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This paper uses qualitative data from a survey of Higher Education students, who are also parents, to reveal changing attitudes towards, and perceptions of, education during the pandemic school closures in England. Thematic analysis reveals the stresses of 'homeschooling' and how parents reacted and adapted to these, including adjusting ideas around education. This adaptation mirrors the changing attitudes of parents found in pre-pandemic home education. The paper suggests that post pandemic education could be enriched by taking forward some of these ideas, particularly greater flexibility, personalisation and child autonomy in education.

The value of internationalization within the limits of mobility has become more pronounced during the COVID-19 pandemic. As reflection occurs on our own history, navigating a period of reset and renewal, this paper examines how to advance our thinking, and explore and transverse essential differences within the digital space. Hence, recalibrating the global north and south agenda to create inclusionary principles through virtual exchange. First, this ethnographic paper explores the sympoeitic relationship of creating opportunities and a sense of agency toward morphogenesis. Second, it focuses on the contextual rationale for Collaborative Online International Learning (COIL) within higher education. Third, it explores equity in the digital space through multiple engagements in COIL. The paper offers associated conclusions for critical virtual exchange to advance equity, inclusion, and social justice and suggests responsible pluralistic internationalization.

England is experiencing a teacher recruitment and retention crisis which has only worsened since the COVID-19 pandemic. One-third of teachers leave before they have completed five years. This paper discusses the results of a small-scale study completed with six inner-London secondary teachers which focuses on their everyday experiences in these complex times. The study finds that teacher identity for those who have fewer than five years' experience can be considered under the three headings of passion, frustration and hope. While these are in balance, the teacher is likely to stay in the profession. If the frustration component grows too large, the teacher is likely to leave. This paper uses the study to discuss the retention and recruitment crisis.

In an attempt of curricula improvement, many seek to create new approaches that would help develop the necessary knowledge within a shorter period of time. The primary purpose of this paper is to investigate the role of interactive piano teaching in distance learning. The paper suggests new learning approaches to interactive piano instruction. The training programme is based on interactive groups, the Flowkey application, technical and psychological aspects, improvisation, changing role positions, and the development of self-control. The programme results showed that 83% out of 120 students demonstrated a high level of knowledge, and only 2% showed a low level, which was explained by absenteeism. 28% out of 120 students learned to recognise melodies, 27% improved rhythm and tempo, 25% gained two-handed playing skills, and 20% out of 120 students developed improvisation skills. The results have scientific value for researchers engaged in studying various training programmes.

With the widespread implementation of COVID-19 prevention and control measures during the pandemic, online classes have become a normal and indispensable part of college students' lives. Analysis of the factors affecting college students' behavioural intention towards online classes will help improve online class quality. This paper sets up a model to analyse the factors that may affect such intentions . The results show that social influence, performance expectancy, effort expectancy, perceived usefulness and perceived ease of use have a significant positive effect on college students' behavioural intention, and enabling environment(i.e. the infeasibility of offline teaching due to the pandemic)has a significant negative effect on it. Gender and voluntariness, as moderator variables, also clearly influence behavioural intention. Based on pandemic prevention and control measures, along with education reform and modernisation, this paper offers valuable suggestions to online learning platform and education administrators.

In this paper, we present the analysis of the students' achievements in learning calculus in a dynamic software environment during the COVID-19 crisis. Two groups of students, the experimental and the control one, were monitored. Blended learning was applied to the students in the experimental group, with the help of "Microsoft Teams" and dynamic software "GeoGebra," in autumn 2020. All students in the control group learned in the classroom without using "GeoGebra" in 2019. The comparison between these two groups of first-year students, regarding their calculus test results, is described in this paper. It is interesting that the results of the experimental group were significantly better than the results of students in the control group, despite the fact that the students from the experimental group learned during the COVID-19 crisis.

The global surge in academic misconduct during the COVID-19 pandemic, exacerbated by remote teaching and online assessment, necessitates a comprehensive understanding of the multidimensional aspects and stakeholders' perspectives associated with this issue. This paper addresses the prevalent use of answer-providing sites and other types of academic misconduct, underscoring the challenge of detecting all or most of the student misconduct. Exploring factors such as faculty inexperience in remote teaching and assessment, the paper advocates for proactive measures to preserve integrity in education. Emphasizing the need for a culture of integrity beyond traditional classrooms, the paper reviews existing models, then details steps to create a framework using the International Labour Organization (ILO)'s TREE training method. It presents the IEPAR framework (Inspiration, Education, Pedagogical considerations, Assessment design, Response and Restorative practice), and assesses its effectiveness. Incorporating faculty feedback, the paper concludes with evidence-based findings, positioning the IEPAR framework as a robust approach for addressing academic misconduct and fostering a culture of academic integrity in higher education through responsible training of all stakeholders.

The COVID-19 lockdown in the UK during the spring of 2020 led to the closure of schools and school premises to most students, including complementary school pupils; yet while the lockdown in autumn 2020 allowed state schools to remain open, Polish complementary schools found themselves in an ambiguous position. This paper explores the experiences of eight Polish complementary school heads, focusing on their response to lockdown and the measures they took to provide online learning through the year. The paper also examines how changing lockdown policies impacted the running of their schools. Key findings suggest a creative approach was taken to learning, and that students were eager to respond. Meanwhile, there was increasing cooperation between different schools and support from external organisations. However, the challenges of online learning were also highlighted. Additionally, heads expressed concern about student retention and recruitment, and the potential long-term effects on their school. There was also discussion about the position of complementary schools within the broader education system. The paper argues that these findings highlight questions of inequality between the complementary and mainstream sectors, which has been exacerbated by the pandemic.

