Topical Collection "COVID-19: Impact on Public Health and Healthcare"

Printed Edition Available!
A printed edition of this Special Issue is available here.

Editors

Prof. Dr. Manoj Sharma
E-Mail Website
Guest Editor
Department of Social and Behavioral Health, University of Nevada, Las Vegas, NV 89119, USA
Interests: health behavior research; health promotion; stress and coping
Special Issues, Collections and Topics in MDPI journals
Dr. Kavita Batra
E-Mail Website
Guest Editor
Kirk Kerkorian School of Medicine at University of Nevada, Las Vegas, NV 89102, USA
Interests: disparate impact of COVID-19 among population subgroups; mental health; behavior theories; gender minorities research; chronic conditions; systematic reviews and meta-analysis; maternal and child health; global health; impact of COVID-19 on educational activities and curriculum; trauma and injuries; behavior interventions; determinants of human behaviors; vaccine hesitancy
Special Issues, Collections and Topics in MDPI journals

Topical Collection Information

Dear Colleagues,

The COVID-19 pandemic has created a worldwide public health emergency and has had a significant impact on all dimensions of health, including physical, psychological, social, and financial. Therefore, this Special Issue of Healthcare aims to reflect the full breadth of the pandemic’s impact across different populations worldwide and cover all aspects of health. Possible topics include, but are not limited to:

  • Preventive strategies associated with COVID-19 to promote health behaviours, for instance, handwashing, mask-wearing behaviour, social distancing, and vaccine acceptability, screening, testing, and tracing. Theory-based health behaviour intervention studies are highly encouraged.
  • Effect of COVID-19 on job sectors, for example, changes in employment and labour force participation.
  • Effect on psychosocial health across different population groups, including general, healthcare workers, geriatric, young adults, etc.

Prof. Manoj Sharma
Dr. Kavita Batra
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the collection website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • COVID-19
  • Health Behaviour
  • Prevention
  • Impact
  • Healthcare
  • Screening
  • Treatment

Published Papers (45 papers)

2022

Jump to: 2021, 2020

Article
COVID-19 Vaccines and Restrictions: Concerns and Opinions among Individuals in Saudi Arabia
Healthcare 2022, 10(5), 816; https://doi.org/10.3390/healthcare10050816 - 28 Apr 2022
Viewed by 408
Abstract
(1) Background: Recent studies in Saudi Arabia have indicated that a small proportion of the population is hesitant to receive COVID-19 vaccines due to uncertainty about their safety. The objective of this study was therefore to examine concerns about COVID-19 vaccines in Saudi [...] Read more.
(1) Background: Recent studies in Saudi Arabia have indicated that a small proportion of the population is hesitant to receive COVID-19 vaccines due to uncertainty about their safety. The objective of this study was therefore to examine concerns about COVID-19 vaccines in Saudi Arabia; (2) Methods: This cross-sectional study surveyed Saudi residents aged 14 years and older. The online questionnaire consisted of the following sections: (1) demographics; (2) knowledge about COVID-19 vaccines and sources of information; (3) COVID-19 vaccines worry scale; and (4) opinions about restrictions placed on unvaccinated individuals in Saudi Arabia. An adjusted regression model was computed to examine the relationships between demographic factors and worry about COVID-19 vaccines. All analyses were stratified by age, with those aged 19 years and above considered adults and those aged younger than 19 years considered as adolescents; (3) Results: A total of 1002 respondents completed the survey. Of the study sample, 870 were aged ≥19 years and 132 were aged <19 years. Of the adults in the study sample, 52% either agreed or strongly agreed with the statement, “I am worried about the potential side effects of COVID-19 vaccinations in children”. Among adults, females demonstrated higher levels of worry about COVID-19 vaccines than males (β = 1.142; p = 0.004) in the adjusted analyses. A high percentage of the participants either disagreed or strongly disagreed with allowing unvaccinated individuals to enter malls, schools, universities or to live freely without restrictions; (4) Conclusions: A high proportion of individuals in Saudi Arabia are concerned about possible side effects of COVID-19 vaccines, and many believe that unvaccinated individuals should not be restricted from participating in public life. It is therefore crucial to provide easily accessible information on the safety of COVID-19 vaccines in order to accelerate vaccination and minimize hesitancy regarding any future vaccinations that may be necessary. Full article
Show Figures

Figure 1

Article
Association between Frequency of Going Out and Psychological Condition among Community-Dwelling Older Adults after the COVID-19 Pandemic in Japan
Healthcare 2022, 10(3), 439; https://doi.org/10.3390/healthcare10030439 - 25 Feb 2022
Viewed by 467
Abstract
Background: The psychological condition and frequency of going out (FGO) of community-dwelling older adults after the spread of COVID-19 will provide insights for supporting the daily lives of community-dwelling older adults. Going out is defined as moving from one’s own home to a [...] Read more.
Background: The psychological condition and frequency of going out (FGO) of community-dwelling older adults after the spread of COVID-19 will provide insights for supporting the daily lives of community-dwelling older adults. Going out is defined as moving from one’s own home to a place or region beyond one’s own home and is considered to reflect the daily and social life of community-dwelling older adults. This study investigates the relationship between the FGO and current psychological condition after the second wave of COVID-19 in community-dwelling older adults in Japan. Methods: This study adopted a self-administered questionnaire by mail. A total of 493 members of CO-OP Kagoshima were included in the analysis and divided into two groups according to the change in FGO. Multiple logistic regression analysis was conducted after a bivariate analysis to investigate the relationship between the FGO and psychological condition. Results: Significant differences were noted between the groups with decreased FGO and those with increased/unchanged FGO in general and pandemic-related psychological condition. Multiple logistic regression analysis showed a significant relationship between FGO and psychological condition, such as mental fatigue, not smiling as much as before, and anxiousness to go outside. Conclusion: Community-dwelling older adults may have experienced a decrease in the frequency of going out and a detrimental effect on their psychological condition after the COVID-19 pandemic. This finding may inform strategies to identify priorities for psychological approaches altered by COVID-19 to prevent confinement and stress in older adults. Full article
Show Figures

Figure 1

Article
Care Home and Home Care Staff’s Learning during the COVID-19 Pandemic and Beliefs about Subsequent Changes in the Future: A Survey Study in Sweden, Italy, Germany and the United Kingdom
Healthcare 2022, 10(2), 306; https://doi.org/10.3390/healthcare10020306 - 05 Feb 2022
Viewed by 716
Abstract
The aim of this study was to compare perceptions of learning from the COVID-19 pandemic and beliefs in subsequent changes for the future, among care home and home care staff, in four European countries. A 29-item on-line questionnaire was designed in English and [...] Read more.
The aim of this study was to compare perceptions of learning from the COVID-19 pandemic and beliefs in subsequent changes for the future, among care home and home care staff, in four European countries. A 29-item on-line questionnaire was designed in English and later translated into Swedish, Italian, and German on the impact of the pandemic on stress and anxiety. Anonymous data from care staff respondents was collected in four countries between 7 October 2020 and 17 December 2010: Sweden (n = 212), Italy (n = 103), Germany (n = 120), and the United Kingdom (n = 167). While care staff in all countries reported learning in multiple areas of care practice, Italy reported the highest levels of learning and the most agreement that changes will occur in the future due to the pandemic. Conversely, care staff in Germany reported low levels of learning and reported the least agreement for change in the future. While the pandemic has strained care home and home care staff practices, our study indicates that much learning of new skills and knowledge has taken place within the workforce. Our study has demonstrated the potential of cross-border collaborations and experiences for enhancing knowledge acquisition in relation to societal challenges and needs. The results could be built upon to improve future health care and care service practices. Full article

2021

Jump to: 2022, 2020

Article
Association between Perceived Trusted of COVID-19 Information Sources and Mental Health during the Early Stage of the Pandemic in Bangladesh
Healthcare 2022, 10(1), 24; https://doi.org/10.3390/healthcare10010024 - 24 Dec 2021
Cited by 1 | Viewed by 990
Abstract
Unverified information concerning COVID-19 can affect mental health. Understanding perceived trust in information sources and associated mental health outcomes during the COVID-19 pandemic is vital to ensure ongoing media coverage of the crisis does not exacerbate mental health impacts. A number of studies [...] Read more.
Unverified information concerning COVID-19 can affect mental health. Understanding perceived trust in information sources and associated mental health outcomes during the COVID-19 pandemic is vital to ensure ongoing media coverage of the crisis does not exacerbate mental health impacts. A number of studies have been conducted in other parts of the world to determine associations between information exposure relating to COVID-19 and mental health. However, the mechanism by which trust in information sources may affect mental health is not fully explained in the developing country context. To address this issue, the present study examined associations between perceived trust in three sources of information concerning COVID-19 and anxiety/stress with the mediating effects of COVID-19 stress in Bangladesh. An online cross-sectional study was conducted with 744 Bangladeshi adults between 17 April and 1 May 2020. Perceived trust in traditional, social, and health media for COVID-19 information, demographics, frontline service status, COVID-19-related stressors, anxiety (GAD-7), and stress (PSS-4) were assessed via self-report. Linear regression tested for associations between perceived trust and mental health. Mediation analyses investigated whether COVID-19-related stressors affected perceived trust and mental health associations. In fully adjusted models, more trust in social media was associated with more anxiety (B = 0.03, CI = 0.27–0.97) and stress (B = 0.01, CI = −0.34–0.47), while more trust in traditional media was associated with more anxiety (B = 0.09, CI = 0.17–2.26) but less stress (B = −0.08, CI = −0.89–0.03). Mediation analyses showed that COVID-19-related stressors partially explained associations between perceived trust and anxiety. These findings suggest that trusting social media to provide accurate COVID-19 information may exacerbate poor mental health. These findings also indicate that trusting traditional media (i.e., television, radio, and the newspaper) may have stress-buffering effects. We recommend that responsible authorities call attention to concerns about the trustworthiness of social media as well as broadcast positive and authentic news in traditional media outcomes based on these results. Full article
Show Figures

