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Background and Objectives: In March 2020, the WHO declared the SARS-CoV-2 corona virus a pandemic which caused a great disruption to global society and had a pronounced effect on the worldwide supply of blood., Materials and Methods: In 2022 an on-line meeting was organised with experts from Austria, Canada, Germany, Greece, Netherlands and United States to explore the opportunities for increasing preparedness within blood systems for a potential future pandemic with similar, or more devastating, consequences. The main themes included the value of preparedness, current risks to the blood supply, supply chain vulnerabilities, and the role of innovation in increasing resiliency and safety., Results: Seven key recommendations were formulated and including required actions at different levels., Conclusion: Although SARS-CoV-2 might be seen as a unique event, global health risks are expected to increase and will affect blood transfusion medicine if no preparedness plans are developed., (© 2022 International Society of Blood Transfusion.)

Background: The SARS-Cov-2 outbreak in the spring of 2020 challenged the health care system, and thus primary care, on an unprecedented scale. Knowledge about the new disease was low, whereas the dynamics of knowledge generation were high and inhomogeneous. A number of new primary care tasks related to the pandemic situation emerged. Guidance in the management of COVID-19 was therefore needed, although robust evidence was not yet available. The information required concerned not only the virus and the new disease COVID-19, but also regulatory requirements and organizational issues. In this situation, a flexible, web-based information tool, easy to update and usable at the point of care, was developed at Karl Landsteiner Private University Krems and put online under the name of "COVID-19: prevention and management in primary care practices" on March 25, 2020. In a retrospective process description, we describe the needs-triggered process of developing and disseminating a practice-based tool to support practicing primary care physicians in a period of high uncertainty with an urgent need for information. Afterwards, we reflect on the learning process from a purely pragmatic to an increasingly structured approach and try to draw conclusions regarding optimization possibilities in terms of creation and dissemination., Conclusion and Outlook: In situations of high uncertainty combined with an acute need for action and decision-making, there is a significant need for information that is as reliable as possible. Science transfer must be done in such a way that information can be implemented quickly. Dissemination, as always, plays an essential role. Gaps must be accepted. A structured process of quality assurance must be established in parallel. Funds and resources for knowledge transfer should be included in future pandemic plans., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

This paper discusses the conception of a joint intercultural students' research program of one German and two Kyrgyzstani teachers and students from the Otto-von-Guericke University of Magdeburg (Germany) and the American University of Central Asia (Bishkek, Kyrgyzstan). The paper conceptualizes such a research training program and gives reference to qualitative methods teaching in the two corresponding universities. What follows is a description of the chosen research topic: "The 'Intersections' of Gender, Family, and Society in Kyrgyzstan" and the course program. With different academic cultures concerning research ethics in the Anglo-Saxon and continental European contexts, a challenge for such a program will be addressed. A short review of the research results of the different students' teams is provided, and the paper is finalized with a self-reflection upon such a joint intercultural undertaking.

Purpose: Among brain tumor patients, frailty is associated with poor outcomes. The COVID-19 pandemic has led to increased frailty in the general population. To date, evidence on changes in frailty among brain tumor patients during the pandemic is lacking. We aimed to compare frailty among brain tumor patients in Germany during the COVID-19 pandemic to the pre-pandemic era and to assess potential effects on brain tumor care., Methods: In this retrospective observational study, we compared frailty among brain tumor patients hospitalized during the COVID-19 pandemic in years 2020 through 2022 to pre-pandemic years 2016 through 2019 based on administrative data from a nationwide network of 78 hospitals in Germany. Using the Hospital Frailty Risk Score (HFRS), frailty was categorized as low, intermediate, or high. We examined changes in frailty, patient demographics, the burden of comorbidity, rates of surgery, and mortality rates for different frailty groups during the pandemic and compared them to pre-pandemic levels., Results: Of the 20,005 included hospitalizations for brain tumors, 7979 were during the pandemic (mean age 60.0 years (± 18.4); females: 49.8%), and 12,026 in the pre-pandemic period (mean age: 59.0 years [± 18.4]; females: 49.2%). Average daily admissions decreased from 8.2 (± 5.1) during pre-pandemic years to 7.3 (± 4.5) during the pandemic (p < 0.01). The overall median HFRS decreased from 3.1 (IQR: 0.9-7.3) during the pre-pandemic years to 2.6 (IQR: 0.3-6.8) during the pandemic (p < 0.01). At the same time, the Elixhauser Comorbidity Index (ECI) decreased from 17.0 (± 12.4) to 16.1 (± 12.0; p < 0.01), but to a larger degree among high compared to low frailty cases (by 1.8 vs. 0.3 points; p = 0.04). In the entire cohort, the mean length of stay was significantly shorter in the pandemic period (9.5 days [± 10.7]) compared with pre-pandemic levels (10.2 days [± 11.8]; p < 0.01) with similar differences in the three frailty groups. Rates of brain tumor resection increased from 29.9% in pre-pandemic years to 36.6% during the pandemic (p < 0.001) without differences between frailty levels. Rates of in-hospital mortality did not change during the pandemic (6.1% vs. 6.7%, p = 0.07), and there was no interaction with frailty., Conclusion: Even though our findings are limited in that the HFRS is validated only for patients ≥ 75 years of age, our study among patients of all ages hospitalized for brain tumors in Germany suggests a marked decrease in levels of frailty and in the burden of comorbidities during the COVID-19 pandemic., (© 2023. The Author(s).)

The study aims to understand the foremost challenges in the transition to online teaching and learning during the COVID-19 pandemic. The study adopts the PRISMA approach to screening the selection of journal articles and review papers according to the research aims and the inclusion criteria. The journal articles and review papers were extracted and stored in Microsoft Excel and Google Scholar, Academic. Microsoft, Semantic Scholar, Elsevier, and Emerald Insight databases searched relevant documents using formulated keywords. A statistical technique was applied using the M.S. Excel analysis tool (PivotTable and an independent t-Test) to analyze data and determine the differences between teachers and students. The review revealed the evidence that the majority of the studies were primarily focused on the individual developing countries and results from other developing countries were not considered. In addition, the foremost challenges in the transition to online teaching and learning during the COVID-19 pandemic were inadequate skills and training, inadequate Internet/Infrastructure, lack of supporting resources and lack of online student engagement and feedback. Finally, the independent t-test reveals there is no statistically significant difference in challenges in the transition to online teaching and learning during the COVID-19 pandemic. Both teachers and students encounter similar challenges. The systematic review raised concerns that higher learning needs to effectively implement long term strategies and support teachers and students in getting into online teaching and learning.

