Impact of the COVID-19 Epidemic on Lifestyle Behaviors and Their Association With Subjective Well-Being Among the General Population in Mainland China: Cross-Sectional Study

Perceived Overload on Short Video Platforms and Its Influence on Mental Health Among the Elderly: A Moderated Mediation Model

Background

In the post-epidemic era, the problem of short-video app addiction among older adults has become increasingly prominent, and people have begun to pay attention to the negative emotional and psychological consequences of Perceived Overload of short-video apps. Given the growing mental health concerns of older adults, it is critical to understand the potential relationship between the Perceived Overload of short video apps for older adults and older adults' mental health.

Methods

This study applied the stress-strain-outcome (SSO) framework to explore the relationship between perceived overload of a short-video application and loneliness, mental health, and Confucianism tenets in 1300 Chinese older adults. The relationship between perceived overload and loneliness, mental health, and Confucianism tenet moderated mediation models of perceived overload and mental health were created using SPSS 26.0 and PROCESS 4.1 for SPSS.

Results

The perceived overload of a short video application for older adults directly predicted loneliness and mental health in older adults, and the Confucianism tenet moderated the mediation process between perceived overload and mental health. Perceived overload affects mental health through loneliness in older adults.

Discussion

The results of this study are of practical significance for understanding the current problem of short-video addiction among older adults. Understanding the effects of perceived overload on older adults' loneliness and mental health can help prevent loneliness and mental health problems caused by short-video addiction among older adults on the one hand, and on the other hand, it can also help to develop targeted coping strategies and create psychological intervention programs based on the Confucianism tenet of intervention ethics to improve mental health in a changing technological stress environment.

The Impact of a Global Pandemic on Young Adult Sedentary Behavior and Physical Activity

Introduction

The novel COVID-19 disease detected in 2019 widely affected individuals' social movements, likely disrupting the ability to participate in leisure-related physical activity. Because of this, participation in sedentary behavior is thought to have increased. The purpose of this study was to determine how the COVID-19 pandemic affected U.S. young adult physical activity and sedentary behavior.

Methods

A total of 333 U.S. young adults (aged between 18 and 30 years) completed an online, comprehensive questionnaire during the early parts of COVID-19. Wilcoxon signed-rank tests were used to determine the change in time spent in physical activity and sedentary behavior during COVID-19 compared with that before COVID-19.

Results

There was a significant decrease in physical activity minutes (p<0.0001) and a significant increase in sedentary behavior (p<0.005) during COVID-19 compared with that before COVID-19. Significant differences were found by stratifying the data by sex and relationship status. Although both males and females reduced their physical activity, only males significantly increased their time in sedentary behavior during COVID-19 compared with that before COVID-19 (p<0.05). Furthermore, married young adults significantly reduced their physical activity during COVID-19 (p<0.001), whereas single individuals did not. Single young adults saw significant increases in sedentary behavior during COVID-19 (p<0.005), whereas married individuals did not exhibit any change in sedentary behavior.

Conclusions

Stay-at-home orders enforced in the U.S. during the summer of 2020 led to increases in sedentary behavior and decreases in physical activity, particularly among males and single young adults. Future studies should determine whether these behavior changes persist.

Changes in dietary, lifestyle habits and mood in college students during the COVID-19 pandemic: a survey distributed across Greek universities

Introduction: The COVID-19 pandemic had implications on students' life. This study aims to identify positive and negative effects of COVID-19 pandemic on students' life habits with the final goal to promote their general wellbeing.Methods: An online questionnaire was administered to Greek undergraduate and graduate college students during the COVID-19 quarantine. The impact of the pandemic on the dietary and lifestyle habits were evaluated in 246 participants.Results: The study revealed that 57.7% of students boosted their fruit and vegetable intake, 43.1% consumed more meals, and 57.7% increased snacking. Breakfast eaters went from 57.7% to 66.6%, and those preparing homemade meals rose to 58.9%. Conversely, 61.4% reported increased sedentary time, 61.8% noted weight gain, and only 71% claimed a medium level of life satisfaction post-pandemic.Conclusion: Students developed some healthier dietary habits during the pandemic. However, many of them gained weight because of inactivity, adverse dietary behaviors and decreased level of life satisfaction.

The Burden of Chronic Disease

Chronic diseases like diabetes, heart disease, stroke, and cancer have been and continue to be some of the major causes of worldwide morbidity and mortality. A transition between infectious and noncommunicable diseases occurred in the early 1900s as a result of improved public health and has persisted ever since. Now, as individuals live longer, the prevalence and cost of chronic disease continue to grow. The estimated cost of chronic disease is expected to reach $47 trillion worldwide by 2030. Individual lifestyle and behaviors and community factors play important roles in the development and management of chronic diseases. Many of these conditions (diabetes, heart disease, and respiratory diseases) are preventable, and their leading risk factors are physical inactivity, poor nutrition, tobacco use, and excessive alcohol. Unfortunately, the investment in prevention remains small compared with treatment, both from a lifestyle perspective and a social determinants of health perspective. Given the future trajectory of chronic disease, innovation in technology and pharmaceuticals with a concomitant investment in prevention will be required. Our future depends on it.

Do nutritional habits and supplement use affect health-related quality of life during social isolation period in the community of North Cyprus?

The aim of study was to comprehensively investigate the effect of nutritional habits and supplement use on health-related quality of life during social isolation period. This study was a cross-sectional study. A total of 418 participants (73.4% were women and 26.6% were men) participated in this study. Participants' demographic information, nutritional habits, and quality of life were questioned, and anthropometric measurements were obtained. A significant difference was found in the main meal skipping status of individuals by age group. The consumption of milk, yoghurt, ayran, legumes, cereal products other than bread, vegetables, fruits, oilseeds, and snack foods was similar in both periods. Furthermore, frequencies of multivitamins, multiminerals, vitamin B12, vitamin C, vitamin D, iron, calcium, omega-3, and probiotics were similar during and before the pandemic. A significant difference was found in scores obtained on the Quality of Life Scale (QOLS) by age group. There was a significant difference in the quality of life scores by body mass index (BMI) groups. It was concluded that quality of life decreased due to the increase in body weight during pandemic period. The social isolation period did not make a clear difference in the nutritional habits of individuals and the use of nutritional supplements. When the main meal skipping situations were evaluated within the scope of nutritional habits, those who did not skip their main meal received the highest score on the QOLS.

Changes in lifestyle and physical and mental health related to long-confinement due COVID-19: a study during the first and second pandemic waves in Mexico and Chile

We investigate changes in lifestyle, physical, and mental health during the confinement period of the first and second waves of COVID-19, as well as their relation to sociodemographic parameters and confinement status. Sociodemographic data and information regarding changes in their lifestyle behavior and changes in body weight and physical activity (PA) were collected. The SF-36 questionnaire was implemented for measuring the domains related to physical health (PH) and mental health (MH). The growth frequency of weight gain in the Mexican (4.8%) and Chilean (10.9%) populations was observed during the second wave. The MH component decreased in the Mexican and the Chilean population (p < 0.05). Moreover, the MH decreased significantly according to the degree of confinement (p < 0.01). Although some sociodemographic factors were related to the presence of a very low score (<50 scores) for the MH component during the first wave, it is perceived as a higher relative risk during the second wave in both populations. The long confinement due to COVID-19 is associated to negative changes in nutritional and physical lifestyle behavior, affecting mainly the MH component.

The impact of COVID-19 on neck pain intensity and onset: A systematic review

BACKGROUND

The COVID-19 pandemic has had significant impacts on most aspects of life, including physical and psychological wellbeing. Neck pain is a very common musculoskeletal complaint worldwide, and one that has been impacted by COVID-19. Such impacts have been studied by a few researchers, but not without inconstancies. Moreover, understanding those impacts in relation to rehabilitation is not fully comprehended.

OBJECTIVE

The aim of this study was to systematically examine the impacts of COVID-19 on neck pain intensity and onset pre and post the pandemic.

METHODS

This study was developed following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A systematic literature search was conducted on PubMed-MEDLINE, EMBASE, and Cochrane Library. Keywords used were "COVID-19" and "Neck Pain". Risk of bias was assessed using the Joanna Briggs Institute Checklist for prevalence studies.

RESULTS

A total of five studies were included with an overall sample size of 2618 participants. Three studies were at moderate risk and two were at high risk of bias. Results from three studies reported an increase in neck pain intensity and onset, while the other two did not report an increase.

