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This paper provides insights into the impacts of a self-employment and entrepreneurship education program for high-skilled long-term unemployed workers aged 45-65 in France during the COVID-19 pandemic. The training program involves individual tutoring, synchronous online classes and lead generation workshops with a freelancing project to design and present to a committee. We studied the impact of the training through an adapted version of the CHEERS questionnaire sent to the trainees six months after the training completion. In contrast to the previous literature, we show promising results for this kind of training. Our results show that this training program not only helps people to start a freelancing career but also prepares many of them to find an employee position after a long period of unemployment. We have also been able to identify the main characteristics of the jobs obtained afterwards that matter to high-skilled senior workers and to describe five trainee profiles through a cluster analysis: (1) enthusiastic but not confident, (2) quick return to salaried employment, (3) focused on freelancing, (4) demanding and disappointed elders, and (5) struggling with business tasks. [ABSTRACT FROM AUTHOR]

We analyze how far-sightedness and risk aversion as well as the perceived trustworthiness of others correlate with COVID-19-related protective behaviors in France. We leverage individual-level data from the corona survey of the Survey of Health Aging and Retirement in Europe linked with a paper questionnaire survey about preferences conducted in France just before the coronavirus outbreak. Our results suggest that far-sightedness and risk aversion are strong predictors of individuals' protective behavior. More far-sighted individuals are more likely to not visit their family members anymore, wear a mask, and keep their distance from others when outside, wash their hands more regularly and cover their cough. Risk aversion increases the likelihood of not meeting more than 5 other people and not meeting with family members anymore. Concerning the perceived trustworthiness, we find that a higher level of trust in others reduces compliance with the recommendations about meeting with 5 or more people and family gatherings. We interpret this result as a sign that individuals with trust in others perceive a lower risk of being infected by friends and family members. Hence, they are more willing to take risks when they engage in social interactions when they perceive their relatives as trustworthy. The government should therefore consider individuals' heterogeneity in preferences and beliefs when implementing a strategy to encourage people to comply with its COVID-19 protective recommendations. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to explore the protective and risk factors involved in student loneliness after the lockdown measures taken limiting social contact during the COVID-19 pandemic in France. Design/methodology/approach: Using a cross-sectional survey methodology, the authors collected data on a sample of 546 students pursuing management education in a French business school in several campuses. Loneliness was measured by the three-item UCLA loneliness scale. Logistic regression analysis examined the factors influencing student loneliness. Findings: The prevalence of loneliness was 23.4%. Risk factors for loneliness were social isolation especially in terms of intensity and isolation from friends (OR: 5.40), having a regular paid activity (OR: 1.62) and not getting academic help from other students (OR: 2.11) or taking meals alone during the lockdowns (OR: 1.94). Being a male student (OR: 0.47), practicing a sport (OR: 0.64) and studying at a specific campus (OR: 0.43) were protective factors. Practical implications: Understanding protective and risk factors affecting student loneliness helps higher education decision-makers to take the necessary actions to enhance student well-being which have an effect on learning processes. Originality/value: Loneliness is a major public health concern among students. Knowledge of the determinants for loneliness are limited and this article attempts to augment this by exploring several protective and risk indicators of loneliness among French students. [ABSTRACT FROM AUTHOR]