The COVID pandemic forced universities worldwide to shift to remote and online formats of teaching delivery. In design education, this shift has impacted Experiential Education (EE) pedagogical approach to studio teaching, an approach that gives students an opportunity to apply theory to a concrete experience in a reflective manner and provides cross-disciplinary learning opportunities. This paper discusses Global Design Studio (GDS), a collaborative cross-disciplinary teaching initiative between three design disciplines across three continents: Industrial Design in Australia, Interaction Design in Canada, and User Experience Design in Germany. The objective was to develop a support framework during emergency situations to facilitate cross-disciplinary EE to design students. This paper discusses the three teaching experiences as case studies that offer opportunity for deep analysis and reflection of challenges and enablers to EE education in the shift from traditional design studio to remote and online delivery. While navigating COVID-19 barriers to EE education, GDS aimed to achieve these objectives by sharing resources, ideas, and expertise across the three universities. Each unit dedicated the entire academic term to a first exploration of GDS through a semester-long project 'Interactive Mannikin for children to learn CPR techniques'. This article discusses the context and outcomes of EE teaching and learning experiences at each unit. This paper also reviews the lessons design educators learned about: inter disciplinarity, inter-intra-cultural issues, group working, timing, remote collaboration, and proposing a GDS model for cross-disciplinary EE.

Since 1995, the Poverty and Health Congress has been organized annually by Gesundheit Berlin-Brandenburg e. V. in cooperation with various partners. It is one of the largest regular public health events in Germany. The congress is a platform for exchange between science, practice, civil society, and politics. In 2022, the motto was "What counts now." Public health and health inequalities were discussed in the light of the SARS-CoV‑2 pandemic and the war in Ukraine. Professional exchange on various topics took place in over 100 digital events with more than 2000 participants, among them around 500 speakers., (© 2022. The Author(s).)

This paper examines Bauhaus School (1919-1933) innovation and relevance today. The School is a landmark in the history of design as a discipline and the development of design education. The School was also a workplace, commercialising Bauhaus-designed products. While drawing global interest in its innovations, the School faced resistance in Germany because it challenged conventions. This problem raises the questions: How did the School-workplace generate innovations amid the calamity of post-war Germany, and what is the significance of the Bauhaus for post-pandemic education and workplaces one hundred years on? The concept of 'transgression' is used to understand innovation at the Bauhaus School-workplace. Haraway discusses transgressive practices that disrupt established knowledges, moving ways of thinking and doing in new directions. Analysis of workplace learning research reveals that three interfacing dimensions make up innovation: (1) workplace environments, (2) the culture-order that facilitates innovation, and (3) learning in practice in authentic settings. This qualitative case study reports on how Bauhaus innovation emerged at the intersection of these key dimensions. There are surprising commonalities between the Bauhaus approach to innovation in challenging times and contemporary thinking about supporting innovation which are relevant to education, particularly STEAM (Science, Technology, Engineering, Arts and Mathematics) education, and workplaces in a world affected by the COVID 19 pandemic. Thus, encouraging people who challenge boundaries, rules or 'the way things are' can support innovation. This paper addresses a gap in workplace learning research on interrelated dimensions of innovation which the Bauhaus recognized. The study also offers an innovative approach to the examination of innovation across time and space whereas most contemporary studies of innovation focus on the present. Further, conceptualizing innovation as transgression offers a new way of thinking about innovation in design and in the workplace.

This paper explores the leadership styles of fourteen elected female politicians in executive government positions, as communicated through the official Instagram accounts that were in use during the COVID-19 pandemic. Seven of them are, or were, heads of government, six are or were mayors, and one is the president of an autonomous region in Spain. These women are Angela Merkel (Germany), Jacinda Ardern (New Zealand), Sanna Marin (Finland), Mette Frederiksen (Denmark), Erna Solberg (Norway), Katrin Jakobsdottir (Iceland), Tsai Ing-Wen (Taiwan), Anne Hidalgo (Paris), Virginia Raggi (Rome), Ada Colau (Barcelona), Claudia López (Bogotá), Claudia Sheinbaum (Mexico City), London Breed (San Francisco) and Isabel Díaz Ayuso (Madrid Region). A comparative content analysis of 2,330 units was conducted over a 6-month period. The study analyses the hard or soft leadership style conveyed by the women politicians selected in relation to four variables: political ideology, generational affiliation, level of government and techniques used in communication. The results show that the values of the variables affect leadership styles; therefore, the assumption that all female politicians have a single leadership style is erroneous and related to gender stereotyping.

The paper begins with the prerequisite assumption that social deprivation is a fragile and porous category. Thus, our hypothesis is, that how people are affected by the restrictions against the spreading of the coronavirus is often discussed in far too general and simplistic terms. It is often taken as a given, that the virus and the restriction measures not only have caused severe difficulties for us all (due to social distancing, fear, affected health, etc.), but that the measures have exacerbated already previously existing forms of social deprivation. Therefore, it is assumed that marginalized groups are particularly affected by these effects of the pandemic. Two major German studies show the alleged effects of the relevant measures on adolescents and emerging adults (COPSY and FIBS) against the backdrop of social and economic deprivation; their results confirmed that social deprivation entails a higher degree of being affected by the pandemic. However, this picture becomes thwarted by considering the results of 10 narrative interviews, that were conducted by us with emerging adults in a German vocational training institute between April and August 2021 and showed variegated forms of experiencing issues related to the pandemic. In our analysis, we used the method of objective hermeneutics. In this paper, we present our considerations by outlining two contrastive experiences with the COVID-19 pandemic, in order to highlight the divergent ways in which the pandemic has been experienced even among individuals who previously had been affected by social deprivation -- at least at first glance -- in similar ways. The conceptual lens through which we interpret these two examples is, firstly, the one of precariousness and precarity (Butler 2009). And secondly, the concept of recognition derived from Honneth's pertinent theory and Butler's account of recognizability will play a pivotal role. While Honneth's approach allows us to emphasize the normative and existential role of the fulfilment of our basic desire for recognition and the detrimental implications of disregard, Butler provides us with the means to thoroughly analyse the socio-historical conditions of misrecognition and social invisibility. Moreover, Butler focuses specifically on the recognizability of precariousness (Honneth's triad of love, being respected as a rights bearer and solidarity shows a different focus). Combining qualitative research on precarious live circumstances with a theoretical perspective on recognition can also be found in a stunning research on couples in atypical working relations (Wimbauer and Motakef 2019). Proceeding from these theories and 'applying' them to our empirical material, we seek to call into question a too generalizing and hegemonic picture of how people were affected by pertinent restrictions. Qualitative interviews are able to point us to significant differences in the experience of the restrictions. In terms of an outlook, we suggest that a sensitization for previously excluded kinds of experiences forms a crucial basis for a less normalizing, that is, more inclusive account of interpreting the affectedness and needs of variegated social groups; the pandemic has influenced and altered structures of the recognition of vulnerability and, by the same token, made them more explicit. It thus is an occasion for a critical engagement with the recognizability of needs, deprivation, discrimination, and related phenomena.