CONCLUSION

The impact of COVID-19 on neck pain is unclear. The inconsistency in results sheds the light on the importance of having future research (including longitudinal studies) to help guide us towards understanding the real impacts of COVID-19 on neck pain.

The impact of COVID-19 on physical and mental health: A longitudinal study

In this paper, we exploit variation in COVID-19 infections and deaths across Chinese cities to identify the health impacts of COVID-19 based on longitudinal data at the individual level. Our paper provides empirical evidence of the immediate impact of COVID-19 on both physical and mental health. Utilizing a difference-in-differences methodology and focusing on changes in within-individual health condition between pre-COVID-19 and the early stages of COVID-19, we find robust evidence that the COVID-19 pandemic has an adverse effect on self-perceived health condition, chronic illness, sleep, and depression. Our findings are robust to alternative constructions of cities' exposure to COVID-19, to the exclusion of Wuhan city, which was hit the hardest and had experienced the most stringent lockdowns. Furthermore, accounting for the impact of COVID-19 policies, our results indicate that the decline in physical health can be attributed to the shock of the pandemic, while emotional health is mainly affected by anti-contagion policies.

Risk profiles for smoke behavior in COVID-19: a classification and regression tree analysis approach

BACKGROUND

COVID-19 pandemic emerged worldwide at the end of 2019, causing a severe global public health threat, and smoking is closely related to COVID-19. Previous studies have reported changes in smoking behavior and influencing factors during the COVID-19 period, but none of them explored the main influencing factor and high-risk populations for smoking behavior during this period.

METHODS

We conducted a nationwide survey and obtained 21,916 valid data. Logistic regression was used to examine the relationships between each potential influencing factor (sociodemographic characteristics, perceived social support, depression, anxiety, and self-efficacy) and smoking outcomes. Then, variables related to smoking behavior were included based on the results of the multiple logistic regression, and the classification and regression tree (CART) method was used to determine the high-risk population for increased smoking behavior during COVID-19 and the most profound influencing factors on smoking increase. Finally, we used accuracy to evaluated the performance of the tree.

RESULTS

The strongest predictor of smoking behavior during the COVID-19 period is acceptance degree of passive smoking. The subgroup with a high acceptation degree of passive smoking, have no smokers smoked around, and a length of smoking of ≥ 30 years is identified as the highest smoking risk (34%). The accuracy of classification and regression tree is 87%.

CONCLUSION

The main influencing factor is acceptance degree of passive smoking. More knowledge about the harm of secondhand smoke should be promoted. For high-risk population who smoke, the "mask protection" effect during the COVID-19 pandemic should be fully utilized to encourage smoking cessation.

Self-rated health impact of COVID 19 confinement on inmates in Southeastern of Europe: a qualitative study

INTRODUCTION

The COVID-19 pandemic necessitated the implementation of various measures within closed institutions like prisons to control the spread of the virus. Analyzing the impact of these measures on the health of inmates is crucial from a public health perspective. This study aimed to explore inmates' subjective perception of the COVID-19 lockdown, the implemented measures, their physical self-perception, and their views on the vaccination process.

METHOD

Between April 2021 and January 2022, 27 semi-structured individual interviews and 1 focus group were conducted with inmates in a prison located in northwest Spain. The interviews were conducted in person and audio-recorded. Thematic content analysis was employed, utilizing methodological triangulation to enhance the coherence and rigor of the results.

RESULTS

The analysis revealed two main themes and nine subthemes. The first theme focused on inmates' perception of the implementation of protective measures against COVID-19 within the prison and its impact on their well-being. The second theme explored the pandemic's emotional impact on inmates. All participants reported negative consequences on their health resulting from the measures implemented by the institution to contain the pandemic. However, they acknowledged that measures like lockdowns and mass vaccination helped mitigate the spread of the virus within the prison, contrary to initial expectations.

CONCLUSION

COVID-19 and related measures have directly affected the health of inmates. To improve their health and minimize the impact of pandemic-induced changes, community participation and empowerment of individuals are essential tools, particularly within closed institutions such as prisons.

Impact of COVID-19 on Lifestyle: A Sample of Iranian Older Adults

The COVID-19 pandemic and prolonged quarantine affect the health behaviors of older adults. We investigated the changes in older adults' lifestyles during the pandemic in a sample of 1020 people aged 60 years old and over in Tehran. The results revealed that the COVID-19 pandemic had a positive impact on nutritional behaviors and social support while having a negative impact on physical activity and anxiety in older adults. Due to the greater deterioration of health behaviors among unmarried older adults, low socio-economic status, and COVID-19 inpatients, policymakers must pay attention to interventions to promote healthy lifestyles.

Information Cocoons on Short Video Platforms and Its Influence on Depression Among the Elderly: A Moderated Mediation Model

Background

As the elderly increasingly engage with new media, particularly short video platforms, concerns are arising about the formation of "information cocoons" that limit exposure to diverse perspectives. While the impact of these cocoons on society has been investigated, their effects on the mental well-being of the elderly remain understudied. Given the prevalence of depression among the elderly, it is crucial to understand the potential link between information cocoons and depression among older adults.

Methods

The study examined the relationships between information cocoons and depression, loneliness, and family emotional support among 400 Chinese elderly people. The statistical software package SPSS was used to establish a moderated mediation model between information cocoons and depression.

Results

Information cocoons directly predicted depression among the elderly participants. Family emotional support moderated the first half and the second half of the mediation process, whereby information cocoons affected the depression of the elderly through loneliness. Specifically, in the first half of the mediation process, when the level of information cocoons was lower, the role of family emotional support was more prominent. In the second half of the process, when the level of family emotional support was higher, such support played a more protective role in the impact of loneliness on depression.

Discussion

The findings of this study have practical implications for addressing depression among the elderly population. Understanding the influence of information cocoons on depression can inform interventions aimed at promoting diverse information access and reducing social isolation. These results will contribute to the development of targeted strategies to improve the mental well-being of older adults in the context of evolving media landscapes.

The mitigating role of physical activities on emotions is gender-specific: An experience during "lenient" COVID-19 prevention protocols

The researchers examined emotional status subsequent to changes in physical (PA) and sedentary (SA) activities during "lenient" COVID-19 prevention protocols that allowed being outdoors. Emotions, PA, and SA were collected from 272 women and 145 men in Qatar. The researchers showed a decrease (p < 0.05) in PA and an increase (p < 0.05) in SA participation during the pandemic. These alterations were different (p < 0.05) between genders and associated (p < 0.05) with emotional status during the COVID-19-induced confinement, but only (p < 0.05) in men. The "mitigating" role of PA for the adverse emotional effects of the pandemic is demonstrated, especially among men. Therefore, "lenient" regulations should be considered around the globe during future pandemics for adequate PA and emotional wellbeing. However, plans should incorporate additional tactics to PA to manage emotional status among women.

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

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

Appearance Comparisons, Affect, Body Dissatisfaction and Eating Pathology in Portuguese Female University Students

Physical appearance comparisons have been theorized to be associated with negative indicators of body image. This study aimed to study appearance comparisons and their association to affect, body dissatisfaction, and eating pathology. Three hundred and ten female university students with ages between 17 and 25 years (M = 20.2, SD = 1.9) completed sociodemographic and clinical data, self-reported questionnaires, and questions about appearance comparisons. Among the participants, 98.71% reported making appearance comparisons, and 42.15% of these reported making them frequently or always. Higher reported frequencies of appearance comparisons were related to higher levels of body dissatisfaction, negative affect, and eating pathology. Appearance comparisons to acquaintances were the most frequent. Comparisons in person and through media were reported in similar proportions. Upward comparisons were more frequent than lateral and downward comparisons and were related to higher levels of body dissatisfaction than downward comparisons and to higher levels of body dissatisfaction, negative affect, and eating pathology than lateral comparisons. Upward comparisons to close peers were associated with higher body dissatisfaction as opposed to models/celebrities. Results, limitations, and implications are discussed.

Impact of the COVID-19 pandemic on some modifiable risk factors of dementia in an aging, rural Indian population

Introduction

The impact of the COVID-19 pandemic and associated lockdowns is likely to have caused adverse changes in lifestyle-related/cardiovascular risk factors and other such modifiable risk factors of dementia. We aimed to examine the pandemic's impact on some modifiable risk factors of dementia among rural Indians belonging to a large, prospective aging cohort-Srinivaspura Aging, NeuoSenescence, and COGnition (SANSCOG).

