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The main purpose of this study is to examine the opinions of teachers about technology leadership roles of school principals during the Covid-19 pandemic. The study, which utilized qualitative research methods, was designed as a survey study. Sample group of the study constituted of 259 teachers. Data of the study was collected with "Elementary School Principals' Technology Leadership Role Scale" and analyzed via descriptive statistics, independent sample t-test, one-way ANOVA and Mann Whitney-U test. According to the results, both elementary school teachers and subject matter teachers think that school principals successfully demonstrated the role of technology leadership roles during the Covid-19 pandemic. As a result of the analyses conducted to determine whether teachers' opinions vary according to various variables, it was concluded that there are no differences in terms of the entire scale and its dimensions based on genders and seniority of teachers. In terms of the working domain, it was seen the opinions of elementary school teachers on vision dimension are higher than those of subject matter teachers. Based on the results, some recommendations which can contribute to both implementation and theory have been developed. Accordingly, conducing researches which employ multiple data collection methods and tools to investigate technology leadership roles of school principals is considered important.

There are many rewards associated with teaching in public schools, but there are also several challenges such as understaffing, limited resources, overcrowded classrooms, and underpaid employees. All of these issues combined often lead to burnout and mental health concerns among public school teachers, particularly those in urban settings. Since the onset of the COVID-19 pandemic, literature regarding teachers' psychological distress has increased in a general sense; however, there remains limited exploration of a potential increase in job-related mental health concerns of urban teachers after the onset of COVID. Therefore, in this study we compare the 2018 (pre-COVID) and 2020 (early-COVID) results of the North Carolina Teacher Working Conditions Survey in order to answer whether there has been a change in the psychological distress of urban school teachers in North Carolina since the onset of COVID. Based on the findings, we offer recommendations to key stakeholders in an effort to better support the health and outcomes of K-12 urban school teachers as they continue adapting to the ever-expanding and ever-evolving implications of COVID.

During the COVID-19 pandemic, students faced increased risk of contracting the virus due to the relaxation of health protocols by the Philippine government and the authorization of face-to-face instruction in schools by the Department of Education. There is little data on basic education school students' awareness of COVID-19 in the Philippines, particularly in Cebu City. A cross-sectional descriptive-correlational research design was utilized to determine junior and senior high school students' knowledge, attitudes, and practices regarding COVID-19. In this study, a survey questionnaire was used to compare and attempt to identify relationships between the demographic profile of students and their KAPs regarding COVID-19. This study also investigated the relationships between students' KAPs. JHS and SHS students exhibited outstanding KAPs for COVID-19. Students' demographic characteristics, including grade level and family income, were significantly associated with their KAPs toward the disease. However, their gender was not significantly associated with their KAPs. There was a significant relationship between students' COVID-19 KAPs. It is imperative that the DepEd develop strategies and programs to combat the situation due to pandemic and prepare for similar situations in future. With the aid of curriculum designers, science educators must adapt the science education curriculum to address current and future health concerns.

In response to the COVID-19 pandemic, technological and administrative systems for implementing online learning, and the infrastructure that supports its access and delivery, had to be adapted quickly. While disparity in accessibility existed between urban and rural students, extensive resources had been allocated and processes developed to connect learners with course activities and materials, to facilitate communication between instructors and students, and to manage the administration of online learning. Educators needed to make way for this transition with the available technological support and their existing IT skills. Although the pandemic is over, online education still remains a viable option for continuing education in an emergency situation. Exploring the challenges faced during the COVID-19 pandemic and delving deep into the nature and the types of these challenges and their possible reasons will pave the way of translating these insights into academic practices required for laying the foundation of blended learning (BL) in higher education. Recently the University Grants Commission of Bangladesh has published a proposal for adopting BL in the higher education institutions of Bangladesh. This case study consisting of both quantitative and qualitative research, explores the challenges faced by the teachers of the University of Asia Pacific (UAP) during the online shift of education because of the pandemic. Based on the findings, a blended learning framework has been developed which can be applied in tertiary level education in Bangladesh and elsewhere.

Background: Long COVID, also known as post-acute sequelae of COVID-19 (PASC), is a poorly understood condition with symptoms across a range of biological domains that often have debilitating consequences. Some have recently suggested that lingering SARS-CoV-2 virus particles in the gut may impede serotonin production and that low serotonin may drive many Long COVID symptoms across a range of biological systems. Therefore, selective serotonin reuptake inhibitors (SSRIs), which increase synaptic serotonin availability, may be used to prevent or treat Long COVID. SSRIs are commonly prescribed for depression, therefore restricting a study sample to only include patients with depression can reduce the concern of confounding by indication., Methods: In an observational sample of electronic health records from patients in the National COVID Cohort Collaborative (N3C) with a COVID-19 diagnosis between September 1, 2021, and December 1, 2022, and a comorbid depressive disorder, the leading indication for SSRI use, we evaluated the relationship between SSRI use during acute COVID-19 and subsequent 12-month risk of Long COVID (defined by ICD-10 code U09.9). We defined SSRI use as a prescription for SSRI medication beginning at least 30 days before acute COVID-19 and not ending before SARS-CoV-2 infection. To minimize bias, we estimated relationships using nonparametric targeted maximum likelihood estimation to aggressively adjust for high-dimensional covariates., Results: We analyzed a sample (n = 302,626) of patients with a diagnosis of a depressive condition before COVID-19 diagnosis, where 100,803 (33%) were using an SSRI. We found that SSRI users had a significantly lower risk of Long COVID compared to nonusers (adjusted causal relative risk 0.92, 95% CI (0.86, 0.99)) and we found a similar relationship comparing new SSRI users (first SSRI prescription 1 to 4 months before acute COVID-19 with no prior history of SSRI use) to nonusers (adjusted causal relative risk 0.89, 95% CI (0.80, 0.98))., Conclusions: These findings suggest that SSRI use during acute COVID-19 may be protective against Long COVID, supporting the hypothesis that serotonin may be a key mechanistic biomarker of Long COVID., (© 2024. The Author(s).)

