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Pregnant women who contract the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) face an elevated risk of preterm birth, and their newborns are more prone to stillbirth or admission to a neonatal unit. Despite the World Health Organization declaring the end of the coronavirus disease 2019 (COVID-19) pandemic as a global health emergency in May 2023, pregnant women continue to contract SARS-CoV-2. Limited information is available on the impact of SARS-CoV-2 infection in early pregnancy on pregnancy outcomes. Additionally, understanding the safety of vaccination is crucial. Current evidence suggests that SARS-CoV-2 infection in early pregnancy does not seem to heighten the risk of miscarriages. Moreover, vaccinations have demonstrated efficacy in safeguarding both pregnant women and their pregnancies
This chapter tells the story of how the uncensored text of Pepys’s diary was finally published in the late twentieth century, before turning to the diary’s online presence in the twenty-first century. The complete text, edited by Latham and Matthews, appeared between 1970 and 1983. However, the decision to publish the diary in full was made much earlier, at the time of the controversial Lady Chatterley trial (1960). Getting all the diary into print required navigating the new law against obscene publications, with implications for how the diary is read today. International collaboration – and behind-the-scenes controversy – also shaped this edition. Collaboration is likewise a feature of the site pepysdiary.com (2003-present), which attracts an international community of readers. As the COVID-19 pandemic hit, this site became a record of how readers worldwide used Pepys’s history to interpret a contemporary plague.
To examine opinions about incentives for vaccination against COVID-19.
Methods
A qualitative study was conducted in spring 2022. The study population consisted of pairs of university students and their parents throughout Serbia. The qualitative content analysis was applied.
Results
A total of 18 participants (9 student-parent pairs) were included. The following themes were identified: 1) Attitudes about financial incentives for vaccination, 2) Non-financial incentives for vaccination, and 3) Suggestions to enhance vaccination coverage. Theme 1 comprised several subthemes: General response to money, Dissatisfaction with financial incentives, Satisfaction with financial incentives and Amount of money to change people’s opinion. Most parents and some students expressed a clear dissatisfaction and disapproval of the concept of financial incentives for compliance with vaccination. Financial offers would not make our participants change their position on whether to receive the vaccine, as no major differences in attitude towards vaccinations between the vaccinated and the non-vaccinated study participants was observed. Non-financial incentives were more acceptable compared to financial ones, but they were also seen as beneficial for some and not others.
Conclusions
Financial incentive programs’ potential for inefficiency and public mistrust make other methods to boost vaccine uptake better public health choices for now.
The objectives of this study were to determine how university and surrounding area characteristics are associated with student vaccination rates and vaccine exemption stringency.
Methods
This study collected data from publicly available university-associated and government-associated websites. The university and surrounding area characteristics were evaluated to elucidate how they impact student vaccination rates and ease of exemption from vaccine mandates using statistical correlations and linear regression.
Results
Lower student-to-faculty ratios and stricter university exemption strategies were significantly correlated with higher vaccination rates. Schools that did not allow for personal exemptions to vaccine mandates had significantly higher vaccination rates as compared to schools without vaccine mandates. Certain university and surrounding area characteristics, such as regional location and surrounding area vaccination rates, might serve as underlying factors in inconsistent vaccination rates on university campuses.
Conclusions
Associations were seen between some of the explanatory variables and student vaccination rates. However, more research needs to be conducted to better understand how these discussed factors affect university vaccination rates. This will allow public health professionals to be more prepared as new health concerns arise in the future.
Global crises constitute challenges for social policy. While social policy is predominantly a national concern, international organisations (IOs) contribute frames of reference for state decisions. In this article, we explore whether the COVID-19 pandemic led to changes in IOs’ social policy ideas and recommendations in health care, labour market, and social protection policies due to how IOs perceived the crisis’ specific nature, severity, and global scope. We focus on four IOs regarded as key actors in global social policy, namely the ILO, OECD, WHO, and the World Bank. Theoretically, we employ a framework of ideational policy change combining different levels (recommendations – including parameters and instruments – and paradigmatic ideas) with different types of change (layering, conversion, dismantlement, and displacement). We find that IOs have not fundamentally reimagined their pre-pandemic stances during the pandemic. The IOs’ perceptions of the crisis do not undermine IOs’ ideas and recommendations but highlight their appropriateness.