Lockdowns imposed by many countries on their populations at the beginning of the COVID-19 crisis forced teachers to adapt quickly and without adequate preparation to distance teaching. In this paper, we focus on one of the most formidable challenges that teachers faced during the lockdowns and even in the post-lockdown emergency period, namely, developing assessment that maintains the pedagogical continuity that educational institutions typically require. Based on the results of a previous study, focused on the analysis of answers to an open-ended questionnaire administered to a population of 700 teachers from France, Germany, Israel and Italy, a semi-structured interview series was designed and implemented by the authors of this paper with a small group of teachers. The transcripts of these interviews were analysed according to the interpretative phenomenological analysis methodology, with the aim of investigating teachers' own perspectives on the following: (a) the difficulties with which they had to contend, with respect to the question of assessment; (b) the techniques adopted to deal with these difficulties; and (c) the ways in which the lockdown experience could affect the future evolution of teachers' assessment practices. This analysis supported us in formulating hypotheses concerning the possible long-term effects of lockdown on modes of assessment in mathematics.

Purpose: To continue to stay relevant in the era of Industry Revolution 4.0 (IR4.0) alongside the unprecedented disruption of COVID-19, the importance of lifelong learning is indisputable though this concept has existed for decades. In this context, open and distance learning (ODL) institutions are urged to re-think and re-design their online learning support systems that inculcate self-regulated lifelong learning (SR3Ls) in their learners to be adaptable and resilient for the post-pandemic economy. The purpose of this paper is to develop a SR3Ls model, namely SR3Ls model by utilising the collective opinions of a panel of experts to determine the key domains and attributes. Design/methodology/approach: A 2-round Delphi consensus study was conducted with 39 experts from five countries. The mean, standard deviation (SD), inter-quartile range (IQR) and the ratio of experts assigned score of 4 or greater were used as the basis of consensus assessment with criteria set at mean = 3.0, SD = 1.5, IQR = 1, ratio on score 4 or greater at = 75%. The questionnaire consisted of 5-point Likert-type scale rating the importance level of each attribute combined with open-ended questions. Findings: This paper presented the findings of the first round of Delphi consensus study. For the first round, the experts were asked to evaluate 31 key attributes of SR3Ls model under five domains. The findings revealed that there were five key attributes to be eliminated from the list, while there were seven attributes identified as the key attributes with highest consensus. There were additional attributes suggested by the Delphi panel to be added in the second round of evaluation. Originality/value: This international consensus-based SR3Ls model serves as an important benchmark for ODL institutions across the regions in developing meaningful and relevant online learning support systems for their learners to adopt SR3Ls attributes in order to meet the dynamic market demands.

Purpose: This paper aims to investigate student subgroups' responses to the coercive digitalisation of teaching and learning processes during the pandemic. Respective variance is discussed in terms of digital inequality and is interpreted as a need to individualise teaching and learning and quality assurance practices. Design/methodology/approach: This study uses data from surveys (N = 955) on student perceptions of the introduction of emergency digitalisation -- an important aspect of higher education. The authors perform latent class analyses to identify student subgroups. The students were asked to rate digital learning processes and their overall learning experiences. Findings: The identified student subgroups are proponents, pragmatics and sceptics of digitalised teaching and learning processes. These subgroups have different preferences with regard to teaching and learning modes of delivery, which implies the relevance of individualised educational services and respective quality assurance practices to reflections on improvement needs. Research limitations/implications: The data are from a single, typical German university; therefore, the scope of the results may be limited. However, this study enriches future research on the traits of student subgroups and students' coping strategies in an ever-changing learning environment. Practical implications: The findings may help individualise universities' counselling services to enhance overall teaching performance and quality assurance practices in a digitalised environment. Originality/value: The findings provide insights into students' responses to the COVID-19 pandemic and its impact on teaching and learning. This paper enriches the research on student heterogeneity and relates this to development needs of quality assurance practice.

School-home communication is a growing research field in social sciences, particularly in education sciences and communication studies. While previous studies have paid much attention to the importance of school-home interaction in supporting primary academic socialisation and progress of elementary school pupils, the role of teacher-parent communication and collaboration in influencing the development of children's and adolescents' digital skills remains an under-researched area. This paper employed thematic analysis of in-depth interviews with education experts in six European countries, providing an insight into their opinions and views on the problems in communication between homes and schools. The analysis identified main problems in and obstacles to school-home collaboration on children's digital skills development, and the changes the COVID-19 pandemic brought along in this field of education. The paper provides five policy recommendations for enhancing school-home collaboration on digital skills development.

The COVID-19 pandemic put academic institutions around the world in the difficult position of suddenly having to organize many lectures and examinations over online channels only, due to students' physical access to their campus buildings being restricted. While the search for possible solutions to this problem was often challenging, this situation also offered the unique opportunity to establish remote examination options, that might hold the potential to be continued even after the pandemic has hopefully ended. This report looks at how the Munich University of Applied Sciences (MUAS), one of the biggest universities of applied sciences in Germany, established its own solution for remote examination over the Internet. This report provides an overview of how MUAS developed its on-site competence- and application-oriented digital examination tool to work remotely during the pandemic, its general framework and experiences that were made during its inception. Included are descriptions of the technical setting of the solution, as well as some challenges that were had when implementing it and how those were resolved. As part of this research it was concluded, that support and administrative work for this kind of remote examination was much more intensive than for on-site digital examinations, but also lessened each subsequent semester. A well-organized support system makes it possible to offer remote digital examinations with good conditions regarding, for example, student equal opportunities and secure examination environments, although even now perfect conditions cannot be guaranteed. While not without its own deficiencies, MUAS new established system was lauded by many Bavarian educational facilities and is in the process of being deployed to other Bavarian universities. This paper serves to highlight a qualitative example of how e-learning approaches can be of use in the context of higher education examinations and hopefully provide ideas for others trying to establish their own similar solutions.