Figure 1

Article
A Local Survey of COVID-19: Vaccine Potential Acceptance Rate among Personnel in a Level 1 Trauma Center without Severe COVID-19 Cases
Healthcare 2021, 9(12), 1616; https://doi.org/10.3390/healthcare9121616 - 23 Nov 2021
Viewed by 580
Abstract
Background: Healthcare workers (HCWs) in hospitals are at high risk during the COVID-19 pandemic. Healthcare workers’ infection risk could be amplified during the ongoing pandemic due to various factors, including continuous exposure to patients and inadequate infection control training. Despite the risk healthcare [...] Read more.
Background: Healthcare workers (HCWs) in hospitals are at high risk during the COVID-19 pandemic. Healthcare workers’ infection risk could be amplified during the ongoing pandemic due to various factors, including continuous exposure to patients and inadequate infection control training. Despite the risk healthcare workers face, vaccine hesitancy remains a global challenge. Differences in acceptance rates have ranged from less than 55% (in Russia) to nearly 90% (in China). In order to improve our knowledge of vaccine acceptance and its variation in rates, an evaluation is warranted. A survey was thus administered to healthcare workers. Methods: This survey aimed to address vaccination acceptance among employees in an urban level 1 trauma hospital. It was conducted through a developed and structured questionnaire that was randomly distributed online among the staff (age ≥18 years) to receive their feedback. Results: Among 285 participants (out of 995 employees), 69% were female, and 83.5% were overaged more than 30 years of age. The two largest groups were nurses (32%) and doctors (22%). The majority of respondents reported that they would “like to be vaccinated” (77.4%) and that they trusted the COVID-19 vaccine (62%). Moreover, 67.8% also reported that they felt the vaccination was effective. They reported that vaccination was a method to prevent the spread of COVID-19 (85.15%) and was a way to protect individuals with weak immune systems (78.2%). More importantly, the participants were concerned about other people (80.1%) and believed the vaccine would protect others. On the other hand, the result showed that the majority of participants (95.3%) chose to be vaccinated once everyone else was vaccinated, “I don’t need to get vaccinated”. Results showed that the majority of participants that chose “I don’t need to get vaccinated” did so after everyone else was vaccinated. Our results show that COVID-19 vaccination intention in a level 1 trauma hospital was associated with older age males who are more confident, and also share a collective responsibility, are less complacent, and have fewer constraints. Conclusion: Acceptance of the COVID-19 vaccine is relatively low among healthcare workers (HCWs). Differences in vaccine acceptance have been noted between different categories of HCWs and genders. Therefore, addressing barriers to vaccination acceptance among these HCWs is essential to avoid reluctance to receive the vaccination, but it will be challenging. Full article
Show Figures

Figure 1

Article
Survival of COVID-19 with Multimorbidity Patients
Healthcare 2021, 9(11), 1423; https://doi.org/10.3390/healthcare9111423 - 22 Oct 2021
Viewed by 605
Abstract
Background: The outbreak of SARS-CoV-2 abruptly disseminated in early 2020, overcoming the capacity of health systems to respond the pandemic. It was not until the vaccines were launched worldwide that an increase in survival was observed. The objectives of this study were to [...] Read more.
Background: The outbreak of SARS-CoV-2 abruptly disseminated in early 2020, overcoming the capacity of health systems to respond the pandemic. It was not until the vaccines were launched worldwide that an increase in survival was observed. The objectives of this study were to analyse the characteristics of survivors and their relationship with comorbidities. We had access to a database containing information on 16,747 hospitalized patients from Mexico, all infected with SARS-CoV-2, as part of a regular follow-up. The descriptive analysis looked for clusters of either success or failure. We categorized the samples into no comorbidities, or one and up to five coexisting with the infection. We performed a logistic regression test to ascertain what factors were more influential in survival. The main variable of interest was survival associated with multimorbidity factors. The database hosted information on hospitalized patients from Mexico between March 2020 through to April 2021. Categories 2 and 3 had the largest number of patients. Survival rates were higher in categories 0 (64.8%), 1 (57.5%) and 2 (51.6%). In total, 1741 (10.5%) patients were allocated to an ICU unit. Mechanical ventilators were used on 1415 patients, corresponding to 8.76%. Survival was recorded in 9575 patients, accounting for 57.2% of the sample population. Patients without comorbidities, younger people and women were more likely to survive. Full article
Article
Exploring and Monitoring the Reasons for Hesitation with COVID-19 Vaccine Based on Social-Platform Text and Classification Algorithms
Healthcare 2021, 9(10), 1353; https://doi.org/10.3390/healthcare9101353 - 12 Oct 2021
Viewed by 793
Abstract
(1) Background: The COVID-19 pandemic is globally rampant, and it is the common goal of all countries to eliminate hesitation in taking the COVID-19 vaccine and achieve herd immunity as soon as possible. However, people are generally more hesitant about the COVID-19 vaccine [...] Read more.
(1) Background: The COVID-19 pandemic is globally rampant, and it is the common goal of all countries to eliminate hesitation in taking the COVID-19 vaccine and achieve herd immunity as soon as possible. However, people are generally more hesitant about the COVID-19 vaccine than about other conventional vaccines, and exploring the specific reasons for hesitation with the COVID-19 vaccine is crucial. (2) Methods: this paper selected text data from a social platform to conduct qualitative analysis of the text to structure COVID-19 vaccine hesitancy reasons, and then conducted semiautomatic quantitative content analysis of the text through a supervised machine-learning method to classify them. (3) Results: on the basis of a large number of studies and news reports on vaccine hesitancy, we structured 12 types of the COVID-19 vaccine hesitancy reasons. Then, in the experiment, we conducted comparative analysis of three classifiers: support vector machine (SVM), logistic regression (LR), and naive Bayes classifier (NBC). Results show that the SVM classification model with TF-IDF and SMOTE had the best performance. (4) Conclusions: our study structured 12 types of COVID-19 vaccine hesitancy reasons through qualitative analysis, filling in the gaps of previous studies. At the same time, this work provides public health institutions with a monitoring tool to support efforts to mitigate and eliminate COVID-19 vaccine hesitancy. Full article
Show Figures

Graphical abstract

Article
A Theory-Based Analysis of COVID-19 Vaccine Hesitancy among African Americans in the United States: A Recent Evidence
Healthcare 2021, 9(10), 1273; https://doi.org/10.3390/healthcare9101273 - 27 Sep 2021
Cited by 4 | Viewed by 2429
Abstract
African Americans have been disproportionately vaccinated at lower rates, which warrants the development of theory-based interventions to reduce vaccine hesitancy in this group. The fourth-generation theories, e.g., multi-theory model (MTM) of health behavior change, are vital in developing behavioral interventions. Therefore, the current [...] Read more.
African Americans have been disproportionately vaccinated at lower rates, which warrants the development of theory-based interventions to reduce vaccine hesitancy in this group. The fourth-generation theories, e.g., multi-theory model (MTM) of health behavior change, are vital in developing behavioral interventions. Therefore, the current study aims to determine recent trends in COVID-19 vaccination rates and to test the MTM model in predicting the initiation of COVID-19 vaccines among vaccine-hesitant Blacks. A sample of 428 unvaccinated African Americans were recruited through a web-based survey using a 28-item psychometric valid questionnaire. Chi-square, independent-samples-t-test or Welch’s t test, and Pearson’s correlation tests were utilized for the analyses. Hierarchical regression modelling was performed to determine the increment in variation accounted for through addition of predictors over a set of models. Nearly 48% of unvaccinated Blacks reported being vaccine-hesitant. The vaccine-hesitant group was relatively younger (40.5 years ± 15.8 vs. 46.2 years ± 17.4, p < 0.001), were Republicans (22.1% vs. 10.0%, p < 0.001), lived in the North-East region (26.0% vs. 11.4%, p < 0.001) and had religious affiliations other than Christianity (21.2% vs. 13.6%, p = 0.04). The mean scores of perceived advantages ((9.01 ± 3.10 vs. 7.07 ± 3.60, p < 0.001) and behavioral confidence (8.84 ± 3.76 vs. 5.67 ± 4.09, p < 0.001) were higher among vaccine non-hesitant group as opposed to the hesitant ones. In a final regression model, all MTM constructs) predicted nearly 65% of variance in initiating COVID-19 vaccination behavior among the vaccine-hesitant group (adjusted R2 = 0.649, F = 32.944, p < 0.001). With each unit increment in MTM constructs (e.g., participatory dialogue and behavior confidence), the initiation of COVID-19 vaccination among vaccine-hesitant Blacks increased by 0.106 and 0.166 units, respectively. Based on the findings of this study a m-health educational intervention to promote COVID-19 vaccine uptake behavior among Blacks is proposed. Full article
Show Figures

Figure 1

Article
Modeling-Based Estimate of the Vaccination Rate, Lockdown Rules and COVID-19
Healthcare 2021, 9(10), 1245; https://doi.org/10.3390/healthcare9101245 - 22 Sep 2021
Viewed by 542
Abstract
COVID-19 has become a severe infectious disease and has caused high morbidity and mortality worldwide. Restriction rules such as quarantine and city lockdown have been implemented to mitigate the spread of infection, leading to significant economic impacts. Fortunately, development and inoculation of COVID-19 [...] Read more.
COVID-19 has become a severe infectious disease and has caused high morbidity and mortality worldwide. Restriction rules such as quarantine and city lockdown have been implemented to mitigate the spread of infection, leading to significant economic impacts. Fortunately, development and inoculation of COVID-19 vaccines are being conducted on an unprecedented scale. The effectiveness of vaccines raises a hope that city lockdown might not be necessary in the presence of ongoing vaccination, thereby minimizing economic loss. The question, however, is how fast and what type of vaccines should be inoculated to control the disease without limiting economic activity. Here, we set up a simulation scenario of COVID-19 outbreak in a modest city with a population of 2.5 million. The basic reproduction number (R0) was ranging from 1.0 to 5.5. Vaccination rates at 1000/day, 10,000/day and 100,000/day with two types of vaccine (effectiveness v = 51% and 89%) were given. The results indicated that R0 was a critical factor. Neither high vaccination rate (10,000 persons/day) nor high-end vaccine (v = 89%) could control the disease when the scenario was at R0 = 5.5. Unless an extremely high vaccination rate was given (>4% of the entire population/per day), no significant difference was found between two types of vaccine. With the population scaled to 25 million, the required vaccination rate was >1,000,000/day, a quite unrealistic number. Nevertheless, with a slight reduction of R0 from 5 to 3.5, a significant impact of vaccine inoculation on disease control was observed. Thus, our study raised the importance of estimating transmission dynamics of COVID-19 in a city before determining the subsequent policy. Full article
Show Figures

