Search

This paper discusses key themes of the 15th biennial conference of the Association for Language Awareness (2020), with a focus on increasing digital engagement in language education. The COVID-19 pandemic occasioned an abrupt transition to emergency remote language teaching and learning (ERLTL) worldwide. The ALA 2020 conference was also affected by this transition; originally planned as a located conference in Geelong, Australia, it was eventually held online, a first in ALA's conference history. The current paper engages with contemporary debates of language teaching and learning in two ways. Firstly, it traces recent discussions by presenting key findings from five papers given at the conference, and secondly, via a scoping review of literature focusing on critical lessons from the pandemic regarding language teaching and learning. The review captures recent research from the Australasian region. Key debates identified in the literature include the needs of teachers and learners during the transition to online learning, and how student engagement was affected. The literatures highlight that both educators and students have been developing new practices in teaching and learning resulting from the shift to online and blended modes, which may continue to shape language education and new pedagogies in the future.

Background: Attention to the healthcare workforce has increased, yet comprehensive information on migrant healthcare workers is missing. This study focuses on migrant healthcare workers' experiences and mobility patterns in the middle of a global health crisis, aiming to explore the capacity for circular migration and support effective and equitable healthcare workforce policy., Methods: Romanian physicians working in Germany during the COVID-19 pandemic served as an empirical case study. We applied a qualitative explorative approach; interviews (n = 21) were collected from mid of September to early November 2022 and content analysis was performed., Results and Discussion: Migrant physicians showed strong resilience during the COVID-19 crisis and rarely complained. Commitment to high professional standards and career development were major pull factors towards Germany, while perceptions of limited career choices, nepotism and corruption in Romania caused strong push mechanisms. We identified two major mobility patterns that may support circular migration policies: well-integrated physicians with a wish to give something back to their home country, and mobile cosmopolitan physicians who flexibly balance career opportunities and personal/family interests. Health policy must establish systematic monitoring of the migrant healthcare workforce including actor-centred approaches, support integration in destination countries as well as health system development in sending countries, and invest in evidence-based circular migration policy., (© 2024 The Authors. The International Journal of Health Planning and Management published by John Wiley & Sons Ltd.)

Introduction: Direct-acting antivirals (DAAs) are key to eliminating hepatitis C virus (HCV). In men who have sex with men (MSM) with HIV co-infection, recently acquired HCV infection is common. Sexual practices and reinfection rates may hamper micro-elimination despite high treatment rates., Methods: The cohort included MSM with recently acquired HCV infection from 2014 to 2021. The patients' demographic, clinical, behavioural, and laboratory data and treatment and reinfection outcomes were documented., Results: A total of 237 men with recently acquired HCV infection were included: 216 (91%) had HIV. The median age was 46 years (interquartile range [IQR] 39-52), and the median CD4 count was 660/mm 3 (IQR 527-835). The annual incidence of recently acquired HCV remained between 0.28% and 0.43% but dropped to 0.02% in 2021 during the COVID pandemic, almost reaching micro-elimination. The reinfection incidence was 15.5 per 100 patient-years (95% confidence interval 12.6-18.8), and reinfection was associated with the use of crystal methamphetamine (p = 0.032) and ketamine (p = 0.042). In total, 31.3% had multiple reinfections, and four reinfections occurred in users of pre-exposure prophylaxis., Conclusions: High treatment and cure rates did not lead to HCV elimination. A change in sexual behaviour, potentially imposed by COVID-19 restrictions, led to micro-elimination in the NoCo cohort. As recently acquired HCV is prevalent in MSM with and without HIV, surveillance is necessary to consolidate elimination goals., (© 2024 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association.)

Free play is a natural activity in toddlerhood, depending on environmental conditions like available objects and the social environment. The COVID-19 pandemic and its consequences for parents' mental health held the potential to change toddlers' play environment. This cross-sectional study investigated 2-year-olds' (N = 97) free play with objects, and aspects of caregiver mental well-being in three cohorts during the pandemic in Germany. Caregivers reported their positive mental health (PMH), threat perception, perception of current family situation from negative to positive, and workload. We categorized toddlers' behavior in free play sessions in their homes with a fixed set of objects through behavioral coding. Play behavior did not differ between cohorts and did not correlate with caregivers' positive mental health, threat perception, and perception of family situation. A MANOVA revealed a significant main effect of cohort on PMH, threat perception and perception of family situation, qualified by two discriminant functions. Full sample analyses revealed that toddlers of caregivers perceiving a workload increase compared to the time before the pandemic showed less pretend play, and less functional and nonfunctional play. The results provide insights into 2-year-olds' play behavior during a global pandemic and highlight the role of caregiver availability for children's play., (© 2024 The Authors. Infancy published by Wiley Periodicals LLC on behalf of International Congress of Infant Studies.)

Objective: In clinical practice, persistent somatic symptoms are regularly explained using a cognitive-behavioral model (CBM). In the CBM, predisposing, perpetuating, and precipitating factors are assumed to interact and to cause the onset and endurance of somatic symptoms. However, these models are rarely investigated in their entirety., Methods: We conducted an online survey during the COVID-19 pandemic. A total of 2114 participants from the general German population completed questionnaires that measured different factors of the CBM. We used state negative affectivity and neuroticism as predisposing factors, fear of a COVID-19 infection as the precipitating factor, and somatic symptoms, misinterpretation of bodily symptoms, attention allocation to bodily symptoms, and health anxiety as perpetuating factors. Moreover, we added safety and avoidance behavior as end points to the model. We conducted a psychological network analysis to exploratively study the relationships between the model's different factors and tested the assumptions of the CBM by evaluating a structural equation model (SEM) that incorporated all factors of the model., Results: Network analyses revealed clustering in our data: Health anxiety and different cognitive factors are closely related, whereas somatic symptoms and state negative affectivity are strongly associated. Our SEM showed adequate fit., Conclusions: Our findings from an exploratory and a confirmatory approach give empirical support for the CBM, suggesting it as a suitable model to explain bodily symptoms in the general population and to possibly guide clinical practice. The network model additionally indicates the necessity to apply an individualized CBM for patients, depending on a preponderance of either persistent somatic symptoms or health concerns., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Psychosomatic Society.)

Higher education informatization (HEI) is an interdisciplinary field that examines the use and integration of information and communication technologies (ICTs) in higher education. This paper provides a bibliometric and visual analysis of the research trends, patterns, and topics in this field. Using the Web of Science database, the authors selected and analyzed 199 SCI and SSCI papers on HEI published from 2000 to 2023 by VOSviewer and CiteSpace software. The results indicate that the publication volume of HEI research has grown significantly in recent years. The author network shows the collaboration and contribution of different researchers and institutions, while the journal network reveals the multidisciplinary nature and scope of the field. The keyword network and the burst keyword analysis identify the main research themes and the emerging hot topics in HEI. The co-citation network of sources illustrates the theoretical and methodological foundations and influences of the field. The paper concludes with some implications and suggestions for future HEI research.

BACKGROUND: The emergence of COVID-19 resulted in a substantial loss of education because of global school closures. Face masks are a potential measure to restrain the COVID-19 spread; therefore, this paper evaluated the effectiveness of face masks in reducing COVID-19 incidence in school settings. METHODS: A systematic review was conducted by searching the literature in the Cochrane COVID-19 Study Register and the World Health Organization COVID-19 global literature. Data were summarized in tabular forms, and the findings were presented as narrative synthesis. RESULTS: A total of 15,709 records were retrieved. The screening and selection led to the inclusion of 12 observational and 2 quasi-experimental studies. Nine studies were conducted in different states, counties, or districts of the United States, and the remaining 5 were reported from Germany, Finland, Spain, and the United Kingdom. The results of 10 out of 14 studies favored mask use in reducing school COVID-19 incidence. Three studies found no link between mask use and COVID-19 incidences, whereas 1 quasi-experimental study noted a higher COVID-19 incidence with mask use in students aged 6-11 years than no use of mask among preschool children aged 3-5 years. CONCLUSION: Mask mandates may lessen the incidence of respiratory infectious diseases in school settings during a pandemic; more well-designed studies are warranted to clarify further the evidence regarding mask use in school settings.