Severe fatigue following COVID-19 is a debilitating symptom in adolescents for which no treatment exists currently.
Aims:
The aim of this study was to determine the effectiveness and feasibility of cognitive behavioural therapy (CBT) for severe fatigue following COVID-19 in adolescents.
Method:
A serial single-case observational design was used. Eligible patients were ≥12 and <18 years old, severely fatigued and ≥6 months post-COVID-19. Five patients, consecutively referred by a paediatrician, were included. The primary outcome was a change in fatigue severity, assessed with the fatigue severity subscale of the Checklist Individual Strength, 12 weeks after the start of CBT, tested with a permutation distancing two-phase A-B test. Secondary outcomes were the presence of severe fatigue, difficulty concentrating and impaired physical functioning directly post-CBT as determined with questionnaires using validated cut-off scores. Also, the frequency of post-exertional malaise (PEM) and absence from school directly post-CBT determined with self-report items were evaluated.
Results:
All five included patients completed CBT. Twelve weeks after starting CBT for severe post-COVID-19 fatigue, three out of five patients showed a significant reduction in fatigue severity. After CBT, all five patients were no longer severely fatigued. Also, four out of five patients were no longer physically impaired and improved regarding PEM following CBT. All five patients reported no school absence post-CBT and no difficulties concentrating.
Conclusion:
This study provides a first indication for the effectiveness and feasibility of CBT among adolescents with post-COVID-19 fatigue.
This chapter introduces the book, laying out its central questions, including what it means to be postdigital, what diverse kinds of life and humanity can be found in screens, and what new technologies such as automation and AI might mean for screen lives. Chapter 1 also describes both the background and aspirations of the book, as well as its structure and a guide on how to approach reading it. Beyond discussing the defining research questions, this chapter also details the ideas underpinning the book, including the notion that there has been a tangible shift between how we related to screens a decade ago and how we do now. In addition, the book is guided by an awareness of the often conflicting and intricate relationships people have with screens, as well as the concept of the ‘smallness of screen lives’, inspired by Deborah Hicks’ notion. The Comfort of Screens is a tapestry which unfolds a story of postdigital life, sewn from the fabric of 17 people’s screen lives, interviews with whom form the backbone of the book. These ‘crescent voices’ are also introduced in this chapter.
This chapter begins with a reflection of the Find My iPhone app, employing it as an example of how physical and digital place can exist simultaneously and in interconnected ways. Afterwards, it turns to explaining the notion of physical-digital place as parallel universes, subsequently unravelling this idea through strands taken from across crescent voice interviews. The emphasis of this chapter is on place, or more specifically the intermingling of physical and digital places, whereby the commitments, practices, and imaginaries of screens can shape one’s understandings of place and allow one to form a consciousness that is a kind of home. By employing notions of the ‘digital home’, social imaginaries, digital twins, and a postdigital concept of community, this chapter unsettles the binary between digital and physical spaces, employing Dezuanni’s definition of community to help get at the ways that online spaces feel like home. It explores these ideas primarily through crescent voices and their experiences of the Covid-19 pandemic, an event which lent more prominence to practices such as digital twins.
Chapter 4 delves deeper into screen life, adopting an even more human-centred focus, in order to uncover the affective aspect of screen lives. Maintaining an embodied approach, this chapter explores how affective experiences with screens are intentionally elicited through how media is designed, how affect on screens might differ from affect outside screens, and how digital affect can inform practices, and practices induce affect. The chapter begins by defining affect, then digital affect more specifically, before turning to interviewees for their perspectives on how they feel and sense on screens, touching on topics such as micro digital affect, algorithms, and the pandemic. Crescent voices in this chapter help illustrate how digital affect is vital to understanding digital literacy practices and screen lives, especially the double-edged aspects of our affective relationships to screens.