The COVID-19 pandemic has led to the disruption of classroom activities and adoption of online teaching-learning in almost all parts of the globe, including India. The sudden switch from classroom blackboards to laptop screens may have influenced students' study approaches, especially with challenges related to technology access and readiness for online learning among Indian students. Since different social and economic factors bring about differences in students' learning, an online survey was conducted with 296 randomly selected undergraduate distance learning (DL) students at Indira Gandhi National Open University to examine how technology access during the pandemic influenced the study approaches of Indian DL students from various marginalized and non-marginalized groups. The research results showed that marginalized students had lower access to technology than did their non-marginalized counterparts, although no gender differences were found in access to technology in both the groups. Lower access to technology was associated with a surface approach to study among the DL students in general and the marginalized students in particular. Females in the marginalized group were found to be at risk in terms of both access to technology and study approaches. The findings were intended to enrich our understanding of the role of technology vis-à-vis distance learners' study approaches during the pandemic and formulate appropriate teaching-learning strategies for the future.

The recent expansion of the COVID-19 outbreak has drastically altered the educational landscape, causing certain schools to operate on a distance education basis. The goal of this study is to investigate this phenomenon in depth, focusing on the elements that may contribute to the marginalization of students with learning disabilities and their immigration biography. At the same time, it attempts to investigate the perspectives of a group of students, teachers, and parents on how to avoid marginalization as a result of distance education. We employed a mixed research style to study the aforementioned problem. A total of 132 secondary school students, 52 secondary school teachers, and 49 secondary school parents were included in the study. As research tools, questionnaires, focus groups, observations and interviews were used. The data analysis reveals that the elements which may contribute to marginalization in remote education are primarily related to attention challenges, but also to technical difficulties. According to the participants, a closer collaboration between the Ministry of Education, school administrations and teachers, as well as revisions to the substance of teaching subjects, may be the solution to the problem.

This study aimed to investigate decreasing student academic stress in distance learning during the COVID-19 pandemic, transition period, and new normal era by giving a self-help module to students. This research employed an experimental approach with a group pre-test post-test design with quantitative analytics. The perceived academic stress scale (PASS) and module evaluation scale were utilized to assess students' academic stress levels and their understanding of the module. The subjects consisted of one male student and thirty-seven female students, as the school was dominated by female students. This study indicated that students' academic stress levels during the pandemic and the new normal were in the medium range (18.82 - 19.97). The results showed that there was no significant difference in academic stress between the pandemic and the transition period (t = 1.322, p > 0.05) and the data between the pandemic and the new normal (t = -1.426, p > 0.05), while between the transition period and the new normal, it showed a significant difference (t = -4.189, p < 0.05). The study recommends that schools develop future guidance and counseling programs to help students cope with stress and build resilience. This study's findings can inform policy decisions and academic interventions to support students' mental health and academic success during challenging times.

In this study, the crisis management performance of the Turkish Education System and School Administration in the case of the COVID-19 Pandemic was evaluated by considering the importance of post-crisis evaluation and research gap. For this purpose, qualitative (N=17) and quantitative (N=444) data of the experiences and opinions of school administrators working in formal compulsory schools selected by purposeful, random and available sampling techniques from different provinces representing first-level statistical regions were evaluated. Crisis management performance evaluation criteria, which were created by a literature review, were utilized in the evaluation. Semi-structured interviews and questionnaires were used to collect data. We implemented both content analysis and descriptive statistics in line with the mixed method exploratory sequential research design. We first carried out the content analysis then, we investigated the prevalence of the matter by surveying. At the last phase of the analysis, we synthesized the qualitative and quantitative results. At the end of the study, it was observed that the crisis management practices of the Turkish Education System were not based on a long-term foresight, no preliminary preparation was made, and the problems in performing the basic functions during the crisis could not be completely resolved. For this reason, it has been concluded that the performance of the Turkish Education System and school administrations in managing the crisis is low.

Technological advances and the COVID-19 pandemic have led to a significant paradigm shift in the field of education, especially in the field of distance education. In this period, although distance education offers a number of advantages to its users, it has also brought some difficulties. This sudden transition has had a profound impact on students, teachers, and institutions, leading to changes in teaching methods, assessment practices, and student engagement strategies. This study aims to investigate the problems that arise in the distance education process and to examine the effects of these problems on students in detail. A qualitative approach is considered ideal since it enables deeper understanding of experiences of university students during distance education. Convenience sampling was chosen because it provided easy access for the researchers and allowed the inclusion of participants who met the required criteria. The participants consisted of 37 people, 28 girls and 9 boys, who had experienced the distance education and were studying in the Psychological Counselling and Guidance programme in the second year of a state university located in the Aegean region of Türkiye. The data were collected through semi-structured interviews and analysed using content analysis and thematic analysis methods. According to the findings of the study, the problems encountered by the students in the distance education process were listed under the following main themes: technological problems, problems related to the monitoring and evaluation of the course, motivation problems, emotional and physical problems, communication problems, problems related to domestic and environmental factors, feeling of professional inadequacy. In addition, students' suggestions for solutions to these problems and their opinions about whether they prefer face-to-face or online education were also discussed. As a result, the study offers suggestions for educational institutions and educators to overcome the difficulties encountered in distance education and to make the experience a positive one.

The purpose of this research was to investigate the possibilities and opportunities for ASEAN and Korea student exchange programs in the post-COVID-19 pandemic era, by focusing on the needs of non-participating ASEAN students. To do so, this study conducted an online survey to analyze ASEAN students' understanding, views, expectations, and reasons for not participating in student exchange programs to Korea, while investigating their considerations and preferences for future participation. The findings revealed significant differences between ASEAN students in terms of nationality (especially Vietnamese students), academic field, and gender. They also highlighted the rising role and importance of hybrid and online modes of student mobility, that grew in the wake of the COVID-19 pandemic. Therefore, there is a need for universities, government policy makers and educational scholars to reflect the emerging new needs of students concerning ASEAN-Korea exchange programs in the post-COVID-19 pandemic era.