This paper examines the influence of COVID-19 on social inequality in higher education. In particular, we focus on the study duration of international students compared to domestic ones in Germany. We assume that the pandemic has increased or decreased existing differences between both groups, affecting their study delay. The multilevel analyses with data "Studying in Germany in Corona Times" (2020) confirm most of our theoretical assumptions: on the one hand, international students expect a longer study duration due to their worsening financial situation. On the other hand, domestic students expect a longer study duration due to greater learning issues, which are provoked by a lower level of interaction in online teaching. Our results propose a more differentiated picture of the impact of the COVID-19 pandemic on social inequality: not only do financially poor international students get poorer but educationally advantaged domestic students lose, too.

This paper examines school management and policies in Germany and Australia during the COVID-19 pandemic. The study, which is comparative and qualitative, explores the interrelationship between different levels of governance and the responses of teacher unions. The inquiry is informed by the perspectives of historical institutionalism and path dependency, and the document analysis is conducted by utilising the justification categories of value, collective, and formal and procedural driven arguments. We argue the contestation which occurred between different levels of school governance and the teacher unions amidst the pandemic created the potential for changes in policy settings and influence over the administration of schooling. However, there is no indication of fundamental shifts in the organisation, policy direction or control over schooling in Germany or Australia. Instead, there is a conformity to established institutional arrangements and path dependencies, which secure and protect the vested interests of the different policy actors.

Due to the COVID-19 pandemic, contact, education, and employment opportunities have fundamentally changed worldwide. However, various studies have pointed out that not everyone is equally affected by the changed circumstances. This paper focuses on the impact of the pandemic on the study situation in German higher education and explores the question to what extent the pandemic has led to increasing or decreasing social inequalities. Building on social stratification research and Tinto's model of social and academic integration we focus on dropout intentions of traditionally disadvantaged student groups--students with disabilities, with children, from families with lower levels of education, and with a migrant background. Based on comparable data from a German-wide representative student survey 'Studying in Corona Times' (2020) and data from the '21st Social Survey' (2016) our analysis shows to what extent the outbreak of the COVID-19 pandemic has influenced students' dropout intentions in Germany and which vulnerable student groups are particularly affected. The results of our logistic regression analysis indicate that compared to 2016 social inequalities in dropout intention have increased significantly in all vulnerable student groups. In particular, students with disabilities and students with children have a higher risk of intending to drop out in 2020.

The COVID-19 pandemic has changed the didactic landscape of adult education. To meet clients' ongoing demand for support, adult educators had to expand their didactic toolkit and enhance digital literacy. Relying on data gathered during a training series on digital adult education, this paper will examine the following questions: (1) How did adult educators manage to adopt digital methods despite pressing issues and hurdles in regards to the change? (2) Which conditions support efficient training of adult educators, aiming at 'nudging' digitalisation in adult education for families? To gain insight into this didactic transformation, we systematically analyse both quantitative and qualitative data collected during a training series fostering digital literacy such as technology handling, online counselling and the usage of social media. These events attracted 1,250 participants that specialise in parenting programmes, family counselling and institutionalised family welfare. Findings include how practitioners with different backgrounds and levels of digital skills assess different methods and didactic choices. Further, we will examine how providing accessible and applicable information can act as a nudge to spark intrinsic motivation for further learning and as a starting point for new ideas.

The political participation literature has documented a long-term trend of the normalization of noninstitutional participation that is often equated with the conventionalization of engagement in protest politics. Less is known on the extent to which noninstitutional forms are differentiated by their mobilization context. Population surveys find it difficult to contextualize individual engagement, and on-site surveys point to effects that are hard to generalize. This study fills this gap by emphasizing differentiation and distinguishing participation according to the issue of engagement. It introduces a conceptual distinction between political insiders and outsiders, defined based on the extent to which they are embedded in the organizational landscape of the dominant cleavage dimension. Using an original survey conducted in Germany during the Covid-19 crisis, the analysis demonstrates that general-population surveys are fit to examine issue-specific participation patterns. The results expose an insider and outsider divide, captured by the effect of attitudinal and behavioral indicators, and demonstrates that the two groups are equally likely to participate in noninstitutional forms. However, insiders engage on the established issues of climate and anti-racism, whereas outsiders engage on the new issues of Covid-19 related economic assistance and civil liberties restrictions. In addition, dynamic models reveal that noninstitutional participation is rooted in volatile issue preferences. Overall, the paper argues that participation during the Covid-19 crisis has furthered the trend towards a differentiated protest arena. [ABSTRACT FROM AUTHOR]

This paper examines school management and policies in Germany and Australia during the Covid-19 pandemic. The study, which is comparative and qualitative, explores the interrelationship between different levels of governance and the responses of teacher unions. The inquiry is informed by the perspectives of historical institutionalism and path dependency, and the document analysis is conducted by utilising the justification categories of value, collective, and formal and procedural driven arguments. We argue the contestation which occurred between different levels of school governance and the teacher unions amidst the pandemic created the potential for changes in policy settings and influence over the administration of schooling. However, there is no indication of fundamental shifts in the organisation, policy direction or control over schooling in Germany or Australia. Instead, there is a conformity to established institutional arrangements and path dependencies, which secure and protect the vested interests of the different policy actors. [ABSTRACT FROM AUTHOR]