Background: Many instructors transitioned their courses from face‐to‐face environments to computer‐mediated learning environments (CMLEs) following the onset of the coronavirus disease 2019 (COVID‐19) pandemic. However, little was known about how teleconferencing platforms and their corresponding functions affect student learning when the COVID‐19 pandemic began. Objectives: The aim of this study was to provide more clarity on the conditions through which online teleconferencing platforms influence student achievement. More specifically, this study investigated how displaying lecture‐relevant and lecture‐irrelevant messages in a chat box during a video lecture delivered via the Zoom teleconferencing platform affected student learning and note taking. Methods: Participants viewed the video lecture either with (relevant or irrelevant) or without messages appearing in the chat box of the Zoom window. Participants completed a learning test immediately following the lecture. Results and Conclusions: No difference regarding student achievement was observed between the three groups. However, results revealed that students in the relevant‐lecture messages group reported a higher extraneous cognitive load than the other groups even if they reported positive attitudes about the messages appearing on the chat box. Students in the lecture‐relevant group also recorded more notes during the lecture compared to the two other groups, but this result did not reach significance. This study extends previous research that investigated how messaging influences learning in classroom settings. Findings suggest that allowing relevant discussions is not the best strategy to promote learning in CMLEs as this information seems to compete with the other relevant information being presented during the ongoing lecture. Lay Description: What is already known about this topic: In video lectures, the chat box has been identified as the function most often used to support students' learning.Responding to lecture‐relevant messages can enhance students' learning.However, it remains unknown how simply reading, but not responding to, lecture‐relevant and lecture‐irrelevant messages can affect learning and note taking. What this paper adds: In previous studies, researchers examined how messaging affects learning in a classroom setting, but not within a computer‐mediated lecture environment.The present study extends previous research that investigated how messaging influences learning in classroom settings.This study provides more clarity on the conditions through which online teleconferencing platforms affect student learning and note taking.Findings suggest that allowing relevant discussions is not the best strategy to promote learning in CMLEs as this information seems to compete with the other relevant information being presented during the ongoing lecture. Implications for practitioners: The features of video lectures are critical factors, as they influence students' learning and should therefore be taken into account when designing educational materials.Instructors should not allow students to engage in lecture‐relevant and irrelevant messaging and discussion during video lectures as it competes with the other relevant information being presented. [ABSTRACT FROM AUTHOR]

In the context of increasing attention on museum sustainability, this research adopts a dictionary‐based, content‐analysis approach to measure the degree of sustainability disclosed in European museum annual reports and similar documents. The analysis is carried out through the lens of institutional theory, assuming that the presence of formal and informal regulations positively affects the level of sustainability in annual reporting practices. Furthermore, the paper discusses the level of sustainability disclosed by different types of museums and the impact of the COVID‐19 pandemic on the extent of sustainability‐oriented reporting. The article compares top public museums in the UK and France, the European countries where accountability practices are most deeply rooted for legal and cultural reasons, and where the most visited museums in the world are located. The findings show that the type of museum and the country significantly affect the ESG (Environmental, Social, and Governance) score, whereas mentioning COVID‐19 or the year of publication does not. [ABSTRACT FROM AUTHOR]

The Paris-Lyon line is the busiest High-Speed Line in Europe and has been open to competition in open access since December 18, 2021. The main objective of the paper is to explore the effects for users with respect to price and frequency compare with the existing literature. The analysis is based on a large database (n = 1243) collected by web scraping from September 2019 to October 2022. The method relies on a descriptive analysis with a similar route without competition (Paris-Bordeaux) in the comparison group. The results highlight an increase of frequency by 15% and a decrease in price by 23%. The prices charged by the newcomer are lower than those of the incumbent (−30% to −50%). The comparison with the control route suggests a positive effect on price that moderates the economic catch-up effect following the COVID-19 pandemic in an inflationary context. More specifically, SNCF appears to take a wait and see attitude to competitive pressure from Trenitalia. It has moderated its prices since the new offer was introduced and has maintained its trains. • Competition have a positive effect on user welfare. • Barriers to competition underscore the importance of public regulation for success. • Incumbent adopts a wait and see attitude in response to competitive pressure. [ABSTRACT FROM AUTHOR]

At the outbreak of the Covid-19 pandemic, several countries declared “states of exception,” that is, authorized legal devices that, in the face of circumstances deemed catastrophic, permit the implementation of extraordinary measures and the temporary suspension of some rights in order to restore the previous state of affairs as soon as possible. This paper offers a comparative textual analysis of the different states of exception declared in the USA, France, and Spain. I argue that these texts constitute a privileged site to explore how prevalent global political logics and mainstream discourses on illness are interwoven. Regarding the global political logics in play, I hold that these declarations constitute an instantiation of democracy’s autoimmune character; it attacks itself in order to protect itself. Regarding mainstream discourses on illness, I explore how illness is regarded as a threat to one’s self (by something seemingly other) and the notion that therapy must consist of securing the self’s triumph over anything seemingly other. This twofold analysis reveals that an aporetic dialectic between self and other—as regards politics and illness—operates in these declarations, most likely because it is, in fact, one and the same dialectic, upon which Western epistemology rests. Furthermore, I suggest that these texts reflect and promote these dominant logics, contributing to shape human relationships around the globe in a certain dangerous way. [ABSTRACT FROM AUTHOR]