Introduction: The COVID-19 pandemic may increase women's vulnerability through violations of their integrity during birth. In a cross-sectional study (March 2020 to March 2022), we investigated how women giving birth experienced maternity care during the pandemic in Germany and which factors were associated with their birth integrity., Methods: In a survey (validated questionnaire and two open-ended questions), women ≥ 18 years described their experiences of maternity care. We conducted quantitative analyses using descriptive statistics and logistic regressions to investigate factors associated with dignified care and emotional support, which are understood as proxies of birth integrity. We analysed the open-ended questions through inductive content analysis., Results: We included data from 1271 participants and 214 comments. The majority of respondents felt emotionally supported (71%) and treated with dignity (76%). One third reported not always being involved in decision-making, while 14% felt they were subjected to physical, verbal or emotional abuse. For 57% of women, their companion of choice was absent or their presence limited. Those factors were all associated with the chances of feeling treated with dignity and emotionally supported. The qualitative comments provided an insight into what specifically women perceive as violating their integrity., Discussion: During the COVID-19 pandemic, the vulnerability of parturients lies in the violation of their birth integrity. Measures to promote respectful maternity care of women who give birth include comprehensive structural and political solutions as well as further research on the determinants of birth integrity., (© 2023. The Author(s).)

An ISMRM workshop on MR elastography was held at Charité-Universitätsmedizin Berlin on August 25-26, 2022. As an exclusively in-person event, 65 participants from 9 countries attended the workshop despite COVID-19-related restrictions. The topics of the workshop covered cellular and microtissue mechanical interactions, the development of MR elastography driver technology, approaches to inverse problems, clinical applications, and integration of MR elastography into multiparametric MRI protocols. The workshop was a great success by promoting direct knowledge exchange as well as for strategizing future directions for MR elastography. In this symposium review, we briefly summarized all oral presentations as well as the concluding panel discussion., (© 2022 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.)

The genesis and spread of COVID-19 around the world since 2020 have caused severe impacts in every aspect of people's lives, from work life to recreation, social activities to physical health. Higher education has not been excluded. Universities have altered curriculum, changed delivery methods, provided more counseling, purchased new technology, and altered attendance policy for classroom, athletic, social and artistic events (Hamlin, 2021). To assess the impacts of these changes on college students, the authors created a questionnaire to ask students about their perceptions of these COVID-related impacts on their own personal lives. The survey had 56 questions about how the virus affected their academic, social, financial, physical and emotional lives. Over 800 students responded with objective input and subjective comments. Due to the volume of data, the authors have split the study into two parts. The survey results for the first part, academic and social aspects of the survey, were published in "Understanding the Impact of Covid-19 on College Student Academic and Social Lives," Research in Higher Education Journal Volume 41 (see http://www.aabri.com/manuscripts/213347.pdf). It will sometimes be referred to herein to provide clarity to the reader. The actual survey itself can also be found at that site. This paper focuses on the impact of the coronavirus on student financial and physical well-being, which have become major stressors to this age group and have contributed to higher levels of anxiety and depression. It also examines how the virus has affected their social and emotional well-being. Lastly, recommendations are made to help educators understand the severity of the problem, and to take action to provide assistance for those students who have been adversely affected.

Between 2014 and 2022, the 5 German research networks AEQUIPA, CAPITAL4HEALTH, HLCA, PartKommPlus, and SMARTACT are investigating topics of primary prevention and health promotion with the aim of further deepening the evidence base in these areas. The work of the 5 research networks for primary prevention and health promotion is presented, analysed, and discussed from an internal perspective. A model of evidence-based public health serves as a structuring framework.The 5 research networks use a variety of access routes for the generation of evidence with regard to the participation of nonacademic, civil society actors and users. There is a wide range of study designs - from randomised controlled trials and systematic reviews to diverse qualitative designs. The use of models and theories supports the evidence base. Beyond evidence generation, all research networks focus on at least exemplary implementation of new evidence.Due to the diversity of methods, a diversified evidence-based approach can be realised, taking into account network-specific aspects. Structural circumstances limit the further systematic strengthening of the evidence base. In particular, the involvement of nonacademic, civil society actors for the work with hard-to-reach target groups often cannot be financed or is considered too time consuming under the given circumstances. The COVID-19 pandemic highlights the importance of a flexible spectrum of methods, employing both digital and analogue methods in a meaningful way.

Purpose: Virtual collaboration provides students with an opportunity to develop cultural intelligence while fitting into the team where the members are from diverse cultures. The purpose of this study is to explore whether global virtual team (GVT) projects raise students' understanding of cultural differences. In addition, it is interesting to know how internationally disruptive events such as the coronavirus disease 2019 (COVID-19) pandemic influence GVT projects. Design/methodology/approach: The research involved two parts--In the first part, a two-wave longitudinal study was conducted to investigate how intercultural sensitivity and intercultural communication competence coevolve within a group of international students enrolled in a virtual business professional project. In the second part, using word clouds and topic modelling on the participants' perceptions, the study investigated whether the sudden disruption caused by the pandemic show similar results in performance, focussing primarily on the resilience of virtual teams. Further, the study explored participants' perceptions towards online learning in higher education institutions as well as the attitude of corporate organizations towards remote working in the post-pandemic years. Findings: The results confirmed that GVT projects, in fact, do raise students' understanding of cultural differences and the need to adjust their behaviour accordingly in order to engage with their culturally different counterparts effectively. Participants reported an increase in their cognitive, behavioural and affective attributes. Research limitations/implications: Among the limitations of this study is the relatively small number of student participants. Furthermore, the number of respondents from India dominated the sample. Since the Indian students were disproportionately affected by the shutdown, causing them to return often to rural areas with poor Internet connectivity, responses concerning the disruption caused by the pandemic may be overriding negative. The same could be said of responses from US-American students, who often rely heavily on-campus employment or whose parents became unemployed during the pandemic, and thus were faced with disproportionate economic insecurity. Practical implications: This paper provides insights to the educators and international organizations on how such projects provide the skills essential for reducing costs, accessing knowledge, skills and abilities (KSAs) across borders, maintaining flexible work schedules and arrangements, and taking advantage of multiple time zones to increase productivity. Originality/value: While highlighting the significance of cultural intelligence, this paper investigated how the sudden disruption caused by a crisis such as the COVID-19 pandemic impacts performance, focussing primarily on the resilience of virtual teams.

