1.38) at the school-level and 1.78 (95% CI 1.40, 2.06) at the class-level. SARS-CoV-2 seroprevalence was similar between students and staff, without a clustering effect observed at the school level, and only a moderate clustering effect documented within classes. These results indicate that the mitigation measures in the school environment can prevent the spread of class outbreaks to the remaining school community.

The negative association of the SARS-CoV-2 pandemic with the health of mother and child considering maternal childhood maltreatment

BACKGROUND

Social distancing strategies during the SARS-CoV-2 pandemic have left families facing a variety of different constraints. Especially in this stressful time, children need a stable parental home to prevent developmental consequences. Additional risk factors such as maternal childhood maltreatment (CM) may affect mother's psychosomatic health and children's physical well-being in this period.

OBJECTIVE

It was aimed to analyze the associations between maternal CM, mother's mental health, and children's physical complaints during the SARS-CoV-2-pandemic.

METHOD

Mothers of a well-documented birth cohort from a longitudinal study were included in this study. Psychosomatic health was assessed with the PHQ-D and children's physical health with the GBB-KJ during the pandemic. N = 159 mothers completed the online survey. To describe the maternal CM, data from a longitudinal survey were used.

RESULTS

The calculation of three mediation analyses demonstrate that maternal depression symptoms (c-path: β = 0.10, p = .02; c'-path: β = 0.07, p = .13), somatic symptoms (c-path: β = 0.10, p = .02; c'-path: β = 0.07, p = .13) and psychosomatic symptoms (c-path: β = 0.10, p = .02; c'-path: β = 0.06, p = .19) fully mediate the relationship between CM and children's physical health complaints.

CONCLUSIONS

Maternal CM experiences seem to be one relevant risk factor during the pandemic and seem to influence the way in which parents deal with stressful situations and increase the risk for depressive symptoms. The present results highlight the importance to provide individually adjusted assistance to help the families to get through the pandemic.

Atopy and Elevation of IgE, IgG3, and IgG4 May Be Risk Factors for Post COVID-19 Condition in Children and Adolescents

SARS-CoV-2 infection causes transient cardiorespiratory and neurological disorders, and severe acute illness is rare among children. Post COVID-19 condition (PCC) may cause profound, persistent phenotypes with increasing prevalence. Its manifestation and risk factors remain elusive. In this monocentric study, we hypothesized that atopy, the tendency to produce an exaggerated immunoglobulin E (IgE) immune response, is a risk factor for the manifestation of pediatric PCC. We present a patient cohort (n = 28) from an early pandemic period (2021-2022) with comprehensive evaluations of phenotypes, pulmonary function, and molecular investigations. PCC predominantly affected adolescents and presented with fatigue, dyspnea, and post-exertional malaise. Sensitizations to aeroallergens were found in 93% of cases. We observed elevated IgE levels (mean 174.2 kU/L, reference < 100 kU/L) regardless of disease severity. Concurrent Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) was found in 29% of patients that also faced challenges in school attendance. ME/CFS manifestation was significantly associated with elevated immunoglobulin G subclasses IgG3 (p < 0.05) and IgG4 (p < 0.05). A total of 57% of patients showed self-limiting disease courses with mean recovery at 12.7 months (range 5-25 months), 29% at 19.2 months (range 12-30 months), and the rest demonstrated overall improvement. These findings offer additional insights into immune dysregulation as a risk factor for pediatric PCC.

Back to School after Corona Virus Disease of 2019: New Relationships, Distance Schooling, and Experienced Routine

The Corona Virus Disease of 2019 (COVID-19) pandemic has upset the students' daily routine, forcing them at first into a sudden transition to distance learning and then to a return to school modelled on the basis of infection containment measures. The present research involved 157 students from schools in central Italy with a mean age of 13.58 years old to investigate the affective impact of the pandemic on the school experience and its components (recess, oral testing, relationships with classmates, and relationship pupils-teachers). The results show that only a few have experienced school interruption in a traumatic way: they have appreciated neither distance learning, nor the return to school; for these teenagers, the school of the past has died. Other adolescents and pre-adolescents tried to replace the face-to-face mode with distance learning, maintaining certain attention to the school even during the quarantine. However, the online mode did not keep its promise. Those who have invested more in digital innovation find it difficult to return to normality today. For all of them, socialization mediated by school experience is decisive in supporting the return to ordinary life after the pandemic.