Figure 1

Article
Early Spatiotemporal Patterns and Population Characteristics of the COVID-19 Pandemic in Southeast Asia
Healthcare 2021, 9(9), 1220; https://doi.org/10.3390/healthcare9091220 - 16 Sep 2021
Cited by 3 | Viewed by 1269
Abstract
This observational study aims to investigate the early disease patterns of coronavirus disease 2019 (COVID-19) in Southeast Asia, consequently providing historical experience for further interventions. Data were extracted from official websites of the WHO and health authorities of relevant countries. A total of [...] Read more.
This observational study aims to investigate the early disease patterns of coronavirus disease 2019 (COVID-19) in Southeast Asia, consequently providing historical experience for further interventions. Data were extracted from official websites of the WHO and health authorities of relevant countries. A total of 1346 confirmed cases of COVID-19, with 217 recoveries and 18 deaths, were reported in Southeast Asia as of 16 March 2020. The basic reproductive number (R0) of COVID-19 in the region was estimated as 2.51 (95% CI:2.31 to 2.73), and there were significant geographical variations at the subregional level. Early transmission dynamics were examined with an exponential regression model: y = 0.30e0.13x (p < 0.01, R2 = 0.96), which could help predict short-term incidence. Country-level disease burden was positively correlated with Human Development Index (r = 0.86, p < 0.01). A potential early shift in spatial diffusion patterns and a spatiotemporal cluster occurring in Malaysia and Singapore were detected. Demographic analyses of 925 confirmed cases indicated a median age of 44 years and a sex ratio (male/female) of 1.25. Age may play a significant role in both susceptibilities and outcomes. The COVID-19 situation in Southeast Asia is challenging and unevenly geographically distributed. Hence, enhanced real-time surveillance and more efficient resource allocation are urgently needed. Full article
Show Figures

Figure 1

Article
A Report Card on Prevention Efforts of COVID-19 Deaths in US
Healthcare 2021, 9(9), 1175; https://doi.org/10.3390/healthcare9091175 - 07 Sep 2021
Viewed by 631
Abstract
COVID-19 (otherwise known as coronavirus disease 2019) is a life-threatening pandemic that has been combatted in various ways by the government, public health officials, and health care providers. These interventions have been met with varying levels of success. Ultimately, we question if the [...] Read more.
COVID-19 (otherwise known as coronavirus disease 2019) is a life-threatening pandemic that has been combatted in various ways by the government, public health officials, and health care providers. These interventions have been met with varying levels of success. Ultimately, we question if the preventive efforts have reduced COVID-19 deaths in the United States. To address this question, we analyze data pertaining to COVID-19 deaths drawn from the Centers for Disease Control and Prevention (CDC). For this purpose, we employ incidence rate restricted Poisson (IRRP) as an underlying analysis methodology and evaluate all preventive efforts utilized to attempt to reduce COVID-19 deaths. Interpretations of analytic results and graphical visualizations are used to emphasize our various findings. Much needed modifications of the public health policies with respect to dealing with any future pandemics are compiled, critically assessed, and discussed. Full article
Show Figures

Figure 1

Article
The Role of Resilience for Migrants and Refugees’ Mental Health in Times of COVID-19
Healthcare 2021, 9(9), 1131; https://doi.org/10.3390/healthcare9091131 - 30 Aug 2021
Cited by 4 | Viewed by 1256
Abstract
Migrants and refugees need international protection, particularly during a crisis such as the current health pandemic. The aim of this research was to examine the mental health and attitudes towards COVID-19 in migrants and refugees compared to the general Spanish population. Moreover, the [...] Read more.
Migrants and refugees need international protection, particularly during a crisis such as the current health pandemic. The aim of this research was to examine the mental health and attitudes towards COVID-19 in migrants and refugees compared to the general Spanish population. Moreover, the nature of resilience was examined as a mixed component though life experiences. For this proposal, an interview was carried out in a sample of 245 participants who volunteered to participate in the study. The sample was divided into Spanish non-migrants, Spanish migrants, non-Spanish migrants and refugees. Attitudes towards COVID-19, resilience (based on BRCS) and mental health (based on DASS-21) were measured. The results obtained can be described as follows: (i) Migrant participants indicated worse mental health than non-migrants, and within the migrant group, refugees presented worse scores; (ii) No differences were found in attitudes towards COVID-19 in any of the subgroups; (iii) A moderating effect of group was found for the relationship between resilience and mental health but not between resilience and fear of COVID-19. These results might be of great interest in making visible the vulnerability of migrants and specifically refugees, and the proposal of intervention programs based on resilience training. Full article
Show Figures

Figure 1

Article
Associations between Personality Traits, Intolerance of Uncertainty, Coping Strategies, and Stress in Italian Frontline and Non-Frontline HCWs during the COVID-19 Pandemic—A Multi-Group Path-Analysis
Healthcare 2021, 9(8), 1086; https://doi.org/10.3390/healthcare9081086 - 23 Aug 2021
Cited by 3 | Viewed by 1114
Abstract
The COVID-19 pandemic represented a very difficult physical and psychological challenge for the general population and even more for healthcare workers (HCWs). The main aim of the present study is to test whether there were significant differences between frontline and non-frontline Italian HCWs [...] Read more.
The COVID-19 pandemic represented a very difficult physical and psychological challenge for the general population and even more for healthcare workers (HCWs). The main aim of the present study is to test whether there were significant differences between frontline and non-frontline Italian HCWs concerning (a) personality traits, intolerance of uncertainty, coping strategies and perceived stress, and (b) the models of their associations. A total of 682 Italian HCWs completed a self-report questionnaire: 280 employed in COVID-19 wards and 402 in other wards. The analysis of variance omnibus test revealed significant differences between the two groups only for perceived stress, which was higher among the frontline. The multi-group path analysis revealed significant differences in the structure of the associations between the two groups of HCWs, specifically concerning the relations between: personality traits and intolerance of uncertainty; intolerance of uncertainty and coping strategies. Regarding the relation between coping strategies and stress no difference was identified between the two groups. In both of them, emotionally focused coping was negatively related with perceived stress, whereas dysfunctional coping was positively related with stress. These results could be useful in planning actions aiming to reduce stress and improve the effectiveness of HCWs’ interventions. Training programs aimed to provide HCWs with a skillset to tackle uncertain and stressful circumstances could represent an appropriate support to develop a preventive approach during outbreaks. Full article
Show Figures

Figure 1

Article
COVID-19 Vaccine Literacy of Family Carers for Their Older Parents in Japan
Healthcare 2021, 9(8), 1038; https://doi.org/10.3390/healthcare9081038 - 12 Aug 2021
Cited by 5 | Viewed by 1120
Abstract
In super-ageing Japan, COVID-19 vaccinations were starting to reach older people as of June 2021, which raises the issue of vaccine literacy. This study focuses on family members who work and also care for their older parents, as they are at risk of [...] Read more.
In super-ageing Japan, COVID-19 vaccinations were starting to reach older people as of June 2021, which raises the issue of vaccine literacy. This study focuses on family members who work and also care for their older parents, as they are at risk of COVID-19 and also risk transmitting COVID-19 to the parents they care for and potentially influencing their parents’ vaccine uptake. Such family carers are central to the approach in Japan to achieving a sustainable and resilient society in response to ageing. Contrasting family carers’ COVID-19 vaccine literacy with their overall health literacy provides insights into their preparedness for COVID-19 vaccinations. The purpose of this study is to understand how vaccine literacy, compared to health literacy, varies across family carers and the sources of information they use. Through a cross-sectional online survey, family carers’ vaccine literacy, health literacy and their sources of information, including mass media, social media, health and care professionals, family, colleagues, friends, and others, were assessed. The participants’ (n = 292) mean age was 53, with 44% women, and an average of 8.3 h per week caring for their parents. Notwithstanding the increased risks from COVID-19 with age, COVID-19 vaccine literacy relative to health literacy for older family carers is lower on average, higher with increased provision of care, and more variable, resulting in a substantial proportion of older family carers with relatively low vaccine literacy. At this stage of vaccine rollout in Japan, family carers’ sources of information to inform COVID-19 vaccine literacy is distinct, including more national and local mass media versus less health and care professionals and informal networks, which indicates the importance of tailored health communication strategies to enhance vaccine literacy Full article
Show Figures

Figure 1

Article
Characteristics of COVID-19-Related Free Telephone Consultations by Public Health Nurses in Japan: A Retrospective Study
Healthcare 2021, 9(8), 1022; https://doi.org/10.3390/healthcare9081022 - 09 Aug 2021
Cited by 1 | Viewed by 722
Abstract
This study aimed to (1) describe the characteristics of community residents who used coronavirus disease 2019 (COVID-19)-related telephone consultation systems by public health nurses (PHNs) and (2) analyze the concerns they had during the first wave of COVID-19 in Japan. Among 1126 telephone [...] Read more.
This study aimed to (1) describe the characteristics of community residents who used coronavirus disease 2019 (COVID-19)-related telephone consultation systems by public health nurses (PHNs) and (2) analyze the concerns they had during the first wave of COVID-19 in Japan. Among 1126 telephone consultations, PHNs recorded telephone consultations between 25 March, and 30 April, 2020, in City A, Japan. We analyzed 1017 consultations involving 799 (79%) community residents (resident group) and 218 (21%) organizational representatives (organization group) located in City A. Half of the consultations were made during midmorning, and most of the consultations were regarding COVID-19 symptoms. Among the resident group, visiting a primary care doctor was the most common recommendation by the PHNs; there was no difference in provision of consultation by sex. Health- and welfare-related organizations mainly consulted PHNs about “having COVID-19-related symptoms” and “undergoing PCR testing,” and PHNs’ recommended them to visit a primary care doctor and coordinate PCR testing. The results suggest that public health centers should provide more helpful information on COVID-19 that accurately reflects the concerns of the population. Full article
Show Figures

Figure 1

Article
Perceptions and Preventive Practices Regarding COVID-19 Pandemic Outbreak and Oral Health Care Perceptions during the Lockdown: A Cross-Sectional Survey from Saudi Arabia
Healthcare 2021, 9(8), 959; https://doi.org/10.3390/healthcare9080959 - 29 Jul 2021
Cited by 1 | Viewed by 876
Abstract
Aims: The study aimed to evaluate perceptions and preventive practices regarding the COVID-19 pandemic and oral health care perceptions during the lockdown in the Saudi Arabian population. Materials and Method: This cross-sectional study was performed by collecting the data from individuals belonging to [...] Read more.
Aims: The study aimed to evaluate perceptions and preventive practices regarding the COVID-19 pandemic and oral health care perceptions during the lockdown in the Saudi Arabian population. Materials and Method: This cross-sectional study was performed by collecting the data from individuals belonging to various parts of the Saudi Arabian Population through an online self-reported questionnaire. The questionnaire had two main parts: first comprised of demographic data include the region of residence, gender, nationality, age, the number of family members, monthly income of the family, and the second was further divided into three sections of perception (P), practice (PRA) and oral health care practice (D) questions. All these (P, PRA, and D) were analyzed by comparing all of the demographic characteristics. Statistical analysis was performed using SPSS IBM (version 21.0), and statistical significance was set at a 5% level. Results: Overall, 2013 participants (54% males and 46% females) contributed to the Saudi Arabia study. Only 5% of non-Saudis live in Saudi Arabia were participated in the study, while the majority of participants were of 21–40 years age group (45%), 59% of having more than five family members, and 60% of them had ≤10 K Suadi riyal monthly income respectively. The majority of the participants were from Riyadh (33.7%) and Asir (25.1%) in the study. Overall, 89.5% of the participants were aware of the COVID-19 global pandemic. The majority of the participants (55%) from Saudi Arabia utilized the Ministry of Health website, a source of information regarding COVID-19. However, 56.5% of the participants had COVID-19 related perception, and 74.3% followed an appropriate preventive practice. Approximately 60% had good oral health practice. The study participants showed mixed opinions on perceptions regarding COVID-19, preventive practice, and oral health practices. Conclusion: The present study suggested that the Saudi Arabian population has good attention to COVID-19, but preventive practice and oral health perception need better awareness to control this novel virus spread. The Ministry of Health website utilized as a significant source of information among the Saudi Arabian population regarding COVID-19. Full article
Show Figures