Background This study aimed to describe the mortality excess during the three first epidemic periods of COVID-19 in all regions of France. Methods Two complementary approaches were implemented. First, we described the number of death of patients infected with or diagnosed with COVID-19 in health care (HC) and medico-social (MS) institutions. Then, we estimated general all-cause mortality excess (all ages) by comparing the mortality observed with the expected mortality. We used a daily number of death model according to a negative binomial distribution, as a function of the long-term trend in mortality (penalized spline function of time) and its seasonal variation (cyclic spline function). The model provided expected mortality during epidemic periods with a 95% credibility interval. Each region defined three epidemic periods, including the overseas territories. Results The two approaches were consistent in the most affected regions but there are major regional disparities that vary according to the epidemic period. There is an east–west gradient in the relative excess of deaths from all-causes during each epidemic period. The deaths observed in HC and MS institutions alone do not explain the excess (or deficit) of mortality in each region and epidemic period. Conclusion An analysis by age group according to the two approaches and a comparison of death specific causes could provide a better understanding of these differences. Electronic death registration system (mortality by medical causes) would allow a rapid mortality related estimation to an emerging pathology like Coronavirus Disease-2019 (COVID-19) but is still insufficient for real-time medical causes of death monitoring. [ABSTRACT FROM AUTHOR]

Projects such as the European Covid-19 Forecast Hub publish forecasts on the national level for new deaths, new cases, and hospital admissions, but not direct measurements of hospital strain like critical care bed occupancy at the sub-national level, which is of particular interest to health professionals for planning purposes. We present a sub-national French framework for forecasting hospital strain based on a non-Markovian compartmental model, its associated online visualisation tool and a retrospective evaluation of the real-time forecasts it provided from January to December 2021 by comparing to three baselines derived from standard statistical forecasting methods (a naive model, auto-regression, and an ensemble of exponential smoothing and ARIMA). In terms of median absolute error for forecasting critical care unit occupancy at the two-week horizon, our model only outperformed the naive baseline for 4 out of 14 geographical units and underperformed compared to the ensemble baseline for 5 of them at the 90% confidence level (n = 38). However, for the same level at the 4 week horizon, our model was never statistically outperformed for any unit despite outperforming the baselines 10 times spanning 7 out of 14 geographical units. This implies modest forecasting utility for longer horizons which may justify the application of non-Markovian compartmental models in the context of hospital-strain surveillance for future pandemics. Author summary: The US and European Covid-19 Forecast Hubs focus on metrics such as deaths, new cases, and hospital admissions, but do not offer measurements of hospital strain like critical care bed occupancy, which was essential for the provisioning of healthcare resources during the COVID-19 pandemic. Furthermore, forecasting support was only guaranteed on the national level leaving many countries to look elsewhere for valuable sub-national forecasts. In France statistical modelling approaches were proposed to anticipate hospital stain at the sub-national level but these were limited by a two-week forecast horizon. We present a sub-national French modelling framework and online application for anticipating hospital strain at the four-week horizon that can account for abrupt changes in key epidemiological parameters. It was the only publicly available real-time non-Markovian mechanistic model for the French epidemic when implemented in January 2021 and, to our knowledge, it still was at the time it stopped in early 2022. Further adaptations of this surveillance system can serve as an anticipation tool for hospital strain across sub-national localities to aid in the prevention of short-noticed ward closures and patient transfers. [ABSTRACT FROM AUTHOR]