COVID-19-related adolescent mortality and morbidity in nineteen European countries

Prior to the COVID-19 pandemic, adolescents in most countries experienced a syndemic of malnutrition, obesity, deprivation, mental health problems, inequalities, and the effects of climate change. Today, other factors have added to this burden during the pandemic, and it is important to have an updated reflection. We aimed to assess the risk and protective factors for COVID-19-related adolescent mortality and morbidity in the European region. Three double models were fitted to analyze the relationship between different factors with the number of diagnosed cases and deaths. The 1a and 1b use a multiple Poisson regression. The 2a and 2b are optimized models that use the same variables as prior models but with backward selection with a p value < 0.05 as the limit. Finally, the 3a and 3b models (backward stepwise multivariable Poisson regression) include the variable "fully vaccinated." All models used the at-risk population (15-19 years or total population) as a regression covariate (offset). Increased access to quality healthcare (IRR 0.68; CI 0.55-0.84), increased private sector involvement (IRR 0.86; CI 0.82-0.90), Gini coefficient (IRR 0.93; CI 0.88-0.99), and full vaccination (IRR 0.94; CI 0.90-0.99) represent protective factors of COVID-19 mortality in this population. Additionally, a positive association between pollution and mortality was found.  Conclusion: Being fully vaccinated and having access to quality medical care are protective factors against COVID-19 mortality in this age group. Interestingly, the more the pollution, the greater the risk of dying from COVID-19. We stress the great importance of coordination between the public and private sectors to address crises such as the current one. What is Known: • Compared to other age groups, adolescents have been little studied, and most studies focused on mental health during the COVID-19 pandemic. What is New: • In this study, we show how in 19 European countries, different factors interact, such as socio-demographic, environmental, health system, and control measures with morbidity and mortality by COVID-19, in a very little studied age group as teenagers.

Impacts of public health and social measures on COVID-19 in Europe: a review and modified Delphi technique

Introduction

The emergence of the COVID-19 pandemic in early 2020 led countries to implement a set of public health and social measures (PHSMs) attempting to contain the spread of the SARS-CoV-2 virus. This study aims to review the existing literature regarding key results of the PHSMs that were implemented, and to identify the PHSMs considered to have most impacted the epidemiological curve of COVID-19 over the last years during different stages of the pandemic.

Methods

The PHSM under study were selected from the Oxford COVID-19 Government Response Tracker (OxCGRT), supplemented by topics presented during the Rapid Exchange Forum (REF) meetings in the scope of the Population Health Information Research Infrastructure (PHIRI) project (H2020). The evidence- based review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to identify which reviews have already been published about each PHSMs and their results. In addition, two modified Delphi panel surveys were conducted among subject matter experts from 30 European countries to uphold the results found.

Results

There were 3,212 studies retrieved from PubMed, 162 full texts assessed for eligibility and 35 included in this PHSMs summary. The measures with clearest evidence on their positive impact from the evidence-based review include social distancing, hygiene measures, mask measures and testing policies. From the modified Delphi panel, the PHSMs considered most significant in the four periods analyzed were case isolation at home, face coverings, testing policy, and social distancing, respectively.

Discussion

The evidence found has significant implications for both researchers and policymakers. The study of PHSMs' impact on COVID-19 illustrates lessons learned for future pan- and epidemics, serving as a contribution to the health systems resilience discussion. These lessons, drawn from both the available scientific evidence and the perspectives of relevant subject matter experts, should also be considered in educational and preparedness programs and activities in the public health space.

Global impact and cost-effectiveness of one-dose versus two-dose human papillomavirus vaccination schedules: a comparative modelling analysis

BACKGROUND

To eliminate cervical cancer as a public health problem, the World Health Organization had recommended routine vaccination of adolescent girls with two doses of the human papillomavirus (HPV) vaccine before sexual initiation. However, many countries have yet to implement HPV vaccination because of financial or logistical barriers to delivering two doses outside the infant immunisation programme.

METHODS

Using three independent HPV transmission models, we estimated the long-term health benefits and cost-effectiveness of one-dose versus two-dose HPV vaccination, in 188 countries, under scenarios in which one dose of the vaccine gives either a shorter duration of full protection (20 or 30 years) or lifelong protection but lower vaccine efficacy (e.g. 80%) compared to two doses. We simulated routine vaccination with the 9-valent HPV vaccine in 10-year-old girls at 80% coverage for the years 2021-2120, with a 1-year catch-up campaign up to age 14 at 80% coverage in the first year of the programme.

RESULTS

Over the years 2021-2120, one-dose vaccination at 80% coverage was projected to avert 115.2 million (range of medians: 85.1-130.4) and 146.8 million (114.1-161.6) cervical cancers assuming one dose of the vaccine confers 20 and 30 years of protection, respectively. Should one dose of the vaccine provide lifelong protection at 80% vaccine efficacy, 147.8 million (140.6-169.7) cervical cancer cases could be prevented. If protection wanes after 20 years, 65 to 889 additional girls would need to be vaccinated with the second dose to prevent one cervical cancer, depending on the epidemiological profiles of the country. Across all income groups, the threshold cost for the second dose was low: from 1.59 (0.14-3.82) USD in low-income countries to 44.83 (3.75-85.64) USD in high-income countries, assuming one dose confers 30-year protection.