Introduction: Vaccinations are important for informal caregivers and their care recipients. Mental health problems are common among care givers. The aim of this study was to investigate vaccination readiness in informal caregivers and associations with mental health issues. Associations between vaccination readiness in informal caregivers and the vaccination status of their aged care recipients were examined., Methods: Within the multicenter prospective registry study 'Bavarian ambulatory Covid-19 Monitor (BaCoM) ', informal caregivers were asked for symptoms of depression (PHQ-9), burden of caretaking (BSFC-s), psychological antecedents of vaccination readiness (5C model) and previous Covid-19 infections of their care recipients. The vaccination status against Covid-19, seasonal influenza and pneumococcal disease was determined via vaccination certificates. Data analysis was performed using ordinal regressions and Mann-Whitney-U tests., Results: Data of n = 91 informal caregivers, associated with n = 84 care recipients were collected. Symptoms of depression were associated with reduced vaccination readiness (Calculation: p = 0.026, OR = 1.18), as well as the perceived burden of caretaking (Confidence: p = 0.006, OR = 0.88). A previous Covid-19 infection of the care recipients was associated with decreased vaccination readiness of informal caregivers (Median (Q1-Q3) Confidence: 5.0 (4.5-6.0) vs. 4.0 (3.0-5.0); Calculation: 5.0 (3.0-6.0) vs. 4.0 (1.0-5.0)). The vaccination status of the care recipients interrelated significantly with vaccination readiness of their informal caregivers (Confidence: p < 0.001; Complacency: p < 0.01; Constraints p < 0.05). No significant interrelations between vaccination readiness and the vaccination status against seasonal influenza or pneumococcal disease occurred., Conclusion: Mental health issues of informal caregivers seem to be associated with the actual vaccination status against Covid-19 in their care recipients. Target group specific counselling as well as an active involvement of informal caregivers in shared decision-making processes can be of relevance, but even more attention should be paid to the protection of mental health for informal caregivers., Trial Registration Number: German Register of Clinical Studies DRKS 26039., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The lockdown restrictions against coronavirus disease 2019 (COVID-19) have led to unprecedented reductions in global anthropogenic activities. Polycyclic aromatic hydrocarbons (PAHs) are carcinogenic combustion-induced pollutants, but the influence of anthropogenic responses to COVID-19 on PAH contamination remains largely unknown. Here we quantified the impacts of lockdown restrictions on 16PAH pollution based on the data in concentrations dissolved in the water phase and absorbed on the suspended particulate matter (SPM) in the Elbe River from 2015 to 2021 and determined the changes in source contributions classified by individual years and stations. Results show that the annual average PAH concentrations in water and SPM were determined as 0.055 μg·L -1 and 3.77 mg·kg -1 from 2015 to 2021, respectively. Pronounced declines in PAH on SPM (up to -18 %) were observed during the three lockdowns in Germany from 2020 to 2021. However, dramatic rebounds of anthropogenic activities during the removal of the lockdown led to increases (up to 29 %) in ∑ 16 PAH concentrations compared to the same period in previous years. Through the source apportionment method, vehicle and coal emissions were the two most predominant sources of PAHs in the river. Vehicle contribution decreased during the lockdown, while coal emissions increased by 5 %. Health risks for three age groups were assessed as potential low risk and decreased by 18 % from 1.54 × 10 -4 in 2015 to 1.27 × 10 -4 in 2019, and rebounded to 1.40 × 10 -4 in 2020-2021. The findings of this study highlight the strong consistency between PAH concentrations and anthropogenic intensity, implying that source control from improved cleaner production is an effective pathway for mitigating PAH contamination in the aquatic environment., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

The role of fear of COVID-19 in prospectively predicting changes in psychopathological symptoms during the COVID-19 pandemic remains unclear. The present data were obtained from a longitudinal non-probability sample in Germany, initially assessed at the beginning of the COVID-19 pandemic in Germany (April-May 2020) and reassessed after two years (n = 846; 83% female; mean age: 44.59 years, SD = 12.32; response rate: 19.5%). Multiple linear regressions were used to examine associations of fear of COVID-19 at baseline with depressive symptoms, anxiety, health anxiety, psychosocial distress, and loneliness controlling for (a) the respective symptom measure, and (b) all psychopathological symptoms at baseline. The data were weighted to minimize attrition and representativeness biases. Overall, loneliness decreased from the beginning of the COVID-19 pandemic until the two-year follow-up, whereas all other symptoms did not change. Fear of COVID-19 at the beginning of the pandemic predicted an increase in anxiety symptoms, health anxiety, psychosocial distress, and loneliness two years later. In addition, fear of COVID-19 predicted higher health anxiety, depressive symptoms, psychosocial distress, and loneliness, but not anxiety symptoms when controlling for all baseline symptom measures at once. Fear of COVID-19 seems to play a central role in predicting negative mental health outcomes, emphasizing the necessity of indicated prevention and intervention to decrease worry and manage anxiety, thereby reducing the negative impact on mental health caused by fear during future pandemics., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Christiane Melzig reports financial support was provided by LOEWE program of the Hessian Ministry of Science and Arts. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: The governments of democracies worldwide are relying on the active cooperation of their populations to combat COVID-19. Simultaneously, beliefs in conspiracy theories surrounding the pandemic have flourished. The present article examines the effects of the big five personality traits and conspiracy beliefs on the intention to get vaccinated against COVID-19 in Germany., Methods: This correlational, cross-sectional mediation analysis was conducted using data from a nationwide German household panel (N = 1390)., Results: Openness to experience (β = -.082, p = .004) and neuroticism (β = .112, p < .001) showed direct effects on conspiracy beliefs, while conspiracy beliefs had the strongest effect on vaccination intention (β = -.424, p < .001). Indirect positive effects of openness (β = .035, p = .005) and negative effects of neuroticism (β = -.047, p < .001) on the intention to get vaccinated via conspiracy beliefs were identified, with a mediation in the strict sense only for openness. No direct or total effect of the big five on vaccination intention could be found., Conclusions: The big five personality traits are associated, although indirectly, with the intention to be vaccinated. Compared with similar studies on the effects of the big five on COVID-19-related outcomes, we found slightly higher proportions of explained variance in conspiracy beliefs and significantly higher explained variance in vaccination intention. In order to increase the willingness to be vaccinated, targeted and nationwide uniform information measures should be provided addressing feelings of security, of not being excluded, and the activation of critical reasoning., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: The Brief Resilience Coping Scale (BRCS) is a brief instrument suitable for epidemiological studies. The aims of this paper were to analyze changes in BRCS depending on time, sex, age group, relationship status, as well as risk of poverty, to test the psychometric properties including test-retest reliability and measurement invariance, and to determine associations with psychosocial stress, depressiveness, anxiety, social support, as well as subjective mental and physical health. As the data from this study was collected during the pandemic, an additional sensitivity analysis was performed with pre-pandemic data., Methods: A longitudinal study of resilience and distress in a large-sized community sample was performed at one pre-pandemic (T0) and three pandemic time points (T1-3). Resilient coping was assessed by the 4-Item short form of the BRCS, distress by the PHQ-9 and GAD-2., Results: BRCS decreased between the first and the second and increased at the third pandemic time point. The scale had a good internal consistency. Test-retest correlation coefficients ranged from 0.527 to 0.589. Higher resilient coping was found in younger participants, participants not at-risk-of-poverty and in males. Stability was higher in those with a partner, and at-risk-of-poverty. Significant negative associations with psychosocial stress, loneliness, depressiveness, anxiety, social support, as well as subjective and physical health and SES underscored the construct validity., Conclusion: Overall, findings underscore that resilient coping is a dynamic construct with considerable stability. The scale showed good psychometric properties including test-retest reliability over four months to two years. We found that it is not only important to describe the level of resilient coping, but also its stability., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Petersen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Alcohol is often consumed in a social context. We aim to investigate whether social mobile sensing is associated with real-world social interactions and alcohol consumption. In addition, we investigate how social restriction policies implemented during the COVID-19 pandemic have influenced these associations., Methods: We conducted a smartphone-based ecological momentary assessment (EMA) study for 7 days over a 213-day period from 8 August 2020 to 9 March 2021 in Germany, including both no-lockdown and lockdown stages. Participants used a smartphone application which passively collects data on social behavior (e.g., app usage, phone calls, SMS). Moreover, we assessed real-world social interactions and alcohol consumption via daily questionnaires., Results: We found that each one-hour increase in social media usage was associated with a 40.2% decrease in the average number of drinks consumed. Mediation analysis suggested that social media usage decreases alcohol intake through decreased real-world social interactions. Notably, we did not find that any significant influence of the lockdown stage on the association between social mobile sensing and alcohol intake., Conclusions: Our study suggests that people who use more social media drink less, likely due to reduced face-to-face social interactions. This highlights the potential of social mobile sensing as an objective measure of social activity and its implications for understanding alcohol consumption behavior., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Anthropogenic gadolinium from MRI contrast agents has been detected in surface waters worldwide. It is released with the treated effluents of wastewater treatment plants, similar to other wastewater-derived substances (WWDS) such as pharmaceuticals and personal care products. We determined concentrations of the rare earth elements in tap water from Berlin, Germany, using an automated preconcentration procedure that is both time- and cost-efficient. Anthropogenic gadolinium concentrations in Berlin's tap water increased on average 30-fold between 2009 and 2021. However, the tap water composition responded quickly to the reduced number of MRI scans during the COVID-19 pandemic, and some districts show a decrease from 2016 to 2021. Since climate change causes groundwater levels to decline in many regions, this needs to be mitigated by artificial groundwater recharge with surface water. This will inevitably lead to an increase in WWDS in potable water, which can be cost-efficiently monitored using anthropogenic gadolinium as tracer., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Background: Older age is a risk factor for a fatal course of SARS-CoV‑2 infection, possibly due to comorbidities whose exact role in this context, however, is not yet well understood. In this paper, the characteristics and comorbidities of persons who had died of COVID-19 in Bavaria by July 2022 are shown and compared with the characteristics of other fatalities during the pandemic., Methods: Based on data from multiple cause of death statistics, odds ratios for dying from COVID-19 (compared to dying from other nonexternal causes of death) were calculated by using logistic regression models, stratified by age, sex, and pandemic waves., Results: In Bavaria, a total of 24,479 persons (6.5% of all deaths) officially died from COVID-19 between March 2020 and July 2022. In addition to increasing age and male sex, preexisting diseases and comorbidities such as obesity, degenerative diseases of the nervous system, dementia, renal insufficiency, chronic lower respiratory diseases, and diabetes mellitus were significantly associated with COVID-19-related deaths. Dementia was mainly associated with increased COVID-19 mortality during the first and second waves, while obesity was strongly associated during the fourth wave., Discussion: The frequency of specific comorbidities in COVID-19 deaths varied over the course of the pandemic. This suggests that wave-specific results also need to be interpreted against the background of circulating virus variants, changing immunisation levels, and nonpharmaceutical interventions in place at the time., (© 2024. The Author(s).)