In this paper, we consider the challenges for Physical Education Teacher Education (PETE) that were presented during the COVID-19 pandemic in regard to preservice teachers' knowledge in and about movement and their developing movement capability. Historically, learning about movement as well as learning in movement has always been central for physical education and PETE. The question this paper addresses is how the teaching and learning of movement capability are experienced by PETE educators and preservice teachers when taught online. We specifically ask what are the gains and losses when movement knowledge is taught online in PETE compared to when taught in face-to-face teaching? Movement knowledge in this study is firstly inspired by Arnold's (1991. The preeminence of skill as an educational value in the movement curriculum. "Quest", 43(1), 66-77) conceptualisation of knowing in and about movement. Our conception of the meaning of knowing in movement is also informed by the concept of movement capability as outlined by recent research. We argue that movement capability offers some additional unique perspectives to our research question. Educators and preservice teachers at two PETE institutions in Sweden were interviewed in order to investigate their experiences of teaching and participating respectively in movement courses as full online education due to restrictions imposed by the COVID-19 pandemic. The informants were asked questions about their experiences of having participated in movement courses face-to-face as well as online. The combination of Arnold's framework (knowledge in and about movement) with movement capability in this study increases the understanding of the meaning of movement knowledge for future physical education teachers. The results show that possibilities to develop movement capability at the one hand seem to be reduced with regard to opportunities to interact face-to-face with other people whilst at the other hand, possibilities to develop movement capability seem to be increased when learners can practise specific ways of moving without an audience.

This paper aims at identifying and explaining the correlation between the Covid-19 and multi-lingualism through cross-country research, drawing on three datasets: WHO data on the expanse of the pandemic, UNESCO data on endangered languages, and the LDI (Linguistic Diversity Index). Results establishing a direct correlation between the pandemic and multi-lingualism vary across the countries, except the USA, India, and Brazil. The three countries experiencing the highest global pandemic caseload occupy the top positions in the number of endangered languages and are among the top ten linguistically diverse countries. Drawing from the research findings, the paper addresses the criticality of investing in multi-lingualism and calls for a shift of perspective among policymakers driven by neoliberal rationale towards greater recognition and higher funding for multi-lingual education.

This paper describes a case study of an online physics laboratory course implemented for 254 engineering students at Walailak University in Thailand in response to the COVID-19 pandemic. The laboratory sequence was designed based on the United Kingdom Professional Standards Framework and covered eight experiments on fundamental concepts of motion, electricity, waves, and fluid mechanics. The experiments were conducted at students' homes using physics education technology simulations, Tracker for video analysis, smartphones, and home-based apparatuses. During the experiments, students shared their progress with classmates and lecturers through screen sharing, which facilitated exchanges of ideas and difficulties. The paper discusses the successful implementation of the online laboratory course and the challenges encountered, such as student engagement, resource limitations, and practical skill development. The insights gained from this case study may be useful for online laboratory education beyond the pandemic.

This paper aims to provide evidence on student teachers' perceptions of Flipped Classroom (FC) to help teacher educators (TEs) to make informed decisions about implementing FC and support student teachers to reflect on the value of FC in their teaching practice. FC, a pedagogical model requiring digital competence of students and teachers, has been a popular teaching approach for nearly two decades in K-12 and higher education. After the outbreak of Covid-19, more teachers have started to implement FC. In post-COVID-19, with the possibility of reusing video lectures made during the pandemic and the familiarity of digital skills to create digital lectures, a question for teachers is whether to continue with this approach. This paper follows an explanatory sequential mixed methods research approach. Insights from student teachers (STs) in the field of English as a foreign language (EFL) in Norway are the primary data, and surveys and focus group interviews are the main instruments to collect the data. FC's advantages and challenges perceived by STs are reported, and the possibility of STs becoming future flippers is explored. Findings from this paper indicate that STs would like to have more courses flipped in their studies, yet STs seem hesitant about flipping their courses in their teaching practice. STs also provide some practical suggestions on implementing the FC approach.

The current digital transformation agenda connects beliefs/attitudes to behaviour/practice. Both of these elements are well established and continue to evolve. This paper conceptualizes the effects of digital transformation during the COVID-19 pandemic. It focuses on understanding the effects of causal factors (COVID-19 and digital transformation, on teachers' beliefs and practices. In the context of this conceptual paper, we delineate this to university education but argue that it is conceptually applicable to any educational setting. Our exploration of the phenomenon has yielded the conclusion that beliefs/attitudes are fluid, are formed cyclically, and that teachers' associated behaviour/practices are located along a continuum and are influenced by both technological and personal factors. We believe our arguments are valid because when COVID-19 fades as an "event", the world will have evolved new norms that include newer practices, inevitably informed by technological and personal factors. We provide a basis for understanding the effects of digitally transformed environments and how one might respond to such eventualities. We suggest a theoretical model that outlines the moderating constructs inherent in any digitally transformed environment. The theoretical model provides a hook for research into the beliefs-practice nexus and as a basis for supporting teachers in digitally transformed environments.

This paper focuses on the epistemic inequality of international students as a "new" inequality that is under-represented in the current debates about decolonisation (albeit shaped by colonial discourses depicting international students as in deficit and incapable of meeting the standards of (colonial) universities). In this theoretical context, the paper reflects on a multi-modal digital methodology used in a research project that aimed to understand how international students deploy their epistemological resources to learn the curriculum. The paper describes selected artefacts submitted by the students around which their epistemic frames were expressed, suggesting where these may be concealed by epistemological situatedness of the lecturers. Based on the analysis of these artefacts, the paper develops and interrogates an epistemology for support towards interrogating the role of our own epistemological binaries in adversely affecting students' epistemic frames in the curriculum. As such, it contributes to a gap in the literature around decolonial pedagogy, and its role in tackling educational inequalities.