In response to the COVID-19 pandemic caused by SARS-CoV-2, governments have adopted a wide range of non-pharmaceutical interventions (NPI). These include stringent measures such as strict lockdowns, closing schools, bars and restaurants, curfews, and barrier gestures such as mask-wearing and social distancing. Deciphering the effectiveness of each NPI is critical to responding to future waves and outbreaks. To this end, we first develop a dynamic model of the French COVID-19 epidemics over a one-year period. We rely on a global extended Susceptible-Infectious-Recovered (SIR) mechanistic model of infection that includes a dynamic transmission rate over time. Multilevel data across French regions are integrated using random effects on the parameters of the mechanistic model, boosting statistical power by multiplying integrated observation series. We estimate the parameters using a new population-based statistical approach based on a Kalman filter, used for the first time in analysing real-world data. We then fit the estimated time-varying transmission rate using a regression model that depends on the NPIs while accounting for vaccination coverage, the occurrence of variants of concern (VoC), and seasonal weather conditions. We show that all NPIs considered have an independent significant association with transmission rates. In addition, we show a strong association between weather conditions that reduces transmission in summer, and we also estimate increased transmissibility of VoC. [ABSTRACT FROM AUTHOR]

The role of fathers in Western societies has undergone significant change over time. However, their psychopathology remains largely misunderstood and difficult to identify. This study aims to explore the lived experiences of first-time fathers during the COVID-19 pandemic. Twenty-seven first-time French fathers were recruited for the study, which involved a narrative interview, the Rorschach projective test, the Edinburgh Postnatal Depression Scale (EPDS), and a semi-structured interview. Narrative interviews revealed several challenges faced by these fathers, including the pressure of paternal responsibility, the need to be actively involved in the prenatal activities and caregiving (haptonomy, skin-to-skin contact), and concerns about the future of their couple and family as a triad. The Rorschach tests showed numerous perinatal responses and difficulties in identifying phallic representations among the fathers. Additionally, the EPDS scores indicated that 15% of fathers showed signs of depression, while 52% exhibited signs of anxiety. This study also examines the impact of the COVID-19 pandemic and its associated health context on creating the initial triad. Lastly, the case of one father is presented to illustrate the need for diagnostic tools to address the psychopathology of fathers, as narrative or semi-structured interviews have often fallen short of addressing this issue. [ABSTRACT FROM AUTHOR]

In the early months of the COVID-19 pandemic, European countries implemented several non-pharmaceutical interventions with country-specific policies and reduced coordination. Digital Contact Tracing (DCT) was one of the few interventions on which European countries had a common approach oriented toward DCT apps' interoperability. As most EU countries implemented interoperable apps relying on an Apple and Google's framework, France developed the app autonomously. Recent literature argues that France's choice was mainly due to its strong stance in defense of national digital sovereignty. However, current contributions do not largely cover the issue empirically. Therefore, we aim to better explore the role played by digital sovereignty in the political debate related the development of DCT apps. To do so, we conducted a thematic analysis of 16 documents from France's political bodies, selected from a larger corpus of 438 documents dealing with DCT. Three main relevant dimensions related to digital sovereignty emerge. First, the initially sponsored EU interoperability progressively faded in the French political debate. Then, Apple and Google's involvement in the healthcare domain was perceived as highly problematic. Finally, having national players developing the DCT app was largely preferred. Based on our empirical findings, we further engaged with the concept of digital sovereignty, pointing out its difference from digital sovereignism by highlighting the ontological distinction between practices and ideas. Building on these reflections, we argue that France's stance towards DCT and the related digital sovereignty practices subtended digital sovereignism positions. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has negatively impacted not only students' lives but also their professional perspectives. This study analyses the educational impact, perspectives, and vaccine hesitancy among higher education students enrolled in a business school during this pandemic. A cross-sectional study was carried out through univariate and bivariate analysis with their respective statistical significances. Supply Chain and International Logistics and Port Management represented 40.2% of the sample student population. Due to the COVID-19 pandemic, about 20% had to delay their graduation, 64.9% decreased their professional perspectives, 78.4% preferred in-person lectures, 67% felt depressed, and 32% demonstrated vaccine hesitancy. Other relevant results are also described and discussed. These insights can contribute to a better understanding of these phenomena by higher educational institutions (HEIs) to enhance their experiences not only in distance learning but also to provide better designed support services to their students during this pandemic crisis. [ABSTRACT FROM AUTHOR]