Background: The COVID-19 pandemic has significantly impacted global health and prompted studies on its effects across various diseases. Recent data suggest a potential correlation between COVID-19 and a decrease in lung cancer incidence. This study examines the association between COVID-19 infection and changes in lung cancer cases., Material and Methods: We conducted a retrospective analysis of medical records from Clinic Lüdenscheid, Germany, from January 1, 2018, to December 31, 2021, comparing lung cancer cases before and during the pandemic. Demographic characteristics and cancer stages were also assessed., Results: We evaluated 523 patients; 269 pre-COVID and 254 during COVID. While the overall number of cases declined, a significant increase in advanced stage cancers was noted during COVID (P = 0.04). The adjusted incidence rates showed a nuanced decrease from approximately 33 cases per 100,000 pre-COVID to 31 during COVID., Conclusion: This retrospective study suggests a modest decline in lung cancer incidence and an increase in advanced stages during COVID. Further comparisons with national data indicate a similar trend across Germany, with a decrease of about 3 % in lung cancer diagnoses post-2020, highlighting potential pandemic impacts on cancer detection., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Josef Yayan reports financial support was provided by University Witten Herdecke Faculty of Health. Josef Yayan reports a relationship with University Witten Herdecke Faculty of Health that includes: employment. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Many countries face substantial shortages of skilled nurses. With an aging population and global demographic changes, developing a skilled workforce of nurses has become one of the central challenges for public health care. The recent COVID-19 pandemic has exacerbated labor shortages, which pose a threat to the quality of publicly provided health care. Improving nurses' working conditions could be a means by which to address the global shortages of nurses. However, in countries with public health care, such improvements may come with additional costs in the form of higher taxes or social security contributions. Therefore, such improvements partly depend on people's willingness to pay (WTP) for them., Objective: In this paper, we investigate workers' willingness to pay for improvements in the working conditions of nurses., Design: This study is a factorial survey experiment included as part of an online survey., Setting(s): The factorial survey experiment was implemented within the high-frequency online panel survey "Life and Employment in Times of Corona" (IAB-HOPP) conducted by the Institute for Employment Research (Germany)., Participants: We analyze data from N = 2128 survey participants; our main analysis consists of N = 6384 responses from those participants., Methods: Our research is based on a factorial survey experiment (vignette analysis) designed to quantitatively measure the willingness to pay for various improvements in the working conditions of nurses. We use random effect models and mixed models to estimate the individual-level willingness to pay for these improvements., Results: Our results show that the survey participants are generally willing to pay for particular policies aimed at improving the working conditions of nurses. However, the amount that respondents are willing to pay varies with the type of policy changes. Survey participants exhibit a high willingness to pay for increases in minimum wages for nurses and wage-related improvements in general. We find, however, a lower willingness to pay for the right to participate in training courses aimed at reducing work-related stress., Conclusions: The broad support for improvements in the working conditions of nurses provides policymakers with some guidance in implementing policy measures that might address labor shortages in the nursing sector., Registration: There was no preregistration., Tweetable Abstract: Many people are willing to pay extra to improve the working conditions of nurses. Wage-related increases for nurses show the highest willingness to pay., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest to declare., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

For the investigation of diseases and other harmful environmental influences (e.g., chemicals) epidemiological studies rely on high quality human samples, among others. Collecting samples and data in the field can pose an enormous challenge to the study team with regard to health protection and occupational safety, especially in the context of a pandemic where there was great uncertainty about the biological risks associated with SARS-CoV-2. The German Environmental Specimen Bank (German ESB) is a key element of environmental and human biomonitoring in Germany with the aim to document and assess trends of human and environmental exposure to chemicals over time and to provide scientific data for policy decision makers. Starting with a pilot study in 1978 human samples are now collected at four sampling locations annually, while sampling is carried out with a highly standardized mobile laboratory since 2013. Due to the corona pandemic 3 of 4 ESB sampling campaigns had to be cancelled in 2020. However, a continuous sampling is crucial to generate current policy relevant data on chemical exposure. Hence, a protection and hygiene concept has been developed including COVID-19 testing with the goal to protect the health of participants and employees during sampling and to meet legal requirements, while sustaining the standardized procedures of sampling and sample preparation. The concept is based on a flexible approach to allow adjustments to changing government regulations and recommendations in the course of the pandemic. By implementing this concept, all samplings were successfully carried out in 2021 & 2022, with the pandemic still ongoing. This paper provides an example of good practice and valuable insights in how to collect human samples during a pandemic., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

In Rhineland-Palatinate, Germany, a system of three data sources has been established to track the Covid-19 pandemic. These sources are the number of Covid-19-related hospitalizations, the Covid-19 genecopies in wastewater, and the prevalence derived from a cohort study. This paper presents an extensive comparison of these parameters. It is investigated whether wastewater data and a cohort study can be valid surrogate parameters for the number of hospitalizations and thus serve as predictors for coming Covid-19 waves. We observe that this is possible in general for the cohort study prevalence, while the wastewater data suffer from a too large variability to make quantitative predictions by a purely data-driven approach. However, the wastewater data and the cohort study prevalence are able to detect hospitalizations waves in a qualitative manner. Furthermore, a detailed comparison of different normalization techniques of wastewater data is provided., (© 2024. The Author(s).)