Figure 1

Article
The Effect of Post-Graduate Year Training on the Self-Efficacy and Emotional Traits of Physicians Facing the COVID-19 Pandemic
Healthcare 2021, 9(7), 912; https://doi.org/10.3390/healthcare9070912 - 19 Jul 2021
Viewed by 856
Abstract
Background: Taiwan implemented the post-graduate year (PGY) training to reform the medical education system to provide holistic medical care after severe acute respiratory syndrome in 2003. In late 2019, COVID-19 quickly spread across the globe and became a pandemic crisis. This study aimed [...] Read more.
Background: Taiwan implemented the post-graduate year (PGY) training to reform the medical education system to provide holistic medical care after severe acute respiratory syndrome in 2003. In late 2019, COVID-19 quickly spread across the globe and became a pandemic crisis. This study aimed to investigate whether the establishment of the PGY training had positive effects on the self-efficacy and emotional traits of medical workers. Methods: One hundred and ten physicians, including PGY, residents, and visiting staff, were investigated using the General Self-Efficacy Scale (GSES) and Emotional Trait and State Scale (ETSS), and their feedback and suggestions were collected. An exploratory factor analysis was done to reduce the factor dimensions using the varimax rotation method, which was reduced to four factors: “the ability to cope with ease”, “proactive ability”, “negative emotion”, and “positive emotion”. A comparison with and without PGY training when facing the COVID-19 pandemic was conducted. Results: Those who had received PGY training (n = 77) were younger, had a lower grade of seniority, and had less practical experience than those who had not received PGY (n = 33). Those who had received PGY training had significantly higher scores for the factors “ability to cope with ease”, “proactive ability”, and “positive emotion” than those who had not received PGY training. Conclusion: The study revealed that PGY training may have had positive effects on the personal self-efficacy and emotional traits of physicians coping with the COVID-19 pandemic. Full article
Show Figures

Figure 1

Article
Testing the Multi-Theory Model (MTM) to Predict the Use of New Technology for Social Connectedness in the COVID-19 Pandemic
Healthcare 2021, 9(7), 838; https://doi.org/10.3390/healthcare9070838 - 01 Jul 2021
Cited by 4 | Viewed by 1560
Abstract
Loneliness or social isolation, recently described as a “behavioral epidemic,” remains a long-standing public health issue, which has worsened during the COVID-19 pandemic. The use of technology has been suggested to enhance social connectedness and to decrease the negative health outcomes associated with [...] Read more.
Loneliness or social isolation, recently described as a “behavioral epidemic,” remains a long-standing public health issue, which has worsened during the COVID-19 pandemic. The use of technology has been suggested to enhance social connectedness and to decrease the negative health outcomes associated with social isolation. However, till today, no theory-based studies were performed to examine the determinants of technology use. Therefore, the current study aims to test theory-based determinants in explaining the adoption of new technology in a nationally representative sample during the COVID-19 pandemic (n = 382). A psychometrically reliable and valid instrument based on the multi-theory model (MTM) of health behavior change was administered electronically using a cross-sectional study design. A total of 47.1% of the respondents reported high levels of social isolation, and 40.6% did not use any new technology. Among technology users (59.4%), the three initiation constructs participatory dialogue (b = 0.054, p < 0.05), behavioral confidence (b = 0.184, p < 0.001), and changes in the physical environment (b= 0.053, p < 0.05) were significant and accounted for 38.3% of the variance in the initiation of new technologies. Concerning sustenance in technology users, all three constructs emotional transformation (b = 0.115, p < 0.001), practice for change (b = 0.086, p < 0.001), and changes in the social environment (b = 0.061, p < 0.001) were significant and accounted for 42.6% of the variance in maintaining the use of new technology. MTM offers a powerful framework to design health promotion interventions encouraging the use of new technologies to foster greater social connectedness amid the COVID-19 pandemic and beyond it. Full article
Show Figures

Figure 1

Article
Concerns, Knowledge, and Practices of Dentists in Mexico Regarding Infection Control during the Coronavirus Disease Pandemic: A Cross-Sectional Study
Healthcare 2021, 9(6), 731; https://doi.org/10.3390/healthcare9060731 - 14 Jun 2021
Cited by 1 | Viewed by 922
Abstract
Dentists are highly exposed and vulnerable during the coronavirus disease (COVID-19) pandemic, as physical proximity to patients is necessary for effective dental examination and treatment. The objective of this study was to describe the concerns, knowledge, and infection control practices of dentists in [...] Read more.
Dentists are highly exposed and vulnerable during the coronavirus disease (COVID-19) pandemic, as physical proximity to patients is necessary for effective dental examination and treatment. The objective of this study was to describe the concerns, knowledge, and infection control practices of dentists in Mexico during the COVID-19 pandemic. In this cross-sectional study conducted from 22 May 2020 to 8 July 2020, an anonymous survey was distributed to dentists, which covered information regarding dentists’ sociodemographic and professional characteristics, clinical practices during the pandemic, and perceptions regarding the application of infection prevention and control guidance for dental settings during the COVID-19 pandemic. Out of 703 respondents, 73.1% (n = 514) were women and 53.6% (n = 377) were dentists with 1–10 years of experience. Regarding the statements issued by the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), the responses for 11 survey items had total agreement rates >90% (high frequency); seven and nine items had moderate and low frequency of total agreement, respectively. Most dentists in this study agreed with the WHO and CDC statements and were concerned regarding the possibility of infection, despite using the protective gear. Full article
Article
Face Mask Usage among Young Polish People during the COVID-19 Epidemic—An Evolving Scenario
Healthcare 2021, 9(6), 638; https://doi.org/10.3390/healthcare9060638 - 27 May 2021
Cited by 2 | Viewed by 1718
Abstract
The usage of face masks has been mandated in many countries in an attempt to diminish the spread of SARS-CoV-2. In this cross-sectional study, we aimed to determine face mask-wearing behaviors and practices in 1173 young Polish people during the second wave of [...] Read more.
The usage of face masks has been mandated in many countries in an attempt to diminish the spread of SARS-CoV-2. In this cross-sectional study, we aimed to determine face mask-wearing behaviors and practices in 1173 young Polish people during the second wave of the COVID-19 epidemic in October 2020. The majority of respondents (97.4%) declared that they wore face masks in areas/situations where it is mandatory. The most common types of utilized face masks were cloth masks (47.7%) and surgical masks (47%), followed by respirators (N95/FFP3) (3.2%) and half-face elastomeric respirators (0.9%). Over 38% reported frequently disinfecting their face masks, especially females. Respondents reporting personal atopic predisposition (64.5% vs. 72.1%; p = 0.02) or sensitive skin (65.5% vs. 74.3%; p = 0.005) declared multiple use of face masks less commonly than other individuals. Individuals suffering from facial skin lesions declared disinfecting face masks more commonly (40.8% vs. 34.9%; p = 0.04). Overall, the self-declared utilization of face masks among young people in Poland has improved since the beginning of the epidemic as compared with our previous study. Until the mass vaccination of the public is achieved and government policy is changed, face mask use remains a valuable tool to decrease the transmission of SARS-CoV-2. Full article
Article
Knowledge, Protective Behaviors and Risk Perception of COVID-19 among Dental Students in India: A Cross-Sectional Analysis
Healthcare 2021, 9(5), 574; https://doi.org/10.3390/healthcare9050574 - 13 May 2021
Cited by 11 | Viewed by 1556
Abstract
Objective: This study’s objective was to examine the knowledge, performance in practicing protective behaviors, and risk perception of Coronavirus disease-19 (COVID-19) among dental students of India. Methods: A web-based cross-sectional survey was conducted from 10–30 August 2020, involving 381 dental students that were [...] Read more.
Objective: This study’s objective was to examine the knowledge, performance in practicing protective behaviors, and risk perception of Coronavirus disease-19 (COVID-19) among dental students of India. Methods: A web-based cross-sectional survey was conducted from 10–30 August 2020, involving 381 dental students that were enrolled at the Uttaranchal Dental and Medical Research Institute in India. A web-based structured questionnaire assessed the COVID-19 related knowledge, protective behaviors, and risk perception performance. The independent-samples-t and analysis of variance tests were used to analyze the differences in knowledge, protective behaviors, and perception across the groups. Results: Of the dental students surveyed, 83% had adequate knowledge of COVID-19, and nearly 80% followed appropriate practices regarding COVID-19. The COVID-19 related risk perception was higher among females as compared to males. COVID-19 related knowledge was significantly correlated with preventive behaviors (r = 0.18; p < 0·01) and risk perception (r = 0.10; p < 0.05). We found a high score of COVID-19 related knowledge and precautionary behaviors and moderate risk perception among students. Conclusions: Knowledge and protective behaviors towards infectious diseases, such as COVID-19, have clinical applications in developing educational and formal training programs to promote adherence to the infection control practices among dental students. Clinical significance: The findings of this study will inform policymakers to emphasize on effective risk communication. Dental institutions can incorporate infection control modules in the current curriculum, thereby making future dental professionals capable of performing effective infection control management in the clinical settings. This is critical in improving their knowledge of infection control practices to minimize the risk of nosocomial infections. Full article
Article
Work-Related Stressors among the Healthcare Professionals in the Fever Clinic Centers for Individuals with Symptoms of COVID-19
Healthcare 2021, 9(5), 548; https://doi.org/10.3390/healthcare9050548 - 08 May 2021
Cited by 4 | Viewed by 1023
Abstract
Work-related stress can affect the quality of healthcare during the COVID-19 pandemic. This study aimed to assess the relationship between selected work-related stressors and stress levels among healthcare professionals providing preventive and curative services to people with COVID-19 symptoms in the Fever Clinics [...] Read more.
Work-related stress can affect the quality of healthcare during the COVID-19 pandemic. This study aimed to assess the relationship between selected work-related stressors and stress levels among healthcare professionals providing preventive and curative services to people with COVID-19 symptoms in the Fever Clinics in Saudi Arabia. A systematic random sampling using an online questionnaire approach was used to select healthcare professionals in the Fever Clinics in Saudi Arabia during September 2020. Participants were asked to fill out a questionnaire including data on their sociodemographic and occupational characteristics, role conflict and ambiguity, social support, and stress. The results showed that role conflict and ambiguity were significant risk factors for stress, and social support was negatively associated with stress levels. Additionally, younger and non-Saudi healthcare professionals exhibited higher stress levels than their older and Saudi counterparts. In conclusion, role conflict, ambiguity, and social support can predict the risk of stress among healthcare professionals in the Fever Clinics in Saudi Arabia. Full article
Review
Analysis of Facilitators and Barriers to the Delivery of Routine Care during the COVID-19 Global Pandemic: A Systematic Review
Healthcare 2021, 9(5), 528; https://doi.org/10.3390/healthcare9050528 - 01 May 2021
Cited by 3 | Viewed by 999
Abstract
The delivery of routine health care during the COVID-19 global pandemic continues to be challenged as public health guidelines and other local/regional/state and other policies are enforced to help prevent the spread of the virus. The objective of this systematic review is to [...] Read more.
The delivery of routine health care during the COVID-19 global pandemic continues to be challenged as public health guidelines and other local/regional/state and other policies are enforced to help prevent the spread of the virus. The objective of this systematic review is to identify the facilitators and barriers affecting the delivery of routine health care services during the pandemic to provide a framework for future research. In total, 32 articles were identified for common themes surrounding facilitators of routine care during COVID-19. Identified constructed in the literature include enhanced education initiatives for parents/patients regarding routine vaccinations, an importance of routine vaccinations as compared to the risk of COVID-19 infection, an enhanced use of telehealth resources (including diagnostic imagery) and identified patient throughput/PPE initiatives. Reviewers identified the following barriers to the delivery of routine care: conservation of medical providers and PPE for non-routine (acute) care delivery needs, specific routine care services incongruent the telehealth care delivery methods, and job-loss/food insecurity. Review results can assist healthcare organizations with process-related challenges related to current and/or future delivery of routine care and support future research initiatives as the global pandemic continues. Full article
Show Figures

