Search Results (3,564)

Major societal stressors such as pandemics and economic crises can significantly disrupt individual well-being through altered sleep patterns. This study uses a mixed-methods approach to explore the underlying causes and consumption expressions of sleep disturbance during the COVID-19 lockdown. Based on qualitative responses from 59 participants, the findings reveal three core disturbance patterns: delayed sleep schedules, increased sleep duration, and sleep restriction. These shifts were associated with a combination of emotional arousal, cognitive overload, and disrupted routines. Two dominant types of pre-sleep thought processes—pressing and comforting—appear to influence sleep outcomes. Despite the availability of mindfulness and guided-meditation technologies, most participants did not adopt these tools, citing either skepticism or inertia. The proposed model highlights the interplay between personal traits, pre-sleep behavior, and stress responses in shaping sleep. The study offers implications for public health initiatives, suggesting that targeted and accessible interventions are needed to support sleep health during a major stressor. Full article

The COVID-19 pandemic caused sudden changes in school routines, creating conditions that may have been relevant to students’ self-efficacy for self-regulated learning (SESRL). This research investigated high-school students’ SESRL during the initial lockdown (Study 1) and across three pandemic stages (Study 2). Using a cross-sectional retrospective design, Study 1 (N = 802, 32.5% males; M_age [Time1 (T1)] = 16.40, SD = 1.52) revealed a significant difference between retrospectively reported SESRL for the pre-pandemic period and SESRL perceived during the first lockdown. Also, higher perceived teacher support and effortful control were associated with higher SESRL during the lockdown. Latent Growth Curve Analyses in Study 2 [N (T1) = 455, 31.9% males; M_age (T1) = 15.37, SD = 1.10; 71% attrition rate] showed a declining trend for perceived SESRL over time, regardless of gender and school grade, whereas COVID-19-related life disruption showed a significant time-varying effect. Specifically, higher levels of COVID-19-related life disruption were associated with lower SESRL at each time point. These findings highlight the potential value of monitoring students’ SESRL and exploring educational initiatives that support self-regulatory skills and positive teacher–student relationships, particularly during periods of widespread educational disruption. However, the longitudinal findings should be interpreted cautiously given the substantial attrition across waves. Full article

Ensuring a high quality of life for citizens is a fundamental objective for every city, with public safety representing one of the most critical challenges to social sustainability and equitable urban development. This study analyzes the spatiotemporal dynamics of violent crime in Mexico City across pre-pandemic, pandemic, and post-pandemic periods (2019–2023) to evaluate how COVID-19 mobility restrictions were associated with changes in crime patterns. Using publicly available crime reports, we applied Seasonal-Trend decomposition using Loess (STL) and Moran’s I to examine four violent crimes: homicide, robbery, kidnapping, and rape. The results reveal crime-specific pandemic-related patterns. While robbery showed a sustained decline, its spatial clustering intensified significantly, with Moran’s I increasing from 0.22 to 0.59, indicating highly localized risk zones. Conversely, rape exhibited a steady increase that appeared unaffected by lockdown measures, while maintaining significant spatial autocorrelation. Likewise, Cuauhtémoc borough persisted as the main urban hotspot across all phases. Overall, crime did not decline uniformly during the pandemic; instead, mobility restrictions reshaped the geographic distribution and concentration of specific offenses. This research contributes to the understanding of crime dynamics during and after a public health emergency. Full article