Background: The closure of bars and lockdowns related to the Covid-19 pandemic changed alcohol use levels in France during the spring of 2020. We wondered whether this sudden cessation of social interactions impacted students more than non-students and what factors specific to students would explain the increase in alcohol misuse. The aims of this study were to compare self-reported changes in alcohol misuse (alcohol intake and binge-drinking frequency) during the first Covid-19 lockdown from March 17 to May 10, 2020, between French students and non-students and describe factors associated with this alcohol misuse in each subgroup. Methods: Data collected in the Confins study from April 8 to May 10, 2020, were used in cross-sectional analyses stratified by student status. Multiple logistic regression was performed to estimate the association between self-reported increase in alcohol intake or binge-drinking frequency (at least six drinks of alcohol on one occasion) and demographic, socioeconomic, and clinical factors, as well as conditions associated with the Covid-19 pandemic. The population-attributable fraction was then used to estimate the contribution of identified risk factors to increased alcohol misuse in students and non-students. Results: Among both students and non-students, a self-reported decrease or no change in alcohol intake or binge-drinking was more common than an increase. However, the risk factors explaining an increase in alcohol intake differed among students (≥ 25 years old, not working or studying in the health field, and having suicidal ideation during the last 7 days) and non-students (having a medical diagnosis of mental disorders). The risk factors explaining an increase in binge-drinking frequency were similar in the two subgroups (being a tobacco smoker before lockdown and not practicing any physical activity during the last 7 days), except suicidal thoughts, which was a risk factor for alcohol misuse specific to students. Conclusions: These results highlight the vulnerability of certain French students to alcohol misuse and the necessity of combining both mental health and substance use-related screening in the student population. [ABSTRACT FROM AUTHOR]

Aims: The aims of the study were to describe the processes used to introduce advanced practice nursing roles and factors that facilitated or hindered role implementation, examine the time advanced practice nurses (APNs) spend in role activities and how these activities relate to domains of advanced practice nursing and examine how implementation processes influenced APN integration within healthcare teams. Design: A multiple case study was conducted. Methods: Five cases were included, representing the four population areas approved for advanced practice nursing in France. Data were collected from January to March 2021 using observation, interview and document analysis methods. Data were examined using thematic analysis. Results: Participants included APNs (n = 5), nurses/allied health providers (n = 5), physicians (n = 5), managers (n = 4) and decision-makers (n = 4). Stakeholder engagement and leadership provided by decision-makers, managers, physicians and APNs facilitated role implementation. Poor stakeholder role understanding, uncertain role funding, and the COVID-19 pandemic hindered role implementation. APNs spent the most time in clinical activities. Participants perceived the integration of APNs within the healthcare team and their impact on patient care to be positive. Conclusion: Stakeholder engagement and organizational and APN leadership facilitated the implementation of the roles, especially related to team-based patient care. Further efforts are needed to strengthen APN involvement in non-clinical activities and address role barriers. Implications for nursing and patient care: Systematic and system-wide approaches are needed to improve role clarity, role autonomy and health systems integration of APNs. Research should examine patient perspectives about APNs in France. Impact: The results highlight how policies can create favourable conditions for advanced practice nursing role implementation in France. Internationally, this study serves as a reminder to APNs and nurse leaders about the strategies for and importance of implementation evaluation to support the optimal development of advanced practice nursing roles. Reporting Method: The study reporting followed the Consolidated Criteria for Reporting Qualitative Research. Patient or Public Contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Since 2018, TROPOMI on-board Sentinel-5P provides unprecedented images of NO2 tropospheric columns at a relatively high spatial resolution with a daily revisit. This study aims at assessing the potential of the TROPOMI-PAL data to estimate the national to urban NO x emissions in France from 2019 to 2021, using the variational mode of the recent Community Inversion Framework coupled to the CHIMERE regional transport model at a spatial resolution of 10×10 km2. The seasonal to inter-annual variations of the NO x French emissions are analyzed. A specific attention is paid to the current capability to quantify strong anomalies in the NO x emissions at intra-annual scales such as the ones due to the COVID-19 pandemic, by using TROPOMI NO2 observations. The inversions lead to a decrease of the average emissions over 2019–2021 compared to 2016 of -3 % at national scale, which is lower than the decrease of -14 % between these years in the estimates of the French Technical Center for Air Pollution and Climate Change (CITEPA). This may be linked especially to the limited level of constraint brought by the TROPOMI data, due to the observation coverage and the ratio between the current level of errors in the observation and the chemistry-transport model, and the NO2 signal from the French anthropogenic sources. Focusing on local analysis and selecting the days during which the TROPOMI coverage is good over a specific local source, we compute the reductions in the NO x anthropogenic emission estimates by the inversions from spring 2019 to spring 2020. These reductions are particularly pronounced for the largest French urban areas (e.g., -26 % from April 2019 to April 2020 in the Paris urban area) and along major roadways, consistently with the reduction in the intensity of vehicle traffic reported during the lockdown period. [ABSTRACT FROM AUTHOR]