Figure 1

Article
Student Health Implications of School Closures during the COVID-19 Pandemic: New Evidence on the Association of e-Learning, Outdoor Exercise, and Myopia
Healthcare 2021, 9(5), 500; https://doi.org/10.3390/healthcare9050500 - 23 Apr 2021
Cited by 14 | Viewed by 1849
Abstract
The coronavirus disease 2019 (COVID-19) pandemic forced many education systems to consider alternative remote e-learning modalities, which have consequential behavioral and health implications for youth. In particular, increased e-learning engagement with digital screens and reduction in outdoor activities are two likely channels posing [...] Read more.
The coronavirus disease 2019 (COVID-19) pandemic forced many education systems to consider alternative remote e-learning modalities, which have consequential behavioral and health implications for youth. In particular, increased e-learning engagement with digital screens and reduction in outdoor activities are two likely channels posing adverse risks for myopia development. This study investigated the association between e-learning screen use, outdoor activity, lighting condition, and myopia development among school-age children in China, during the first wave of the COVID-19 pandemic. Data were collected from 3405 school-age children attending primary, lower-secondary, and upper-secondary schools in China. Univariate parametric and nonparametric tests, and multivariate logistic regression analysis were used. Findings show that each diopter hour increase in daily e-learning screen use is significantly associated with progression of myopia symptoms (OR: 1.074, 95% CI: 1.058–1.089; p < 0.001), whereas engaging in outdoor exercise four to six times per week (OR: 0.745, 95% CI: 0.568–0.977; p = 0.034) and one to three times per week (OR: 0.829, 95% CI: 0.686–0.991; p = 0.048) is associated with a lower likelihood of myopia progression than none at all. In addition, we found that indoor lighting that is either “too dim” (OR: 1.686, 95% CI: 1.226–2.319; p = 0.001) or “too bright” (OR: 1.529, 95% CI: 1.007–2.366; p = 0.036) is significantly associated higher likelihood of myopic symptoms. Findings in this study uncover the less observable vision consequences of the COVID-19 pandemic on youths through digital online learning and highlight the importance of considering appropriate mitigation strategies to deal with this emerging public health challenge. Full article
Show Figures

Figure 1

Article
Older Adults’ Avoidance of Public Transportation after the Outbreak of COVID-19: Korean Subway Evidence
Healthcare 2021, 9(4), 448; https://doi.org/10.3390/healthcare9040448 - 11 Apr 2021
Cited by 4 | Viewed by 1105
Abstract
With the spread of the coronavirus worldwide, nations have implemented policies restricting the movement of people to minimize the possibility of infection. Although voluntary restriction is a key factor in reducing mobility, it has only been emphasized in terms of the effect of [...] Read more.
With the spread of the coronavirus worldwide, nations have implemented policies restricting the movement of people to minimize the possibility of infection. Although voluntary restriction is a key factor in reducing mobility, it has only been emphasized in terms of the effect of governments’ mobility restriction measures. This research aimed to analyze voluntary mass transportation use after the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak by age group to explore how the perception of the risk of infection affected the public transit system. Mass transportation big data of Seoul Metro transportation use in the capital city of Korea was employed for panel analyses. The analysis results showed that in the period with both the highest and lowest number of infections of SARS-CoV-2, users aged 65 years and over reduced their subway use more than people aged between 20 and 64. This study also found that the decrease in subway use caused by the sharp increase of coronavirus disease 2019 (COVID-19) cases was the most prominent among people aged 65 years and over. The results imply that the elders’ avoidance of public transportation affected their daily lives, consumption, and production activities, as well as their mobility. Full article
Show Figures

Figure 1

Article
The Psychological Symptoms of College Student in China during the Lockdown of COVID-19 Epidemic
Healthcare 2021, 9(4), 447; https://doi.org/10.3390/healthcare9040447 - 11 Apr 2021
Cited by 1 | Viewed by 912
Abstract
The COVID-19 epidemic has had a huge impact on the mental state of human beings due to its high infection and fatality rates in early 2020. In this paper, a cross-sectional online survey was designed to understand the mental state of college students [...] Read more.
The COVID-19 epidemic has had a huge impact on the mental state of human beings due to its high infection and fatality rates in early 2020. In this paper, a cross-sectional online survey was designed to understand the mental state of college students in a university located in Wuhan city during the lockdown. Out of 1168 respondents, above 50% participants had obvious fear and anxiety symptoms; anxiety and fear were 61.64% and 58.39%, respectively. Conformity (49.49%), invulnerability (26.11%), insensitivity (21.49%) and rebelliousness (12.41%) symptoms also appeared. Meanwhile, it was revealed that the senior students experienced more anxiety than the freshmen. Moreover, it was found that the psychological symptoms (except for the insensitivity symptom) had no significant difference in gender, residence and annual household income after the one-way analysis of variance. Full article
Article
Development of a Novel Design and Subsequent Fabrication of an Automated Touchless Hand Sanitizer Dispenser to Reduce the Spread of Contagious Diseases
Healthcare 2021, 9(4), 445; https://doi.org/10.3390/healthcare9040445 - 10 Apr 2021
Cited by 5 | Viewed by 2953
Abstract
Background: The use of a touchless automated hand sanitizer dispenser may play a key role to reduce contagious diseases. The key problem of the conventional ultrasonic and infra-red-based dispensers is their malfunctioning due to the interference of sunlight, vehicle sound, etc. when deployed [...] Read more.
Background: The use of a touchless automated hand sanitizer dispenser may play a key role to reduce contagious diseases. The key problem of the conventional ultrasonic and infra-red-based dispensers is their malfunctioning due to the interference of sunlight, vehicle sound, etc. when deployed in busy public places. To overcome such limitations, this study introduced a laser-based sensing device to dispense sanitizer in an automated touchless process. Method: The dispensing system is based on an Arduino circuit breadboard where an ATmega328p microcontroller was pre-installed. To sense the proximity, a light-dependent resistor (LDR) is used where the laser light is to be blocked after the placement of human hands, hence produced a sharp decrease in the LDR sensor value. Once the LDR sensor value exceeds the lower threshold, the pump is actuated by the microcontroller, and the sanitizer dispenses through the nozzle. Results and discussion: A novel design and subsequent fabrication of a low-cost, touchless, automated sanitizer dispenser to be used in public places, was demonstrated. The overall performance of the manufactured device was analyzed based on the cost and power consumption, and environmental factors by deploying it in busy public places as well as in indoor environment in major cities in Bangladesh, and found to be more efficient and cost-effective compared to other dispensers available in the market. A comprehensive discussion on this unique design compared to the conventional ultrasonic and infra-red based dispensers, is presented to show its suitability over the commercial ones. The guidelines of the World Health Organization are followed for the preparation of sanitizer liquid. A clear demonstration of the circuitry connections is presented herein, which facilitates the interested individual to manufacture a cost-effective dispenser device in a relatively short time and use it accordingly. Conclusion: This study reveals that the LDR-based automated hand sanitizer dispenser system is a novel concept, and it is cost-effective compared to the conventional ones. The presented device is expected to play a key role in contactless hand disinfection in public places, and reduce the spread of infectious diseases in society. Full article
Show Figures

Figure 1

Article
Application of Artificial Intelligence in COVID-19 Pandemic: Bibliometric Analysis
Healthcare 2021, 9(4), 441; https://doi.org/10.3390/healthcare9040441 - 09 Apr 2021
Cited by 6 | Viewed by 1983
Abstract
The application of artificial intelligence (AI) to health has increased, including to COVID-19. This study aimed to provide a clear overview of COVID-19-related AI publication trends using longitudinal bibliometric analysis. A systematic literature search was conducted on the Web of Science for English [...] Read more.
The application of artificial intelligence (AI) to health has increased, including to COVID-19. This study aimed to provide a clear overview of COVID-19-related AI publication trends using longitudinal bibliometric analysis. A systematic literature search was conducted on the Web of Science for English language peer-reviewed articles related to AI application to COVID-19. A search strategy was developed to collect relevant articles and extracted bibliographic information (e.g., country, research area, sources, and author). VOSviewer (Leiden University) and Bibliometrix (R package) were used to visualize the co-occurrence networks of authors, sources, countries, institutions, global collaborations, citations, co-citations, and keywords. We included 729 research articles on the application of AI to COVID-19 published between 2020 and 2021. PLOS One (33/729, 4.52%), Chaos Solution Fractals (29/729, 3.97%), and Journal of Medical Internet Research (29/729, 3.97%) were the most common journals publishing these articles. The Republic of China (190/729, 26.06%), the USA (173/729, 23.73%), and India (92/729, 12.62%) were the most prolific countries of origin. The Huazhong University of Science and Technology, Wuhan University, and the Chinese Academy of Sciences were the most productive institutions. This is the first study to show a comprehensive picture of the global efforts to address COVID-19 using AI. The findings of this study also provide insights and research directions for academic researchers, policymakers, and healthcare practitioners who wish to collaborate in these domains in the future. Full article
Show Figures