Background: COVID-19, a global pandemic, has had a profound impact on the world, overwhelming healthcare systems worldwide. These disruptions were associated with significant disparities in healthcare access to routine consultations and elective surgeries, adversely affecting patient health and altering injury patterns in emergency departments. This retrospective observational study aims to compare patient profiles and treatment during the pandemic compared to the pre-pandemic period. Methods: Patients admitted to the orthopaedic and traumatology department before, during, and after the COVID-19 pandemic. The full (unmatched) cohort comprised 8413 patients (6175 before, 1188 during, and 1050 after the pandemic). To ensure balanced comparisons, propensity score matching (1:2, based on age, sex, and comorbidities) was applied separately to the during- and after-pandemic groups, each matched against pre-pandemic controls. Collected information incorporated demographics, comorbidities, and injury circumstances. Results: After matching, the during-pandemic group (1188 patients) was compared with 2376 pre-pandemic controls, and the after-pandemic group (1050 patients) with 2100 pre-pandemic controls. A higher proportion of same-region re-injuries was observed during and after the pandemic, as well as higher medical leave during the pandemic and post-pandemic, and longer hospital stays of over 10 days during the pandemic and post-pandemic. Injury patterns changed, with an increase in lower leg injuries and a decrease in wrist injuries during the pandemic. Additionally, the proportion of open wounds was lower during the pandemic. Conclusions: The pandemic and post-pandemic periods were associated with marked changes in trauma care, including more conservative treatment, fewer surgeries, and longer hospital stays. Same-region re-injuries were more frequent and sports-related injuries less frequent—patterns that temporally coincided with the periods of repeated lockdowns. Notably, differences persisted into the post-pandemic period. Given the retrospective, observational design, these findings represent associations rather than causal effects. Full article

We propose a family of spectral hypergraph algorithms for early detection of connectivity collapse in pharmaceutical supply chain networks. The Fiedler eigenvalue λ₂ of the normalised hypergraph Laplacian serves as the order parameter. Five geometry-aware early warning indicators (TSI, HSST, HOMFA, HOTV, ORC) monitor network topology rather than scalar residuals, with provable detection guarantees under geometric ergodicity. A Greedy Dejamming algorithm restores connectivity via rank-2 Laplacian updates, achieving a (1 − 1/e)-approximation within a procurement budget constraint. Monte Carlo validation on a calibrated pharmaceutical distribution hypergraph demonstrates substantially higher detection sensitivity and shorter lead times than classical statistical process control. Hyperedge representation yields detection gains exceeding 90% for simultaneous multi-party failures that pairwise graph projections miss entirely. A COVID-19 lockdown episode provides a held-out directional consistency check. Full article

The COVID-19 pandemic generated unprecedented disruptions to the global tourism industry, severely affecting tourism-dependent economies and related employment. India, as one of the world’s major tourist destinations, experienced substantial declines in tourist arrivals during the pandemic period. This study investigates the effects of COVID-19-induced fear on tourism demand and economic performance in India using the COVID-19 Fear Index, which captures behavioural responses to pandemic-related uncertainty beyond conventional indicators such as infection rates, mortality, and lockdown restrictions. The COVID-19 Fear Index is constructed using reported COVID-19 cases and mortality data sourced from the European Centre for Disease Prevention and Control and the Johns Hopkins Coronavirus Resource Centre. Monthly data from January 2020 to October 2023 are analysed using autoregressive distributed lag (ARDL) and nonlinear autoregressive distributed lag (NARDL) models to examine both tourism demand dynamics and the asymmetric tourism–growth relationship. The results confirm a stable long-run cointegration relationship among tourism demand, the COVID-19 Fear Index, exchange rate, and ICT development. Pandemic-induced fear significantly reduces tourism demand in the long run ($-0.152$, $p=0.021$) and short run ($-0.084$, $p=0.000$), indicating that heightened uncertainty suppresses tourist arrivals. Exchange rate depreciation also negatively affects tourism demand ($-0.267$, $p=0.000$), whereas ICT development positively enhances tourism resilience ($0.463$, $p=0.000$). The error correction term ($-0.436$, $p=0.000$) confirms rapid adjustment toward long-run equilibrium. Furthermore, the nonlinear analysis reveals asymmetric effects, where positive tourism shocks increase economic growth by $0.088\%$ ($p=0.003$), while negative shocks exert a stronger contractionary effect ($0.409$, $p=0.000$). These findings highlight the vulnerability of tourism-dependent economies to uncertainty shocks and emphasise the importance of ICT-driven resilience strategies, adaptive tourism policies, and crisis-responsive economic planning. Full article