Objectives: We investigated the mortality patterns of chronic obstructive pulmonary disease (COPD) patients in France relative to a control population, comparing year 2020 to pre-pandemic years 2017-2019. Methods: COPD patient and sex, age and residence matched control cohorts were created from the French National Health Data System. Survival was analyzed using Cox regressions and standardized rates. Results: All-cause mortality increased in 2020 compared to 2019 in the COPD population (+4%), but to a lesser extent than in the control population (+10%). Non-COVID-19 mortality decreased to a greater extent in COPD patients (-5%) than in the controls (-2%). Death rate from COVID-19 was twice as high in the COPD population relative to the control population (547 vs. 279 per 100,000 person-years). Conclusion: The direct impact of the pandemic in terms of deaths from COVID-19 was much greater in the COPD population than in the control population. However, the larger decline in non-COVID-19 mortality in COPD patients could reflect a specific protective effect of the containment measures on this population, counterbalancing the direct impact they had been experiencing. [ABSTRACT FROM AUTHOR]

Objectives: During the COVID-19 pandemic in France, abortion was recognized as an essential service that cannot be delayed, and such care was therefore presumed to be maintained. The aim is to analyze the changes in the practice of abortion in 2020 to identify the consequences of the two lockdowns and the effects of the extension of the legal time limit. Methods: We analyzed the data collected by the French national health insurance system, which covers 99% of the population. All women who had an elective abortion, either surgical or with medication, in France in 2019 and 2020 were included in the study. Trend changes in abortions were analyzed by comparing the ratio of the weekly number of abortions in 2020 with the weekly number in 2019. Results: Both 2020 lockdowns were followed by a drop in abortions, particularly after the first and stricter lockdown. This may be explained not by an abrupt shutdown of access to abortion services, but rather by a decrease in conceptions during the lockdown weeks. The decrease was more marked for surgical abortions than for medication abortions in a hospital setting, and less so for medication abortions in non-hospital settings. Moreover, the proportion of the latter type of abortions continued to increase, showing the reinforcement of a previous trend. Conclusions: Our findings indicate that expanding the legal time limit for abortion, diversifying the settings where abortions can be performed and the range of abortion providers help to facilitate access to this fundamental reproductive care. [ABSTRACT FROM AUTHOR]

Background: Covid-19 epidemics raged around the world in years 2020–2022. The dynamics of the epidemics and their mortality varied by country depending on prevention, treatments, vaccination and health status of the population. Objective: The study compares Covid-19 morbidity and mortality in South-Africa and in France, two countries with similar population size and with reliable reporting systems, in order to better understand the dynamics and impacts of the epidemics and the effects of health policies and programs. Data and methods: Data on cases, deaths, hospitalizations, vaccinations were drawn from national statistics. Published data on cases and deaths were corrected for undercount. Results: Results show a different epidemiology in the two countries in the first three years of the epidemic (2020–2022). Incidence was higher in South Africa, and some 44% more people were infected by December 2022 than in France. Mortality and case-fatality were also higher in South Africa despite a favourable age structure. The age pattern of mortality showed higher values in South Africa among the young adults. Young women appeared somewhat disadvantaged in South Africa. Lastly, vaccination appeared to have had no effect on incidence, but a large effect on case-fatality in France. Conclusions: Despite about the same population size and the same crude death rate at baseline, South Africa exhibited more cases and more deaths from Covid-19 over the 2020–2022 period. Prevention strategies (lockdown and vaccination) appear to have had large impacts on morbidity and mortality. [ABSTRACT FROM AUTHOR]