Background: In Germany, an estimated number of 70,000 people diagnosed with long COVID or post-COVID syndrome (PCS) had received inpatient medical rehabilitation by the end of 2022. Due to the heterogeneity of the clinical picture, the variability of interventions and inconsistent endpoints, previous studies on the effectiveness of rehabilitation are of limited value. It therefore remains unclear whether and to what extent rehabilitation measures established for, e.g., pulmonary, cardiovascular, or neurological diseases are suitable for patients with PCS., Objectives: To identify the experiences and perspectives of those affected by PCS, in relation to inpatient rehabilitation and to describe patients' values and wishes with respect to evidence-based medicine., Methods: In January/February 2023, the German initiative "Long COVID Deutschland" conducted a retrospective online survey (39 closed items, two open answer fields) among adult PCS sufferers on their experiences with inpatient rehabilitation. Recruitment was carried out via social media and websites of patient initiatives. The open answers were analyzed using a structuring and summarizing qualitative content analysis according to Mayring, supplemented by descriptive representations of the distribution of standardized information., Results: Of 1,191 participants in the survey, 733 used open response formats to additionally explain their experiences and the effects of individual measures on their general condition. 366 (50%) reported that their state of health deteriorated, mainly because of strength or endurance training and too extensive treatment plans. The presence of a post-exertional malaise (PEM) or its insufficient consideration during rehabilitation was described as the main barrier. Recognition and acceptance of individual performance limits, flexible and coordinated individual treatment plans tailored to the patient's limitations, and support in coping with the disease were described as supportive factors. From the participants' perspective, learning strategies to avoid deterioration in their state of health due to overexertion, the so-called pacing, should be the core treatment goal for patients affected by PEM., Discussion: The results are not statistically representative but ensure systematic insights into the subjective perspectives of those affected, the consideration of which represents one of the three principles of evidence-based medicine. The results show that for PCS patients with PEM, even minimum requirements for rehabilitation measures can lead to overexertion and aggravation., Conclusions: Common subject-specific rehabilitation concepts appear to be only partially suitable for dealing with the symptoms and the heterogeneity of the disease. Aims and interventions should be individually adapted, and the focus should be on pacing, disease coping and management. A reliable test for PEM and rehabilitation ability before the start of rehabilitation is needed to ensure safety for those affected. To adequately classify studies on the effectiveness of rehabilitation, risks and side effects should be disclosed., (Copyright © 2024. Published by Elsevier GmbH.)

Background: the spread of SARS-CoV-2 in the population has amplified the effects of health inequalities, particularly in the most vulnerable groups such as immigrants and refugees. An assessment of the intervention to contain the COVID-19 in these population groups was essential to define new strategies for more equitable, inclusive, and effective health policies to on health., Objectives: to provide a systematic synopsis of the impact of interventions to contain the spread of SARS-CoV-2 in immigrants., Methods: data sources included major bibliographic databases. Using a study protocol, already shared with the international scientific community, two independent researchers reviewed the citations, selected and evaluated the interventions studies. Due to the heterogeneity of the interventions, a narrative synthesis was carried out., Results: three eligible studies were identified. The first study modelled the incidence of the disease in a refugee camp in Greece, based on an intervention of sectorialization of people that accessed to services, the use of masks, the early identification and isolation of cases and their family members, and the limitation of movements within the camp. The second evaluated the impact of preventive pharmacological interventions such as the use of hydroxychloroquine, ivermectin, povidone-iodine, zinc, and vitamin C, in different dosages and combinations, to a group of immigrant workers in a city dormitory in Singapore. The third study evaluated an intervention to increase vaccination coverage within a Latino immigrant community in the United States, moving the location of vaccine supply throughout the most frequented contexts by the immigrant community to access the city services. The results of the first and second studies suggest impacts for some of the proposed interventions even if they have been partially overcome due to the use of mass vaccination. The third showed a reduction in vaccine hesitancy and an increase in vaccination uptake and a snowball effect., Conclusions: the systematic review identified few heterogeneous studies, preventing any generalization of the results. Probably, the low scientific production does not reflect the successful experiences implemented. In the case of a possible resumption of the epidemic or new emergencies, it will be necessary to rely on indirect evidence and the scientific community should consider more the responsibility to evaluate and make available the experiences gained in the field. A constant monitoring activity of the evidence that will be necessary to updating the results for suggest consolidated prevention measures to for controlling the incidence of COVID-19 in immigrants during a possible resumption of the epidemic and for application in other similarly emergency contexts.

Objective: The prevalence of long-/post-COVID-associated chemosensory symptoms is reported in the literature to be significantly higher than clinical reality reflects., Methods: 1. N= 4062 adults acutely infected with SARS-CoV-2 and their symptoms transmitted by the Jena health office to the Robert Koch Institute between March 2020 and September 2021 were evaluated. 2. Part of the same cohort (N = 909 of 4062) answered an extensive questionnaire at least 3 months after the start of the infection, including existing chemosensory post-COVID-associated complaints. 3. Fourteen post-COVID Jena patients with chemosensory symptoms who had become acutely infected during the same period were diagnosed, treated and advised in our ENT specialist outpatient clinic., Results: The prevalence of chemosensory symptoms at the onset of infection was 19% (600/3187). About every second written respondent of the formerly acutely infected (441/890) remembered chemosensory symptoms during their COVID-19 infection. Of these, around 38% (167/441) complained of persistent chemosensory post-COVID symptoms after an average of 14.5 months. Only 2.3% (14/600) of the previously acutely infected patients with chemosensory symptoms sought medical help in a special consultation. Quantitative chemosensory damage could only be objectified in half, i.e. 1.2% (7/600) of the total cohort., Conclusions: Despite a high prevalence of subjective chemosensory symptoms in acutely and formerly SARS-CoV-2 infected people, there is only a low need for specialized treatment, so that, unlike other post-COVID-associated complaints, the healthcare system as a whole appears to be less significantly burdened., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