COVID-19 lockdowns reduced nitrogen dioxide (NO 2 ) and fine particulate matter (PM 2.5 ) emissions in many countries. We aim to quantify the changes in these pollutants and to assess the attributable changes in mortality in Jiangsu, China; California, U.S.; Central-southern Italy; and Germany during COVID-19 lockdowns in early 2020. Accounting for meteorological impacts and air pollution time trends, we use a machine learning-based meteorological normalization technique and the difference-in-differences approach to quantify the changes in NO 2 and PM 2.5 concentrations due to lockdowns. Using region-specific estimates of the association between air pollution and mortality derived from a causal modeling approach using data from 2015 to 2019, we assess the changes in mortality attributable to the air pollution changes caused by the lockdowns in early 2020. During the lockdowns, NO 2 reductions avoided 1.41 (95% empirical confidence interval [eCI]: 0.94, 1.88), 0.44 (95% eCI: 0.17, 0.71), and 4.66 (95% eCI: 2.03, 7.44) deaths per 100,000 people in Jiangsu, China; California, U.S.; and Central-southern Italy, respectively. Mortality benefits attributable to PM 2.5 reductions were also significant, albeit of a smaller magnitude. For Germany, the mortality benefits attributable to NO 2 changes were not significant (0.11; 95% eCI: -0.03, 0.25), and an increase in PM 2.5 concentrations was associated with an increase in mortality of 0.35 (95% eCI: 0.22, 0.48) deaths per 100,000 people during the lockdown. COVID-19 lockdowns overall improved air quality and brought attributable health benefits, especially associated with NO 2 improvements, with notable heterogeneity across regions. This study underscores the importance of accounting for local characteristics when policymakers adapt successful emission control strategies from other regions., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Rationale and Objectives: The prognostic role of pericardial effusion (PE) in Covid 19 is unclear. The aim of the present study was to estimate the prognostic role of PE in patients with Covid 19 in a large multicentre setting., Materials and Methods: This retrospective study is a part of the German multicenter project RACOON (Radiological Cooperative Network of the Covid 19 pandemic). The acquired sample comprises 1197 patients, 363 (30.3%) women and 834 (69.7%) men. In every case, chest computed tomography was analyzed for PE. Data about 30-day mortality, need for mechanical ventilation and need for intensive care unit (ICU) admission were collected. Data were evaluated by means of descriptive statistics. Group differences were calculated with Mann-Whitney test and Fisher exact test. Uni-and multivariable regression analyses were performed., Results: Overall, 46.4% of the patients were admitted to ICU, mechanical lung ventilation was performed in 26.6% and 30-day mortality was 24%. PE was identified in 159 patients (13.3%). The presence of PE was associated with 30-day mortality: HR= 1.54, CI 95% (1.05; 2.23), p = 0.02 (univariable analysis), and HR= 1.60, CI 95% (1.03; 2.48), p = 0.03 (multivariable analysis). Furthermore, density of PE was associated with the need for intubation (OR=1.02, CI 95% (1.003; 1.05), p = 0.03) and the need for ICU admission (OR=1.03, CI 95% (1.005; 1.05), p = 0.01) in univariable regression analysis. The presence of PE was associated with 30-day mortality in male patients, HR= 1.56, CI 95%(1.01-2.43), p = 0.04 (multivariable analysis). In female patients, none of PE values predicted clinical outcomes., Conclusion: The prevalence of PE in Covid 19 is 13.3%. PE is an independent predictor of 30-day mortality in male patients with Covid 19. In female patients, PE plays no predictive role., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Introduction: Cross-border mobility (CBM) to visit social network members or for everyday activities is an important part of daily life for citizens in border regions, including the Meuse-Rhine Euroregion (EMR: neighboring regions from the Netherlands, Belgium, and Germany). We assessed changes in CBM during the COVID-19 pandemic and how participants experienced border restrictions., Methods: Impact of COVID-19 on the EMR' is a longitudinal study using comparative cross-border data collection. In 2021, a random sample of the EMR-population was invited for participation in online surveys to assess current and pre-pandemic CBM. Changes in CBM, experience of border restrictions, and associated factors were analyzed using multinomial and multivariable logistic regression analysis., Results: Pre-pandemic, 82% of all 3,543 participants reported any CBM: 31% for social contacts and 79% for everyday activities. Among these, 26% decreased social CBM and 35% decreased CBM for everyday activities by autumn 2021. Negative experience of border restrictions was reported by 45% of participants with pre-pandemic CBM, and was higher (p < 0.05) in Dutch participants (compared to Belgian; aOR= 1.4), cross-border [work] commuters (aOR= 2.2), participants with cross-border social networks of friends, family or acquaintances (aOR= 1.3), and those finding the measures 'limit group size' (aOR= 1.5) and 'minimalize travel' (aOR= 2.0) difficult to adhere to and finding 'minimalize travel' (aOR= 1.6) useless., Discussion: CBM for social contacts and everyday activities was substantial in EMR-citizens, but decreased during the pandemic. Border restrictions were valued as negative by a considerable portion of EMR-citizens, especially when having family or friends across the border. When designing future pandemic control strategies, policy makers should account for the negative impact of CBM restrictions on their citizens., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 van Bilsen, Brinkhues, Hoebe, Stabourlos, Moonen, Demarest, Hanssen, van Loo, Savelkoul, Philippsen, van der Zanden and Dukers-Muijrers.)

Purpose: To investigate determinants of willingness to adopt telerehabilitation, willingness of technology use, core affect regarding using telerehabilitation, and digital competencies in rehabilitation professionals in Austria and Germany before and during the COVID-19 pandemic., Materials and Methods: A cross-sectional paper-based and online survey was conducted before and during COVID-19, respectively, with three cohorts of rehabilitation professionals. Outcomes were the willingness to adopt telerehabilitation evaluated using the extended Unified Theory of Acceptance and Use of Technology; willingness of technology use using the short scale for assessing the willingness of technology use; digital competencies and core affect using the Digital Competence Framework and semantic differential, respectively. Multivariate ordinal regression analysis was performed to determine predictors., Results: Included were 603 rehabilitation professionals. Analysis revealed differences between Austria and Germany and before and during the pandemic for most outcomes. German residency, the pandemic, and a higher educational level were most important predictors of higher willingness to adopt telerehabilitation, willingness of technology use, digital competencies, and positive core affect., The pandemic increased most aspects of willingness to adopt telerehabilitation, willingness of technology use, digital competencies, and positive core affect. Results confirm that rehabilitation professionals with higher degrees are more prone to adopt innovations in healthcare.Registration: German Clinical Trials Register (DRKS00021464)IMPLICATIONS FOR REHABILITATIONThe willingness to adopt telerehabilitation is associated with external factors increasing the need for alternative rehabilitation delivery, such as COVID-19, and with financial facilitators, such as reimbursement.As the willingness to adopt telerehabilitation is higher among speech and language therapists and dietitians, efforts are necessary to enhance its use in physiotherapists and occupational therapists.As a higher willingness to adopt telerehabilitation was observed in younger rehabilitation professionals and those with higher education, increasing the importance of telerehabilitation in education curricula and further knowledge transfer into practice for those already working in the field seems necessary.

In the context of the COVID-19 pandemic, there has been a scarcity of resources with various effects on the care of cancer patients. This paper provides an English summary of a German guideline on prioritization and resource allocation for colorectal and pancreatic cancer in the context of the pandemic. Based on a selective literature review as well as empirical and ethical analyses, the research team of the CancerCOVID Consortium drafted recommendations for prioritizing diagnostic and treatment measures for both entities. The final version of the guideline received consent from the executive boards of nine societies of the Association of Scientific Medical Societies in Germany (AWMF), 20 further professional organizations and 22 other experts from various disciplines as well as patient representatives. The guiding principle for the prioritization of decisions is the minimization of harm. Prioritization decisions to fulfill this overall goal should be guided by (1) the urgency relevant to avoid or reduce harm, (2) the likelihood of success of the diagnostic or therapeutic measure advised, and (3) the availability of alternative treatment options. In the event of a relevant risk of harm as a result of prioritization, these decisions should be made by means of a team approach. Gender, age, disability, ethnicity, origin, and other social characteristics, such as social or insurance status, as well as the vehemence of a patient's treatment request and SARS-CoV-2 vaccination status should not be used as prioritization criteria. The guideline provides concrete recommendations for (1) diagnostic procedures, (2) surgical procedures for cancer, and (3) systemic treatment and radiotherapy in patients with colorectal or pancreatic cancer within the context of the German healthcare system., (© 2024 S. Karger AG, Basel.)