The aim of this study was to reconstruct the subjective theories of national parent associations in Chile regarding school violence in the post-pandemic period. We performed a collective case study, employing a qualitative, interpretative, and exploratory approach. Information was produced through semi-structured interviews with leaders of four national associations. The information was examined using inductive thematic analysis. In general, parent association representatives largely described school violence as a loss of parental and pedagogical authority, weakening of the family–school bond, centralized school administration, and social vulnerability factors, intensified by the psychosocial impact of the COVID-19 pandemic lockdowns. The interviewees emphasized preventive and community-based approaches, including strengthening family involvement, incorporating school climate specialists, and implementing educational and recreational activities. Overall, the interviews show that parent association representatives tended to regard violence as a multisystemic phenomenon that, according to their accounts, requires joint efforts involving families, schools, the state, and communities rather than punitive or individualized approaches. Full article

Urban air quality management has been playing a significant role due to its effects on public health and pollution characteristics of countries with constantly changing policies. Traditional approaches capture how much pollution is present but are unable to detect changes in the chemical character of the atmosphere, the relationships between co-emitted species, the balance of photochemical processing, and the combustion fingerprint of emission sources. This study introduces a framework that identifies and diagnoses such evolutions within the pollutants of the atmosphere. A chemistry-aware Variational Autoencoder is trained on 19 multivariate pollution features (7 raw concentrations, 5 chemical ratios, 7 temporal gradients) at London Marylebone Road (urban roadside) and North Kensington (urban background) from 2015 to 2019, and tested on 2022–2025. A four-method ensemble framework (VAE reconstruction error, reconstruction probability, Isolation Forest, and statistical Z-score) requires ≥3 agreement to identify high-confidence departed pollution states. Per-feature decomposition of the reconstruction probability diagnoses the chemical character of each departure. At the roadside site, 14.5% of post-COVID hours fall within departed states, dominated by the CO/NO_x combustion ratio (513.2) and the photostationary state proxy (391.4), chemical relationships rather than individual concentrations. This indicates that at the point of emission, London’s fleet modernisation and Ultra Low Emission Zone (ULEZ) have changed the combustion fingerprint and photochemical equilibrium. The same structural indicators are carried over during the COVID-19 lockdown; however, O₃ rises 3.2× during the pandemic period, reflecting suppressed NO titration. Conversely, at the urban background site, where the departures are driven by concentrations and boundary-layer trapping ($r=-0.659$), the combustion fingerprint of the atmosphere is invisible to detect (CO/NO_x$=-45.0$). These findings indicate that London’s emission landscape has undergone fundamental transformations over the past decade, and the consequences of ULEZ and similar interventions or greater impacts of pandemic-related events are non-homogeneously distributed across the relevant region. Full article

The large-scale mobility restrictions implemented worldwide in response to the COVID-19 (SARS-CoV-2) pandemic led to short-term reductions in anthropogenic emissions, providing an opportunity to explore atmospheric pollutant responses to large-scale changes in human activity and mobility patterns. Although numerous studies have reported air quality improvements during lockdowns, most rely on ground-based monitoring networks and focus on developed regions, leaving gaps in less-studied areas such as Central America. This study evaluates spatiotemporal changes in tropospheric nitrogen dioxide (NO₂) across Central America before, during, and after COVID-19 lockdowns using satellite-based remote sensing. High-resolution NO₂ vertical column density (VCD) data from the TROPOMI instrument onboard Sentinel-5P were processed using Google Earth Engine. Percentage variations were calculated using the March–May 2020 lockdown period as a reference within the 2019–2021 analysis period. Results indicate reductions in NO₂ across several high-density departments, particularly in Guatemala, El Salvador, and Honduras, with decreases of 20–30% and localized negative variations below −40%. In contrast, Nicaragua exhibited comparatively limited changes, while a gradual recovery in NO₂ concentrations was observed during 2021. The observed patterns suggest a potential association between NO₂ variability and changes in anthropogenic activity during the COVID-19 period, while also highlighting the importance of considering meteorological influences in regional atmospheric assessments. The results further demonstrate the potential of cloud-based Earth observation platforms for atmospheric monitoring in data-scarce tropical regions. Full article