This study evaluated the explanatory factors of humoral immune response in older adults admitted to long-term care institutions in Buenos Aires, Argentina, up to 180 days after vaccination. An open-label, prospective, multicenter cohort study was conducted with volunteers who received two doses of the Sputnik V, Sinopharm, or AZD1222 vaccines. Plasma samples were analyzed at 0 and 21 days after the first dose, 21 days after the second dose, and 120 and 180 days after the first dose. Marginal linear models and generalized additives mixed models were adjusted to determine the behavior of anti-spike IgG antibody concentration over time according to exposure group (naïve/no-naïve) and vaccine. Occurrence of an outbreak of COVID-19 in long-term care institutions and comorbidities were the covariates analyzed. A total of 773 participants were included, with a mean age of 83 years (IQR: 76-89). Results showed that antibody levels in the naïve: Sinopharm group were significantly lower to the other groups (p < 0.05). Antibody levels in the no-naïve: Sinopharm group were similar to those in the naïve group who received AZD1222 (p = 0.945) or Sputnik V (p = 1). Participants exposed to outbreaks in long-term care institutions had significantly higher antibody levels, regardless of exposure group and vaccine (p < 0.001). In conclusion, previous exposure to COVID-19, type of vaccine, and admittance into a long-term care institution with a history of outbreaks are factors to be considered in future epidemic events with transmission dynamics and immunological mechanisms similar to COVID-19, in populations similar to the one analyzed.

Introduction: This study evaluated the effect of the COVID-19 pandemic on temporal trends in mental health and addiction-related inpatient hospitalization rates among youth (aged 10-17 years) in Canadian provinces and territories (excluding Quebec) from 1 April 2018 to 5 March 2022., Methods: We conducted an interrupted time series analysis across three periods: T0 (pre-pandemic: 1 April 2018 to 15 March 2020); T1 (early pandemic: 15 March 2020 to 5 July 2020); and T2 (later pandemic: 6 July 2020 to 5 March 2022)., Results: Pre-pandemic mental health and addiction-related hospitalization rates had significant regional variability, with weekly rates from 6.27 to 85.59 events per 100 000 persons in Manitoba and the territories combined, respectively. During T1, the national (excluding Quebec) weekly hospitalization rate decreased from a pre-pandemic level of 12.82 (95% CI: 12.14 to 13.50) to 5.11 (95% CI: 3.80 to 6.41) events per 100 000 persons. There was no statistically significant change in the mental health and addiction- related hospitalization rate across provinces and territories in T2 compared to T0. However, there was a significant increase in the rate of self-harm-related hospitalizations among females Canada-wide and in most provinces during this period., Conclusion: Although several Canadian studies have reported increases in mental health and addiction-related outpatient and emergency department visits among youth during the COVID-19 pandemic, this did not correspond to an increase in the inpatient hospital burden, with the notable exception of self-harm among young females., Competing Interests: The authors have no conflicts of interest. Justin J. Lang is one of this journal’s Associate Scientific Editors, but has recused himself from the review process for this article.

In this article, we describe the case of a 70-year-old man whose diagnosis of a brain meningioma was hindered by a SARS-CoV-2 infection. The patient, who had been vaccinated twice with the AstraZeneca COVID-19 vaccine, was admitted to Temporary Hospital No. 2, University Hospital (Białystok, Poland) with a positive PCR test result for SARS-CoV-2. The patient's general condition was good, but he reported a significant reduction in visual acuity in his left eye and headaches. A series of ophthalmological examinations were conducted, but they did not clarify the cause of the significant decrease in visual acuity. During hospitalization, an abnormal light reaction of the left pupil was observed, which led to the expansion of diagnostics to include imaging studies (CT and MRI). Computed tomography and magnetic resonance imaging revealed extensive isointense areas in the anterior cranial fossa, suggesting the presence of a meningioma. The final diagnosis and clarification of the cause of the visual impairment in the left eye resulted in the patient being transferred to the neurosurgery department for surgical treatment. COVID-19 diagnosis may mask the correct interpretation of other disease symptoms. Accidentally detected asymptomatic SARS-CoV-2 infection accelerated proper ophthalmic and neurology diagnosis. In this article, we describe the case of a 70-year-old man whose diagnosis of a brain meningioma was hindered by a SARS-CoV-2 infection. The patient, who had been vaccinated twice with the AstraZeneca COVID-19 vaccine, was admitted to Temporary Hospital No. 2, University Hospital (Białystok, Poland) with a positive PCR test result for SARS-CoV-2. The patient's general condition was good, but he reported a significant reduction in visual acuity in his left eye and headaches. A series of ophthalmological examinations were conducted, but they did not clarify the cause of the significant decrease in visual acuity. During hospitalization, an abnormal light reaction of the left pupil was observed, which led to the expansion of diagnostics to include imaging studies (CT and MRI). Computed tomography and magnetic resonance imaging revealed extensive isointense areas in the anterior cranial fossa, suggesting the presence of a meningioma. The final diagnosis and clarification of the cause of the visual impairment in the left eye resulted in the patient being transferred to the neurosurgery department for surgical treatment. COVID-19 diagnosis may mask the correct interpretation of other disease symptoms. Accidentally detected asymptomatic SARS-CoV-2 infection accelerated proper ophthalmic and neurology diagnosis.

Objectives: to describe indicators, data sources, and levels of geographical stratification used within the framework of the CCM project "Epidemiological Surveillance and Control of COVID-19 in Metropolitan Urban Areas and for the containment of SARS-CoV-2 circulation in the immigrant population in Italy"., Design: population-based observational study based on data from the Integrated Covid-19 Surveillance System and the archive of hospital discharge records., Setting and Participants: interregional collaborative project. Resident population in 5 Italian Regions (Piedmont, Emilia-Romagna, Tuscany, Lazio, and Sicily)., Main Outcomes Measures: crude and age-standardized rates of diagnostic test utilization and positivity, hospitalization (in any department and in intensive care unit), and mortality in COVID-19 cases., Results: starting from the set of 11 indicators from the Italian National Institute for Health, Migration and Poverty (INMP) project "Epidemiology of SARS-CoV-2 Infection (COVID-19) and Use of Health Services in the Immigrant Population and Vulnerable Population Groups in Italy", the five most effective indicators for CCM purposes were identified. The INMP project highlighted higher rates of test access and positivity among Italians compared to foreigners, higher standardized hospitalization rates among foreigners, and higher standardized mortality rates among Italians, with geographical and temporal heterogeneity. The intersection between the DEGURBA (degree of urbanisation) classification and altimetric zones defined five levels of territorial stratification characterized by decreasing population density. Approximately 81% of the population involved in the CCM project resided in the first two levels; 43% of Italians lived in areas with intermediate population density in hilly or plain areas, while 48% of foreigners were concentrated in densely populated areas., Conclusions: sharing the collaborative approach and a research methodology already tested, integrated with the analysis of disaggregated indicators by morphological, functional, and administrative characteristics of the residential territory, allowed for assessing differences in the impact of the pandemic between Italians and foreigners residing in more or less densely populated areas.