In 2020, anti-Asian racism re-emerged during the coronavirus pandemic in Germany and elsewhere, manifesting in media narratives, and evoking different forms of violence and exclusion, especially in public space. Racialisation as an everyday process creates "counter-frames" by racialised groups. They are constructed in relation to institutionalised interpellation as "the other." Building on Feagin's concept of "white framing" and "counter-framing" and Löw's concept of space, this paper discusses the effects of racialisation, coping and anti-racist resistance strategies as developed by the Asian diaspora. Social change regarding racism will be analysed through Foroutan's concept of "postmigrant society." We based this study on a convenience sample of people with Asian heritage which we conducted in 2020 in Germany. In addition, we included a diary study for which a subset has been sampled. We argue that the pandemic influenced the formation of counter-frames against anti-Asian racism in the specific context of Berlin. [ABSTRACT FROM AUTHOR]

SARS-CoV-2 serology may be helpful to retrospectively understand infection dynamics in specific settings including kindergartens. We assessed SARS-CoV-2 seroprevalence in individuals connected to kindergartens in Berlin, Germany in September 2021. Children, staff, and household members from 12 randomly selected kindergartens were interviewed on COVID-19 history and sociodemographic parameters. Blood samples were collected on filter paper. SARS-CoV-2 anti-S and anti-N antibodies were assessed using Roche Elecsys. We assessed seroprevalence and the proportion of so far unrecognized SARS-CoV-2 infections. We included 277 participants, comprising 48 (17.3%) kindergarten children, 37 (13.4%) staff, and 192 (69.3%) household members. SARS-CoV-2 antibodies were present in 65.0%, and 52.7% of all participants were vaccinated. Evidence of previous infection was observed in 16.7% of kindergarten children, 16.2% of staff, and 10.4% of household members. Undiagnosed infections were observed in 12.5%, 5.4%, and 3.6%, respectively. Preceding infections were associated with facemask neglect. In conclusion, two-thirds of our cohort were SARS-CoV-2 seroreactive in September 2021, largely as a result of vaccination in adults. Kindergarten children showed the highest proportion of non-vaccine-induced seropositivity and an increased proportion of previously unrecognized SARS-CoV-2 infection. Silent infections in pre-school children need to be considered when interpreting SARS-CoV-2 infections in the kindergarten context. [ABSTRACT FROM AUTHOR]

In the Author Contributions, Lukas Broichhaus should be listed as the only author who wrote the paper under 'Writing–original draft.By Lukas Broichhaus; Julian Book; Sven Feddern; Barbara Grüne; Florian Neuhann; Johannes Nießen; Gerhard A. Wiesmüller; Annelene Kossow and Christine JoistenReported by Author; Author; Author; Author; Author; Author; Author; Author; Author [Extracted from the article]

We provide a comparative evaluation of fiscal stabilization strategies during the Covid-19 pandemic. For this purpose, we use Germany's temporary value-added tax (VAT) rate reduction as a reference point. We construct a credible counterfactual for Germany in a two-step procedure. First, we carry out a careful pre-selection of the donor pool countries to obtain a control group that is highly similar to Germany regarding important post-treatment characteristics. Second, we apply a reweighting scheme on the pre-selected donor countries. The synthetic control group only differs from Germany in the way that it did not implement the temporary VAT rate reduction. Our results indicate that the German VAT cut policy and partial VAT reductions in other countries were relatively ineffective in stimulating consumption with regards to their costs when compared to other measures such as (targeted) direct cash transfers (e.g. implemented in Canada, Denmark, Japan, and the United States). We attribute this to the fact that direct cash transfers are more comprehensible, salient, and actionable, in particular, in a dynamic environment with high uncertainty induced by unclear future economic prospects. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic was a major challenge for journalism. In the case of Germany, critics very early on voiced concerns over the quality of mainstream media coverage. Mainstream media were attacked for the intensity of their coverage, for reporting too much and unnecessarily frightening audiences, for not presenting a diversity of viewpoints on the pandemic and the measures taken to mitigate it, and for being one-sided and too close to the government. Against this background, this paper examines the intensity and viewpoint diversity of the coverage of 13 mainstream and two alternative media in Germany in 2020 and 2021. Based on a comprehensive manual content analysis of almost 9000 news stories, we conclude that the mainstream media did not cover the pandemic in a fundamentally exaggerated or one-sided way. However, they did not always report intensively when the pandemic was particularly severe, and they tended to warn against the pandemic rather than criticize the measures taken. In contrast, alternative media coverage tended to be more one-sided and generally biased against government measures. [ABSTRACT FROM AUTHOR]

There are substantial differences across regions regarding COVID-19 infections and deaths, which are partly explained by differences in practicing social distancing. In this paper we argue that the portrayal of COVID-19 in regional media might be an important factor in explaining regional differences in social distancing. By using mobility as a proxy, and analysing data on regional news coverage in Germany, we investigate empirically whether the geographical heterogeneity in COVID-19-related news reporting has translated into spatial variations in social distancing. Our results confirm that the frequency of and the element of fear in COVID-19 news have a significant, albeit time-varying, relationship with social distancing. [ABSTRACT FROM AUTHOR]

This paper investigates the changes in time use, working conditions and subjective time wealth during the COVID-19 pandemic in Germany. Our analysis draws on panel data collected before and during the first lockdown among 786 employees. It employs a recently developed scale on time wealth which has been suggested as a comprehensive measure to capture the subjective experience of time. We provide separate analyses according to gender and essential occupation. First-difference regressions are applied to examine how changes in time use and changes in working conditions during the lockdown affected subjective time wealth. Our results show a general growth in time wealth during the lockdown which is, among other factors, driven by a decline in work hours and an increase in sleep duration. We also find positive effects on time wealth from decreased time pressure at work, more autonomy in organising one's working day, and an improved reconciliation of work and private life. This study contributes to existing research by identifying key aspects how to improve time wealth among employees. [ABSTRACT FROM AUTHOR]

Aim: The goal of this paper is to analyze the COVID-19 policies of 10 European countries, including Sweden, Finland, Norway, Italy, France, Germany, Poland, Belgium, the Netherlands, and Hungary, with a time-series policy analysis tool. Subject and methods: The results of the COVID-19 policy analysis are based on a single time-series indicator, or daily population mortality rate: the number of COVID-19 daily cumulative deaths divided by the population in millions. The lower the score, the better the policy. Although many experts believe that the COVID-19 policy outcome analysis is premature, time series analysis is an excellent analysis that can provide information on the progress and transition of policy outcomes. In other words, the proposed time series analysis tool allows policymakers to identify and quantify when mistakes were made during the on-going COVID-19 pandemic. Results: The COVID-19 policy analysis discovered many useful facts. Sweden failed due to the herd immunity approach. Hungary made a fundamental mistake in COVID-19 tactics. Countries such as Sweden, Hungary, Belgium, and Poland showed time-series changes that differed from the others. Conclusion: Public health interventions can play a key role in mitigating the COVID-19 pandemic. The proposed policy analysis tool, hiscovid demonstrated the effectiveness of the time-series score behavior for discovering when policymakers made mistakes. [ABSTRACT FROM AUTHOR]