Background and Objectives: The COVID-19 pandemic was associated with major disruptions, not only at the environmental, social, and economic levels but also in the public health systems and, therefore, emergency care utilisation. Prior to the pandemic, one of the most significant issues in the ED was overcrowding, with a consequent percentage of people leaving the ED without being seen (LWBS). The aim of this study was to assess the association between the 2020 COVID-19 pandemic and the number of LWBS, compared with the rates recorded during the same period in 2019 and 2021. Materials and Methods: A retrospective comparative observational study of ED admissions was conducted in two university hospitals in Ancona (Italy) between 9 March and 3 May 2020 and in Gran Canaria (Spain) between 14 March and 10 May 2020, corresponding to the lockdown in the two countries, respectively. ED visits were assessed during the defined periods, separately for the Italian and Spanish contexts and between groups, comparing the two contexts for each year. Results: In Italy, during the 2019 timeframe, 597 (7.0%) of 8568 patients who arrived in the ED left before being seen; during the same period in 2020, 100 (3.2%) of 3100; and in 2021, 334 (6.0%) of 5555. In Spain, patients leaving the ED prior to medical consult in 2019 were 567 (4.0%) out of 14,034 visits; in 2020, they amounted to 185 (2.6%) out of 7208; and in 2021, they were 528 (4.0%) out of 13,214. The results of the logistic regression analysis for Italy and Spain showed that male sex [odds ratio (OR), 95% confidence interval (CI): 1.38 (1.24–1.53)], age group between 17 and 43 years compared to those subjects older than 74 years old [OR (95%CI): 4.04 (3.34–4.88)] and a lower priority code at triage were significantly associated with a higher odds of LWBS. Conclusions: The findings suggest that the COVID-19 pandemic was associated with changes in only some characteristics of the profiles and types of patients leaving the ED, while it had a strong impact on the number of patients who left the ED before medical examination. The observed decrease in ED visits and LWBS rates in 2020 suggests that the COVID-19 pandemic has changed the population’s use of the ED, highlighting the potential need for improved public and professional awareness of appropriate care pathways and the role of health professionals in them. Full article

As mobility and transport activities declined during the COVID-19 lockdowns, transactions and operations became increasingly dependent on digitalisation. This shift reduced the need for carbon-emissions-intensive fossil-fuel-based transportation. Using a panel of thirteen (13) Southern African Development Community (SADC) countries over the period 2002–2021, the analysis captures financial inclusion through indicators of ATM density and commercial bank accessibility, while digital inclusion is measured using mobile phone subscriptions and internet penetration. On this basis, it investigates the effects of (a) financial and (b) digital inclusion, and (c) the moderation of financial and digital inclusion on transport-related carbon emissions. Employing the Panel Two-Stage Estimated Generalised Least Square (EGLS) analysis on data obtained from the World Bank database and Our World in Data, the findings reveal statistically significant outcomes. Increasing ATM accessibility, commercial bank branch accessibility and mobile phone subscription rates are associated with reduced transport-related emissions. In contrast, enhanced internet access does not contribute to transport-related carbon emissions. Moderation analyses further indicate that the interaction of the accessibility of ATMs or commercial bank branches with internet access do not lead to a further reduction in carbon emissions than the individual ones but might have a slightly opposing direction (that still do not annihilate the individual effects). Findings show that only the moderation of ATM accessibility and mobile subscriptions reduce transport-related carbon emissions further than the individual effects. Taking the economic development of most SADC countries in the last 20 years into account, the study recommends strategic investment in advanced digital innovations, particularly linked with mobile devices, to strengthen digital banking efficiency and improve customer service while supporting emission-reducing pathways. Full article