Methods

This was a cross-sectional study among adults aged ≥ 45 years (n = 3,148; 1,492 males and 1,656 females) residing in the villages of Srinivaspura in Karnataka state, India. SANSCOG study data (clinical and biochemical assessments) of these participants were obtained from three distinct periods: (i) the "pre-COVID period"-before India's nationwide lockdown on 24 March 2020, (ii) the "COVID period"-during the first and second waves of the pandemic, wherein the social restrictions were prominent (25 March 2020 to 30 September 2021), and (iii) the "post-COVID period"-after easing of restrictions (from 1 October 2021 onward). Proportions of participants with diabetes, hypertension, obesity, dyslipidemia (diagnosed using standard criteria), and depression (diagnosed using the Geriatric Depression Scale) were compared between the above three periods.

Results

The odds of having obesity, abnormal triglycerides, and depression among individuals in the COVID period were 1.42 times, 1.38 times, and 2.65 times more than the odds in the pre-COVID period, respectively. The odds of having hypertension, obesity, abnormal total cholesterol, abnormal triglycerides, abnormal LDL, and depression among individuals in the post-COVID period were 1.27 times, 1.32 times, 1.58 times, 1.95, 1.23, and 3.05 times more than the odds in the pre-COVID period, respectively. The odds of diabetes did not differ between any of the three periods.

Discussion

We found significantly higher odds of some of the studied risk factors in the COVID and post-COVID periods compared to the pre-COVID period, suggesting that the pandemic adversely impacted the physical and psychological health of this marginalized, rural Indian population. We call for urgent public health measures, such as multimodal, lifestyle-based, and psychosocial interventions, to mitigate this negative impact and reduce the future risk of dementia.

The pattern from the first three rounds of vaccination: declining vaccination rates

Introduction

Vaccination rates for the COVID-19 vaccine have recently been stagnant worldwide. We aim to analyze the potential patterns of vaccination development from the first three doses to reveal the possible trends of the next round of vaccination and further explore the factors influencing vaccination in the selected populations.

Methods

On July 2022, a stratified multistage random sampling method in the survey was conducted to select 6,781 people from 4 provinces China, who were above the age of 18 years. Participants were divided into two groups based on whether they had a chronic disease. The data were run through Cochran-Armitage trend test and multivariable regression analyses.

Results

A total of 957 participants with chronic disease and 5,454 participants without chronic disease were included in this survey. Vaccination rates for the first, second and booster doses in chronic disease population were93.70% (95% CI: 92.19-95.27%), 91.12% (95%CI: 94.43-95.59%), and 83.18% (95%CI: 80.80-85.55%) respectively. By contrast, the first, second and booster vaccination rates for the general population were 98.02% (95% CI: 97.65-98.39%), 95.01% (95% CI: 94.43-95.59%) and 85.06% (95% CI: 84.11-86.00%) respectively. The widening gap in vaccination rates was observed as the number of vaccinations increases. Higher self-efficacy was a significant factor in promoting vaccination, which has been observed in all doses of vaccines. Higher education level, middle level physical activity and higher public prevention measures play a positive role in vaccination among the general population, while alcohol consumption acts as a significant positive factor in the chronic disease population (p < 0.05).

Conclusion

As the number of vaccinations increases, the trend of decreasing vaccination rate is becoming more pronounced. In future regular vaccinations, we may face low vaccination rates as the increasing number of infections and the fatigue associated with the prolonged outbreak hamper vaccination. Measures need to be found to counter this downward trend such as improving the self-efficacy of the population.

Psychological well-being of young adults during COVID-19 pandemic: Lesson learned and future research agenda

Psychological and mental well-being has become a topic of concern worldwide after the hit of the COVID-19 pandemic. It has triggered enormous global health care vulnerabilities and resulted in full and partial lockdowns to prevent the new case. This research study provides a comprehensive overview of the published international scientific studies on the effect of COVID-19 on the psychological well-being of young adults. This study aims to review the top-cited authors, documents, journals, productive countries, the most used keywords, and trending themes in this area. Articles related to psychological well-being during the COVID-19 pandemic from January 2020 to December 2022 were extracted from the Scopus database with specified keywords. In total, 482 documents were retrieved as original articles and bibliometric analysis, thematic analysis and content analysis are performed and analyzed. The results show that the United States has contributed the largest publications followed by the United Kingdom and Italy. Through the cluster analysis, it is found that many articles have been published and considered the psychological and mental impact of COVID-19. Young adults from both developed and developing countries are majorly affected by the COVID-19 pandemic. The pandemic prioritizes the importance of global psychological well-being and health care. This study focused on different aspects, such as stress, resilience, and the mental health of young adults. The research findings of this study put forth the urgent need to provide preventive policies and intervention procedures to address the psychological health of young adults and proposed a conceptual framework.

Preschoolers' screen time in China before and during COVID-19 lockdown: a parental survey

OBJECTIVES

Since COVID-19 first appeared in Wuhan, China, in December 2019, the disease has spread rapidly across the country. To reduce the spread of infection, schools including kindergartens were closed. Prolonged home confinement can affect children's behaviour. Therefore, we investigated the change of preschoolers' total daily screen time during the COVID-19 lockdown in China.

DESIGN, SETTING AND PARTICIPANTS

In the parental survey, 1121 preschoolers, whose parents or grandparents completed an online survey from 1 June 2020 to 5 June 2020, were enrolled.

PRIMARY OUTCOME

Total daily screen time. Multivariable modelling was performed to identify factors associated with increased screen time.

RESULTS

The results showed that preschoolers' total daily screen time during lockdown(median 2.5 hours, IQR 2.5 hours) was significantly longer than it was before lockdown (median 1.5 hours, IQR 1.0 hour). Older age (OR 1.26, 95% CI 1.07 to 1.48), higher annual household income (OR 1.18, 95% CI 1.04 to 1.34),and decrease of moderate-vigorous physical activity (OR 1.41, 95% CI 1.20 to 1.66) were independently associated with increased screen time.

CONCLUSIONS

Preschoolers' total daily screen time significantly increased during lockdown.

The association between inflammatory and immune system biomarkers and the dietary inflammatory index in patients with COVID-19

Background

Inflammation and cytokine storm have been reported to be the main cause of acute symptoms of coronavirus disease (COVID-19). Diet-induced inflammation may affect the condition of patients with COVID-19. Therefore, this study aimed to investigate the relationship between disease severity, inflammatory and immune system biomarkers, and the dietary inflammatory index (DII) in patients with COVID-19.

Methods

This cross-sectional study was conducted on 500 adult patients with COVID-19. Patients were divided into mild, moderate, and severe conditions based on clinical and laboratory evidence. A validated food frequency questionnaire (FFQ) was used to determine DII and energy-adjusted DII (E-DII) scores. The serum C-reactive protein (CRP) level and blood cell count were measured for all patients. Multiple linear regression was used to explore the association between DII and E-DII and CRP, blood cell counts, and hospitalization in patients with COVID-19.

Results

Coronavirus disease (COVID-19) patients with higher DII had higher consumption of fat and carbohydrate and lower intakes of protein, anti-inflammatory nutrients, garlic, caffeine, tea, onion, and fiber (P &lt; 0.05). There was a positive association between DII and CRP (β = 1.024, P &lt; 0.001), hospitalization (β = 1.062, P &lt; 0.001), WBC count (β = 0.486, P &lt; 0.009), neutrophil count (β = 0.565, P &lt; 0.001), and neutrophil-to-lymphocyte ratio (β = 0.538, P &lt; 0.001) and a negative association between DII and the lymphocyte count (β = −0.569, P &lt; 0.001). There was a positive association between E-DII and hospitalization (β = 1.645, P &lt; 0.001), WBC count (β = 0.417, P &lt; 0.02), and neutrophil-to-lymphocyte ratio (β = 0.35, P &lt; 0.03).

Conclusion

There is a positive correlation between DII and inflammation, immune hyperactivation, and length of hospital stay in patients with COVID-19. Further longitudinal studies are necessary.

The impact of the COVID-19 pandemic on semen quality of uninfected men

BACKGROUND

Coronavirus disease 2019 (COVID-19) has spread rapidly worldwide since its discovery in December 2019. Research published since the COVID-19 outbreak has focused on whether semen quality and reproductive hormone levels are affected by COVID-19. However, there is limited evidence on semen quality of uninfected men. This study aimed to compare semen parameters among uninfected Chinese sperm donors before and after the COVID-19 pandemic to determine the impact of the COVID-19 pandemic-related stress and lifestyle changes on uninfected men.