Background: Quality of life (QoL) is a widely recognised outcome in residents of long-term care homes. However, little is known about the impact of care satisfaction on QoL. The aim of this study was to assess the association between care satisfaction and QoL in residents of long-term care homes. Additionally, we were able to assess the impact of the Covid-19 contact restrictions on QoL., Methods: We applied a cross-sectional study in N = 40 long-term care homes in Baden-Wuerttemberg, Germany. Using regression models, we analysed the association between QoL (operationalised through the World Health Organization Quality of Life Assessment-Old Module [WHOQOL-OLD]) and self-rated nursing care satisfaction. The date on which the questionnaire was completed was used to calculate whether the completion was prior the emergence of the Covid-19 contact restrictions. Further potential confounders were included in the analysis., Results: N = 419 residents of long-term care homes participated. Explained variance of QoL was low in our models at 2 to 16%. Self-rated nursing care satisfaction was the strongest predictor of QoL and positively linked to the following subdimensions of QoL: autonomy; past, present and future activities; social participation; intimacy. The Covid-19 contact restrictions were negatively linked to social participation., Conclusion: Nursing care satisfaction was associated with QoL in residents of long-term care homes. Future research should focus on the direction of the association and different aspects of nursing care satisfaction with QoL. Furthermore, we showed the impact of contact restriction during the Covid-19 lockdown on social participation., Trial Registration: WHO UTN: U1111-1196-6611; DRKS-ID: DRKS00012703 (Date of Registration in DRKS: 2017/08/23)., (© 2022. The Author(s).)

WhatsApp groups are considered useful for creating and supporting virtual communities. This mixed method case study explores the patterns that emerged when we used WhatsApp to create a community of learning during the multimodal presentation of a postgraduate course in research proposal writing. Three questions drive the study: (1) What kinds of messages were sent? (2) Who participated and how? (3) How did the learners experience the use of WhatsApp in support of the community of learning? Data were collected during the presentation of a five-evening proposal writing workshop that was conducted using Zoom, WhatsApp, and YouTube as communication platforms. To answer the first question, all WhatsApp messages were analysed through both manual (individual) and automated (meta) content analysis. The third question was answered by analysing students' responses to the end-of session online questionnaire that was administered via Google Forms. Results indicate that many messages were administrative in nature, while the most notable academic messages concerned a discussion of empirical research, research paradigms, and research design. The presenter and co-presenter together accounted for almost half of the messages sent, and the other messages were evenly distributed between members of the class, with five notably vocal students. Student responses indicated that they liked the high level of interactivity and the content, but that they disliked the time it took to form groups. The paper contributes to the literature by showing how this use of multiple WhatsApp groups was effective in creating a sense of community by facilitating access, relationships, vision, and function (West and Williams, 2017). More research is needed in determining the extent to which students might support one another with conversations outside of the main WhatsApp group.

This paper develops informed assumptions on the potential loss of trust as an unintended side-effect of the measures in education to contain the spread of the COVID-19 pandemic. Well-founded concerns according to which the pandemic-induced closure of educational facilities and the shift to digitalized distance education are contributing to increased social inequality in education serve as a starting point for the argumentation. The paper contends that together with the temporary changes in the style of educational governance, in the medium term an exacerbated social inequality in education can cause a potential trust problem for the central actors imposing the measures. To support this line of reasoning, the exploratory study describes the context conditions which are relevant for the implementation and participation in digitalized distance education (measures, access and competent use of digital devices in education, level of trust) and combines them with the findings of a qualitative analysis of relevant documents from three European countries (Czech Republic, Denmark, Germany). A neo-institutional view is applied to exploring the implications of the changes in education governance and their potential side-effects on trust.

Parenting during the COVID-19 pandemic is highly challenging, with parents having to meet various demands simultaneously. An increase in adverse childhood experiences (ACEs) has been widely predicted, but empirical evidence is still scarce. This study aimed to (1) generate representative data on pandemic-related stress, parental stress, general stress, parental subjective and mental health, and the occurrence of ACEs; (2) identify risk factors for an increase in ACEs, and (3) provide qualitative data on parents' experiences. A representative survey was conducted in Germany in August 2020 with 1024 parents of underage children (M age  = 41.70, 50.9% female). More than 50% of parents reported being stressed by social distancing and the closure of schools and childcare facilities. Parental stress increased significantly during the pandemic (d = 0.21). Subgroups of parents also reported very high levels of depressive symptoms (12.3%) and anxiety (9.7%). Up to one-third of the sample reported ACEs in the child's lifetime. In this group, 29.1% reported an increase in children witnessing domestic violence during the pandemic, and 42.2% an increase verbal emotional abuse. These families were characterized by higher parental stress, job losses, and younger parent and child age. Positive aspects of the pandemic related primarily to personal or family life (e.g. slower pace of life, increase in family time). While some parents coped well, a particularly negative pattern was observed in a subgroup of families that experienced an increase in ACEs. Parental stress emerged as important target point for interventions addressing the negative sequelae of the pandemic., (© 2021. The Author(s).)

Objective: Anecdotal evidence suggests work fatigue has increased during the COVID-19 pandemic, and work interventions to offset stresses have been effective. Our study sought to test these propositions, documenting and describing the complexity of worker well-being around two lockdown periods., Methods: Using 17 waves of data from a longitudinal study in Germany (December 2019 to June 2021, n = 1053 employees), we model discontinuous changes in work fatigue and how participation in a government-sponsored short-term work program (Kurzarbeit) affected change trajectories., Results: The COVID-19 pandemic has not invariably resulted in work fatigue, and individuals with Kurzarbeit at the first lockdown (but not the second) showed significantly larger decreases in each form of fatigue at this transition., Conclusions: Future policy interventions will require more contextual nuance and to effectively support worker well-being during public health crises., Competing Interests: Conflicts of interest: None declared., (Copyright © 2022 American College of Occupational and Environmental Medicine.)