Purpose: To improve the academic integrity of online examinations, digital proctoring systems have recently been implemented in higher education institutions (HEIs). The paper aims to understand how digital proctoring has been practised in higher education (HE) and proposes future research directions for studying digital proctoring in HE. Design/methodology/approach: A systematic literature review was conducted. The PRISMA procedure was adapted for the literature search. The topics were identified by topic modelling techniques from 154 relevant publications in seven databases. Findings: Seven widely discussed topics in literature were identified, including solutions for detecting cheating and student authentication, challenges/issues of uptakes and students' performance in different proctoring environments. Research limitations/implications: This paper provides insights for academics, policymakers, practitioners and students to understand the implementation of digital proctoring in academia, its adoption by HEIs, impacts on students' and educators' performance and the rapid increase in its use for digital exams in HEIs, with particular emphasis on the impacts of the systems on digitalising examinations in HE. Originality/value: This review paper has systematically and critically described the state-of-the-art literature on digital proctoring in HE and provides useful insights and implications for future research on digital proctoring, and how academic integrity in online examinations can be enhanced, along with digitalising HE.

Purpose: The pandemic's health and social issues have significantly altered the character and manner of teaching and learning in higher education across the country. The use of technology to replace or integrate face-to-face learning with online learning has become a necessary requirement for promoting and continuing learning processes. Furthermore, integrating technology is a goal of Sustainable Development Goal 4 (SDG 4) to make teaching and learning more innovative and sophisticated. This paper is based on a systematic review grounded in a synthesis of research papers and documents analyzing the current status of teachers' pedagogy through online learning modes in the context of Pakistan. Design/methodology/approach: Through content analyses of academic studies in higher education and reflection on the online teaching experiences, this study discusses how students' learning is associated with teachers' teaching approaches in the modern era of digitalization and innovation. Findings: The review and analysis suggest that online teaching is not viewed as an innovative phenomenon; rather, teachers simply teach their traditionally designed face-to-face courses through the use of technology. The paper suggests that transforming teachers' pedagogical insight to make online learning sustainable is an urgent need for higher education. Originality/value: The analysis provides a basis for consideration of teacher learning and quality education (SDG #4) to fulfill the nation's agenda for sustainable development. The analysis helps educators and administrators in higher education institutions reflect on their policies and practices that have short- and long-term effects on students' learning outcomes.

Many studies have recently focused on the importance of the effective integration of Information and Communication Technology (ICT) tools in science education and the need for science teachers to receive adequate training and support to use them effectively. This paper aims to explore the Albanian science teachers' perceptions and use of ICTs in teaching processes. The study provides an interpretative analysis of the opinions of science teachers teaching in the middle and high schools of several Albanian regions expressed in an online survey. Overall, the results suggest that the use of ICT by science teachers in Albania is limited by a lack of proper infrastructure, limited access to technology, and training of teachers on integrating technology. However, there are indications that the adoption of ICT in science education may increase in the future, particularly after the boost from the COVID-19 pandemic emergency.

This paper describes a qualitative study that examined the lived experience of 50 English language instructors who transitioned from in-person teaching to online instruction during the COVID pandemic of 2020. The purpose of this study focused on the contrast between systematic online English language teacher preparation and rapid migration to identify strategies that can facilitate sudden shifts in instructional contexts. The data that was collected through snowball sampling with an anonymous Qualtrics survey revealed that during this rapid transition, instructors struggled with learning the technological pedagogy skills, establishing connections with their students, implementing assessment practices, and organizing student interactions. After a description of the findings, the article concludes with implications for teacher education for online English language instruction.

Grounded in the literature on peer social capital, this study examines middle school students' perspectives on COVID-19-related changes in their peer interactions and friendships. Qualitative analyses of 146 students' survey responses showed that a majority experienced changes in their peer interactions and friendships. These students reported: (a) lasting changes in social-emotional states impacted peer interactions and friendships (e.g., increased anxiety); (b) changes in relationships (e.g., loss of friendships); and (c) visible changes in peer interactions (e.g., reduction in sharing behavior). Conversely, a small group of students perceived the changes in their peer interactions positively. The author argues that this paper's findings have farther-reaching implications than the pandemic, given other types of educational disruptions. Implications for educators, schools, and communities are discussed.

During COVID-19, international students were faced with the decision of remaining in their country of study or returning to their home countries, with little knowledge of when they would next be able to return or leave. Both choices left the students vulnerable to feelings of loneliness and social isolation. This paper examines how international students at a Scottish university experienced and navigated leaving or staying "home" and how loneliness and social isolation characterised these experiences. We further contextualise these experiences through Holbraad et al.'s (2019) prism of "rupture." The data were generated between February-July 2021 through semi-structured focus groups and qualitative questionnaire comments and were analysed through Thematic Analysis. We discuss three themes: 1) Liminal Friends and Strangers, 2) Sense of Home and Family, and 3) Staying or Leaving the Country. The study contributes to the expanding body of research on experiences of loneliness and social isolation amongst international students.

This paper deals with the implementation of flipped learning as a didactic method and its use through the Moodle platform. For this purpose, a quantitative research was carried out with the intention of analyzing the perceptions of new teachers in the acquisition of digital competences that they acquire during their teaching and learning process. The sample is made up of three groups of students in the subject Didactics of Social Sciences in the third year of primary education. The results obtained show that active learning methodologies promote digital literacy in higher education and the improvement of good teaching practices. In this way, through this research, students updated their use of new educational platforms, given the lack of initial training in digital literacy. In short, we can conclude that flipped learning is a useful and innovative teaching method that combines face-to-face and online learning for the education and training of new teachers.