RESULTS

All semen parameters were non-significant except semen volume. The average age of sperm donors was higher after the COVID-19 (all P < 0.05). The average age of qualified sperm donors increased from 25.9 (SD: 5.3) to 27.6 (SD: 6.0) years. Before the COVID-19, 45.0% qualified sperm donors were students, but after the COVID-19, 52.9% were physical laborers (P < 0.05). The proportion of qualified sperm donors with a college education dropped from 80.8 to 64.4% after the COVID-19 (P < 0.05).

CONCLUSION

Although the sociodemographic characteristics of sperm donors changed after the COVID-19 pandemic, no decline in semen quality was found. There is no concern about the quality of cryopreserved semen in human sperm banks after the COVID-19 pandemic.

Nutritional changes during the COVID-19 pandemic: a rapid scoping review on the impact of psychological factors

COVID-19 and the resulting measures to curb the spread of the virus have significantly changed our lives, including our nutritional choices. In this rapid scoping review an overview is provided of what psychological factors may be associated with peoples' eating behaviour during COVID-19 restrictions. Relevant literature was identified using PubMed, PsycInfo, CINAHL and MEDLINE databases from 2019 onwards. For included studies, information on study characteristics, eating behaviours, and psychological factors were extracted. 118 articles were included, representing 30 countries. Findings indicated that most people consumed more and unhealthy food in times of COVID-19 restrictions, while some consumed less but often for the wrong reasons. Several psychological factors, related to (1) affective reactions, (2) anxiety, fear and worriers, (3) stress and (4) subjective and mental wellbeing were found to be associated with this increase in food consumption. These outcomes may help to be better inform future interventions, and with that, to be better prepared in case of future lockdown scenarios.

Lifestyle Behaviour Changes and Associated Risk Factors During the COVID-19 Pandemic: results of the Canadian COVIDiet Online Cohort Study

BACKGROUND

The COVID-19 pandemic and related lockdowns have impacted lifestyle behaviours including eating habits and physical activity; yet few studies identified emerging patterns of such changes and associated risk factors.

OBJECTIVE

To identify patterns of weight and lifestyle behaviour change, and potential risk factors, resulting from the pandemic in Canadian adults.

METHODS

Analyses were conducted on 1,609 adults (18-89 y; 90.1% women; 81.8% White) of the Canadian COVIDiet study baseline data (May-Dec 2020). Self-reported current and pre-pandemic weight, physical activity, smoking status, perceived eating habits, alcohol intake and sleep quality were collected by online questionnaires. Based on these 6 indicator variables, latent class analysis (LCA) was used to identify lifestyle behaviour change patterns. Associations with potential risk factors including age, gender, ethnicity, education, income, chronic diseases, body image perception, and changes in stress level, living situation and work arrangement were examined with logistic regressions.

RESULTS

Participants' mean BMI was 26.1 ± 6.3 kg/m2; 60.9% had >= bachelor's degree. Since the pandemic, 35% had decreased income and 49% changed work arrangement. Most participants reported unchanged weight, sleep quality, physical activity level, smoking and alcohol consumption, yet 44% reported a perceived decrease in eating habits quality. From LCA, 2 classes of lifestyle behaviour change emerged; "healthy" and "less healthy" (probability: 0.605 and 0.395; BIC=15574.3, entropy=4.8). "Healthy" class participants more frequently reported unchanged weight, sleep quality, smoking and alcohol intake, unchanged/improved eating habits and increased physical activity. The "less healthy" class reported significant weight gain, deteriorated eating habits and sleep quality, unchanged/increased alcohol intake and smoking, and decreased physical activity. Among risk factors, body image dissatisfaction OR=8.8, 95%CI (5.3-14.7), depression OR=1.8, 95%CI (1.3, 2.5), increased stress level OR=3.4, 95%CI (2.0, 5.8) and of gender minority identity OR=5.5, 95% CI (1.3-22.3) were associated with adopting "less healthy" behaviours in adjusted models.

CONCLUSIONS

The COVID-19 pandemic appeared to have influenced lifestyle behaviours unfavorably in some, but favorably in others. Body image perception, change in stress level and gender identity were factors associated with behaviour change patterns; whether these will sustain overtime remains to be studied. Findings provide insights to develop strategies in supporting adults with poorer mental well-being in the post-pandemic context and promoting healthful behaviours during future disease outbreaks.

CLINICALTRIAL

This study was registered on ClinicalTrials.gov (NCT04407533).

Regional Difference in the Impact of COVID-19 Pandemic on Domain-Specific Physical Activity, Sedentary Behavior, Sleeping Time, and Step Count: Web-Based Cross-sectional Nationwide Survey and Accelerometer-Based Observational Study

BACKGROUND

Physical activity (PA) and sedentary behavior (SB) have been affected by the COVID-19 pandemic and its restrictive environments, such as social distancing and lockdown measures. However, regional differences in the changes in domain-specific PA and SB in response to the COVID-19 pandemic are not clearly understood.

OBJECTIVE

This study aimed to examine regional differences in domain-specific PA and SB, as well as sleeping time in response to the COVID-19 pandemic in Japan.

METHODS

A web-based cross-sectional nationwide survey and an accelerometer-based longitudinal observation were conducted. In the web-based survey, we recruited 150 Japanese men and 150 Japanese women for each of the following age groups: 20s, 30s, 40s, 50s, 60s, and 70s (n=1800). A total of 1627 adults provided valid responses to web-based surveillance from June to July 2020. Participants were recruited from urban (Greater Tokyo Area, n=1028), urban-rural (regional core cities, n=459), or rural (regional small and medium cities, n=140) areas. They answered sociodemographic and health-related questions and retrospectively registered the PA data of their average day before and during the COVID-19 pandemic in a web-based PA record system. In the accelerometer-based observation, PA and step count data were obtained using a triaxial accelerometer on people living in urban (n=370) and rural (n=308) areas.

RESULTS

Before the COVID-19 pandemic, there were no significant differences between these 3 regions in the time spent sleeping, staying at home, working or studying, and exercising (P>.05). By contrast, people living in urban areas had a longer duration of SB and transportation and a shorter duration of moderate-to-vigorous PA and lying or napping time compared with people living in rural areas (P>.05). During the COVID-19 pandemic, a significant decrease was observed in transportation time in urban (-7.2 min/day, P<.001) and urban-rural (-2.0 min/day, P=.009) areas but not in rural (-0.4 min/day, P=.52) areas. The moderate-to-vigorous PA was decreased in urban (-31.3 min/day, P<.001) and urban-rural (-30.0 min/day, P<.001) areas but not in rural areas (-17.3 min/day, P=.08). A significant increase was observed in time spent sleeping in urban (+22.4 min/day, P<.001) and urban-rural (+24.2 min/day, P<.001) but not in rural areas (+3.9 min/day, P=.74). Lying or napping was increased in urban (+14.9 min/day, P<.001) but not in rural areas (-6.9 min/day, P=.68). PA and step count obtained using an accelerometer significantly decreased in urban (P<.05) but not in rural areas (P>.05).

CONCLUSIONS

The effect of the COVID-19 pandemic on PA and SB was significantly dependent on living area, even in a single country. The effects of PA and SB were greater in the Greater Tokyo Area and regional core cities but were not observed in regional small and medium cities in Japan.

Impact of the COVID-19 Pandemic on the Perceived Physical and Mental Health and Healthy Lifestyle Behaviors of People With Disabilities: A Quantitative Analysis of the International Community Survey

OBJECTIVE

This study aims to determine the perceived impact of the coronavirus pandemic on physical and mental health and healthy lifestyle behaviors in community-dwelling persons with disabilities, as compared with those without disabilities.

DESIGN

A prospective cross-sectional study was conducted with a web-based global survey.

RESULTS

Over 3 mos, 3550 responses were collected from 65 countries. The study included 2689 responses without skipped questions as full data for analysis. Most respondents were women (82.82%), and approximately half (52.81%) were between the ages of 25 and 39 yrs, followed by those between the ages of 40 and 60 yrs (38.6%). Among the participants, 52% indicated physical activity levels decreased and 20% reported eating less fruit and vegetables than before. Furthermore, 45% noted that they slept less than before. Perceived physical and mental health and changes to eating habits during the pandemic showed a significant difference in people with and without disabilities. Furthermore, perceived effects on physical health had a significant effect on the reported degree of disability.