Introduction: The rapid emergence of COVID-19 urged policy responses worldwide, focusing on vaccination and mobility restrictions. Chile represents a unique scenario for analyzing personal preventive measures amid intensive communication and vaccination campaigns. This study aims to explore changes in population adherence to non-pharmacological preventive measures during the pandemic and the factors that explain this adherence each year., Methods: 386 individuals who participated in two population-based studies (2021 and 2022) were considered. An interview was conducted to measure adherence to self-care practices, and case and contact tracing by the health authorities. The Wilcoxon signed-rank test was performed to measure change between 2021 and 2022, bivariate analysis, and a linear regression model for each year were performed., Results: Mask-wearing in public places was the most commonly used measure (95.9% in 2021, 89.9% in 2022). Follow-up of cases and cases contacts by the health authority had high coverage in 2021 (94.3% and 83% respectively). A greater decrease was observed in contact tracing in 2022 totaling 33.3%. An increase in the score of adherence to preventive practices was observed in 2022 (p < 0.00). The regression model showed in 2021 that women were more likely to adopt preventive behaviors (95% confidence interval: 0.27 to 1.13) and the overweight/obese had higher adherence compared to normal body mass index (95% confidence interval: 0.06 to 0.98). In 2022 being a young adult (30 to 49 years) predicted the adoption of behavioral precautions (95% confidence interval: 0.00 to 1.32)., Conclusions: Adherence to preventive measures increased even with high vaccination coverage, likely due to the epidemiological situation with the Omicron variant circulating in 2022., Competing Interests: The authors declare no conflict of interest. At the same time, the funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results., (This work is licensed under a Creative Commons Attribution 4.0 International License.)

Introduction: Following the Omicron wave in early 2022, an estimated 60-70% of the French population was infected with the SARS-CoV-2 virus. One out of ten infected subjects could have persistent symptoms three months after infection, representing a public health challenge., Current State of Knowledge: The persistent symptoms may be secondary to diverse entities with distinct mechanisms. While organic infection sequelae occur mainly after severe COVID-19, some symptoms appear to be essentially psychological in origin; in addition, many subjects present stereotyped symptoms of fluctuating intensity with no identified anatomical or psychic substratum, often in the aftermath of a benign infection. The most frequent complaints are fatigue, pain, dyspnea and difficulty concentrating., Perspectives: The hypotheses explored to explain these symptoms include: persistent immune dysfunction, inducted autoimmunity, and microbiome disturbances. Persistent viral antigens may lie at the crossroads of these mechanisms. To date, these different etiological avenues have yet to lead to the development of diagnostic tests or specific therapeutic strategies., Conclusion: Prolonged symptoms after COVID-19 correspond to heterogeneous nosological entities with poorly understood mechanisms., (Copyright © 2024 SPLF. Published by Elsevier Masson SAS. All rights reserved.)

Introduction: Introduction: during the pandemic, an increase in symptoms of depression and anxiety, as well as lifestyle changes in adolescents has been reported. Objectives: to evaluate anxiety and depression symptoms, risky eating behaviors (REB), eating habits and physical activity after the COVID-19 pandemic in Mexican adolescents; to associate the study variables with the development of REB. Methods: a study was performed with a sample of 2,710 adolescents. The Hospital Anxiety and Depression Scale (HADS) and the Questionnaire to measure Risky Eating Behaviors were applied; eating habits and physical activity were evaluated. A Multivariate Logistic Regression analysis was performed to evaluate an association between study variables and REB. Results: it was found that 34.4 % and 47.2 % of the adolescents presented symptoms of depression and anxiety, respectively. Furthermore, 10.6 % had REB and 18.1 % were at risk of REB. The combined prevalence of overweight and obesity was 46.5 %; only 13.1 % of the participants had healthy eating habits and 18.2 % adequate physical activity. Symptoms of depression (p < 0.0001), anxiety (p < 0.0001), higher BMI (p < 0.0001), female sex, excessive consumption of sugary drinks, eating outside the home (p < 0.0001), and lifestyle (p = 0.001) were associated with REB. Conclusions: confinement caused chaos on the lifestyle of adolescents as well as their psychological health. It is essential to develop educational programs that involve government authorities, parents and health agencies to reinforce the topics of healthy eating, physical activity and mental health in the country's secondary schools.

Background: Motivation for the study. To document the evolution of COVID-19 in rural Amazonian populations, which are still little known., Background: Main findings. COVID-19 spread rapidly through rural communities, initially spreading to mestizo hamlets and later affecting indigenous communities. Rural mortality varied by region and ethnicity. Social distancing was difficult, and travel to receive government vouchers contributed to contagion., Background: Implications. Identifying the factors that contributed to contagion and the barriers to the adoption of protective measures in rural Amazonian populations will help to face future pandemics., Objectives.: To analyze the evolution of COVID-19 in rural populations of Loreto and Ucayali in the early stage of the pandemic., Materials and Methods.: A community-level longitudinal observational study was conducted and based on two rounds of telephone surveys with local authorities of more than 400 indigenous and non-indigenous rural communities in Loreto and Ucayali, in July and August 2020. We collected information on cases and deaths by COVID-19 in their communities, protective measures adopted and if state assistance was received in the early stage of the pandemic. Descriptive statistics allowed us to evaluate the evolution of the pandemic after the initial outbreak and compare the trends of the two regions, as well as between indigenous and non-indigenous populations., Results.: In July 2020, COVID-19 had reached 91.5% of the communities, although deaths from COVID-19 were reported in 13.0% of the communities, with rural mortality being higher in Ucayali (0.111%) than in Loreto (0.047%) and in non-indigenous communities. By August, prevalence decreased from 44.0% to 32.0% of communities, but became more frequent in indigenous communities, and those in Ucayali. Traveling to the city to receive state bonuses and difficulties maintaining social distancing contributed to the spread., Conclusions.: Our findings show the evolution of COVID-19 in rural communities and point to important areas of attention in future public policies, for the adoption of protective measures and reconsidering strategies for the distribution of assistance in the face of future pandemics., Background: Motivation for the study. To document the evolution of COVID-19 in rural Amazonian populations, which are still little known., Background: Main findings. COVID-19 spread rapidly through rural communities, initially spreading to mestizo hamlets and later affecting indigenous communities. Rural mortality varied by region and ethnicity. Social distancing was difficult, and travel to receive government vouchers contributed to contagion., Background: Implications. Identifying the factors that contributed to contagion and the barriers to the adoption of protective measures in rural Amazonian populations will help to face future pandemics.