In the spring of 2020, schools across the United States closed due to the COVID-19 pandemic, forcing a sudden change from the traditional way education was provided. When schools resumed, many teachers found themselves teaching and scaffolding learning in a new situation, online. However, there is limited information on how teachers implement scaffolding--both in-person as well as online. As such scaffolding depends on teachers' perceptions, this suggests the need for a measure of teachers' perceptions of scaffolding across these modalities. This paper reports the design and development of a survey created to measure teacher perceptions of their agency/control related to and self-efficacy for implementing various forms of scaffolding and the forms of scaffolding they use. K-12 teachers who taught before and during the pandemic (N=105) completed the survey in spring/summer 2021. Using exploratory factor analysis, we found that the survey measured these constructs, and that constructs loaded separately by modality (online versus face-to-face). This suggests the survey could be used in shorter forms to provide information about teacher perceptions of scaffolding specific to their modality, in turn providing more information about the kinds of professional development they might benefit from.

The global pandemic highlighted the need for diverse faculty development partners to ensure student and faculty learning was supported, particularly in intensive modes of educational delivery. Our paper presents an institutional case study of how educational technology, in collaboration with the Center for Teaching and Learning and subject matter experts, served as untapped providers of faculty development. We detail the decision to shift to an intensive 7-week module system rather than our traditional 15-week semester in response to COVID-19. Although challenging for both faculty and students, this shift in educational delivery facilitated innovative approaches to faculty and student learning that are present on our campus today. This institutional case study highlights the role that capacity-building plays in capability development and professional learning for faculty and students alike to support effective teaching practice across diverse delivery modes.

Universities across the globe are considering how to effect meaningful change in their higher education (HE) delivery in the face of the COVID-19 pandemic and shifting student learning preferences. This paper reports on a descriptive case- study of whole-of-institution curriculum reform at one regional Australian university, where more traditional 13-week semesters have been replaced with a 6-week immersive block model known as the Southern Cross Model. Based on a synthesis of literature in best practice HE pedagogy and principles, the case study draws on both a review of policy and staff interviews (N = 5) to outline the key changes necessary for successful HE transformation. Analysis revealed themes related to the vital roles of leadership, capacity building, monitoring the transition, staff adoption, and adequate technical systems in implementing a radical, multifaceted institutional transformation. Implications for practice at institutions considering reforming their curriculum model are also discussed. The findings from this case study indicate that an institutional transformation to an immersive block model requires both a considered change in institutional policy and process, as well as the appropriate resourcing of roles, governance committees, technical solutions, and, importantly, communities of practice.

In this paper, the authors explore the conditions that support belonging in remote VU Block Model® teaching. They examine the role of arts-based, embodied pedagogy in promoting engagement in learning, connection between students, and between students and teachers, and in an environment in which vulnerability and risk-taking in learning is valued. A discussion of belonging in higher education and the practice of embodied learning is followed by the reflections of seven participants. These participants were students in a remotely taught, arts-based higher education block unit, which had been mindfully adapted to retain the embodied nature of delivery during the COVID-19 pandemic. After students' participation in focus group interviews, the lead author constructed found poetry from their comments and reflections. This found poetry forms the dataset through which the questions of belonging are explored. The researchers found that when explored through the lens of the Community of Inquiry Framework, embodied and arts-based practices provided opportunities for students to develop a sense of belonging, deepen understanding of lived experiences, and realise higher education and career goals. This study elevates the voices of students, providing opportunities for higher education teachers to consider the importance of belonging for student success in remote, intensive, and on-campus modes of delivery.

Purpose: During Japan's initial pandemic prevention and control period, the Ministry of Education, Culture, Sports, Science, and Technology of Japan (MEXT) issued several notifications to ensure students' continuous learning according to the "leave no one behind" philosophy. This study focused on the comprehensive measures comprising top-level arrangements to implement the "suspending classes without stopping learning" initiative. Design/Approach/Methods: The study reviewed MEXT's guide on ensuring learning for Japanese primary and secondary school students during the pandemic. Findings: The pandemic has accelerated the development of the information and communications technology educational environment and the implementation of the Global and Innovation Gateway for All (GIGA) schools initiative. These developments laid the foundation for the evolution of diverse pedagogical models and feasible methods for promoting equity. The home schooling experience during the pandemic provided a natural base for students to practice and foster survivability. Originality/Value: This paper provides scholars with an understanding of the opportunities and challenges encountered in educational innovation in Japan. It provides insights into the future direction of pedagogical development, capability development, and effective educational arrangements for extraordinary circumstances to facilitate educational development from a broader perspective, particularly under the new normal.

Background: Children's educational experiences worldwide have been significantly impacted as a result of global school closures during the COVID-19 pandemic of Spring 2020. A growing number of studies aim to analyse impacts of these changes on social well-being, with limited studies placing an emphasis on the experiences of students with special educational needs (SENs). This article focusses on parent perspectives regarding impacts of school closures on social well-being in Canadian children with SEN., Methods: This study uses a mixed-methods approach, drawing from both qualitative and quantitative survey data from Spring/Summer 2020. Participants (n = 263) were eligible for participation if they were a parent/guardian of a child or adolescent with an SEN. We first conducted a descriptive analysis of the key variables, namely, social well-being, grade level of the child, internet and device availability, and the presence of other school-aged children in the home (single child vs. multiple children). Next, we explored the relationship between these using a bivariate correlation. Finally, open-ended responses were analysed using an inductive approach to qualitative thematic analysis., Results: The majority of parents expressed concern for their child's social well-being during the Spring 2020 school closures, with increased concerns for younger children. According to parents, children experienced communication barriers to peer interaction and many experienced emotional difficulties as a result. Technology was described as critical for some in maintaining social connections. Parents raised concerns about the impact of limited peer interaction on broader social skill development, in the short and long term. A small number of participants noted feelings of relief and reduced anxiety among their children with SEN., Conclusions: Findings highlight parent views of the negative impact of the pandemic on social well-being and the critical role in-person schooling plays in supporting peer relationships for children with SEN., (© 2024 The Authors. Child: Care, Health and Development published by John Wiley & Sons Ltd.)