Background: Standardised surveillance of COVID-19 infections among healthcare personnel during the current pandemic was and is not available. In particular, the proportion of occupational infections among healthcare personnel and which workers among them are most at risk remains unclear., Objectives: The aim of this study was to analyse the reported COVID-19 cases among healthcare personnel in Frankfurt/Main during the first six months of the pandemic, to determine the number of occupational infections and thus to allow a better interpretation of the data published by the Robert Koch Institute., Methods: Data from the Frankfurt/Main Health Protection Authority was analysed for the period from 1 March to 31 August 2020, and healthcare personnel were recruited for a cross-sectional survey. Three subgroups were defined and analysed according to whether the infectious contact occurred at work, in private or in an unknown setting., Results: Healthcare personnel accounted for 11.8% (319/2700) of all reported COVID-19 cases in Frankfurt/Main during the period studied. In the survey, 47.2% of respondents reported that their infection was acquired in the workplace. There was an association of contact with COVID-19 patients as well as employment in the internal medicine ward and a reported work-related infection. Also apparent was an association between suspected occupational infections and consequently filed reports for alleged occupational disease., Discussion and Conclusion: Health protection authorities are in a position to collect relevant data on work-related transmissions in healthcare occupations and workplaces and should generate standardised data on infected healthcare personnel. This data is necessary to take targeted infection control and prevention measures that protect healthcare personnel and their patients., (© 2022. The Author(s).)

Political measures to confront the COVID-19 pandemic are a stress-test for citizens' institutional trust. Higher education students' trust in political institutions is of particular interest as they are substantially affected by COVID-19 related measures: For the most part, their academic institutions have been put under lockdown, they have had to adapt to new learning formats extemporaneously, and typical sources of income (like marginal employment) have potentially broken off. The paper at hand takes a closer look at determinants of institutional trust among students enrolled at German HEIs from a "government performance" perspective as well as "culturalist approaches." Special attention is paid to intercultural experience in the form of international student mobility, as EHEA policy makers stressed the positive effects of mobility on civic responsibility. Analyses show that indicators from both theoretical points of view have an expressive impact on trust in political institutions to deal properly with the COVID-19 pandemic: The findings support the relevance of government performance and students' individual economic well-being as well as social trust in predicting students' institutional trust; furthermore, evidence suggests a positive relationship between international student mobility (as well as its link to social trust) and civic responsibility.

Background: The COVID-19 pandemic has affected education at all levels in various ways. This paper provides a review of the literature on the challenges of online learning for children with special educational needs and disabilities (SEND). Method: In total, 17 studies from nine countries were analysed. The challenges of online learning for children with SEND reported by teachers and parents and the strategies applied to overcome the challenges were identified. Results: The challenges of online learning were the need of parental support, routine change, inequities of resources and access to technology, lack of accommodations, and social isolation. There was a considerable lack of interventions aimed at promoting the educational outcomes of children with SEND. Conclusions: The findings emphasise the importance of parent-teacher collaboration and communication. Suggestions for strategies to address challenges as well as for further research are also discussed.

Building and sustaining capacity for organisational learning appears to be a prerequisite for organisational resilience. For schools, organisational learning in crisis situations, such as COVID-19, requires that they have certain learning capacities. Using quasi-longitudinal data, the paper analyses how schools' leadership capacity (as perceived by educators) at schools serving disadvantaged communities (SSDC) at the beginning of the COVID-19 pandemic predicted the educators' practice about a half year after returning to face-to-face-teaching (objectives and expectations regarding student performance and the staff's willingness to innovate). We used data from two standardised surveys of the staff from 35 SSDC in North Rhine-Westphalia, Germany, conducted at the beginning of 2020, and at the end of 2021. The results of multilevel regression analyses showed that a higher leadership capacity at the start of the pandemic predicted a stronger orientation towards performance objectives during distance learning. No associations were found, however, between schools' leadership capacity and the educators' expectations regarding student performance as well as between schools' leadership capacity and the staff's willingness to innovate. Our findings help strengthen our knowledge about the antecedents of successful school improvement in challenging locations during times of crisis.

This paper presents a study on remote learning of primary school children during the first school closures that were imposed in Germany in response to the COVID-19 pandemic in spring 2020. Data were collected at a primary school covering learners from age 6-12 and include a comprehensive survey amongst parents (n=69) as well as interviews with learners (n=17). Employing a mixed-methods approach, we first analyse the parent-survey's quantitative dataset. The analyses demonstrate that using modern technology for teaching and for communication between teachers and learners positively impact learners' motivation and well-being. Multivariate statistics show that teacher-learner contact frequency as well as teaching-learning transparency are predictive towards learner well-being. The subsequent analysis of interview data helps to gain a more nuanced picture on learners' experiences and well-being. Analyses show that learners experience multifaceted worries and concerns, and that one of the most substantial challenges of remote learning lies in a perceived change of teacher expectations. Based on the analyses of both datasets, it is argued that the contact frequency and quality, the proficient use of up-to-date technology, as well as transparency of teachers' expectations positively influence learners' well-being, and that thus, contact quality and transparency can counteract children's worries and concerns.

The COVID-19 pandemic required adjustments and limitations in university teaching, thereby challenging teaching concepts in anatomy requiring in-person contact, including the gross anatomy course. Therefore, the present study investigates the impact of COVID-19-associated adjustments on students' perception of the gross anatomy course's importance and quality, students' preferred learning setting and outcome, and their motivation to involve themselves in academic activities, including becoming a future peer-teacher of the course. Using paper-based questionnaires in Ulm, Germany, 397 (response rate: 82.3%) students of the winter term of 2020/2021 were surveyed using quantitative and qualitative items, which were compared with cohorts prior to the pandemic. Students reported a higher global rating on course quality during COVID-19 (pre-COVID-19: 5.3 ± 0.9, during-COVID-19: 5.6 ± 0.7, p < 0.001; 1 = very bad, 6 = very good). Students' perceived importance of the gross anatomy course showed a small but significant increase (pre-COVID-19: 4.2 ± 0.6, during-COVID-19: 4.3 ± 0.6, p < 0.001; 1 = strongly disagree, 6 = strongly agree). Students' motivation to apply as a peer-teacher remained stable, nevertheless, they reported less interest in transferring their knowledge to junior students. Finally, students reported that they spent significantly more learning time alone and their examination grades remained unchanged during the pandemic. Astonishingly, despite radical changes of the teaching environment due to COVID-19, students appreciate the offered teaching and highly valued the gross anatomy course.