After the COVID-19 pandemic, the omicron variant of the SARS-CoV-2 virus became the dominant lineage in Spain in 2022. Although it possesses a milder pathogenicity than previous variants, it still poses a high risk of causing severe COVID-19 for immunocompromised populations. A systematic review was conducted to assess the burden of COVID-19 in Spain among immunocompromised patients during the omicron predominance (1/04/2022-1/04/2023), using PubMed, Cochrane Library, and EPICOVIDEHA between May and July 2023. The search retrieved 217 articles, of which a total of 5 were included. Upon analysis, it was observed that immunocompromised patients during the omicron lineage predominance continue to exhibit higher rates of hospitalizations, ICU admissions, and mortality compared to the general population affected by COVID-19. Although the pandemic has ended, the risk persists for immunocompromised individuals., (Copyright © 2024 The Authors. Published by Elsevier España, S.L.U. All rights reserved.)

Background: While many patients seem to recover from SARS-CoV-2 infections, many patients report experiencing SARS-CoV-2 symptoms for weeks or months after their acute COVID-19 ends, even developing new symptoms weeks after infection. These long-term effects are called post-acute sequelae of SARS-CoV-2 (PASC) or, more commonly, Long COVID. The overall prevalence of Long COVID is currently unknown, and tools are needed to help identify patients at risk for developing long COVID., Methods: A working group of the Rapid Acceleration of Diagnostics-radical (RADx-rad) program, comprised of individuals from various NIH institutes and centers, in collaboration with REsearching COVID to Enhance Recovery (RECOVER) developed and organized the Long COVID Computational Challenge (L3C), a community challenge aimed at incentivizing the broader scientific community to develop interpretable and accurate methods for identifying patients at risk of developing Long COVID. From August 2022 to December 2022, participants developed Long COVID risk prediction algorithms using the National COVID Cohort Collaborative (N3C) data enclave, a harmonized data repository from over 75 healthcare institutions from across the United States (U.S.)., Findings: Over the course of the challenge, 74 teams designed and built 35 Long COVID prediction models using the N3C data enclave. The top 10 teams all scored above a 0.80 Area Under the Receiver Operator Curve (AUROC) with the highest scoring model achieving a mean AUROC of 0.895. Included in the top submission was a visualization dashboard that built timelines for each patient, updating the risk of a patient developing Long COVID in response to clinical events., Interpretation: As a result of L3C, federal reviewers identified multiple machine learning models that can be used to identify patients at risk for developing Long COVID. Many of the teams used approaches in their submissions which can be applied to future clinical prediction questions., Funding: Research reported in this RADx® Rad publication was supported by the National Institutes of Health. Timothy Bergquist, Johanna Loomba, and Emily Pfaff were supported by Axle Subcontract: NCATS-STSS-P00438., Competing Interests: Declaration of interests Danielle Mowery serves as an unpaid member of the Epic Cosmos Governing Council. Romain Pirracchio received funding from the FDA CERSI grant U01FD005978 and the PCORI grant P0562155 and received a consulting honorarium from Phillips. Martin van der Laan received funding from the NIAID grant 5R01AI074345. Johanna Loomba received contract funding from the NIH RECOVER program. Emily Pfaff received funding from the NIH and PCORI. The views expressed in this manuscript are solely those of the authors and do not necessarily represent those of the National Institutes of Health, the U.S. Department of Health and Human Services or the U.S. government. Qi Long was supported by grants from the NIH., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

The arrival of COVID-19 in Brazil had a marked impact on the health network as well as on the professionals involved, due to the significant number of cases and constantly updated information. In this context, the Cooperative Intelligence Platform for Primary Health Care - Picaps - is set up as a technological platform that assists by systematizing the communication and negotiation processes among actors, with a focus on science and technology. This article sets out to describe the processes of Picaps, which consist of a collaborative system conceived of as a public solution capable of generating innovations in the areas of Science, Technology and Health, in order to tackle COVID-19 in territories with populations in socially vulnerable situations in the Federal District (DF). It integrates data collection and processing, as well as the dissemination of information for its use, both at the governmental and societal levels. Picaps can be seen as a powerful government instrument to help societies across the country, especially those in vulnerable situations, capable of assisting in the use of cooperative intelligence in primary care and health surveillance actions to build innovative solutions such as rapid responses to face health crises in modern times.

This paper presents the structuring dimensions of the CEP-Conep System in order to understand the actions promoted by the National Research Ethics Commission in response to demands for the processing and ethical analysis of research protocols related to COVID-19 in 2020. Based on CEP-Conep System public documents, an assessment of legislation, from 1988 to 2020, and its extension in terms of the number of Committees, users, and protocols, from 2012 to 2020 was presented. The minutes of Conep's Ordinary Meetings (RO), for 2020, of a confidential nature, were analyzed, to verify adaptations to the pandemic. At the end of 2020, the System had 844 Committees, 854,741 users, and 701,791 analyzed protocols. The Commission centralized the analysis of COVID-19 protocols, in January 2020, and promoted three decentralizations, as more knowledge was generated, with vaccine protocols for COVID-19 remaining centralized. The history of the CEP-Conep System provided ballast for the adoption of management, educational and communication measures that accelerated the approval of protocols and made the process transparent. The absence of indicators made it impossible to evaluate the performance in 2020, which was apparently satisfactory.