Background: Telehealth is a growing model of care, greatly accelerated with the demands of the COVID-19 pandemic. Telecare is a synchronous audio-visual or audio-only format of health delivery., Aims: To evaluate the existing literature on telecare within adult gastroenterology subspecialties to determine if outcomes are comparable to traditional in-person consultations and to highlight the Pokapū Network, a local initiative in the Lakes Region of New Zealand, amongst these international findings., Methods: We completed an OVID MEDLINE search using the terms gastroenterology, endoscopy, digestive system, inflammatory bowel disease, functional, hepatology, liver, telemedicine, telehealth, videoconferencing, remote consultation, video clinic and telephone clinic., Results: Patients showed positive attitudes towards telecare and, in several reports, would elect to have telecare consults in the future. Telecare reduces travel time and out-of-pocket costs for patients and the need for patients to take time off work. Generally, patients engaging with telecare show equivalent health outcomes to patients engaging with traditional models of care. Patients from ethnic minority groups or lower socio-economic backgrounds, or who are older, are less likely to complete a 'successful' telecare consult., Conclusion: Telecare is a useful model of care to allow gastroenterology centres to function within the context of COVID-19 isolation and beyond. It has significant benefits for patients who face geographical and financial barriers to accessing healthcare. Telecare models such as the Pokapū Network hold promise in reducing inequities for gastroenterology patients. Such models must be introduced with consideration of digital disparities that exist amongst patients to avoid worsening the digital divide., (© 2024 John Wiley & Sons Ltd.)

Background: During the COVID-19 pandemic, the United States' Centers for Disease Control and Prevention (CDC) created guidance documents that were too complex to be read and understood by the majority of adults with intellectual and developmental disabilities who often read at or below a third-grade reading level. This study explored the extent to which these adults could read and understand CDC documents simplified using Minimised Text Complexity Guidelines., Method: This study involved 20 participants, 18-48 years of age. Participants read texts and responded to multiple-choice items and open-ended questions to gather information about how they interacted with and understood the texts., Results: The results provide initial evidence that the Minimised Text Complexity Guidelines resulted in texts that participants could read and understand., Conclusion: Implications for increasing the accessibility of public health information so that it can be read and understood by adults with extremely low literacy skills are discussed., (© 2024 John Wiley & Sons Ltd.)

Purpose of Review: The rapid rollout and uptake of novel coronavirus disease 2019 (COVID-19) vaccines has been accompanied by a small yet noticeable accumulation of reports of liver injury occurring after vaccination. This review describes the present evidence surrounding COVID-19 vaccine-induced liver injury (VILI)., Recent Findings: Liver injury occurring after the COVID-19 vaccine often presents clinically similar to autoimmune hepatitis, with positive autoantibodies and a portal and lobular inflammatory infiltrate and varying degrees of necrosis on biopsy. The overwhelming majority of patients recover, often spontaneously or with a limited course of immunosuppression. The overall incidence of this phenomenon appears to be exceedingly low., Summary: Providers should remain vigilant for ongoing reports of VILI after COVID-19 and yet feel reassured by the low incidence and high likelihood of recovery. Ongoing genetic and histological study, as well as longer-term follow-up of presently identified cases, will shed further light on the clinical entity of VILI., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Bronchiolitis is a common lower respiratory tract infection (LRTI) affecting infants and young children. Respiratory syncytial virus (RSV) has historically been the primary causative agent, but other viruses also contribute to the LRTI epidemiology. Recent changes in epidemiology and clinical patterns due to the coronavirus disease 2019 (COVID-19) pandemic have raised concerns. This study aims to analyze the impact of the pandemic on bronchiolitis epidemiology and severity., Methods: Two consecutive bronchiolitis seasons (October 2021 to March 2022 and October 2022 to March 2023) were compared. Data on viral agents, hospitalization duration, clinical severity, and respiratory support requirements were collected from pediatric patients at San Marco Hospital, University of Catania., Results: In the 2021-2022 season, RSV was the predominant virus (40%), followed by other viruses, with mild clinical outcomes. In the 2022-2023 season, RSV remained prevalent (58.7%), but other viruses, including rhinovirus (RV) and influenza, showed a significant increase (p < .05) in bronchiolitis cases and severity. Notably, RSV-related bronchiolitis did not exhibit greater severity compared to non-RSV cases in the 2022-2023 season, contrary to the previous year., Conclusion: The COVID-19 pandemic appears to have shifted the epidemiological landscape of bronchiolitis, with a peak incidence in November instead of January/February. Non-RSV viruses (RV, influenza A and B, as well as metapneumovirus) have gained prominence, possibly due to viral competition and reduced pandemic-related restrictions. Traditionally, RSV has been the primary pathogen responsible for most bronchiolitis cases. Nonetheless, the findings of this study indicate a shifting landscape in bronchiolitis etiology, with RSV gradually diminishing in its role. Contrary to the previous year, RSV-related bronchiolitis did not exhibit greater severity compared to non-RSV cases in the 2022-2023 season., (© 2024 Wiley Periodicals LLC.)