Substate-level analysis reveals geographical variation in COVID-19 epidemiology and facilitates improvement of prevention efforts with greater granularity.
Methods
We analyzed daily confirmed COVID-19 case count in West Virginia and its 9 regions (March 19, 2020-March 9, 2023). Nonparametric bootstrapping and a Poisson-distributed multiplier of 4 were applied to account for irregular and under-reporting. We used the R package EpiEstim to estimate the time-varying reproduction number Rt with 7-day-sliding-windows (2020-2023) and non-overlapping-time-windows between 5 policy changes (2020 only). Poisson regression was used to estimate the incidence rate ratio (IRR) between each region and West Virginia (2020, 2021, and 2022).
Results
Statewide Rt fluctuated over the study period, with the highest in March 2020 (close to 2) and the lowest Rt (<1) seen in June 2020. The Stay-at-home Order, Face Mask Mandate, and Virtual Learning Resumes saw 38.7% (95% credible interval [CrI]: 21.9%-57.5%), 10.6% (95% CrI, 3.2%-18.9%), and 9.4% (95% CrI, 3.2%-15.4%) corresponding decreases in Rt statewide. All regions experienced incidence rates different from the state. The IRRs ranged from 0.32 (95% CI, 0.32-0.33) (Northern region) to 1.90 (95% CI, 1.87-1.94) (Wood-Jackson region) in 2020.
Conclusions
Policies reducing human contacts, e.g., Stay-at-home Order and Virtual Learning Resumes, effectively reduced transmission statewide.
The threat of novel pathogens and natural hazards is increasing as global temperatures warm, leading to more frequent and severe occurrences of infectious disease outbreaks and major hurricanes. The COVID-19 pandemic amplified the need to examine how risk perceptions related to hurricane evacuations shift when vaccines become available. This study explores individuals’ expected evacuation plans during the early stages of COVID-19 vaccine availability.
Methods
In March 2021, an online survey was disseminated in Puerto Rico and the US Virgin Islands.
Results
An overwhelming majority (72.6%) of respondents said that their vaccination status would not affect their hurricane evacuation intentions. The unvaccinated were significantly more likely to consider evacuating during a hurricane than the vaccinated. Even with vaccines available, respondents suggested they were less likely to evacuate to a shelter during the 2021 season than prior to the COVID-19 pandemic. Respondents generally believed that the risk of contracting COVID-19 at a shelter was greater than the risk of sheltering-in-place during a hurricane.
Conclusions
Government officials need to develop and communicate clear information regarding evacuation orders for municipalities that may be more impacted than others based on the trajectory of the storm, social determinants of health, and other factors like living in a flood zone.
Retracted research publications reached an all-time high in 2023, and COVID-19 publications may have higher retraction rates than other publications. To better understand the impact of COVID-19 on the research literature, we analyzed 244 retracted publications related to COVID-19 in the PubMed database and the reasons for their retraction. Peer-review manipulation (18.4%) and error (20.9%) were the most common reasons for retraction, with time to retraction occurring far more quickly than in the past (13.2 mos, compared with 32.9 mos in a 2012 study). Publications focused on controversial topics were retracted rapidly (mean time to retraction 10.8 mos) but continued to receive media attention, suggesting that retraction alone may be insufficient to prevent the spread of scientific misinformation. More than half of the retractions resulted from problems that could have been detected prior to publication, including compromise of the peer review process, plagiarism, authorship issues, lack of ethics approvals, or journal errors, suggesting that more robust screening and peer review by journals can help to mitigate the recent rise in retractions.
The field of global health law has evolved over the past decade to describe new legal and policy instruments that apply to a changing set of public health threats, non-state actors, and regulatory norms that structure the global response to public health challenges. This special issue—bringing together the O’Neill Institute for National & Global Health Law and the Global Health Law Consortium—examines the expansive evolution of the field of global health law and its continuing development to face new health threats.