Background and Objectives: New Caledonia, an archipelago in the South Pacific, experienced an unprecedented conjunction of prolonged border closure during the COVID-19 pandemic (2020 to 2022) and marked influence of the El Niño/Southern Oscillation (ENSO). This context provided a unique opportunity to explore how environmental drivers, island isolation, and socio-demographic factors interact to shape infectious disease dynamics. This study aimed to assess the respective and combined effects of climatic variability, travel restrictions, and socio-demographic factors on the dynamics of four priority infectious diseases. Materials and Methods: We retrospectively analysed data from 2017 to 2023 on four infectious diseases: leptospirosis, dengue, influenza, and hepatitis A (HAV). Satellite precipitation data and the Multivariate El Niño/Southern Oscillation Index (MEI) were used. Socio-demographic and economic variables were gathered. Statistical analyses employed descriptive analysis and Generalized Additive Mixed Models to evaluate the associations between climatic events, travel restrictions, and disease circulation using the communal level as a random effect and time (daily) as a spline effect. Results: We analysed 878 cases of leptospirosis, 165 of HAV, 6607 of influenza, and 7377 dengue cases. Influenza was associated with rainfall before lockdown (Odds Ratio (OR) 0.7, Confidence interval 95%, (CI95%), (0.6–0.8)) and disappeared during lockdown but resurged post-reopening losing its meteorological association. Dengue epidemics declined, coinciding with the Wolbachia program and border closure, and were associated with lower MEI (OR 0.78, CI95% (0.6–1) during the 2017 to 2020 period. HAV cases were correlated with the MEI (OR: 1.8, CI95% (1–3.3)). Leptospirosis cases were associated with cumulative rainfall (OR 1.12 (1.1–1.2)) and lower education (OR 1.04, CI95% (1–1.1)) and decreased with water supply (OR 0.7, CI95% (0.5–0.8)). Conclusions: Our findings highlight how climatic conditions, mobility restrictions, and socio-environmental inequities differentially shape infectious disease risks in island ecosystems. These results reinforce the need for integrated One Health surveillance that jointly addresses environmental change, social vulnerability, and infectious disease prevention. Full article

The COVID-19 pandemic prompted governments to implement lockdowns and social distancing measures to curb transmission, which, in South Africa, disrupted economic activity, reduced household income, and challenged the sustainability of household food access. This study assessed food accessibility, availability, dietary diversity, food security status, and coping strategies among households in the Tygerberg region during lockdowns. A cross-sectional design was employed using a researcher-administered questionnaire to collect sociodemographic and household data. Food security was assessed using the Household Food Insecurity Access Scale and the Household Food Security Survey Module, dietary diversity using a 24 h recall, and coping strategies through a standardized tool. Among the 432 households surveyed, 62% reported reduced income during lockdowns, while approximately 80% experienced food insecurity in the preceding 30 days and 72% over the past year. Dietary diversity was low in 47.3% of households, consuming fewer than seven food groups, and medium in 46.4%, consuming eight to eleven food groups. Common coping strategies included purchasing cheaper, less preferred foods, skipping meals, and reliance on social relief measures such as food parcels and the Social Relief of Distress grant. Overall, while food availability remained relatively stable, economic access emerged as the principal constraint, undermining dietary quality and household resilience and highlighting the need for income-responsive and socially sustainable food security interventions to strengthen urban food system resilience during prolonged socio-economic shocks. Full article