Elevated psychological distress, experienced by pregnant women and parents, has been well-documented during the COVID-19 pandemic. Most research focuses on the first 6-months postpartum, with single or limited repeated measures of perinatal distress. The present longitudinal study examined how perinatal distress, experienced over nearly 2 years of the COVID-19 pandemic, impacted toddler socioemotional development. A sample of 304 participants participated during pregnancy, 6-weeks, 6-months, and 15-months postpartum. Mothers reported their depressive, anxiety, and stress symptoms, at each timepoint. Mother-reported toddler socioemotional functioning (using the Brief Infant-Toddler Social and Emotional Assessment) was measured at 15-months. Results of structural equation mediation models indicated that (1) higher prenatal distress was associated with elevated postpartum distress, from 6-weeks to 15-months postpartum; (2) associations between prenatal distress and toddler socioemotional problems became nonsignificant after accounting for postpartum distress; and (3) higher prenatal distress was indirectly associated with greater socioemotional problems, and specifically elevated externalizing problems, through higher maternal distress at 6 weeks and 15 months postpartum. Findings suggest that the continued experience of distress during the postpartum period plays an important role in child socioemotional development during the COVID-19 pandemic., (© 2024 The Authors. Infancy published by Wiley Periodicals LLC on behalf of International Congress of Infant Studies.)

While industry and regulators' interest in decentralized clinical trials (DCTs) is long-standing, the Covid-19 pandemic accelerated and broadened the adoption and experience with these trials. The key idea in decentralization is bringing the clinical trial design, typically on-site, closer to the patient's experience (on-site or off-site). Thus, potential benefits of DCTs include reducing the burden of participation in trials, broadening access to a more diverse population, or using innovative endpoints collected off-site. This paper helps researchers to carefully evaluate the added value and the implications of DCTs beyond the operational aspects of their implementation. The proposed approach is to use the ICH E9(R1) estimand framework to guide the strategic decisions around each decentralization component. Furthermore, the framework can guide the process for clinical trialists to systematically consider the implications of decentralization, in turn, for each attribute of the estimand. We illustrate the use of this approach with a fully DCT case study and show that the proposed systematic process can uncover the scientific opportunities, assumptions, and potential risks associated with a possible use of decentralization components in the design of a trial. This process can also highlight the benefits of specifying estimand attributes in a granular way. Thus, we demonstrate that bringing a decentralization component into the design will not only impact estimators and estimation but can also correspond to addressing more granular questions, thereby uncovering new target estimands., (© 2024. The Author(s), under exclusive licence to The Drug Information Association, Inc.)