CONCLUSIONS

Results were consistent across the three independent models and suggest that one-dose vaccination has similar health benefits to a two-dose programme while simplifying vaccine delivery, reducing costs, and alleviating vaccine supply constraints. The second dose may become cost-effective if there is a shorter duration of protection from one dose, cheaper vaccine and vaccination delivery strategies, and high burden of cervical cancer.

Mental Wellbeing and Health-Risk Behaviours of University Students in Brunei: A Cross-Sectional Study during COVID-19 Pandemic

Background: The coronavirus disease discovered in 2019 (COVID-19) has impacted the health behaviour of university students in a range of western nations and had a number of detrimental effects on their mental wellbeing. However, little is known about the impact on university students in Southeast Asia, particularly in Brunei. This study aims to estimate the prevalence and factors related to poor mental wellbeing and engaging in health-risk behaviors among university students in Brunei during the COVID-19 pandemic. Methods: A cross-sectional online survey of students in all public universities was conducted from March to June 2021. Warwick-Edinburgh Mental Well-being Scale, Global Physical Activity Questionnaire, and WHO STEPs questionnaires were used to measure mental wellbeing, physical activity, and health behaviors, respectively. Logistic regressions were applied. Results: A total of 1020 university students participated in this study (57% response rate). Prevalence of poor mental wellbeing and physical inactivity were 30% and 42.8%, respectively. Excessive snacking (89.7%), sugar intake (81.7%), and salt intake (53.8%) were the most prevalent health-risk behaviors. Body mass index and participating in sports activities were the most common factors related to mental wellbeing and health-risk behaviors. Conclusions: Participating in certain sports activities appears to have protective effects against study outcomes. However, a high prevalence of physical inactivity and unhealthy diet among university students is a concern, as it could be indicative of future non-communicable disease trends.

Impact of school operating scenarios on COVID-19 transmission under vaccination in the U.S.: an agent-based simulation model

At the height of the COVID-19 pandemic, K-12 schools struggled to safely operate under the fast-changing pandemic situation. However, little is known about the impact of different school operating scenarios considering the ongoing efforts of vaccination. In this study, we deployed an agent-based simulation model to mimic disease transmission in a mid-sized community consisting of 10,000 households. A total of eight school operating scenarios were simulated, in decreasing order of restrictiveness regarding COVID-19 mitigation measures. When masks were worn at school, work, and community environments, increasing in-person education from 50% to 100% would result in only 1% increase in cumulative infections. When there were no masks nor contact tracing while schools were 100% in person, the cumulative infection increased by 86% compared to the scenario when both masking and contact tracing were in place. In the sensitivity analysis for vaccination efficacy, we found that higher vaccination efficacy was essential in reducing overall infections. Our findings showed that full in-person education was safe, especially when contact tracing, masking, and widespread vaccination were in place. If no masking nor contact tracing was practiced, the transmission would rose dramatically but eventually slow down due to herd immunity.

Psychological Difficulties in Children and Adolescents during the COVID-19 Lockdown: The Effects of Spending Free Time with Parents or Using Digital Devices

The present study investigated protective and risk factors for psychological difficulties in children and adolescents during the COVID-19 lockdown. Specifically, the role of increased use of digital devices (DDs) for recreational purposes and the role of free time spent with parents were explored. Furthermore, the possible mediating effect of increased use of DDs in the relationship between free time spent with parents and psychological difficulties was tested. Participants were 4412 Italian children and adolescents, divided into two groups: children aged 6-10 years (n = 2248) and adolescents aged 11-18 years (n = 2164). Data were collected in Italy during the national lockdown and questionnaires were completed online by parents, who reported on their children's habits. The daily use of DDs increased significantly during the lockdown compared to the previous period, in both children and adolescents. Additionally, psychological difficulties increased in both children and adolescents during the lockdown, with a more severe impairment for children. Increased use of DDs during the lockdown positively predicted psychological difficulties (children: beta = 0.18, p < 0.001; adolescents: beta = 0.13, p < 0.001), while free time spent with parents was protective (children: beta = -13, p < 0.001; adolescents: beta = -0.12, p < 0.001). For children (but not adolescents), increased use of DDs mediated the effects of free time spent with parents on psychological difficulties (children: beta = -0.01, 95% CI [-0.018, -0.002]; adolescents: beta = -0.003, 95% CI [-0.009, 0.003]). The findings provide new insights for education and research.