Physics lab courses permanently undergo transformations, in recent times especially to adapt to the emergence of new digital technologies and the COVID-19 pandemic in which digital technologies facilitated distance learning. Since these transformations often occur within individual institutions, it is useful to get an overview of these developments by capturing the status quo of digital technologies and the related acquisition of digital competencies in physics lab courses. Thus, we conducted a survey among physics lab instructors (N=79) at German, Finnish, and Croatian universities. The findings reveal that lab instructors already use a variety of digital technologies and that the pandemic particularly boosted the use of smartphones and tablets, simulations, and digital tools for communication, collaboration, and organization. The participants generally showed a positive attitude toward using digital technologies in physics lab courses, especially due to their potential for experiments and students' competence acquisition, motivational effects, and contemporaneity. Acquiring digital competencies is rated as less important than established learning objectives, however, collecting and processing data with digital tools was rated as an important competency that students should acquire. The instructors perceived open forms of labwork and particular digital technologies for specific learning objectives (e.g., microcontrollers for experimental skills) as useful for reaching their learning objectives. Our survey contributes to the reflection of what impact the emergence of digital technologies in our society and the COVID-19 pandemic had on physics lab courses and reveals first indications for the future transformation of hands-on university physics education. [This paper is part of the Focused Collection on Instructional labs: Improving traditions and new directions.]

Objective: To assess if metabolic control worsened during the SARS-CoV2 lockdown in spring 2020 in youth with type 1 diabetes (T1D) in Germany., Methods: Data from 19,729 pediatric T1D patients from the diabetes prospective follow-up (DPV) registry were available. Data sets from four time-periods between January 1 and June 30, 2020, were compared with data from the whole year 2019 in the same patient; differences were adjusted for seasonality, increasing age, and longer diabetes duration. HbA1c values from laboratory measurements and estimates derived from continuous glucose monitoring (CGM) were aggregated into a combined glucose indicator (CGI), expressed in analogy to HbA1c., Results: Based on regression models adjusted for differences of sex, age, diabetes duration, and migratory background between the four time-periods, CGI values in 2020 were slightly higher than in 2019, for example, by 0.044% (0.042-0.046) (median [95% CI]) in the second lockdown month, time-period 3. Insulin dose and BMI-SDS were also marginally higher. In 2020, there were fewer hospitalizations (e.g., incidence risk ratio in time-period 3 compared with 2019: 0.52 [95% CI: 0.46-0.58]). In a subgroup of patients reporting CGM data in both years, metrics in 2020 improved: time in target increased, and mean sensor glucose fell, for example, by 2.8% (2.7-2.9), and by 4.4 mg/dl (4.3-4.6) in time-period 3., Conclusion: Before, during, and after the lockdown in spring 2020, metabolic control in youth with T1D in Germany did not differ significantly from the preceding year. Further effects of the ongoing pandemic on pediatric T1D patients need to be evaluated., (© 2022 The Authors. Pediatric Diabetes published by John Wiley & Sons Ltd.)

Background: Estimating COVID-19 mortality is impeded by uncertainties in cause of death coding. In contrast, age-adjusted excess all-cause mortality is a robust indicator of how the COVID-19 pandemic impacts public health. However, in addition to COVID-19 deaths, excess mortality potentially also reflects indirect negative effects of public health measures aiming to contain the pandemic., Objectives: The study examines whether excess mortality in Germany between January 2020 and July 2021 is consistent with fatalities attributed to COVID-19 or may be partially due to indirect effects of public health measures., Methods: Excess mortality trends for the period from January 2020 to July 2021 were checked for consistency with deaths attributed to COVID-19 in both the German federal states and districts of Rhineland-Palatinate. The expected monthly mortality rates were predicted based on data from 2015-2019, taking into account the population demographics, air temperature, seasonal influenza activity, and cyclic and long-term time trends RESULTS: COVID-19-attributed mortality was included in the 95% prediction uncertainty intervals for excess mortality in 232 of 304 (76.3%) month-state combinations and in 607 of 684 (88.7%) month-district combinations. The Spearman rank correlation between excess mortality and COVID-19-attributed mortality across federal states was 0.42 (95% confidence interval [0.31; 0.53]) and 0.21 (95% confidence interval [0.13; 0.29]) across districts., Conclusions: The good agreement of spatiotemporal excess mortality patterns with COVID-19 attributed mortality is consistent with the assumption that indirect adverse effects from public health interventions to contain the COVID-19 pandemic did not substantially contribute to excess mortality in Germany between January 2020 and July 2021., (© 2021. The Author(s).)

In order to cope with the COVID-19 pandemic, many schools have been closed for several months as of March 2020 in Germany. The unplanned and rapid shift to distance learning formats has led to fears that extensive learning deficits will be created and educational inequality will be further exacerbated. This paper, therefore, investigates the impact of the COVID-19 pandemic on spelling skills (capitalisation, sounds and letters, separate and compound spelling and punctuation) of students in German-speaking countries. For this purpose, we use granular learning process data from an online learning platform for spelling competences with over 1 million solved exercise sets. We compare successful completion of exercise sets before the pandemic and after the first wave of the pandemic and estimate personal competence by a Rasch model. The result shows a loss of competence in 2020 and an increase in inequality in some grade levels and spelling domains. A linear model cannot confirm an overarching loss of competence.

With schools and universities closing across Europe, the COVID-19 lockdown left actors in the field of education battling with the unprecedented challenge of finding a meaningful way to keep the wheels of education turning online. The sudden need for digital solutions across the field of education resulted in the emergence of a variety of digital networks and collaborative online platforms. In this joint article from scholars around Europe, we explore the COVID-19 lockdowns of physical education across the European region, and the different processes of emergency digitalization that followed in their wake. Spanning perspectives from Italy, Germany, Belgium, and the Nordic countries, the article's five cases provide a glimpse of how these processes have at the same time accelerated and consolidated the involvement of various commercial and non-commercial actors in public education infrastructures. By gathering documentation, registering dynamics, and making intimations of the crisis as it unfolded, the aim of the joint paper is to provide an opportunity for considering the implications of these accelerations and consolidations for the heterogeneous futures of European education.