Background: The aim of the study was to determine the burden of respiratory syncytial virus (RSV) and influenza disease during the COVID-19 pandemic at 2 Austrian urban pediatric centers between October 1, 2019 and April 30, 2022., Methods: We performed a retrospective observational 2-center study on RSV- and influenza virus-associated hospitalizations in infants and children up to 18 years at the University Hospital of Graz and the Clinic Donaustadt of Vienna from October 1, 2019 to April 30, 2022. Hospitalization had to be associated with the infectious disease, proven by polymerase chain reaction, including presence of respiratory symptoms. Demographic data including underlying diseases and treatment strategies were compared between centers and diseases, respectively., Results: There were 826 cases in Graz and 379 in Vienna with significant more RSV cases in Graz and more influenza cases in Vienna (RSV: 76% vs. 59%, influenza: 24% vs. 41%; both P < 0.001). One death occurred in Graz due to RSV and another due to influenza in Vienna. Seasonality only slightly differed between centers and severity of diseases was not aggravated when measured by pediatric intensive care unit admission rates, need for supplemental oxygen and respiratory support between first and last seasons. Treatment regimen differed regarding higher use of antibiotics and rates of intravenous fluids in Vienna compared to higher rates of bronchodilators, corticosteroids and nose drops in Graz., Conclusions: We observed higher numbers of hospitalizations due to both viruses after the lockdown but not increased severity of the diseases; and mortality remained extremely low. Preventive measures should be implemented with high priority especially focused on infants with underlying diseases., Competing Interests: H.K. received honoraria for oral presentations and travel support from AstraZeneca and Abbvie and Milupa (Danone). G.S.-Y. received honoraria from Sanofi. E.R. received travel support from Milupa (Danone). C.V.K., C.G. and L.T. have no conflicts of interest to disclose. B.R. received honoraria for oral presentations and travel support from Milupa (Danone), Nestle, Germania, Abbvie, AstraZeneca, Sanofi, GSK and Chiesi., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Purpose: The Sino-Nasal-Outcome-Test 22 (SNOT-22) questionnaire assesses treatment outcome and health-related quality of life (HRQOL) in patients with chronic rhinosinusitis (CRS). However, given the overlap between CRS and olfaction in terms of nasal function and the definition of CRS, a fundamental question arises: can patients with olfactory dysfunction (OD) stemming from other causes attain SNOT-22 scores similar to those seen in CRS, even in the absence of CRS? Our study aimed to explore whether OD arising from various postinfectious mechanisms challenges the disease-specificity of SNOT-22 for CRS. If so, could focus on scores within specific symptom domains of SNOT-22 prove valuable in distinguishing between different etiologies., Methods: The study adopted an observational, retrospective cohort design based on prospectively registered patients and related variables using the REDCap platform. 460 patients experiencing OD due to either (1) simple or (2) complex post-COVID-19, (3) postinfectious non-COVID-19, and (4) CRS, were included in the analysis., Results: The study revealed that the total SNOT-22 score lacks disease-specificity for CRS. This is evident, because complex postinfectious mechanisms resulting from COVID-19 can produce similar symptoms in patients. Notably, elevated total scores were primarily driven by high subdomain scores within the "sleep and cognition" domain., Conclusions: The application of SNOT-22 as a screening tool needs to be approached with caution, as the total score alone does not provide disease-specific insights. A more thorough exploration of the four symptom domains and the identification of distinctive scoring patterns within the clinical context may prove pivotal in effectively differentiating between various underlying causes., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: The comprehension of the interests of Internet users regarding their health-related searches may reveal the community's demands about oral health. The study aimed to characterize the interests of Google users related to mouthwash in Australia, Brazil, Chile, Japan, Mexico, Russia, the United Kingdom, the United States, Saudi Arabia and South Africa applying the Google Trends., Methods: This longitudinal retrospective study analysed the mouthwash-related interest of Google users from January 2004 to December 2020. The monthly variation of relative search volume (RSV) and the main queries related were determined using Google Trends. Autoregressive integrated moving average (ARIMA) forecasting models were built to establish the predictive RSV values for mouthwash for additional 12 months. Auto-correlation plots and a general additive model (GAM) were used to diagnose trends and seasonality in RSV curves. In addition, the influence of social isolation related to the outbreak of COVID-19 were analysed., Results: The RSVs curves showed a considerable increase in searches related to mouthwash to AUS, BRA, JAP, MEX, GBR and USA (RSV > 25), while the growth was slight to CHI, KSA, RSA and RUS (RSV < 25) over the years, without influence of monthly seasonality. All countries showed a significant increase in mouthwash interest after the outbreak of COVID-19, except for KSA and RUS. The mouthwash-related searches were associated to specific brands or chemical compositions, treatments, whitening agents, homemade mouthwash and indications for the 'best mouthwash'., Conclusions: In general, there was an increasing interest of Google users in mouthwash-related topics between 2004 and 2020. In addition, in most countries, there was an expansion in searches during the social isolation of the COVID-19 pandemics., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: The COVID-19 pandemic has posed unprecedented challenges, particularly for healthcare workers (HCWs). The prolonged struggles exposed the HCWs to a variety of stressors, potentially leading to burnout. Emotional exhaustion is widely recognized as the core component of burnout. This research aims to conceptualize and develop an emotional exhaustion screening questionnaire through literature review, validation, and accuracy testing., Method: A literature review of questionnaires and extraction of items on emotional exhaustion were performed in June 2022. We proceed with the face validity of the items by experts. The items with good content validity ratio and index were selected and reworded to suit the context of HCWs working during the COVID-19 pandemic. A pilot test of the questionnaire was done in the Central University Hospital of Asturias (HUCA) from October to December 2022 with a sample of 148 HCWs from the ORCHESTRA cohort to determine its reliability, convergent validity, and accuracy., Results: Our literature review identified 15 validated questionnaires. After exclusion, 32 items were sent for content validation by experts, yielding five final items that proceeded with the pilot test. Resulting in a Cronbach's alpha-coefficient of .83 for the scale and .78 for dichotomous responses, demonstrating good internal consistency and convergent validity. The result of our accuracy test yielded sensitivity (90.6%) and specificity (91.6%) for the OEEQ scale; and sensitivity (88.7%) and specificity (89.5%) for OEEQ dichotomous responses., Conclusion: This study developed and validated the ORCHESTRA Emotional Exhaustion Questionnaire, demonstrating the questionnaire's clarity, relevance, and comprehensibility in screening emotional exhaustion among HCWs., (© 2023 The Authors. British Journal of Health Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.)