The COVID-19 pandemic significantly challenged the mental health of children and adolescents, with existing research highlighting the negative effects of restrictive measures to control the virus’s spread. However, in the specific context of this pandemic, there is limited understanding of how these difficulties have persisted over time after the situation was fully restored. This study sought to evaluate the pandemic’s impact on psychological symptoms in children from Italy, Spain, and Portugal across five-time points (2, 5, and 8 weeks, 6 months, and three and a half years after the pandemic’s onset). A total of 1613 parents completed the Psychological Impact of COVID-19 and Confinement on Children and Adolescents Scale, reporting symptoms in their children aged 3–17 years (39.2% female). The findings reveal an initial surge in psychological difficulties—anxiety, mood, sleep, behavioral, eating, and cognitive disturbances—followed by improvements in these domains three and a half years later. By September 2023, Spanish children experienced more significant reductions in symptoms compared to their Italian and Portuguese peers. While the COVID-19 pandemic has been a prolonged crisis, with varying impacts over time and across regions depending on the strictness of restrictions, the trends suggest a gradual improvement in the psychological well-being of children and adolescents.
Despite internet use potentially reducing loneliness among older adults during the Covid-19 pandemic, quantitative research in this area is limited. Our study addresses this gap by exploring how internet use affects loneliness worsening in old age across Europe from a gendered perspective. We adopt a comprehensive approach, considering individual and contextual factors. Using multi-level modelling, we analyse data from the Survey of Health, Ageing and Retirement in Europe (Wave 8 and Corona Survey 1), supplemented by the Oxford Covid-19 Government Response Tracker and the Eurostat Digital Agenda Scoreboard Key Indicators. The empirical analysis has revealed gender-specific differences in the relationship between internet use and the worsening of loneliness among older people during the pandemic, with internet use contributing to increased loneliness for older women, but not for men. In addition, our study indicates that while the contextual factors, namely the severity of the contingency measures and the quality of the internet connection, are not moderators of the relationship between internet use and loneliness worsening, the stringency index specifically exacerbates loneliness in women. These findings contribute to the development of more effective and targeted interventions to combat loneliness worsening and promote wellbeing among older women, particularly in the context of global health crises such as the Covid-19 pandemic.
Southern European welfare states have historically been characterised by the absence of national safety nets. However, these countries have witnessed a succession of policy reforms over the past three decades. In 2020, the Spanish Parliament unanimously approved the ‘Ingreso Mínimo Vital’ to finally cease being the only European country without a minimum income scheme at the national level. This article investigates the political and institutional mechanisms that enabled this policy reform, which was particularly unexpected due to the fragmentation of the party system along both ideological and territorial dimensions. To solve this puzzle, I employ the ‘explaining-outcome’ process tracing method and rely on qualitative data from official documents, party manifestos and parliamentary interventions spanning from 2015 to 2020. In addition, I build on ten expert interviews with relevant actors directly involved in the reform, conducted between 2022 and 2024. Findings illustrate that inclusive path departure was possible through two political stages. First, left-wing party competition and strong socio-political demand (2014–2020) allowed for the introduction of the scheme into the political agenda. Second, territorial politics and the external shock of the coronavirus disease 2019 (COVID-19) pandemic ultimately contributed to mitigating expected political cleavages during the parliamentary process.
Health care comprises a major segment of the US economy and is a critical influence upon citizens’ quality of life. The quality of health care and access to it are negatively affected by corruption. So too is citizen compliance with public health policies, a fact that became apparent during the COVID-19 pandemic. Stay-at-home orders, for example, were significantly less effective in states with more extensive corruption. Low levels of trust in government contributed to those disparities. Such effects are more pronounced in poorer areas and Black communities. Racial contrasts in vaccine equity – access to vaccinations and related services – were pronounced and, again, reflected levels of corruption. Particularly intractable problems of collective action posed by structural corruption and structural racism must be addressed if disparities in the quality of health care are to be reduced.