Background: Survey by the commission for cross-sectoral ophthalmology, as a joint commission of the German Ophthalmological Society (DOG) and the Professional Association of German Ophthalmologists (BVA) on the effects of the SARS-CoV‑2 pandemic on ophthalmological patient care in Germany., Methods: Online-based survey., Results: A total of 1190 questionnaires were (partly) answered. With respect to outpatient care and consultations from 15 March to 15 April 2020, a total of 69 (5.8%) participants indicated unlimited, 756 (63.5%) reduced and 330 (27.7%) emergency care only, independent of the type of institution. Outpatient surgery was restricted to emergency surgery in 68% of clinics, 42.0% of inpatient wards, 45.0% of surgical medical care centers and group practices and 33.0% of private practices. Inpatient procedures were limited to emergency care in 75.0% of inpatient wards and in 71.0% of clinics. With the exception of endophthalmitis (+8.2%), the number of urgent indications and emergencies declined: retinal detachment (-34.8%), perforating eyeball injuries (-7.3%), acute glaucoma (-17.8%), central retinal artery occlusion and anterior ischemic optic neuropathy (-31.0%), others (-30.9%), penetrating keratoplasty and amniotic membrane transplantation (-59.1%). Institutional or professional policy requirements (76.0%) and appointment cancellation by patients (84.0%) were the most common reasons for limitations in ophthalmic patient care., Conclusion: The initial phase of the pandemic was characterized by a massive reduction in non-urgent conservative and surgical treatment that affected all areas of ophthalmology. Due to intensive care capacities required for COVID-19 patients, inpatient treatment was largely restricted to emergencies. Treatment of ophthalmological patients, including ocular emergencies and urgent treatment, was maintained across all sectors with a (considerable) decrease in the number of cases even in these groups., (© 2021. Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Background: The coronavirus disease 2019 (COVID-19) pandemic is associated with extensive changes in the public and private life in Germany. Healthcare personnel are particularly exposed to additional stressors., Objective: To identify the mental burden, resilience, tendency towards absenteeism and associated factors during the COVID-19 pandemic in an anonymous cross-sectional survey., Methods: Data on sociodemographics, occupational situation, contact to COVID-19 patients, mental burden, stressors, resilience, risk and protective factors were assessed among a convenience sample of healthcare personnel in spring 2020 (5 April 2020-7 May 2020). A comparison with the general population in Germany before and during the COVID-19 pandemic was conducted., Results: After the evaluation of 650 completed questionnaires, an increased mental burden was found compared to the German general population before the pandemic, while the mental burden was reduced compared to the general population during the pandemic. The self-reported resilience was slightly higher compared to the general population before and during the pandemic. The COVID-19-related stressors and worries were the most important risk factors, self-efficacy and optimism the most important protective factors. The mental burden was moderately correlated with the intention to change the profession and the tendency towards absenteeism., Conclusion: Mental burden in healthcare personnel during the COVID-19 pandemic is associated with a higher tendency towards taking sick leave. In order to support healthcare personnel interventions that foster resources, such as self-efficacy and optimism should be offered to particularly vulnerable groups .

Teacher education needs to combine training in content knowledge, pedagogical knowledge, and pedagogical content knowledge (PCK). One important part of PCK in science education is knowledge about school science practical work to promote learning by scientific inquiry and about the nature of science. In Germany, practical seminars and lab sessions dealing with "school-type" practical work are mandatory for any preservice chemistry teacher education program. Since practice in handling school-type lab equipment is considered important, courses regularly require attendance in practical sessions. These practical experiences are seen as irreplaceable by digital and video materials when it comes to the development of practical and manual skills. This paper reports on the replacement of a traditional course based in a face-to-face seminar combined with half-day lab sessions for a whole cohort of students. This course was replaced by an individualized, digitally supported, open lab learning experience for prospective secondary school chemistry teachers. The change was implemented due to social distancing rules caused by the COVID-19 pandemic. Elements of the course structure are discussed and related to how students experienced the course.

COVID-19 pandemic continues to obstruct social lives and the world economy other than questioning the healthcare capacity of many countries. Weather components recently came to notice as the northern hemisphere was hit by escalated incidence in winter. This study investigated the association between COVID-19 cases and two components, average temperature and relative humidity, in the 16 states of Germany. Three main approaches were carried out in this study, namely temporal correlation, spatial auto-correlation, and clustering-integrated panel regression. It is claimed that the daily COVID-19 cases correlate negatively with the average temperature and positively with the average relative humidity. To extract the spatial auto-correlation, both global Moran's [Formula: see text] and global Geary's [Formula: see text] were used whereby no significant difference in the results was observed. It is evident that randomness overwhelms the spatial pattern in all the states for most of the observations, except in recent observations where either local clusters or dispersion occurred. This is further supported by Moran's scatter plot, where states' dynamics to and fro cold and hot spots are identified, rendering a traveling-related early warning system. A random-effects model was used in the sense of case-weather regression including incidence clustering. Our task is to perceive which ranges of the incidence that are well predicted by the existing weather components rather than seeing which ranges of the weather components predicting the incidence. The proposed clustering-integrated model associated with optimal barriers articulates the data well whereby weather components outperform lag incidence cases in the prediction. Practical implications based on marginal effects follow posterior to model diagnostics.

The COVID-19 pandemic has been associated with an increase in obsessive-compulsive disorder/symptoms (OCD/OCS). However, knowledge is limited regarding the trajectories of OCS during the pandemic, as well as their predictors and mechanisms (e.g., experiential avoidance, EA). The aim of this study was to describe the trajectories of OCS and the identification of associated factors. We assessed 1207 participants of the general population in March 2020 (t1) and June 2020 (t2). Pre-pandemic data was available from March 2014 for a subsample (n = 519). To define trajectories, we determined OCS status (OCS+/-). We performed a hierarchical multinomial logistic regression to investigate predictors of trajectories. Between t1 and t2, 66% of participants had an asymptomatic trajectory (OCS-/OCS-); 18% had a continuously symptomatic trajectory (OCS+/OCS+). Ten percent had a delayed-onset trajectory (OCS-/OCS+), and the recovery trajectory group (OCS+/OCS-) was the smallest group (6%). Higher education reduced the odds of an OCS+/OCS- trajectory. OCS in 2014 was associated with increased odds of showing an OCS+/OCS+ or OCS-/OCS+ trajectory. When EA at t1 and change in EA from t1 to t2 were added to the model, higher EA at t1 was associated with increased odds of scoring above the cut score on one or more of the assessments. A higher decrease in EA from t1 to t2 reduced the probability of showing an OCS+/OCS+ and an OCS-/OCS+ trajectory. While the current data supports a slight increase in OCS during the pandemic, trajectories differed, and EA seems to represent an important predictor for an unfavorable development.