A three-year (January 2020–December 2022) daily dataset of 16 polycyclic aromatic hydrocarbons (PAHs) collected in parallel with PM_2.5 and a suite of meteorological variables at a coastal Mediterranean urban site in southern Italy (Pomigliano d’Arco, Campania) is presented and analysed. Raw PAH time series were decomposed into a long-term trend component (LT), a seasonal component (ST), and a residual component (RT) using an iterative missing-value-robust Kolmogorov–Zurbenko (KZ) moving-average filter. Spearman rank correlations between PAH concentrations and four meteorological predictors (mean temperature, relative humidity, mean wind speed, and maximum wind speed) were computed for each congener. Diagnostic molecular ratios—Fla/(Fla + Pyr), BaP/BghiP, Indeno[1,2,3-cd]pyrene/(IcdP + BghiP), and BaA/(BaA + Chr)—were evaluated seasonally and interpreted jointly with an information-theoretic Bayesian mixture modelling procedure (SNOB/MML) and with the documented susceptibility of some PAH ratios, especially BaP-containing ratios, to atmospheric ageing, phase repartitioning and summer photodegradation. Total PAH concentrations (sum of 16 congeners) ranged from <1 ng m⁻³ in summer to 46 ng m⁻³ during winter high-pollution episodes, with BaP peaking at ≈6.7 ng m⁻³. Because BaP was measured in the PM_2.5 fraction, comparisons with the EU annual target value of 1 ng m⁻³ established for PM₁₀-bound BaP are treated as indicative context only, not as formal compliance statements. Pronounced seasonal variability was driven primarily by residential heating emissions, and the incremental lifetime cancer risk (ILCR) for inhalation exposure reached $1.03\times {10}^{-4}$ (95% CI: $0.88$–$1.20\times {10}^{-4}$) during the heating season under a continuous outdoor-exposure worst-case scenario. The absolute ILCR magnitude is conditional on the selected TEF scheme and on the adopted BaP unit-risk coefficient; under an additional indoor-dominated scenario (16 h day⁻¹, infiltration factor 0.6), the corresponding risk remained above the conventional ${10}^{-6}$ benchmark. An anomalous near-background PAH signal during spring 2020 is attributed to the COVID-19 national lockdown, which reduced total PAH concentrations by approximately 85% relative to the seasonal component predicted by the iterative moving-average filter for the same calendar window. Source apportionment via diagnostic ratios identifies residential/biomass combustion as the dominant cold-season source and vehicular emissions as the prevailing warm-season source. These results provide a novel characterisation of PAH pollution dynamics in the undersampled southern Mediterranean and provide evidence to support targeted abatement policies. Full article

Background and Objectives: Pediatric forearm fractures are among the most common childhood injuries. COVID-19-related societal restrictions, including school closures and suspension of sports activities, altered children’s daily routines and may have influenced injury patterns. This study aimed to evaluate whether periods of stricter COVID-19 restrictions were associated with changes in the incidence of pediatric distal and diaphyseal forearm fractures after accounting for seasonal variation and long-term temporal trends. Materials and Methods: This retrospective observational time-series study analyzed pediatric patients aged 0–17 years who underwent forearm radiography between January 2018 and June 2023 at a tertiary pediatric trauma center. Cases with radiologically confirmed distal or diaphyseal forearm fractures or epiphyseal injuries were included. Monthly fracture counts were analyzed using generalized linear models with logarithmic link functions. Exposure variables included a COVID-19 restriction index based on governmental measures and a binary pandemic indicator. Seasonal variation and long-term temporal trends were included as covariates. Results: A total of 5702 forearm radiographs were identified, of which 4041 trauma-related presentations met the inclusion criteria. Among these, 2014 children had confirmed forearm fractures. Boys accounted for 61% of cases, and the median age was 9 years (IQR 5). Most fractures were treated conservatively (88%). The most frequent injury mechanisms included soccer-related injuries (9.6%) and bicycle falls (7.3%). In regression analyses adjusted for seasonal variation and temporal trends, neither the COVID-19 restriction index (IRR 1.01, 95% CI 0.87–1.17; p = 0.95) nor the pandemic period indicator (IRR 0.99, 95% CI 0.37–2.65; p = 0.98) was significantly associated with monthly fracture counts. The wide confidence interval of the pandemic indicator reflects limited statistical precision and suggests that both clinically relevant decreases and increases in fracture incidence cannot be excluded. Conclusions: No sustained long-term changes in the incidence or injury patterns of pediatric forearm fractures were observed during the COVID-19 pandemic. Temporary fluctuations during early lockdown phases were not independently associated with governmental restrictions after adjustment for seasonal variability and long-term trends. Full article