Many Emergency Medical Services (EMS) agencies modified their protocols during the height of the COVID-19 pandemic, particularly those involving procedures that lead to an increased risk of airborne exposure, such as intubation. In 2020, local Advanced Life Support (ALS) providers’ first-line airway management device was the supraglottic airway (SGA), and tracheal intubations (TIs) were rarely performed.
Objective:
This study’s aim was to investigate the potential clinical effect of this pandemic-related protocol change on first-pass TI success rates and on overall initial advanced airway placement success.
Methods:
This study was a retrospective prehospital chart review for all ALS encounters from a single urban EMS agency that resulted in the out-of-hospital placement of at least one advanced airway per encounter from January 1, 2019 through June 30, 2021 (n = 452). Descriptive statistics and chi square tests were used to evaluate data. Statistical significance was defined at P < .05.
Results:
Significantly fewer TIs were attempted in 2020 (n = 16) compared to 2019 (n = 80; P < .001), and first-pass TI success rates significantly decreased in 2021 (n = 22; 61.1%) compared to 2019 (n = 63; 78.8%; P = .047). Also, SGA placement constituted 91.2% of all initial airway management attempts in 2020 (n = 165), more than both 2019 (n = 114; 58.8%; P < .001) and 2021 (n = 87; 70.7%; P < .001). Overall first-attempt advanced airway placement success, encompassing both supraglottic and TI, increased from 2019 (n = 169; 87.1%) to 2020 (n = 170; 93.9%; P = .025). Conversely, overall first attempt advanced airway placement success decreased from 2020 to 2021 (n = 104; 84.6%; P = .0072).
Conclusions:
Lack of exposure to TI during the COVID-19 pandemic likely contributed to this local agency’s decreased first-pass TI success in 2021. Moving forward, agencies should utilize simulation labs and other continuing education efforts to help maintain prehospital providers’ proficiency in performing this critical procedure, particularly when protocol changes temporarily hinder or prohibit field-based psychomotor skill development.
Health-related quality of life (HRQoL) in the context of COVID-19 is not fully understood. We assessed HRQoL using Patient-Reported Outcomes Measurement Information System® measures among 559 former COVID-19 patients and 298 non-infected individuals. HRQoL was captured once up to 2 years after the initial test. Additionally, we described associations of characteristics with impaired HRQoL. Overall, HRQoL scores were inferior among former patients. A meaningful group difference of at least three T-score points was discernible until 12 months after testing for fatigue (3.1), sleep disturbance (3.5), and dyspnoea (3.7). Cognitive function demonstrated such difference even at >18 months post-infection (3.3). Following dichotomization, pronounced differences in impaired HRQoL were observed in physical (19.2% of former patients, 7.3% of non-infected) and cognitive function (37.6% of former patients, 16.5% of non-infected). Domains most commonly affected among former patients were depression (34.9%), fatigue (37.4%), and cognitive function. Factors that associated with HRQoL impairments among former patients included age (OR ≤2.1), lower education (OR ≤5.3), and COVID-19-related hospitalization (OR ≤4.7), among others. These data underline the need for continued attention of the scientific community to further investigate potential long-term health limitations after COVID-19 to ultimately establish adequate screening and management options for those affected.
The COVID-19 pandemic showed the vital role of Emergency Medical Teams (EMTs) in international surge responses. The EMTs with their internationally skilled team members were able to meaningfully support countries facing the pandemic, especially those who were suffering from scarcity in the quality and quantity of workforce and financial resources within their health systems. This report summarizes the main operational challenges faced by UK-Med and The Polish Center for International Aid (PCPM) Emergency Medical Teams, based on experiences from their 32 COVID-19 deployments. In particular, the paper discusses the hindrances related to Ministries of Health expectations and the changing roles of EMTs during deployments.