CONCLUSIONS

This study indicates that the pandemic had a larger impact on perceived physical and mental health and changes in eating habits and tobacco use among people with disabilities than people without disabilities.

Sleep quality and the evolution of the COVID-19 pandemic in five European countries

The COVID-19 pandemic has led to lifestyle changes across Europe with a likely impact on sleep quality. This investigation considers sleep quality in relation to the evolution of the COVID-19 pandemic in five European countries. Using panel regressions and keeping policy responses to COVID-19 constant, we show that an increase in the four-week average daily COVID-19 deaths/100,000 inhabitants (our proxy for the evolution of the pandemic) significantly reduced sleep quality in France, Germany, Italy, Spain, and Sweden between April 2020 and June 2021. Our results are robust to a battery of sensitivity tests and are larger for women, parents and young adults. Additionally, we show that about half of the reduction in sleep quality caused by the evolution of the pandemic can be attributed to changes in lifestyles, worsened mental health and negative attitudes toward COVID-19 and its management (lower degree of confidence in government, greater fear of being infected). In contrast, changes in one's own infection-status from the SARS-CoV-2 virus or sleep duration are not significant mediators of the relationship between COVID-19-related deaths and sleep quality.

Smartphone Usage before and during COVID-19: A Comparative Study Based on Objective Recording of Usage Data

Most studies that claimed changes in smartphone usage during COVID-19 were based on self-reported usage data, e.g., that collected through a questionnaire. These studies were also limited to reporting the overall smartphone usage, with no detailed investigation of distinct types of apps. The current study investigated smartphone usage before and during COVID-19. Our study used a dataset from a smartphone app that objectively logged users’ activities, including apps accessed and each app session start and end time. These were collected during two periods: pre-COVID-19 (161 individuals with 77 females) and during COVID-19 (251 individuals with 159 females). We report on the top 15 apps used in both periods. The Mann–Whitney U test was used for the inferential analysis. The results revealed that the time spent on smartphones has increased since COVID-19. During both periods, emerging adults were found to spend more time on smartphones compared to adults. The time spent on social media apps has also increased since COVID-19. Females were found to spend more time on social media than males. Females were also found to be more likely to launch social media apps than males. There has also been an increase in the number of people who use gaming apps since the pandemic. The use of objectively collected data is a methodological strength of our study. Additionally, we draw parallels with the usage of smartphones in contexts similar to the COVID-19 period, especially concerning the limitations on social gatherings, including working from home for extended periods. Our dataset is made available to other researchers for benchmarking and future comparisons.

The perceived influence of COVID-19 lockdown on the circulation of counterfeit drugs and medical supplies through the electronic market

Objectives

Drugs and medical supplies counterfeiting is one of the worldwide major problems that pose a significant threat to both global public health and the economy. Nowadays, one of the major unprecedented challenges of the COVID-19 pandemic is the disastrous repercussions on the economy worldwide. The latter brought forth a noticeable rise in pharmaceutical and medical counterfeit products. Drug counterfeiting has thrived parallel to the expansion of electronic networks and the Internet during the COVID-19 pandemic. The objective of the current study is to explore the perceived influence of the COVID-19 lockdown on the circulation of counterfeit drugs and medical supplies through the electronic market in Jordan.

Methods

A cross-sectional survey study was conducted in Jordan. The questionnaire was self-administered to the public as they are the probable counterfeit medicine victims and as drug counterfeiting is a nationwide problem. To capture participants’ views, a total of 460 respondents were recruited and a simple random sampling strategy was used to collect data. The inclusion criteria were consumers aged 18 years old and above, who use the Internet when purchasing drugs and medical supplies, and are willing to participate in the study.

Key findings

The study indicated an increase in using electronic websites when purchasing medicines during the COVID-19 lockdown. Additionally, there was a significant correlation the between COVID-19 lockdown and the circulation of counterfeit drugs and medical supplies through the electronic market in Jordan.

Conclusions

The study indicated that the COVID-19 lockdown had influenced counterfeit drugs and medical supplies circulation through the electronic market in Jordan.

Gender, loneliness and happiness

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

Psychometric Properties of the Chinese Warwick-Edinburgh Mental Well-being Scale in Medical Staff: Cross-sectional Study

Background

Worldwide, mental well-being is a critical issue for public health, especially among medical staff; it affects professionalism, efficiency, quality of care delivery, and overall quality of life. Nevertheless, assessing mental well-being is a complex problem.

Objective

This study aimed to evaluate the psychometric properties of the Chinese-language version of the 14-item Warwick-Edinburgh Mental Well-being Scale (WEMWBS) in medical staff recruited mainly from 6 hospitals in China and provide a reliable measurement of positive mental well-being.

Methods

A cross-sectional online survey was conducted of medical staff from 15 provinces in China from May 15 to July 15, 2020. Confirmatory factor analysis (CFA) was conducted to test the structure of the Chinese WEMWBS. The Spearman correlations of the Chinese WEMWBS with the 5-item World Health Organization Well-Being Index (WHO-5) were used to evaluate convergent validity. The Cronbach α and split-half reliability (λ) represented internal consistency. A graded response model was adopted for an item response theory (IRT) analysis. We report discrimination, difficulty, item characteristic curves (ICCs), and item information curves (IICs). ICCs and IICs were used to estimate reliability and validity based on the IRT analysis.

Results

A total of 572 participants from 15 provinces in China finished the Chinese WEMWBS. The CFA showed that the 1D model was satisfactory and internal consistency reliability was excellent, with α=.965 and λ=0.947, while the item-scale correlation coefficients ranged from r=0.727 to r=0.900. The correlation coefficient between the Chinese WEMWBS and the WHO-5 was significant, at r=0.746. The average variance extraction value was 0.656, and the composite reliability value was 0.964, with good aggregation validity. The discrimination of the Chinese WEMWBS items ranged from 2.026 to 5.098. The ICCs illustrated that the orders of the category thresholds for the 14 items were satisfactory.

Conclusions

The Chinese WEMWBS showed good psychometric properties and can measure well-being in medical staff.

Lifestyle of Families with Children Aged 4-8 Years before and during Lockdown Due to COVID-19 Pandemic in Poland

The aim of the study was to evaluate the lifestyle changes of families with children aged 4-8 years during lockdown compared to the time before the COVID-19 pandemic. The study was conducted among 1098 parents during the first lockdown in Poland. An originally developed questionnaire was used as the research tool. The Wilcoxon test was used to determine the frequency of differences in the lifestyle of parents and children before the pandemic and during lockdown. Differences were found in the frequency of healthy habits in the periods under investigation, both in the lifestyle of parents and children. A moderately healthy lifestyle was predominant among families with children aged 4-8 years during lockdown. The families' lifestyle significantly changed in relation to the time before the pandemic. There is a need for lifestyle education for families with children to prevent the development of bad habits during and after the pandemic and isolation time.

COVID-19-related anxiety and lifestyle changes

This study aimed to identify factors that affect lifestyle changes and focused on coronavirus disease (COVID-19)-related anxiety since the COVID-19 outbreak in South Korea. Data from 213,848 individuals from the 2020 Korean Community Health Survey were analyzed using a complex sampling design. Descriptive statistics, t-tests, one-way ANOVA, and multiple regression analyses were performed. Participants reported a high level of COVID-19-related anxiety, with a score of 19.28 out of 25. The score of healthy behavioral change index was -0.51, indicating negative changes in physical activity, dietary habits, and sleep patterns. A slight positive change was reported for addictive behavioral change index, such as smoking and alcohol consumption, at 0.27 scores, indicating a decrease in these behaviors. COVID-19-related anxiety was an important factor that negatively affected health behavior. The high-risk groups that were vulnerable to anxiety included older adults and those who have little social support or few social encounters. Thus, identifying high-risk groups with the potential for worsened health behavior and providing interventions to reduce the anxiety caused by COVID-19 are necessary.