Here we provide data from an online survey of 639 people diagnosed with COVID-19 and resident in France, who were diagnosed with COVID-19 between 30th Jan 2020 and 29th August 2022. In addition to demographic information the survey includes questions about participants' symptoms (by category), symptom onset and persistence, and the effects these symptoms had on their daily lives. Participants were able to include information related to their perceived medical, social and professional needs. These data are needed in order to create effective care policies addressing post-COVID sequelae. Information related to symptom association & dynamics is expected to be useful to clinicians and may also inform more fundamental studies. Measurement(s) Physical & Mental Health, Demographics, Perceptions & Needs Technology Type Questionnaire Sample Characteristic - Organism Adult Humans Sample Characteristic - Environment Online Survey Sample Characteristic - Location France [ABSTRACT FROM AUTHOR]

Early evidence shows mixed effects of the COVID-19 pandemic on births in Europe. This research note compares pre-pandemic trends in the general fertility rate (GFR) at the regional level in the four European countries with the largest populations--France, Germany, Italy, and Spain--with those observed after the onset of the pandemic. It also explores the relationship between changes in GFR during the pandemic and factors such as COVID-19-related deaths, changes in labour market characteristics, and shifts in the population at risk of poverty following the pandemic's onset. We collected regional data on monthly births from January 2018 to December 2021 from national statistical offices, with additional data from Eurostat. Our analysis included two sets of regressions. First, regional-level fixed effects linear regression models for monthly GFRs were run separately for each country to estimate the effects of three pandemic periods for each region. The resulting coefficients of the pandemic periods were then integrated into a weighted linear regression as the dependent variable, including regional factors such as changes in labour market characteristics, risk of poverty, and excess mortality as regressors. The results highlight within-country variations in birth rate changes following the pandemic, with a particular association between declining birth rates and increased youth unemployment. [ABSTRACT FROM AUTHOR]

Background: France implemented a combination of non-pharmaceutical interventions (NPIs) to manage the COVID-19 pandemic between September 2020 and June 2021. These included a lockdown in the fall 2020 – the second since the start of the pandemic – to counteract the second wave, followed by a long period of nighttime curfew, and by a third lockdown in the spring 2021 against the Alpha wave. Interventions have so far been evaluated in isolation, neglecting the spatial connectivity between regions through mobility that may impact NPI effectiveness. Methods: Focusing on September 2020–June 2021, we developed a regionally-based epidemic metapopulation model informed by observed mobility fluxes from daily mobile phone data and fitted the model to regional hospital admissions. The model integrated data on vaccination and variants spread. Scenarios were designed to assess the impact of the Alpha variant, characterized by increased transmissibility and risk of hospitalization, of the vaccination campaign and alternative policy decisions. Results: The spatial model better captured the heterogeneity observed in the regional dynamics, compared to models neglecting inter-regional mobility. The third lockdown was similarly effective to the second lockdown after discounting for immunity, Alpha, and seasonality (51% vs 52% median regional reduction in the reproductive number R0, respectively). The 6pm nighttime curfew with bars and restaurants closed, implemented in January 2021, substantially reduced COVID-19 transmission. It initially led to 49% median regional reduction of R0, decreasing to 43% reduction by March 2021. In absence of vaccination, implemented interventions would have been insufficient against the Alpha wave. Counterfactual scenarios proposing a sequence of lockdowns in a stop-and-go fashion would have reduced hospitalizations and restriction days for low enough thresholds triggering and lifting restrictions. Conclusions: Spatial connectivity induced by mobility impacted the effectiveness of interventions especially in regions with higher mobility rates. Early evening curfew with gastronomy sector closed allowed authorities to delay the third wave. Stop-and-go lockdowns could have substantially lowered both healthcare and societal burdens if implemented early enough, compared to the observed application of lockdown-curfew-lockdown, but likely at the expense of several labor sectors. These findings contribute to characterize the effectiveness of implemented strategies and improve pandemic preparedness. [ABSTRACT FROM AUTHOR]