• Childcare policy responses towards Covid-19 differed in European welfare states. • Policy responses cause informalization of childcare to different degrees. • Informalization of childcare is mainly connected with social risks for women. • Cultural and institutional differences help to understand varying policy responses. The closure of extra-familial childcare facilities by European governments in 2020 was an important part of interventions against the spread of the COVID-19 pandemic. One consequence was that childcare was provided by parents at home, mainly by women. As a result, women mainly experienced financial and employment risks related to this "informalization" of childcare. The childcare policies of European welfare states differ in the extent to which they include measures to reduce the social risks related to informalization. Against this backdrop, this paper asks: How should one understand cross-national differences in childcare policies during the pandemic? We are also particularly interested in the effects of childcare policies on the social risks connected with the informalization of childcare and what these mean for the gendered division of paid work and care. Differences in childcare policies during the pandemic are commonly explained in terms of the path dependence of such policies. Using the theoretical approach of "care arrangement," this article introduces a broader theoretical framework that considers the role of cultural and institutional factors for understanding the cross-national differences in childcare policies during the pandemic. We introduce the findings of a comparative empirical study of childcare policies in three European welfare states—Denmark, Germany and England—that represent different types of care arrangements. This paper uses policy and media documents, quantitative data on childcare and women's employment, cultural ideas and secondary analysis of empirical studies. We find that governments did not per se respond to the pandemic based on institutional path dependence regarding childcare policies, while the integration of culture into the theoretical framework allows for a more comprehensive understanding. [ABSTRACT FROM AUTHOR]

This research employs the ARDL (Autoregressive Distributed Lag) model to examine the impact of COVID-19 on mutual trade between Germany and the Visegrad Four (V4). We focus on trade with Germany due to its status as the strongest and geographically closest trade partner of these four post-communist countries. Additionally, the extensive value chains of industrial production create robust economic connections between Germany, as an industrial leader, and the adjacent states, which is evident in the frequent mutual trade. The pandemic caused a sudden disruption of these value chains, particularly in the manufacturing sector, which dominates the region. In our analysis, we estimated the ARDL model for each country, considering both export and import data. Initially, we estimated long-run models, revealing that the coefficients of import and export models for the countries yielded different long-term results. In the short-run models, the dummy variables for both export and import models across all countries were significant, indicating that COVID-19 affected international trade between the V4 and Germany. Moreover, in all models, the coefficient of the dummy variable was negative, suggesting that COVID-19 had a detrimental effect on international trade. An important finding is that, depending on the nature of the dummy variable used, the effect of COVID-19 was observed during the pandemic period, with international trade returning to its previous trend post-pandemic. This experience highlights that while predicting the next pandemic and its negative impacts remains challenging, countries and their production chains are now better prepared. They have adapted to operate with greater flexibility, enabling them to effectively face similar unexpected challenges in the future. [ABSTRACT FROM AUTHOR]

Introduction: In Germany, the estimation of the disease burden of respiratory syncytial virus (RSV) in older adults is limited. This makes it challenging for public health decision-makers to develop evidence-based recommendations for newly available vaccines against RSV for individuals aged 60 years and older (60+). This study investigates publicly available data sources in Germany to address the current gaps in evidence regarding the burden of RSV. Methods: Hospitalisation databases from the German Federal Statistical Office and national mortality statistic between 2000 and 2023, as well as regular surveillance reports from the national public health institute since 2014, were utilised to extract, combine and analyse data on RSV-related morbidity and mortality. These data were used to triangulate the age-specific burden of RSV. Results: The data indicate that the number of RSV-related outpatient consultations ranges between 1,313,100 and 3,911,800 cases per season from 2014/2015 to 2022/2023 for all age groups, with approximately 13.0% of outpatient consultations occurring in adults 60+. The significant increase in hospitalisations over time suggests that heightened testing due to the coronavirus disease 2019 (COVID-19) pandemic revealed the underdetection of inpatient RSV cases in pre-pandemic seasons. In the most recent season recorded, 2022/2023, the data show 12,800 RSV-related hospitalisations in adults 60+ (24% of all RSV-related hospitalisations) and 1340 in-hospital deaths in adults 60+ (93% of all RSV-related deaths). Conclusion: The comparison of pre- to post-pandemic seasons strongly suggest up to a sevenfold underdetection of RSV in individuals 60+, and the analysis of in-hospital mortality reveals higher mortality rates compared with the general German mortality statistics. These findings highlight the urgent need to improve surveillance and implement targeted prevention strategies to mitigate the impact of RSV in older adults. [ABSTRACT FROM AUTHOR]

Background: The underlying mechanisms of post-COVID syndrome (PCS) are still not fully understood. While pre-existing conditions have been described as a risk factor for severe PCS in the general population, data specific to different occupational groups in this context is lacking. This study aimed to investigate the impact of pre-existing conditions on severe post-COVID syndrome among the occupational group of healthcare and social services employees. Methods: Baseline data from a longitudinal, observational study were analysed. In February 2021, health workers who had a COVID-19 infection in 2020 were surveyed about sequelae of the infection. Factors influencing severe PCS with at least one persistent symptom categorised as severe were subjected to a multivariate logistic regression analysis. Results: Of a total of 2,053 participants, 21.5% had severe PCS. Underlying respiratory (OR 1.94; CI 1.44–2.61), cardiovascular (OR 1.35; CI 1.04–1.77) and urogenital (OR 1.79; CI 1.10–2.91) disease were risk factors for severe PCS overall. Respiratory and mental illnesses had a statistically significant impact on persistent fatigue/exhaustion, concentration/memory difficulties and shortness of breath categorised as severe. Urogenital disease was associated with severe fatigue/exhaustion. Other significant risk factors for severe PCS were female sex, smoking, physical exercise and hospitalisation due to COVID-19 infection. Conclusion: Workers in healthcare and social services with pre-existing conditions may face a higher risk of developing severe PCS. Additional analyses performed as part of the longitudinal study will show if and how this result changes over time. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the association of musical activity with mental health during the COVID-19 pandemic. Methods: A total of 3,666 participants reported their musical activity before and mental health indicators before and during the pandemic. Depression was assessed with the Patient Health Questionnaire, anxiety with the Generalized Anxiety Disorder scale. The association between mental health scores and musical activities was investigated using linear regression. Results: Within the last 12 months, 22.1% of the participants reported musical activity (15.1% singing, 14.5% playing an instrument). Individuals with frequent singing as their main musical activity had higher scores before the pandemic than non-musicians and the worsening during the pandemic was more pronounced compared to non-musicians. Instrumentalists tended to have slightly lower scores than non-musicians indicating a possible beneficial effect of playing an instrument on mental health. Conclusion: The pandemic led to a worsening of mental health, with singers being particularly affected. Singers showed poorer mental health before the pandemic. The tendency for instrumentalists to report lower depression scores compared to non-musicians may support the hypothesis that music-making has a beneficial effect on health. [ABSTRACT FROM AUTHOR]

Background: Suboptimal influenza and pneumococcal vaccination rates have been reported before the COVID-19 pandemics in certain populations at risk for severe infection. The aim of this longitudinal cohort study was to investigate changes in influenza and pneumococcal vaccination rates and patient perceptions in patients with psoriasis (PsO) before and during the pandemic. Methods: Data on vaccination, patient and disease characteristics, comorbidity, and patient perceptions were collected with questionnaires before and during the pandemic approximately one year later. Results: Over the whole cohort who participated in the follow-up visit (n = 287; 59.2% male; mean age: 56.3 years), both influenza and pneumococcal lifetime vaccination prevalences increased significantly from 50.5% to 66.2% and from 16.0% to 41.5%, respectively. A total of 88.5% of PsO patients were interested in a COVID-19 vaccination or had already received it. The reasons for and against vaccinations changed significantly before and during the pandemic. Conclusions: Despite a promising increase in the vaccination prevalence in our PsO cohort, it remains important that awareness for vaccinations is encouraged and closely monitored in future research, particularly in populations at risk. [ABSTRACT FROM AUTHOR]