Purpose: Olfactory dysfunction (OD) can be a long-term consequence of various viral infections, including COVID-19. Dysfunction includes hyposmia/anosmia and parosmia (odor distortions). Interactions of the virus with the olfactory nerve have been extensively researched, but little is known about the interactions of the intranasal trigeminal nerve system in modulating this sensory loss., Methods: We investigated intranasal trigeminal function across COVID-19 OD patients with and without parosmia compared to normosmic controls, to determine whether (1) post-viral hyposmia and/or (2) post-viral hyposmia with parosmia is associated with altered trigeminal function. OD patients (n = 27) were tested for olfactory function using the extended Sniffin' Sticks olfactory test and for trigeminal function through three methods-odor lateralization, subjective ratings of nasal patency, and ammonium vapor pain intensity ratings. This group was subsequently compared to controls, normosmic subjects (n = 15)., Results: Our findings revealed that post-COVID OD patients without parosmia experienced decreased sensitivity in ammonium vapor pain intensity ratings and odor lateralization scores-but similar nasal patency ratings-compared to normosmic controls. There were no significant differences in trigeminal function between OD patients with and without parosmia., Conclusions: Based on our results, we conclude that the trigeminal nerve dysfunction may partially explain post-viral OD, but does not seem to be a major factor in the generation of parosmia pathophysiology., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: COVID-19 has placed a disproportionate burden on underserved racial and ethnic groups, community members working in essential industries, those living in areas of high population density, and those reliant on in-person services such as transportation. The goal of this study was to estimate the cross-sectional prevalence of SARS-CoV-2 (active SARS-CoV-2 or prior SARS-CoV-2 infection) in children and adults attending public venues in 15 sociodemographically diverse communities in the United States and to develop a statistical design that could be rigorously implemented amidst unpredictable stay-at-home COVID-19 guidelines., Methods: We used time-location sampling with complex sampling involving stratification, clustering of units, and unequal probabilities of selection to recruit individuals from selected communities. We safely conducted informed consent, specimen collection, and face-to-face interviews outside of public venues immediately following recruitment., Results: We developed an innovative sampling design that adapted to constraints such as closure of venues, changing infection hotspots, and uncertain policies. We updated both the sampling frame and the selection probabilities over time using information acquired from prior weeks. We created site-specific survey weights that adjusted sampling probabilities for nonresponse and calibrated to county-level margins on age and sex at birth., Conclusions: Although the study itself was specific to COVID-19, the strategies presented in this article could serve as a case study that can be adapted for performing population-level inferences in similar settings and could help inform rapid and effective responses to future global public health challenges., Competing Interests: Disclosure: The authors report no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Inappropriate sinus tachycardia (IST) is one of the manifestations of the post-COVID-19 syndrome (PCS), which pathogenesis remains largely unknown. This study aimed to identify potential risk factors for IST in individuals with PCS. The 1349 patients with PCS were included into the study. Clinical examination, 24H Holter ECG, 24H ambulatory blood pressure monitoring and biochemical tests were performed 12-16 weeks after the COVID-19 in all participants. IST was found in 69 (3.5%) individuals. In the clinical assessment IST patients were characterized by a higher age (p < 0.001) and lower prevalence of the diagnosed hypertension (p = 0.012), compared to remaining patients. Biochemical testing showed higher serum triglycerides (1.66 vs. 1.31 pmol/L, p = 0.007) and higher prevalence of a low high-density lipoprotein (HDL) cholesterol (24.6% vs. 15.2%, p = 0.035) in the IST group. Subsequently, the triglicerydes (TG)/HDL ratio, an indicator of insulin resistance, was significantly higher in the IST individuals (3.2 vs. 2.4, p = 0.005). 24H monitoring revealed a significantly higher minimum diastolic, maximum systolic and mean arterial blood pressure values in the IST group (p < 0.001 for all), suggesting a high prevalence of undiagnosed hypertension. A multivariate analysis confirmed the predictive value TG/HDL ratio >3 (OR 2.67, p < 0.001) as predictors of IST development. A receiver operating characteristic curve analysis of the relationship between the TG/HDL ratio and the IST risk showed that the predictive cut-off point for this parameter was 2.46 (area under the ROC curve = 0.600, p = 0.004). Based on these findings, one can conclude that insulin resistance seems to be a risk factor of IST, a common component of PCS., (© 2024 The Authors. Journal of Medical Virology published by Wiley Periodicals LLC.)

Background: Multisystem inflammatory syndrome in children (MIS-C), a relatively uncommon but severe pediatric complication, is associated with coronavirus disease 2019 (COVID-19). A variety of treatment approaches, including intravenous immunoglobulins (IVIGs), glucocorticoids (GCs) and biologic agents, such as anakinra and infliximab, have been described for the management of COVID-19-related MIS-C. Anticoagulant therapy is also important. However, a well-developed treatment system has not been established, and many issues remain controversial. Several recently published articles related to the treatment of MIS-C have been released. Hence, in this review, we identified relevant articles published recently and summarized the treatment of MIS-C more comprehensively and systematically., Data Sources: We reviewed the literature on the treatment of MIS-C through 20 September 2023. The PubMed/Medline, Web of Science, EMBASE, and Cochrane Library databases were searched with the combination of the terms "multisystem inflammatory syndrome", "MIS-C", "PIMS-TS", "therapy", "treatment", "drug", "IVIG", "GCs", "intravenous immunoglobulin", "corticosteroids", "biological agent", and "aspirin"., Results: The severity of MIS-C varies, and different treatment schemes should be used according to the specific condition. Ongoing research and data collection are vital to better understand the pathophysiology and optimal management of MIS-C., Conclusions: MIS-C is a disease involving multiple systems and has great heterogeneity. With the accumulation of additional experience, we have garnered fresh insights into its treatment strategies. However, there remains a critical need for greater standardization in treatment protocols, alongside the pressing necessity for more robust and meticulously conducted studies to deepen our understanding of these protocols. Supplementary file1 (MP4 208044 kb)., (© 2024. Children's Hospital, Zhejiang University School of Medicine.)

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.)

A randomized, double-blind, placebo-controlled study (SAVEMORE trial) provided data to support an Emergency Use Authorization (EUA) of anakinra in hospitalized adults with positive results of direct severe acute respiratory syndrome-coronavirus 2 viral testing with pneumonia requiring supplemental oxygen (low- or high-flow oxygen) who are at risk of progressing to severe respiratory failure and likely to have an elevated plasma soluble urokinase plasminogen activator receptor (suPAR). Currently, the suPAR assay is not commercially available in the United States. An alternative method was needed to identify patients that best reflect the population in the clinical trial selected based on suPAR level ≥ 6 ng/mL at baseline. A machine learning approach based on data from the SAVEMORE trial was used to develop a scoring rule to identify patients who are likely to have a suPAR level ≥ 6 ng/mL at baseline. External validation of the scoring rule was conducted with data from a different trial (SAVE). This clinical scoring rule with high positive predictive value, high specificity, reasonable sensitivity, and biological relevance is expected to identify patients who are likely to have an elevated suPAR level ≥ 6 ng/mL at baseline. As such, it is included in the EUA to identify patients that fall within the authorized population for whom the known and potential benefits outweigh the known and potential risks of anakinra., (Published 2024. This article is a U.S. Government work and is in the public domain in the USA. Clinical Pharmacology & Therapeutics published by Wiley Periodicals LLC on behalf of American Society for Clinical Pharmacology and Therapeutics.)