The impact of diet and lifestyle on wellbeing in adults during COVID-19 lockdown

A healthy diet and lifestyle may protect against adverse mental health outcomes, which is especially crucial during stressful times, such as the COVID-19 pandemic. This preregistered longitudinal online study explored whether diet and lifestyle (physical activity, sleep, and social interactions) were associated with wellbeing and mood during a light lockdown in Germany. Participants (N = 117, 72 males; 28 ± 9 years old) answered mental health and lifestyle questionnaires (social connections, sleep, activity) followed by submitting 1 week of food and mood-lifestyle diary (food intake, positive and negative mood, mental wellbeing, sleep quality, physical activity level, quantity and quality of social interactions) via a smartphone app. We used multivariate linear and mixed-effects models to associate mood and wellbeing with dietary components and lifestyle factors. Interindividual analyses revealed that sleep and social interaction significantly impacted mood and wellbeing. Interestingly, fruit and vegetable intake correlated with wellbeing, even when controlling for all lifestyle factors. Fruit and vegetable intake also significantly correlated with daily fluctuations in wellbeing within individuals next to sleep, physical activity, and social interactions. We observed gender differences in fruit and vegetable intake and anxiety levels. Our results emphasize the importance of diet contributing to individual wellbeing, even in the challenging times of a pandemic. Future research is necessary to test if our findings could extend to other populations.

Essential and non-essential US workers' health behaviors during the COVID-19 pandemic

We seek to quantify the relationship between health behaviors and work-related experiences during the COVID-19 pandemic by predicting health behaviors as a function of essential worker status, job loss, change in work hours, and COVID-19 experiences. We use multivariate models and survey data from 913 employed adults in a semi-rural mid-Atlantic US county, and test whether essential worker results vary by gender, parenthood, and/or university employment. Multivariate models indicate that essential workers used tobacco on more days (4.5; p <.01) and were less likely to sleep 8 h (odds ratio [OR] 0.6; p <.01) than non-essential workers. The risk of sleeping less than 8 h is concentrated among essential workers in the service industry (OR 0.5; p <.05) and non-parents (OR 0.5; p <.05). Feminine essential workers exercised on fewer days (-0.8; p <.05) than feminine non-essential workers. Workers with reduced work hours consumed more alcoholic drinks (0.3; p <.05), while workers with increased work hours consumed alcohol (0.3; p <.05) and exercised (0.6; p <.05) on more days. Essential worker status and changes in work hours are correlated with unhealthy behaviors during the COVID-19 pandemic.

The importance for wellbeing of having views of nature from and in the home during the COVID-19 pandemic. Results from the GreenCOVID study

Introduction

The COVID-19 pandemic has influenced the daily lives of people and may affect their well-being. The aim of the present study is to assess well-being and associated factors during the first wave of the COVID-19 pandemic in the general population in three European countries.

Methods

GreenCOVID was an observational cross-sectional study using an online survey (7 April 2020 to 24 July 2020) promoted by the Health & Territory Research (HTR) of the University of Seville in Spain, Maynooth University in Ireland, and the University of Winchester in England, which included a sample of 3109 unselected adults. Well-being was measured using the World Health Organization-Five Well-Being Index (WHO-5) scale. Seven aspects, related to the natural environment of the home, were evaluated (role of outdoor views in coping with lockdown, importance of blue spaces during lockdown, importance of green spaces during lockdown, quality of view from home, use of outdoor spaces or window views, elements of nature in the home, and views of green or blue spaces from home). Binary logistic regression was conducted to identify the parameters associated with poor well-being.

Results

Mean age was 39.7 years and 79.3% lived in Spain, the majority in urban areas (92.8%). 73.0% were female and 72.0% had undertaken university studies. Poor well-being was reported by 59.0%, while 26.6% indicated the possible presence of clinical depression. The factors most associated with poor well-being were students (OR = 1.541), those who had no engagement in physical activity (OR = 1.389), those who reported 'living in Spain' compared to Ireland (OR = 0.724), being female (OR = 1.256), poor quality views from home (OR = 0.887), less benefit from views of the natural environment to cope with lockdown (OR = 0.964), and those younger in age (OR = 0.990).

Conclusions

More than half of participants reported poor well-being and one in four indicated the possible presence of clinical depression during the first wave of the COVID-19 pandemic. We identified that belonging to a younger age cohort, being a student, being female, not being able to continue with daily pursuits such as physical activity, and having poorer quality of views from home led to poor well-being among participants. Our study highlights the importance of continued physical activity and views of nature to improve the well-being of individuals during times of crisis such as the COVID-19 pandemic.

Relationship between internet use intensity and quality of life in chronic patients during the COVID-19 pandemic: The role of physical exercise and health insurance

The internet use intensity of human has increased substantially during the COVID-19 Pandemic, and it is severely impacting the well-being of chronic patients. This study aimed to explore the underlying mechanism of the relationship between internet use intensity and quality of life in chronic patients, based on the cross-sectional data from China Family Panel Studies (CFPS) during the COVID-19 Pandemic in 2020. The results showed that the internet use intensity had significant positive association with quality of life among chronic patients, and such association has been found in both urban and rural samples. Among the relationship of internet use intensity and quality of life in chronic patients, the mediating effect of physical exercise reached 10.25%. Furthermore, health insurance positively moderated this relationship. There are new insights for policy recommendations and clinical guidance on the role of physical activity and health insurance aimed at improving chronic patients' quality of life. Meanwhile, in both rural and urban governance, public health agencies should promote the "Internet + Healthcare" program to improve health insurance and physical activity literacy, thus providing a higher level of quality of life for patients with chronic diseases during the COVID-19 Pandemic.

Impact of the restrictions on community activities policy during the COVID‐19 on psychological health in Indonesia's urban and rural residents: A cross‐sectional study

Background and Aims

Although extensive research has been conducted on the psychological impact after exposure to the COVID‐19 pandemic, very few studies simultaneously investigated the negative and positive impacts on urban and rural residents. This study aims to compare the extent of psychological impact on Indonesian living in urban and rural areas a year after the first case of COVID‐19 was reported.

Design, Methodology and Approach

We employed a cross‐sectional study design. A total of 428 participants completed a set of web‐based questionnaires from February to March 2021, consisting of the Impact of Event Scale‐Revised (IES‐R), the Perceived Social‐Support (PSS), the mental health‐related lifestyle (MHLS), and 6‐item negative impacts, and the Jenkins' Sleep Scale (JSS).

Findings

Over 40% of the participants reported moderate to severe trauma‐related distress; 30%–40% increased stress at work, home, and financial stress, and 50% more social support gained from their family and friends. Although 62.1% of participants paid more attention to their mental health, only 30% engaged in a healthier lifestyle, and 36.7% had sleep problems. No significant differences were found between urban and rural residents on psychological impact, changes in mental health and related lifestyles, and sleep quality. Urban residents perceived more negative impacts, in parallel with increased social support, compared to rural residents. We also found a significant correlation between psychological impact, sleep disturbance, and increased social support. However, there was no significant association between mental health‐related lifestyles and other scales.

Originality and Value

This is among the first studies that examine the urban–rural disparity on the positive and negative impact of the COVID‐19 in the later stage of the pandemic. Our findings offer insights to provide equal effort to mitigate the negative impacts of the COVID‐19 crisis as well as promote healthy lifestyle behaviors in both urban and rural residencies.

Prevalence of Digital Amnesia, Somatic Symptoms and Sleep Disorders among Youth during COVID-19 Pandemic

Background

The proliferation of COVID-19 radically altered people’s daily routines over the last two years, particularly among young. Closures of schools and colleges resulted in virtual learning that increased reliance on gadgets causing digital dependency among youth. The prevalence of digital amnesia, somatic symptoms and sleep disorders among youth during this pandemic require considerable attention since it has not been addressed widely.

Methods

Cross-sectional study was carried out among 326 youth aged between 18 to 25 years. Digital Amnesia Scale, Somatic Symptom Disorder-B Criteria Scale (SSD-12) and Sleep disorders Symptom Checklist (SDS-CL-17) were used to collect data from participants.

Results

Significant positive relationship was found between digital amnesia, somatic symptoms and sleep disorders among youth. Youth differed significantly in their somatic symptoms based on demographic variables such as gender, family type and area of residence. Digital amnesia had significant impact on somatic symptoms through the mediation effect of insomnia and circadian rhythm dimensions of sleep disorders.

Conclusion

Productive use of digital devices would help youth reduce digital amnesia. Practicing digital break/digital detox could also help them improve their cognitive, affective and behavioural aspects, as well as their quality of sleep.