Figure 1

Project Report
An Experimental Education Project for Consultations of Older Adults during the Pandemic and Healthcare Lockdown
Healthcare 2021, 9(4), 425; https://doi.org/10.3390/healthcare9040425 - 06 Apr 2021
Cited by 4 | Viewed by 1044
Abstract
Objective: To develop a mentor-supervised, interprofessional, geriatric telemedicine experiential education project in response to the COVID-19 pandemic. Method: Medical and pharmacy students collaborated via remote consultations to address the coexistence of multimorbidity and polypharmacy in geriatric patients. In-depth interviews of students and patients [...] Read more.
Objective: To develop a mentor-supervised, interprofessional, geriatric telemedicine experiential education project in response to the COVID-19 pandemic. Method: Medical and pharmacy students collaborated via remote consultations to address the coexistence of multimorbidity and polypharmacy in geriatric patients. In-depth interviews of students and patients as well as Likert scale-based telephonic survey were performed for a comprehensive evaluation of the project’s significance. Results: To date, 49 consultations have been conducted. Remote consultations performed by medical and pharmacy students working collaboratively were beneficial for both students, participants. Conclusions and Practice Implications: This experimental education project provided students with authentic challenges while simultaneously delivering care to the older adults who are susceptible to disruption of care associated with the pandemic. Further development and expanded implementation of such approaches may be a post-pandemic practice to provide more accessible care for senior patients while incorporating interprofessional education. Full article
Show Figures

Figure 1

Article
The ICF Classification as a Simple Tool to Aid in the Assessment of Healthcare Services in a Non-COVID-19 Hospital during the COVID-19 Pandemic
Healthcare 2021, 9(4), 398; https://doi.org/10.3390/healthcare9040398 - 01 Apr 2021
Cited by 2 | Viewed by 631
Abstract
The COVID-19 pandemic has had a significant impact on the operation of medical facilities. In this period, they have seen increased absence of medical staff from work, a decrease in the number of hospitalizations and in the value of healthcare services provided. We [...] Read more.
The COVID-19 pandemic has had a significant impact on the operation of medical facilities. In this period, they have seen increased absence of medical staff from work, a decrease in the number of hospitalizations and in the value of healthcare services provided. We assess the impact of this pandemic on the operation of a non-COVID-19 orthopedic and rehabilitation hospital using International Classification of Functioning, Disability and Health (ICF) categories. The authors analyzed these parameters in relation to the operation of a non-COVID-19 orthopedic, rehabilitation and rheumatological hospital in Q1 2020 compared to Q1 2019. For the analysis, the categories and qualifiers of the ICF were used, allowing for a simple and easily readable data analysis. In March 2020, in comparison to March 2019, the average working time of medical workers (p < 0.001) and the number of hospitalizations (p < 0.034) decreased significantly. In April 2020, compared to April 2019, the average working time of medical workers (<0.001) and the number of hospitalizations (0.002) also decreased significantly. In addition, in April 2020, the percentage value of the contracted services provided decreased significantly (p = 0.017), which was not observed in March of that year. The COVID-19 pandemic has affected the operation of a non-COVID-19 hospital, causing an increase in staff absences from work, a decrease in the number of hospitalizations and a decrease in the value of the revenue generated from health services provided. The ICF is a useful tool for the evaluation of a hospital’s healthcare services. Full article
Article
Prevention and Control of COVID-19 Pandemic on International Cruise Ships: The Legal Controversies
Healthcare 2021, 9(3), 281; https://doi.org/10.3390/healthcare9030281 - 04 Mar 2021
Cited by 4 | Viewed by 1401
Abstract
During the COVID-19 pandemic in 2020, a number of international cruise ships were infected, thereby resulting in serious public health and human rights problems. Multiple difficulties were encountered in the prevention and control of the coronavirus disease onboard ships, while rule-based international cooperation [...] Read more.
During the COVID-19 pandemic in 2020, a number of international cruise ships were infected, thereby resulting in serious public health and human rights problems. Multiple difficulties were encountered in the prevention and control of the coronavirus disease onboard ships, while rule-based international cooperation in this regard appeared inefficient and ineffective. By applying interdisciplinary methodologies, including empirical research of law, policy science, and health studies, this research reviewed the legal difficulties in the prevention and control of COVID-19 on international cruise ships and sought solutions from a policy-making and strategic perspective. We found that, apart from the inherent nature of cruise ships such as crowded semi-enclosed areas, shared sanitary facilities and limited medical resources, there are also nonnegligible legal reasons affecting the effectiveness of containment measures on board. In particular, there is ambiguity and even inconsistency of relevant international norms and domestic regulations, and some of the key rules are neither mandatory nor enforceable. We conclude by suggesting that rule-based international cooperation on this issue must be strengthened with respect to information sharing and management, a more effective supervisory mechanism, clarification of key rules over jurisdiction and distributions of obligations among the port states, flag states, nationality states, and cruise ship companies. Full article
Show Figures

Figure 1

Article
Forecasting COVID-19 Confirmed Cases Using Empirical Data Analysis in Korea
Healthcare 2021, 9(3), 254; https://doi.org/10.3390/healthcare9030254 - 01 Mar 2021
Cited by 6 | Viewed by 923
Abstract
From November to December 2020, the third wave of COVID-19 cases in Korea is ongoing. The government increased Seoul’s social distancing to the 2.5 level, and the number of confirmed cases is increasing daily. Due to a shortage of hospital beds, treatment is [...] Read more.
From November to December 2020, the third wave of COVID-19 cases in Korea is ongoing. The government increased Seoul’s social distancing to the 2.5 level, and the number of confirmed cases is increasing daily. Due to a shortage of hospital beds, treatment is difficult. Furthermore, gatherings at the end of the year and the beginning of next year are expected to worsen the effects. The purpose of this paper is to emphasize the importance of prediction timing rather than prediction of the number of confirmed cases. Thus, in this study, five groups were set according to minimum, maximum, and high variability. Through empirical data analysis, the groups were subdivided into a total of 19 cases. The cumulative number of COVID-19 confirmed cases is predicted using the auto regressive integrated moving average (ARIMA) model and compared with the actual number of confirmed cases. Through group and case-by-case prediction, forecasts can accurately determine decreasing and increasing trends. To prevent further spread of COVID-19, urgent and strong government restrictions are needed. This study will help the government and the Korea Disease Control and Prevention Agency (KDCA) to respond systematically to a future surge in confirmed cases. Full article
Show Figures

Figure 1

Article
Assessing the Psychological Impact of COVID-19 among College Students: An Evidence of 15 Countries
Healthcare 2021, 9(2), 222; https://doi.org/10.3390/healthcare9020222 - 17 Feb 2021
Cited by 31 | Viewed by 4841
Abstract
Mental health issues among college students is a leading public health concern, which seems to have been exacerbating during the COVID-19 pandemic. While previous estimates related to psychological burden among college students are available, quantitative synthesis of available data still needs to be [...] Read more.
Mental health issues among college students is a leading public health concern, which seems to have been exacerbating during the COVID-19 pandemic. While previous estimates related to psychological burden among college students are available, quantitative synthesis of available data still needs to be performed. Therefore, this meta-analysis endeavors to present collective evidence discussing the psychological impact of COVID-19 among college students. Bibliographical library databases, including Embase, Medline, CINAHL, Scopus, and PsycINFO, were systematically searched for relevant studies. Titles, abstracts, and full articles were screened, and two reviewers extracted data. Heterogeneity was assessed by I2 statistic. The random-effects model was utilized to obtain the pooled estimates of psychological indicators among college students. Location, gender, level of severity, and quality scores were used as moderator variables for subgroup analyses. Funnel plot and Egger linear regression test was used to assess publication bias. Twenty-seven studies constituting 90,879 college students met the inclusion criteria. The results indicated 39.4% anxiety (95% CI: 28.6, 51.3; I2 = 99.8%; p-value < 0.0001) and 31.2% depression (95% CI: 19.7, 45.6; I2= 99.8%, p < 0.0001) among college students. The pooled prevalence of stress (26.0%), post-traumatic stress disorder (29.8%), and impaired sleep quality (50.5%) were also reported. College students bear a disproportionate burden of mental health problems worldwide, with females having higher anxiety and depression levels than males. This study‘’s findings underscore the need to develop appropriate public health interventions to address college students’ emotional and psychosocial needs. The policies should be reflective of demographic and socioeconomic differentials. Full article
Show Figures

Figure 1

Article
Assessment of Awareness and Knowledge on Novel Coronavirus (COVID-19) Pandemic among Seafarers
Healthcare 2021, 9(2), 120; https://doi.org/10.3390/healthcare9020120 - 25 Jan 2021
Cited by 8 | Viewed by 2244
Abstract
Background: The ongoing pandemic due to the novel coronavirus (COVID-19) is becoming a serious global threat. Experts suggest that the infection can be controlled by immediate prevention measures. Sailing is one of the occupational categories more vulnerable to this virus outbreak due [...] Read more.
Background: The ongoing pandemic due to the novel coronavirus (COVID-19) is becoming a serious global threat. Experts suggest that the infection can be controlled by immediate prevention measures. Sailing is one of the occupational categories more vulnerable to this virus outbreak due to the proximity of the working conditions. Objective: Awareness and knowledge assessments of seafarers towards the current epidemic is mandatory to understand the effectiveness and success of the infection control measures adopted by shipping companies. Methods: In this study, we presented an online questionnaire survey to determine the knowledge levels of COVID-19 among seafarers. The data were collected by self-reported survey, and analysis was done by the analysis of variance (ANOVA). The t-test was used to understand the knowledge attitude differences to COVID-19 among different occupational groups of seafarers, and the p-value ≤ of 0.05 was considered statistically significant. Results: Among 1,458 responses received, 92.82% had a college or university degree. The results reported that the mean COVID-19 knowledge score was 5.82 (standard deviation = 0.51, range 0–6), and the overall correct percentage was 97%. There was a statistically significant difference between age groups (F (4, 1453) = 5.44, p < 0.001) and educational groups (F (4, 1453) = 1.52, p < 0.001). The knowledge score was not significantly different across the educational status of the participants (F (2, 1455) = 1.52, p = 0.220). Conclusions: The present study highlighted good knowledge and behaviours among sailors about COVID-19. However, shipping companies need to come up with new campaigns to hold optimistic practices and suitable guidelines on ships, including cruise boats, to keep sea workers always alert and collaborative in mitigating the spread of COVID-19. Full article
Show Figures