Background: Increased working from home has imposed new challenges on public service employees, while also granting opportunities for job crafting. Grounding on the Job Demands-Resources model and Hobfoll's Conservation of Resources theory this exploratory research aims to investigate the work-nonwork balance of employees one and a half years after the outbreak of the COVID-19 pandemic. Therefore, the research focus lies on employees' job crafting strategies to optimize their working from home experience concerning boundary management and energy resource management. Methods: Twelve semi-structured telephone interviews were conducted with public service employees from different sectors in Germany. The experiences were content analyzed using the software MaxQDA and inductive and deductive categories were derived. Results: Boundary management comprised different strategies such as communicative (e.g., negotiating work time), physical (e.g., going to the garden), temporal (e.g., logging off in between the work day) and behavioral (e.g., prioritizing tasks) strategies. The job crafting strategies regarding energy management included preventing exhaustion (e.g. taking breaks), healthy cooking and energy management in case of sickness (e.g. deciding on sick leave). Conclusions: This qualitative case study enriches research on job crafting by offering insights on boundary tactics and energy resources management strategies for remote working during the COVID-19 pandemic. The results point out different starting points for employees and decision makers, how a work-nonwork balance, energy management and thus employees' wellbeing may be increased when working from home in the future. Trial registration: The study design and methodology were approved by the Ethics Committee of the University of Cologne and the study was prospectively registered (Ref No. 21-1417_1). [ABSTRACT FROM AUTHOR]

Efficiency in stock markets is essential for economic stability and growth. This study investigates the efficiency and herding behavior of the stock markets from the top economies of the world (known as G20 countries). We classify stock market indices using MSCI classification for the developed and emerging markets to provide a comparative examination using the latest data and by employing the robust multifractal detrended fluctuation (MFDFA) method. In addition to the full sample, the analysis uses sub-sample periods to reveal the hidden features and efficiencies of the G20 markets during the Russia–Ukraine War and COVID-19 for the first time. The findings show the availability of varied multifractality among all G20 stock markets during the overall and crisis periods, exhibit long-range correlations, and may support the fractal market hypothesis. In addition, Italy remains the least efficient, while Germany remains the most efficient stock market. The sub-sample results further reveal unevenness in the local fluctuations and resultant higher inefficiency considering the sheer magnitude and impact of crises on the G20 stock markets. However, the efficiency of developed stock markets performed better as compared to emerging markets. The study of G20 stock markets is useful and provides several implications for a wider audience. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic publicly exposed the urgent need for seasonal workers in agriculture. In Germany, an entry ban and entry quotas for seasonal workers at the beginning of the pandemic caused major attention. Taking this moment as magnifying glass, the article asks how the German seasonal labour migration regime is constructed (legally) and legitimated (discursively), and in how far the pandemic has caused shifts within this regime. Based on an analysis of the legal framework and the political discourse around seasonal work from 2018 to 2020 in Germany, the seasonal labour migration regime is characterised as just-in-time migration tailored to the needs of agricultural business, where migrants' work force is not absorbed homogenously by precarious labour sectors, but rather specific groups of migrant workers are integrated differently through mechanisms of differential inclusion. Within this regime, seasonal workers function as outsourced labour, whose reproduction costs remain abroad. On the discursive level, the article shows how seasonal workers are produced as 'wanted migrants' by linking seasonal migration to the interests of the 'homeland'. While the pandemic momentarily caused some shifts on the discoursively level, the article shows that the seasonal labour regime as a whole remains rather stable in time. [ABSTRACT FROM AUTHOR]

Objective: To investigate the psychosocial burden in children and adolescents with juvenile rheumatic diseases during the COVID-19 pandemic. Methods: As part of the multicentre observational KICK-COVID study linked to the National Pediatric Rheumatology Database, adolescents < 21 years and parents of children < 12 years with rheumatic diseases answered questions on perceptions of health risk (PHR) due to SARS-CoV2, stress, well-being (WHO-5) and symptoms of depression (PHQ-9) and anxiety (GAD-7). Data were collected at routine visits from June to December 2021 and assessed for association with demographic and clinical parameters, treatment and patient-reported outcomes by multivariable regression analyses. Results: Data from 1356 individuals (69% female, 50% adolescents) were included. Median PHR on a numeric rating scale (NRS, 0–10) was 4 (IQR 2–6), median perceived stress was 3 (IQR 1–6). Adolescents reported a worse well-being with a significantly lower median WHO-5-score (60, IQR 40–76) than parents reported for their children < 12 years (80, IQR 68–84). Moderate to severe symptoms of depression and anxiety were reported by 14.3% and 12.3% of the adolescents, respectively. PHR was significantly higher in patients with systemic lupus erythematosus, methotrexate or biologic disease-modifying anti-rheumatic drug therapy than in patients without these characteristics, whereas lower WHO-5 or higher PHQ-9 or GAD-7 scores were only associated with poorer patient-reported health status and physical functioning. Conclusion: The perception of health risk due to SARS-CoV2 infection was not paralleled by an impairment of mental health, which were, however, significantly correlated with self-rated health status and functional capacity, highlighting the importance of patient-reported outcome assessment. Trial registration: German Clinical Trials Register (DRKS), no. DRKS00027974. Registered on 27th of January 2022. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 outbreak necessitated physical distancing, as part of secondary prevention, at a personal and professional level. Working from home (WFH) became increasingly important. In this study, the impact of the COVID-19 pandemic restrictions on physical and mental health is investigated, compared with pre-pandemic data, and with employees who WFH and are on-site. Methods: Data from the German Saxon longitudinal study population were used. Attitudes towards WFH as well as mental and physical health assessments during the COVID-19 pandemic were examined. Comparisons were made with corresponding pre-pandemic scores and between employees WFH and on-site in 2022. Results: In total, 319 participants with equal gender distribution were included. Of those, 86 worked from home stating better organizability of their work, more time for partnership, less stress, and greater work satisfaction. Compared to pre-pandemic data, the D-score, PHQ-4, G-Score, and PHQ-SSS-8 showed a significant increase. No difference in physical or mental health between employees WFH and on-site was observed. Conclusion: In general, COVID-19 restrictions had a negative impact on mental and physical health. Although WFH is well accepted, it did not show significant health benefits. [ABSTRACT FROM AUTHOR]

The adoption of COVID-19 contact tracing apps (CTAs) has been proposed as an important measure to contain the spread of COVID-19. Based on a cross-national dataset, this article analyzes public perceptions toward CTAs and the factors that drive CTA acceptance in China, Germany, and the United States. We find that public acceptance of CTAs is significantly higher in China as compared with Germany and the United States. Despite very different sociopolitical contexts, there are striking similarities in the factors that drive CTA acceptance in all three countries. Citizens are willing to accept digital contact tracing despite concerns about privacy infringement and government surveillance, as long as the apps are perceived as effective in lowering infection rates and providing health information. This creates a chicken-and-egg problem for CTAs in Germany and the United States where CTAs are voluntary: a high citizen adoption rate is necessary for CTAs to be effective, but CTAs are only effective if adoption rates are high. [ABSTRACT FROM AUTHOR]