The scope of this article is to identify the impact of the COVID-19 pandemic on the incidence of sexual violence against children and adolescents in the home environment in Brazil. It involves an ecological time-series study using joinpoint regression based on data from the Notifiable Diseases Information System from 2009 to 2021. The relative frequency and crude incidence rates of sexual violence occurring in the home against the population group aged 0 to 19 years were analyzed, estimating the annual percentage change (APC) and average annual percentage change (AAPC), with a 95% confidence interval. The relative frequency of the problem was higher in 2020 (69.8%) and 2021 (71.7%), with an increase of 3.1% (p = 0.001) in 2017-2021. Girls were more affected, with rates rising in 2009-2012 (APC = 44.4; p = 0.010) and 2015-2019 (APC = 16.6; p=0.017) but falling in 2019-2021 (APC= -17.7; p = 0.042). All age groups showed a significant increase until 2019, and a reduction after this year for 5-9 years (APC = -18.6; p = 0.016), 10-14 years (APC = -14.1; p = 0.040) and 15-19 years (APC = -18.4; p = 0.021). The reduction in the incidence rates of this type of violence may have been influenced by the context of social isolation during the COVID-19 pandemic, which led to the underreporting of cases.

Objective: To analyze the experiences regarding the implementation of COVID-19 vaccination strategies, emphasizing the opportunities and challenges identified during its implementation., Design: A systematic review of the literature published between 2020 and 2022., Data Sources: The study was conducted across four databases: PubMed, ScienceDirect, Scielo, and Lilacs., Selection of Studies: Publications selection followed the PRISMA methodology (Preferred Reporting Items for Systematic Review and Meta-Analysis)., Data Extraction: A database was created where key elements of the selected study were identified and recorded, such as results, discussion, and conclusions. In addition, analysis categories were created such as: stages of the implementation plan, challenges identified and opportunity areas., Results and Conclusions: 292 publications were found, of which 25 were selected for analysis. Of these, 64% came from high-income countries and 32% from upper-middle-income countries. According to the stages of the implementation plan, 20% of the studies focused on regulations, planning and coordination; 28% in prioritization of the population to be vaccinated; 16% in acceptance, demand, and risk communication; and 16% in administration and information systems. Reflection on the response to the pandemic invites us to consider various aspects, such as the organization and function of health systems, the importance of collaborative work, efforts to achieve equity, communication strategies, as well as ethical dilemmas when seeking preserve health., (Copyright © 2024 The Author(s). Publicado por Elsevier España S.L.U. All rights reserved.)

Introduction: The importance of knowing the impact of work on people's health has increased after the COVID-19 pandemic. Burn Out (BO) syndrome arises from the tension emerging from the conflictive interaction between the worker and his or her employment. The objective was to describe the prevalence and frequency of diagnosis of BO in the health human resources of critical services of the Bahía Blanca Municipal Hospital in the context of the COVID-19 pandemic.Methods: Descriptive, cross-sectional study. The study population was the medical and nursing staff of the Intensive Care (IT), Emergency Medicine (SMU) and Clinic services who worked with COVID-19 during 2021. The Maslach Burnout Inventory (MBI) questionnaire was used and complementary closed questions to identify, among these cases, those that were diagnosed and treated by the institution.Results: Of the 219 workers, 55.3% (121/219) were nurses. In the SMU, 25% (24/96) of respondents had BO, followed by 20.4% (11/54) in Clinic and 8.7% (6/69) in IT (p value=0.004). Only 5.5% (12/219) of the total were diagnosed with BO by the institution and of this group, two people (0.9%) had previously consulted for characteristic symptoms.Discussion: A high prevalence of BO and a marked underdiagnosis were evident at the institutional level during the pandemic. Although the IT Service had the highest demand for attention, it was the one that presented the lowest BO values in relation to other services., (Universidad Nacional de Córdoba)

Background: Voivodeship Occupational Medicine Centres (VOMC), being higher-level units towards basic units providing preventive care for employees in Poland, play a consultative, appeal, supervisory and registration role towards them. Additionally, they perform many other tasks specified in the Occupational Medicine Service Act, including conducting diagnostic and jurisprudential activities related to occupational diseases and postgraduate education in occupational medicine., Material and Methods: The analysis covers data from 2017-2022 on VOMCs activities, derived from mandatory MZ-35 reporting., Results: Over 6 years, the number of employed physicians at VOMCs decreased from 830 in 2017 to 820 in 2022, with >20% of employment contracts transitioning to other forms of cooperation. The number of employed nurses decreased from 375 to 342, and the number of psychologists from 86 to 82. During the 3 years of the pandemic (2020-2022), compared to 2017-2019, the consultative activity of VOMCs for basic units of occupational health service decreased by nearly 30%, while appeal and supervisory activities decreased by 15.2% and 15.8%, respectively. The number of individuals receiving outpatient medical rehabilitation for occupational pathology decreased by >32%, and the number of services provided for established occupational pathology decreased by >14%. The number of certifications for occupational diseases decreased from 3963 in 2019 to 3518 in the first year of the pandemic, then increased to 4145 in 2021 and 3990 in 2022., Conclusions: The COVID-19 pandemic had a significant impact on the functioning of VOMCs. Changes in specific areas of their judicial, consultative, appeal, supervisory, training and rehabilitation activities corresponded with the socio-legal changes observed between 2020-2022. The structure of employment at VOMCs and the scope of their tasks remained stable during the pandemic. The observed changes in employment of medical staff were in line with general trends in healthcare institutions and regional conditions. Med Pr Work Health Saf. 2024;75(4):367-381., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