Figure 1

Article
Determinants of Behavioral Changes Since COVID-19 among Middle School Students
Healthcare 2021, 9(1), 75; https://doi.org/10.3390/healthcare9010075 - 14 Jan 2021
Cited by 4 | Viewed by 1600
Abstract
Middle school students are of particular interest when examining the impact of the COVID-19 pandemic because they are in a formative period for socioemotional development, and because they are not as mature as adults, making them more vulnerable to the effects of the [...] Read more.
Middle school students are of particular interest when examining the impact of the COVID-19 pandemic because they are in a formative period for socioemotional development, and because they are not as mature as adults, making them more vulnerable to the effects of the current pandemic. This study seeks to examine determinants of protective behavior changes since COVID-19 among middle school students. Participants were recruited through an official online flatform used by public schools. The final sample included 328 middle school students in South Korea. A multiple linear regression was conducted to explore what factors influence protective behavior changes since COVID-19. Gender and health status were associated with protective behavior changes since COVID-19. Family satisfaction was positively associated with protective behavior changes. Levels of sanitation since COVID-19 and perceptions regarding the risk of COVID-19 were significantly related to protective behavior changes. This study suggests to consider three factors–individual, family, and environmental—in order to prevent middle school students from contracting and spreading the virus. Full article
Show Figures

Figure 1

Article
Explaining Handwashing Behavior in a Sample of College Students during COVID-19 Pandemic Using the Multi-Theory Model (MTM) of Health Behavior Change: A Single Institutional Cross-Sectional Survey
Healthcare 2021, 9(1), 55; https://doi.org/10.3390/healthcare9010055 - 06 Jan 2021
Cited by 14 | Viewed by 2323
Abstract
Amidst the COVID-19 pandemic, handwashing offers a simple and effective hygienic measure for disease prevention. Reportedly, a significant proportion of college students did not follow handwashing recommendations provided by the Centers for Disease Control and Prevention (CDC) in the pre-COVID era. The purpose [...] Read more.
Amidst the COVID-19 pandemic, handwashing offers a simple and effective hygienic measure for disease prevention. Reportedly, a significant proportion of college students did not follow handwashing recommendations provided by the Centers for Disease Control and Prevention (CDC) in the pre-COVID era. The purpose of this cross-sectional study was to explore and explain the handwashing behavior among college students during the COVID-19 pandemic using a contemporary fourth-generation multi-theory model (MTM) of health behavior change. Data were collected from 713 college students at a large public university in the Southern U.S. in October 2020 using a validated 36-item survey. Statistical analyses included independent samples t-tests, Pearson correlation, and hierarchical regression modeling. Among students not following handwashing recommendations, the constructs of participatory dialogue (β = 0.152; p < 0.05) and behavioral confidence (β = 0.474; p < 0.0001) were statistically significant and accounted for 27.2% of the variance in the likelihood of initiation of the behavior. Additionally, the constructs of emotional transformation (β = 0.330; p < 0.0001), practice for change (β = 0.296; p < 0.0001), and changes in the social environment (β = 0.180; p < 0.05) were statistically significant and accounted for 45.1% of the variance in the likelihood of sustaining handwashing behavior. This study highlights the applicability and usability of the MTM in designing and testing behavior change interventions and media messaging in campaigns targeting college students. Full article
Article
Lack of Antibodies to SARS-CoV-2 among Blood Donors during COVID-19 Lockdown: A Study from Saudi Arabia
Healthcare 2021, 9(1), 51; https://doi.org/10.3390/healthcare9010051 - 05 Jan 2021
Cited by 8 | Viewed by 1614
Abstract
In response to the coronavirus disease 2019 (COVID-19), Saudi Arabia have imposed timely restrictions to minimize the infection spread, lower the risk for vulnerable groups, and reduce the pressure on healthcare services. The effectiveness of these measures has not been assessed comprehensively and, [...] Read more.
In response to the coronavirus disease 2019 (COVID-19), Saudi Arabia have imposed timely restrictions to minimize the infection spread, lower the risk for vulnerable groups, and reduce the pressure on healthcare services. The effectiveness of these measures has not been assessed comprehensively and, thereby, remains uncertain. Besides monitoring the number of COVID-19 cases diagnosed by molecular assays, the seroprevalence can serve as an indicator for the incidence rate among the general population. This study aimed to evaluate seroprevalence status of all healthy blood donors who attended one of the main largest hospital located in the western region of Saudi Arabia from 1 January to 31 May 2020. The study period covered two months prior to reporting the first COVID-19 case in the country on 2 March 2020. Importantly, it covered the period when “lock-down type” measures have been enforced. Samples were subjected to in-house enzyme-linked immunosorbent assay (ELISA), chemiluminescence immunoassay (CLIA), and microneutralization (MN). The sero statuses of all samples were confirmed negative, demonstrating the lack of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among blood donors during COVID-19 lockdown period. This study supports the hypothesis that COVID-19 restrictions have potential for limiting the extent of the infection. Full article
Show Figures

Figure 1

Article
Postponed Dental Visits during the COVID-19 Pandemic and their Correlates. Evidence from the Nationally Representative COVID-19 Snapshot Monitoring in Germany (COSMO)
Healthcare 2021, 9(1), 50; https://doi.org/10.3390/healthcare9010050 - 05 Jan 2021
Cited by 8 | Viewed by 1377
Abstract
(1) Background: The COVID-19 pandemic is accompanied by various societal and economic challenges. Furthermore, it is associated with major health challenges. Oral health is a key component of health. Therefore, both curative and preventive dental visits are important during pandemics. Since there is [...] Read more.
(1) Background: The COVID-19 pandemic is accompanied by various societal and economic challenges. Furthermore, it is associated with major health challenges. Oral health is a key component of health. Therefore, both curative and preventive dental visits are important during pandemics. Since there is a lack of nationally representative studies focusing on postponed dental visits and their correlates during the COVID-19 pandemic, we aimed to fill this gap in knowledge; (2) Methods: Cross-sectional data (wave 17) were collected from a nationally representative online-survey (COVID-19 Snapshot Monitoring in Germany (COSMO)) conducted in July 2020. The analytical sample consisted of 974 individuals (average age was 45.9 years (SD: 16.5, from 18 to 74 years)). The outcome measure was postponed dental visits since March 2020 (yes; no) due to the COVID-19 pandemic. Furthermore, the type of postponed dental visits was recorded (check-up/regular dental examination; pain/dental complaints; planned therapy); (3) Results: 22% of participants reported to have postponed dental visits due to the COVID-19 pandemic since March 2020, whereas 78% of individuals did not report postponed visits (“no, attended as planned”: 29.2%; “no, examining pending”: 44.9%; “no, other reasons”: 3.9%). Among individuals who reported postponed dental visits, 72% postponed a “check-up/regular dental examination”, whereas 8.4% postponed a dental visit despite “pain/dental complaints” and 19.6% postponed “planned therapy”. Furthermore, multiple logistic regressions showed that the likelihood of postponed dental visits was positively associated with being younger (aged 65 and older, OR: 0.43, 95% CI: 0.22–0.85; compared to individuals 18 to 29 years), and higher affect regarding COVID-19 (OR: 1.36, 95% CI: 1.13–1.64); (4) Conclusions: Our study showed that more than one out of five individuals postponed a dental visit—particularly check-ups and regular dental examination—due to the COVID-19 pandemic since March 2020. Several correlates of these postponed visits have been identified. This may help identify and address individuals at risk for deterioration of oral health amplified by postponed dental visits. Full article
Show Figures

Figure 1

Article
A Direct Method for RT-PCR Detection of SARS-CoV-2 in Clinical Samples
Healthcare 2021, 9(1), 37; https://doi.org/10.3390/healthcare9010037 - 04 Jan 2021
Cited by 7 | Viewed by 1632
Abstract
Introduction: the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global pandemic of acute respiratory disease (COVID-19). SARS-CoV-2 is a positive-strand RNA virus and its genomic characterization has played a vital role in the design of appropriate diagnostics tests. [...] Read more.
Introduction: the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global pandemic of acute respiratory disease (COVID-19). SARS-CoV-2 is a positive-strand RNA virus and its genomic characterization has played a vital role in the design of appropriate diagnostics tests. The current RT-PCR protocol for SARS-CoV-2 detects two regions of the viral genome, requiring RNA extraction and several hours. There is a need for fast, simple, and cost-effective detection strategies. Methods: we optimized a protocol for direct RT-PCR detection of SARS-CoV-2 without the need for nucleic acid extraction. Nasopharyngeal samples were diluted to 1:3 using diethyl pyrocarbonate (DEPC)-treated water. The diluted samples were incubated at 95 °C for 5 min in a thermal cycler, followed by a cooling step at 4 °C for 5 min. Samples then underwent reverse transcription real-time RT-PCR in the E and RdRp genes. Results: our direct detection protocol showed 100% concordance with the standard protocol with an average Ct value difference of 4.38 for the E region and 3.85 for the RdRp region. Conclusion: the direct PCR technique was found to be a reliable and sensitive method that can be used to reduce the time and cost of the assay by removing the need for RNA extraction. It enables the use of the assay in research, diagnostics, and screening for COVID-19 in regions with fewer economic resources, where supplies are more limited allowing for wider use for screening. Full article
Show Figures

Figure 1

2020

Jump to: 2022, 2021

Article
Impact of the COVID-19 Pandemic on Manual Therapy Service Utilization within the Australian Private Healthcare Setting
Healthcare 2020, 8(4), 558; https://doi.org/10.3390/healthcare8040558 - 13 Dec 2020
Cited by 7 | Viewed by 1834
Abstract
The COVID-19 pandemic has impacted a wide range of health services. This study aimed to quantify the impact of the COVID-19 pandemic on manual therapy service utilization within the Australian private healthcare setting during the first half of 2020. Quarterly data regarding the [...] Read more.
The COVID-19 pandemic has impacted a wide range of health services. This study aimed to quantify the impact of the COVID-19 pandemic on manual therapy service utilization within the Australian private healthcare setting during the first half of 2020. Quarterly data regarding the number and total cost of services provided were extracted for each manual therapy profession (i.e., chiropractic, osteopathy, and physiotherapy) for the period January 2015 to June 2020 from the Australian Prudential Regulation Authority. Time series forecasting methods were used to estimate absolute and relative differences between the forecasted and observed values of service utilization. An estimated 1.3 million (13.2%) fewer manual therapy services, with a total cost of AUD 84 million, were provided within the Australian private healthcare setting during the first half of 2020. Reduction in service utilization was considerably larger in the second quarter (21.7%) than in the first quarter (5.7%), and was larger in physiotherapy (20.6%) and osteopathy (12.7%) than in chiropractic (5.2%). The impact varied across states and territories, with the largest reductions in service utilization observed in New South Wales (17.5%), Australian Capital Territory (16.3%), and Victoria (16.2%). The COVID-19 pandemic has had a profound impact on manual therapy service utilization in Australia. The magnitude of the decline in service utilization varied considerably across professions and locations. The long-term consequences of this decline in manual therapy utilization remain to be determined. Full article
Show Figures