Lifestyle Changes Before and During the COVID-19 Pandemic in West Java Province, Indonesia

BACKGROUND: West Java is ranked 4th as the province with the highest number of COVID-19 cases in Indonesia up to December 1, 2020. The COVID-19 pandemic has a major impact on human health, lifestyle changes, and economic life. AIM: The purpose of this study was to analyze the impact of the COVID-19 pandemic on lifestyle changes among the community of West Java. METHODS: The study was conducted in September 2020 using a cross-sectional study design. A total of 2502 people aged ≥12 years living in West Java were involved in this study as a sample, willing to fill out a questionnaire in the form of a Google form that was distributed online through social media (WhatsApp, Facebook, and Instagram). RESULTS: The results showed that the COVID-19 pandemic had an effect on lifestyle changes in the people of West Java. During the COVID-19 pandemic, the people of West Java became more frequent to wash their hands, do regular exercise, sunbathe in the morning, consume more vegetables and fruits, and consume vitamins or supplements to increase endurance (p < 0.05). CONCLUSION: Based on the result, the community should continue to improve the COVID-19 prevention practices in breaking the chain of transmission.

Knowledge, Attitude, and Practice Patterns Related to Digital Eye Strain Among Parents of Children Attending Online Classes in the COVID-19 Era: A Cross-sectional Study

PURPOSE

To assess the prevalence of digital eye strain among children and extrapolate the association between knowledge, attitude, and practice patterns related to device use during the coronavirus disease 2019 (COVID-19) lockdowns.

METHODS

A cross-sectional, descriptive, questionnaire-based analysis was done to assess the knowledge, attitude, and practice patterns related to digital device use among parents of children attending online classes.

RESULTS

A total of 305 responses were obtained. The most common reason for device use was online classes (288 children; 94.4%) and the most common mode was smartphone (263 children; 86.3%). The prevalence of digital eye strain was 64.6%. The mean knowledge score was 48.5 ± 5.1, the mean attitude score was 26.7 ± 4.9, and the mean practice score was 17.8 ± 3.5. The difference between knowledge, attitude, and practice scores among parents of children with and without glasses was not statistically significant (P = .580, .521, and .503, respectively). A direct correlation was found between the knowledge and practice scores (P = .002), but attitude scores did not show a significant correlation (P = .712).

CONCLUSIONS

Digital devices have been a boon to continue education during the ongoing COVID-19 pandemic. This study reveals a large knowledge gap among parents related to safe digital device use. Further, there is a need to adopt methods that would help spread awareness to the masses about the effects of excessive screen time in children in the form of digital eye strain and myopia and the corrective measures to avoid the same. [J Pediatr Ophthalmol Strabismus. 2022;59(4):224-235.].

The Effect of Perceived Social Support on Psychological Well-Being in COVID-19 Patients

Aim: This study aims to determine the effect of perceived social support experienced by COVID-19 patients on their psychological well-being. Methods: This study is a cross-sectional descriptive study. In the research, the data were collected through online platforms (such as Facebook and WhatsApp) via Google form between March-April 2021 to reduce the risk of transmission. Results: This cross-sectional study was performed on 403 COVID-19 patients. There were statistically significant positive correlations between the mean Psychological Well-Being Scale total score and the Multidimensional Scale of Perceived Social Support total score (r=0.772; p<0.001). Conclusion: It is extremely important to increase social support resources to maintain psychological well-being during and after quarantine practice in patients diagnosed with COVID-19. Keywords: COVID-19, patient, social, support, quarantine

The Effect of Ramadan and COVID-19 on the Relationship between Physical Activity and Burnout among Teachers

The objective of this study was to explore the effect of COVID-19 and Ramadan on physical activity (PA) and burnout in teachers and the relationship between them. A total of 57 secondary school teachers from public education centers participated in the present study. They were aged between 29 and 52 years. To determine the effect of Ramadan and COVID-19 on PA and burnout, participants completed the online questionnaires before COVID-19, one week before Ramadan and during the second week of Ramadan. The International Physical Activity Questionnaire-BREF and the Maslach Burnout Inventory-Human Services Survey were used to assess PA intensities and burnout, respectively. The data revealed that total PA (p < 0.001, p < 0.05, respectively) vigorous metabolic equivalent of task (MET) (p < 0.001, p < 0.05, respectively), moderate MET (p < 0.001, p < 0.01, respectively) were higher before COVID-19 and before Ramadan than during Ramadan. Regarding burnout subscales, emotional exhaustion (p < 0.001, p < 0.01, respectively) was higher before Ramadan than before COVID-19 and during Ramadan. A lower personal accomplishment was reported before Ramadan than before COVID-19 and during Ramadan (both p < 0.05). In addition, low to high correlations were observed between PA intensities and burnout subscales, except for the correlation between depersonalization and all PA intensities. In conclusion, Ramadan intermittent fasting along with PA was highly recommended for teachers and the general population to improve positive emotions and general health.

Pandemic Policy and Life Satisfaction in Europe

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

Changes and correlates of screen time in adults and children during the COVID-19 pandemic: A systematic review and meta-analysis

BACKGROUND

Screen time has increased as a result of the COVID-19 pandemic, and several correlates have been associated with these increases. These changes, however, have not been aggregated. It was the aim of this review to (a) aggregate changes in screen time in adults and children, and (b) report on variables in relation to screen time during the COVID-19 pandemic.

METHODS

A systematic review of major databases was undertaken for studies published from inception to 06/12/2021, using a pre-published protocol (PROSPERO ID: CRD42021261422). Studies reporting (a) screen time pre-versus-during the pandemic, (b) screen time percentage change, or (c) correlates of screen time during the pandemic were included. A random effects meta-analysis was undertaken with subgroup analysis by age group and type of screen time.

FINDINGS

After review, 89 studies (n = 204,734; median age=20·6; median female=53·3%) were included. The majority of studies were cross-sectional. With regards to total screen time, primary aged children (6-10 years) reported largest increases (1·4 hrs/day; 95%CI 1·1-1·7), followed by adults (>18 years; 1·0 hrs/day; 95%CI 0·7-1·2), adolescents (11-17 years; 0·9 hrs/day; 95%CI 0·3-1·5), and young children (0-5 years; 0·6 hrs/day 95%CI 0·3-0·9 hrs/day). For leisure screen time (non-work/non-academic), primary aged children reported largest increases (1·0 hrs/day 95%CI 0·8-1·3), followed by adults (0·7hr/day 95%CI 0·3-1·2), young children (0·6 hrs/day; 95%CI 0·4-0·8), with adolescents reporting the lowest increase (0·5 hrs/day 95%CI 0·3-0·7). Several correlates were associated with reported increases in screen time, including adverse dietary behaviours, sleep, mental health, parental health, and eye health.

INTERPRETATION

Pooled evidence suggest that primary aged children reported the highest increase in both total and leisure screen time during COVID-19. It is recommended that screen time should be reduced in favour of non-sedentary activities. This study has the potential to inform public health policy and future guidance regarding screen time, and to inform future research in this area.

FUNDING

No funding was received for this study.

Impact of gender differences on lifestyle and glycemic control in Japanese patients with diabetes during COVID-19 lockdowns

AIMS

The COVID-19 pandemic has drastically changed global lifestyles. Some reports about lifestyle changes during this pandemic have been published. However, these studies have not assessed gender differences. Thus, we analyzed three lifestyle changes to determine gender differences.

METHODS

We analyzed physical activity, snacking habits, and drinking habits in 323 patients with diabetes. Gender differences in lifestyle habits were analyzed using the ꭓ² test, and comparisons of HbA1c between 2019 and 2020 were analyzed using the paired t-test. The factors that influenced the deterioration of HbA1c were determined using multivariate logistic regression analyses.

RESULTS

Of the 323 patients, 212 were male and 111 were female. When examined by quarter, the HbA1c values increased significantly in 2020 compared with that in 2019 in the July-September period. In terms of gender differences in the changes of lifestyle habits, decreased physical activity was higher in women. The factors that affected deterioration in HbA1c were snacking habits for the overall and the male populations.

CONCLUSIONS

The lifestyle changes differed between the genders during the pandemic. A balanced diet is important for all patients with diabetes. Additionally, more attention should be paid to physical inactivity in women.