In the phase 3 Coronavirus Efficacy (COVE) trial (NCT04470427), post-dose two Ancestral Spike-specific binding (bAb) and neutralizing (nAb) antibodies were shown to be correlates of risk (CoR) and of protection against Ancestral-lineage COVID-19 in SARS-CoV-2 naive participants. In the SARS-CoV-2 Omicron era, Omicron subvariants with varying degrees of immune escape now dominate, seropositivity rates are high, and booster doses are administered, raising questions on whether and how these developments affect the bAb and nAb correlates. To address these questions, we assess post-boost BA.1 Spike-specific bAbs and nAbs as CoRs and as correlates of booster efficacy in COVE. For naive individuals, bAbs and nAbs inversely correlate with Omicron COVID-19: hazard ratios (HR) per 10-fold marker increase (95% confidence interval) are 0.16 (0.03, 0.79) and 0.31 (0.10, 0.96), respectively. In non-naive individuals the analogous results are similar: 0.15 (0.04, 0.63) and 0.28 (0.07, 1.08). For naive individuals, three vs two-dose booster efficacy correlates with predicted nAb titer at exposure, with estimates -8% (-126%, 48%), 50% (25%, 67%), and 74% (49%, 87%), at 56, 251, and 891 Arbitrary Units/ml. These results support the continued use of antibody as a surrogate endpoint., (© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

Background:  Patients with severe coronavirus disease-19 (COVID-19) may require the use of invasive mechanical ventilation (MV) for prolonged periods. Aggressive MV parameters have been associated with changes in intracranial pressure (ICP) in patients with acute intracranial disorders. Significant ICP elevation could compromise intracranial compliance (ICC) and cerebrovascular hemodynamics (CVH). However, the effects of these parameters in individuals without neurological disorders have not yet been evaluated., Objective:  To evaluate ICC in patients on MV with COVID-19 infection compared to other diagnoses, to better characterize the effects of MV and COVID-19 upon ICC. We also compared between the ICC in patients with COVID-19 who did not require MV and healthy volunteers, to assess the isolated effect of COVID-19 upon ICC., Methods:  This was an exploratory, observational study with a convenience sample. The ICC was evaluated with a noninvasive ICP monitoring device. The P2/P1 ratio was calculated by dividing the amplitude of these two points, being defined as "abnormal" when P2 > P1. The statistical analysis was performed using a mixed linear model with random effects to compare the P2/P1 ratio in all four groups on the first monitoring day., Results:  A convenience sample of 78 subjects (15 MV-COVID-19, 15 MV non-COVID-19, 24 non-MV-COVID-19, and 24 healthy participants) was prospectively enrolled. There was no difference in P2/P1 ratios between MV patients with and without COVID-19, nor between non-MV patients with COVID-19 and healthy volunteers. However, the P2/P1 ratio was higher in COVID-19 patients with MV use than in those without it., Conclusion:  This exploratory analysis suggests that COVID-19 does not impair ICC., Competing Interests: AFS: has a scholarship financial support from FAPESP (São Paulo Research Foundation) grant 2023/00506-3. GF: is an employee at Brain4care Development and Innovation Technological S.A. and received financial support in form of salary during this study. MBS, NZC, CYH, SLSA, JBCA, SR, FMM, VCV, UAPF, TLR, GSS: have no conflicts of interest to declare., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/).)

A systemic inflammatory response occurs during SARS-CoV2 infection and is associated with hypercoagulability and thrombotic events. From March 2020 in our hospital different dosages of low-molecular weight heparin (LMWH) were introduced according to the level of patient care intensity. Because bleeding episodes occurred in hospitalized COVID-19 patients on heparin, the dosage of LMWH at the end of first wave was tailored on the severity of COVID-19. The aim of this study is to describe bleeding and thrombotic events in patients hospitalized with SARS-CoV2 infection on LMWH therapy in the two waves of COVID-19 and analyze the factors associated with these events. Among 1143 patients enrolled in the COVID-19 Network registry, 912 were included in the analysis, 537 of them admitted during the first wave and 375 during the second. Bleeding events were 30 (3.3%): 22 (2.4%) major and 8 (0.9%) non-major. Arterial and venous thrombotic events were 6 (0.7%) and 24 (2.6%). The incidence of venous thrombotic events was higher in the first than in the second wave (0.29% [95% CI 0.20-0.45] events/day vs. 0.05% [95% CI 0.02-0.16]), with a 71% risk reduction (95% CI 22%-94%). The incidence of bleeding was 0.33% (95% CI 0.22-0.50) vs 0.14% events/day (95% CI 0.07-0.28), with no statistical between-wave difference (HR 0.41 95% CI 0.16-1.08). After adjusting for the competing risks of death and comorbidities, patients in the second wave had lower odds to have thrombotic events than in the first wave (0.24 HR [95% C.I. 0.07-0.89]). In this retrospective study on COVID-19 we found a low rate of hemorrhagic and thrombotic events, that may be explained by the absence in the case material of patients admitted to intensive care unit., (© 2024. The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI).)

This essay argues that principals' capacity to advance equity might have been constrained by pre-COVID conditions. Drawing on the emerging literature on school leadership during the pandemic, the current article discusses how principals' capacity to advance equity was expanded as a result of the window of opportunities created by the COVID-19 pandemic. Given the increased frequency at which schools experience crises, understanding these opportunities may allow stakeholders to better support principals' efforts to enact equity-oriented leadership practices. Implications for leadership preparation, school funding, accountability policies, and future research are discussed.

Background: Rural populations in the USA demonstrate a high degree of vaccine hesitancy, particularly surrounding COVID-19 vaccines. Objectives: Following the successful implementation of a COVID-19 vaccination campaign with a rural-based health system in New York state, the goal of this project was to develop a large community-academic partnership with multiple rural-based community organisations to implement an additional COVID-19 vaccination campaign tailored to rural audiences. Methods: Campaign materials were created and refined with several collaborators across multiple ruralbased hospitals, health centres and community organisations. Campaign effectiveness was examined through an analysis of New York state vaccination data. Lessons learned: This project shows that larger community-academic partnerships involving multiple organisations can be achieved and utilised to address complex public health issues such as vaccine hesitancy. Conclusions: Larger and longer-term community-academic partnerships can be leveraged to combat a wide range of public health issues and enable a personalised focus on specific communities.