Figure 1

Article
COVID-19 and Psychological Health of Female Saudi Arabian Population: A Cross-Sectional Study
Healthcare 2020, 8(4), 542; https://doi.org/10.3390/healthcare8040542 - 09 Dec 2020
Cited by 4 | Viewed by 1117
Abstract
The influence of the COVID-19 pandemic is unprecedented on physical and mental health. This study aimed to determine the impact of the COVID-19 event on mental health among Saudi Arabian females of Riyadh by a cross-sectional study design. The samples of the study [...] Read more.
The influence of the COVID-19 pandemic is unprecedented on physical and mental health. This study aimed to determine the impact of the COVID-19 event on mental health among Saudi Arabian females of Riyadh by a cross-sectional study design. The samples of the study were recruited using convenience and snowball sampling methods. The questionnaire is composed of items related to sociodemographic profile, general mental status, negative attitude scale, impact of event (COVID-19 pandemic) scale (R) and negative health impact. The data obtained were analyzed using multivariate regression analysis. Out of the 797 samples (34.58 ± 12.89 years), 457 (57.34%) belonged to an age group of ≥25 years. The average BMI of the participants was 26.73 (kg/m2). Significantly (p = 0.000), a large proportion of the participants were overweight and unemployed. Age group (>25 years) have more odds for abnormal mental status (OR; 1.592), development of negative attitudes (OR; 1.986), the intense impact of COVID-19 events (OR; 1.444) and susceptibility to attain negative health impacts (OR; 1.574). High body weight is another risk factor for altered mental status, negative attitude and developing impact of COVID-19 quickly. Overall, the COVID-19 pandemic was directly associated with stress (53%), anxiety (63%) and depression (44%) in our sample population. There is an urgent need for psychological counseling for the distressed population. Full article
Article
Echocardiography Abnormal Findings and Laboratory Operations during the COVID-19 Pandemic at a High Volume Center in New York City
Healthcare 2020, 8(4), 534; https://doi.org/10.3390/healthcare8040534 - 03 Dec 2020
Cited by 2 | Viewed by 911
Abstract
(1) Background: This study sought to explore how the novel coronavirus (COVID-19) pandemic affected the echocardiography (TTE) laboratory operations at a high volume medical center in New York City. Changes in cardiac imaging study volume, turn-around time, and abnormal findings were analyzed and [...] Read more.
(1) Background: This study sought to explore how the novel coronavirus (COVID-19) pandemic affected the echocardiography (TTE) laboratory operations at a high volume medical center in New York City. Changes in cardiac imaging study volume, turn-around time, and abnormal findings were analyzed and compared to a pre-pandemic period. (2) Methods: Volume of all cardiac imaging studies and TTE reports between 11 March 2020 to 5 May 2020 and the same calendar period in 2019 were retrospectively identified and compared. (3) Results: During the pandemic, our center experienced a 46.72% reduction in TTEs, 82.47% reduction in transesophageal echocardiograms, 83.16% reduction in stress echo, 70.32% reduction in nuclear tests, 46.25% reduction in calcium score, 73.91% reduction in coronary computed tomography angiography, and 87.23% reduction in cardiac magnetic resonance imaging. TTE findings were overall similar between 2020 and 2019 (all p ≥ 0.05), except for a significantly higher right ventricular systolic pressure in 2020 (39.8 ± 14.2 vs. 34.6 ± 11.2 mmHg, p = 0.012). (4) Conclusions: Despite encountering an influx of critically ill patients, our hospital center experienced a reduction in the number of cardiac imaging studies, which likely represents a change in both patient mindset and physician management approach. Full article
Show Figures

Figure 1

Article
Clinical Characteristics of the COVID-19 Patients with Pneumonia Detected by Computerized Tomography but Negative for Infiltration by X-ray
Healthcare 2020, 8(4), 518; https://doi.org/10.3390/healthcare8040518 - 29 Nov 2020
Cited by 1 | Viewed by 1242
Abstract
Coronavirus Disease 2019 (COVID-19) has rapidly spread to all corners of the globe. Different diagnostic tools, such as Chest X-ray (CXR), lung ultrasound (LUS), and computerized tomography (CT), have been used to detect active pneumonic lesions associated with COVID-19 with their varying degrees [...] Read more.
Coronavirus Disease 2019 (COVID-19) has rapidly spread to all corners of the globe. Different diagnostic tools, such as Chest X-ray (CXR), lung ultrasound (LUS), and computerized tomography (CT), have been used to detect active pneumonic lesions associated with COVID-19 with their varying degrees of sensitivity and specificity. This study was undertaken to investigate the clinical characteristics of COVID-19 patients with a pneumonic lung lesion detected by CT that is not detected by CXR. A total of 156 COVID-19 patients hospitalized at three nationally designated South Korean hospitals with no active lesion detected by CXR but on clinical suspicion of pneumonia underwent the CT examination and were enrolled. Medical records, which included demographic and clinical features, including comorbidity, symptoms, radiological, and laboratory findings on admission, were reviewed and analyzed. The risk factors of pneumonia detected by CT for patients without an active lesion detected by CXR were investigated. Of the 156 patients without an active lesion detected by CXR, 35 (22.44%) patients were found to have pneumonia by CT. The patients with pneumonia defined by CT were older than those without (64.1 years vs. 41.2 years). Comorbidities such as hypertension, diabetes, cardiovascular disease, preexisting stroke, and dementia were more common among patients with pneumonia defined by CT than those without. Serum albumin level, C-reactive protein (CRP), stroke, and age ≥ 70 years were significantly associated with pneumonia defined by CT after adjustment for age. In multivariable regression analysis, serum albumin level (adjusted odds ratio (AOR) = 0.123, 95% CI = (0.035–0.429)) and preexisting stroke (AOR = 11.447, 95% CI = (1.168–112.220)) significantly and independently predicted pneumonia detection by CT. Our results suggest that CT scans should be performed on COVID-19 patients negative for a pneumonic lung lesion by CXR who are suspected to be pneumonic on clinical grounds. In addition, older patients with a lower albumin level and a preexisting stroke should be checked for the presence of pneumonia despite a negative CXR finding for an active lesion. Full article
Review
Maternal Coronavirus Infections and Neonates Born to Mothers with SARS-CoV-2: A Systematic Review
Healthcare 2020, 8(4), 511; https://doi.org/10.3390/healthcare8040511 - 24 Nov 2020
Cited by 26 | Viewed by 2895
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is continuously affecting the lives of all people. Understanding the impact of COVID-19 on pregnancy in terms of morbidity, mortality, and perinatal maternal and fetal outcomes is essential to propose strategies for prevention and infection control. Here, [...] Read more.
The coronavirus disease 2019 (COVID-19) pandemic is continuously affecting the lives of all people. Understanding the impact of COVID-19 on pregnancy in terms of morbidity, mortality, and perinatal maternal and fetal outcomes is essential to propose strategies for prevention and infection control. Here, we conducted a systematic review to investigate pregnant women infected with COVID-19 in terms of signs and symptoms, type of delivery, comorbidities, maternal and neonatal outcomes, and the possibility of vertical transmission. A search on Embase and PubMed databases was performed on 31 October 2020. Observational studies and case reports on pregnant women infected with COVID-19 were included without language restrictions. The 70 selected studies included a total of 1457 pregnant women diagnosed with COVID-19 in the first, second, and third trimesters of pregnancy. The most common signs and symptoms were fever, cough, and nausea. The most frequent comorbidities were obesity, hypertensive disorders, and gestational diabetes. Among maternal and fetal outcomes, premature birth (n = 64), maternal death (n = 15), intrauterine fetal death or neonatal death (n = 16), cases of intrauterine fetal distress (n = 28), miscarriage (n = 7), decreased fetal movements (n = 19), and severe neonatal asphyxia (n = 5) were the most frequent. Thirty-nine newborns tested positive for SARS-CoV-2. Additionally, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA was detected in the placenta (n = 13) and breast milk (n = 6). This review indicates that COVID-19 during pregnancy can result in maternal, fetal, and neonatal complications. In addition, SARS-CoV-2 viral exposure of neonates during pregnancy and delivery cannot be ruled out. Thus, we highlight the need for long-term follow-up of newborns from mothers diagnosed with COVID-19 to establish the full implications of SARS-CoV-2 infection in these children. Full article
Show Figures

Figure 1

Article
Predictors of Staying at Home during the COVID-19 Pandemic and Social Lockdown based on Protection Motivation Theory: A Cross-Sectional Study in Japan
Healthcare 2020, 8(4), 475; https://doi.org/10.3390/healthcare8040475 - 11 Nov 2020
Cited by 24 | Viewed by 2521
Abstract
During the COVID-19 pandemic, a social lockdown should be put in place and individuals should stay at home. Behavioral change is the only way to prevent the pandemic and overwhelmed healthcare systems until vaccines are available. We aimed to examine the psychological factors [...] Read more.
During the COVID-19 pandemic, a social lockdown should be put in place and individuals should stay at home. Behavioral change is the only way to prevent the pandemic and overwhelmed healthcare systems until vaccines are available. We aimed to examine the psychological factors that predict staying at home during the COVID-19 pandemic and social lockdown. A total of 1980 participants in Japan completed a survey for this study from 9 to 11 May 2020, when the state of emergency covered all prefectures in the country. Self-reported behavior in terms of staying at home, the perceived severity of the pandemic, vulnerability to the pandemic, response efficacy, and self-efficacy based on protection motivation theory were assessed. Multiple regression analysis showed that perceived severity (standardized β = 0.11, p < 0.001) and self-efficacy (standardized β = 0.32, p < 0.001) significantly predicted greater levels of staying at home, after controlling for socio-demographics. However, perceived vulnerability and response efficacy did not. To encourage people to stay at home during the pandemic and social lockdown, increasing the perceived severity of infection by COVID-19 and self-efficacy in terms of exercising restraint with respect to going out may consequently encourage people to stay at home. Full article
Back to TopTop