The Impact of Physical Activity on Mental Health during COVID-19 Pandemic in China: A Systematic Review

The outbreak and spread of novel coronavirus disease (COVID-19) in 2019 was a public health emergency of global concern. As an important health behavior, physical activity (PA) and its impact on mental health have been increasingly explored during the epidemic period. The keywords and references were searched on PubMed, Web of Science, Scopus, Cochrane Library, EBSCO, and CNKI since the inception of an electronic bibliographic database until October 2021. A total of 2979 articles were identified, of which 23 were eligible for inclusion to examine the relationship between PA and mental health during the COVID-19 epidemic. Residents with regular PA, high-intensity PA, and PA duration of 30–60 min or more per day were associated with a lower risk of anxiety, depression, and negative emotions. In contrast, residents with no exercise and physical inactivity were more likely to have anxiety, depression, sleep disturbances, and lower subjective well-being. In addition, the dose–response curve between PA and negative emotions indicated a U-shaped relationship, and there were urban–rural differences in the relationship between emotional status and the levels of PA in adolescents. The findings have significant implications for addressing mental health issues during the current pandemic and future pandemics. Future studies adopting an experimental study design, conducting objective PA measures, and focusing on the vulnerable subpopulations are warranted to further explore the association of PA on mental health during the COVID-19 pandemic.

Impact of Prolonged COVID-19 Lockdown on Body Mass Index, Eating Habits, and Physical Activity of University Students in Bangladesh: A Web-Based Cross-Sectional Study

Objectives

This current study aims to assess the prevalence and factors associated with body mass index (BMI), dietary patterns, and the extent of physical activities among university students following the prolonged coronavirus disease 2019 (COVID-19) lockdown in Bangladesh.

Methods

A cross-sectional web-based survey was conducted between July 10 to August 10, 2021, through a pre-designed Google Form to collect the data from Bangladeshi university students (age: ≥18 years). Informed consent was electronically obtained from each participant, and a simple snowball technique was employed during the sampling. Frequency and percentage distribution, paired t-test, chi-square [χ²] test, and multinomial and binary logistic regression analyses were consecutively applied to analyze the collected data.

Results

Among the total participants (n = 1,602), 45.1% were female and 55.6% were 22–25 years' age group students. The BMI (mean ± standard deviation, SD) during the COVID-19 lockdown was 23.52 ± 7.68 kg/m², which was 22.77 ± 4.11 kg/m² during the pre-lockdown period (mean difference = 0.753; p < 0.001). The multinomial logistic regression analysis found a significant impact of gender [male vs. female: adjusted relative risk ratio (RRR) = 1.448; 95% confidence interval (CI) = 1.022, 2.053; p = 0.037], age (years) (<22 vs. >25: RRR =0.389, 95% CI = 0.213,0.710; p = 0.002, and 22–25 vs. >25: RRR = 0.473, 95% CI = 0.290, 0.772; p = 0.003), monthly family income (BDT) (<25,000 vs. >50,000: RRR = 0.525, 95% CI = 0.334,0.826; p = 0.005), university type (public vs. private: RRR = 0.540, 95% CI = 0.369, 0.791; p = 0.002), eating larger meals/snacks (increased vs. unchanged: RRR = 2.401, 95% CI = 1.597, 3.610; p < 0.001 and decreased vs. unchanged: RRR = 1.893, 95% CI = 1.218, 2.942; p = 0.005), and verbally or physically abuse (yes vs. no: RRR = 1.438, 95% CI = 0.977, 2.116; p = 0.066) on obesity during COVID-19 pandemic. Besides, the female students and those who have constant eating habits, were more likely to be underweight. Additionally, the binary logistic regression analysis found that the students from private universities [others vs. private: adjusted odds ratio (AOR) = 0.461, 95% CI = 0.313, 0.680; p < 0.001], urban areas (urban vs. rural: AOR = 1.451, 95% CI = 1.165, 1.806; p = 0.001), wealthier families (<25,000 BDT vs. >50,000 BDT: AOR = 0.727, 95% CI = 0.540, 0.979; p = 0.036), and who were taking larger meals/snacks (increased vs. unchanged: AOR = 2.806, 95% CI = 2.190, 3.596; p < 0.001) and had conflicts/arguments with others (no vs. yes: AOR = 0.524, 95% CI = 0.418, 0.657; p < 0.001), were significantly more physically inactive. Finally, the level of education and smoking habits significantly influenced the eating habits of university students during the extended strict lockdown in Bangladesh.

Conclusion

The current findings would be helpful tools and evidence for local and international public health experts and policymakers to reverse these worsening effects on students mediated by the prolonged lockdown. Several effective plans, programs, and combined attempts must be earnestly implemented to promote a smooth academic and daily life.

A cross-sectional study examining self-reported anthropometric measurements with adolescents' nutrition attitudes, obesity awareness and diet quality indices during the pandemic

PURPOSE

The purpose of this study is to evaluate the relationship between adolescents' nutritional attitudes, obesity awareness, and diet quality with their self-reported anthropometric measurements taken during the COVID-19 pandemic.

DESIGN AND METHODS

This cross-sectional type of study was conducted in a district in the south of Turkey. The research was carried out online with 907 adolescents who agreed to participate voluntarily.

RESULTS

Among the adolescents, 28.5% considered themselves overweight, and 32.1% were currently trying to lose weight. According to BMI, 16.1% were affected by overweight/obesity. Adolescents' nutritional attitudes and obesity awareness levels were moderate, while their KIDMED nutritional habits were also moderate. In this study, a negative relationship was found between the adolescents' ASHN mean scores and their body weight, waist circumference, hip circumference, neck circumference, waist/hip ratio and waist/height ratio measurements; and between their OAS mean scores and their body weight, waist circumference, waist/hip ratio and waist/height ratio measurements; and between their KIDMED index scores and their waist/height ratio measurements (p < 0.001).

CONCLUSIONS

The rate of adolescents who perceive themselves as overweight is higher than the results obtained from the measurement values. BMI levels and other anthropometric measurement values of adolescents with positive nutrition attitudes and physical activity behaviours are also positively affected.

PRACTICE IMPLICATIONS

This study may have a significant impact on the formulation and implementation of interventions to prevent obesity and increase physical activity for school health nurses. Since the pandemic is still continuing, healthcare providers must stress the risk of obesity in adolescence.

Physical Activity and Exercise Addiction During the Covid-19 Pandemic in Italy

Severe restrictive measures were implemented globally to limit the spread of the Covid-19 pandemic leading to significant lifestyle changes and impacting on both the physical and the mental health of citizens. Caught by the fear of getting sick, some individuals have adopted behaviors which favored the development of exercise addiction (EA). Our aim was to evaluate physical activity habits and the risk of EA in the general Italian population during phase 1 of the lockdown. The role of appearance anxiety (AA), self-compassion, and use of performance and image enhancing drugs (PIEDs) as predictors of EA development were investigated. A comparison between physically active subjects with the inactive ones was also included. Between April and May 2020, an online survey was conducted across Italy. Nine hundred thirty-six answers were collected. The rate of EA in the physically active sample (782 subjects) was 4.1%. The physically active group showed higher SCS scores and a greater use of PIEDs. Of the physically active participants, 84.2% reported variations in their fitness routine. Perceived benefit of exercising resulted significantly higher in those with EA. Subjects with EA reported stronger motivation in engaging in physical activity as for "physical wellness," "psychological well-being," and "sexual attractiveness and confidence in relationship." A higher level of AA, a lower level of self-compassion, and a higher perceived benefit of exercising during lockdown were all significant predictors for the presence of EA. Our findings suggest that the fear of getting sick from Covid-19, combined with radical changes in the lifestyles induced by the lockdown and individual personological characteristics, can favor the development of EA and related phenomena in the general population.

Perceived Physical and Mental Health and Healthy Eating Habits During the COVID-19 Pandemic in Korea

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has disrupted the lives of people around the world since 2020. This study aims to reveal perceived impact of the coronavirus pandemic on physical and mental health and eating behaviors among people with disabilities and without disabilities in South Korea, as compared to other countries.

METHODS

A secondary analysis of a prospective cross-sectional study which was conducted with a web-based global survey.

RESULTS

Among the 3,550 responses from 65 countries, 2,621 responses with nation information were set as full data, 189 for South Korea and 2,432 for other countries. In Korea, there was no significant difference in healthy lifestyle behaviors between people with and without disabilities before the COVID-19 pandemic. Perceived physical and mental health and changes in eating habits during the COVID-19 pandemic showed no significant difference between people with and without disabilities in Korea. There were significant differences in physical health and dietary habits, but no differences in its effect on mental health between people living in Korea and other countries in both people with and without disabilities groups. In other words, more than 60% of people in all groups (disability vs. non-disability, Korea vs. non-Korea) reported worse mental health than before the COVID-19 pandemic.

CONCLUSION

In Korea and other countries, mental health showed a tendency to deteriorate regardless of the presence or absence of disability during the COVID-19 pandemic. In terms of healthy eating habits, Koreans were relatively less affected than people from other countries.