Search Results (199)

Since the establishment of the State of Alarm resulting from the current COVID-19 pandemic, lockdown, and quarantine have been imposed in most countries, with serious health, social, economic, and educational consequences. The health emergency caused by COVID-19 led to the closure of schools, forcing students from all over the world to stop attending schools and compromising the quality of care offered to students with autism spectrum disorder (ASD). In order to examine how teachers supervised students with ASD virtually during the lockdown period, and to determine whether families considered the support provided by teachers to be adequate, a cross-cultural study design was adopted. An ad hoc questionnaire was administered to 415 families in Spain and Mexico in April 2020. We calculated frequencies and carried out descriptive analyses, parametric inferential analyses, and correlations. Families reported that educational monitoring and contact with the family member with ASD during home lockdown was scarce, despite the provision of activities appropriate to their needs. Significant differences were found as a function of country, age of participant, age of family member with ASD, type of ASD, type of schooling, and length of lockdown. This study highlights the need to train teachers in inclusive digital education and to establish effective protocols for communication and follow-up with the families of students with ASD. Full article

Background/Objectives: COVID-19 has impacted Romania’s healthcare, economy, society, and public health. This study aims to evaluate the financial impact of the COVID-19 pandemic in Romania by analyzing both hospital costs and key elements of economic costs. The assessment was conducted from the perspective of the national payer. Hospital costs were analyzed covering two distinct timeframes: Q4 2020–Q3 2021 and Q1 2022–Q4 2022. The estimation of economic costs covered Q4 2020–Q3 2021. Methods: Hospital care costs were estimated using financial data from eight hospitals. The costs were extrapolated to inpatient data from 60 public hospitals for each of the two study periods. The disease burden was determined based on official data, including the number of confirmed cases, hospital bed occupancy, reported fatalities, and various cost components from an economic perspective. Results: The findings indicate that the average hospital cost per patient episode was EUR 2267 (95% CI: 2137–2396) during the first period and EUR 2003 (95% CI: 1799–2207) in the second. The total national hospitalization expenses amounted to EUR 1.35 billion and EUR 730 million, respectively. When accounting for productivity losses and testing costs, the overall expenditure reached EUR 5.39 billion for Q4 2020–Q3 2021. Conclusions: In conclusion, the total economic burden of the COVID-19 pandemic in Romania by the end of 2021 was estimated at EUR 5.39 billion, encompassing hospitalization, isolation, premature deaths, quarantine, testing, and parental allowances. Despite the emergence of costlier treatment options, overall treatment costs declined, possibly due to increased vaccination rates. The study highlights the significant financial strain on the healthcare system and underscores the importance of evidence-based resource allocation to better manage future public health crises. Full article

Objective: To examine associations among psychological distress, perceptions of life changes, and perceptions of family support among college students during the quarantine period of the pandemic. Background: A supportive family can buffer psychological distress during crises. During the early months of the COVID-19 pandemic, many college students abruptly returned to their family home, disrupting a developmental stage typically oriented toward independence and peer connection. While previous research has highlighted the stressors of this period, less is known about the role of perceived family support in shaping students’ mental health outcomes. Method: Data from a cross-sectional sample of 339 college students were collected. Statistical analysis included a hierarchical multiple regression and moderated moderation to investigate the relationship between the life changes college students experienced due to COVID-19 and distress and how family support moderated this relationship while treating gender as a secondary moderator. Results: Perceptions of worsening life conditions due to COVID-19 were associated with higher levels of distress and vice versa. Perceptions of emotional forms of family support moderated this relationship, but only among male participants. Conclusions: This study contributes to our understanding of the mental health implications of the pandemic on college students by identifying emotional family support as a gender-specific protective factor. Implications: Insights from this study may inform mental health interventions that consider family dynamics and gender-specific coping during large-scale crises. These findings may also guide strategies for supporting students facing the long-term psychological impacts of the COVID-19 pandemic. Full article

Dengue fever is a widespread mosquito-borne viral disease caused by infections with dengue virus (DENV). Since its initial detection in 1979, the disease has posed a significant public health threat to the Lao People’s Democratic Republic (Lao PDR). Surveillance is crucial for understanding the circulation of DENV in endemic regions and identifying potential hot spots with higher-than-expected case numbers of dengue fever. In this study, we present the results from our surveillance activities in the Lao PDR spanning 2020–2023. While quarantine restrictions from the COVID-19 pandemic posed substantial disruptions to performing DENV surveillance, over 8800 samples were tested during this period, with a positive rate of close to 60%. Cases were reported from all three regions (northern, Central, and southern) of the Lao PDR. Three circulating serotypes (DENV-1, DENV-2, and DENV-4) were detected, with DENV-1 dominant in 2021 and 2022, while DENV-2 was dominant in 2020 and 2023. Phylogenetic analyses suggest that the genotypes of DENV-1, DENV-2, and DENV-4 were closely related to corresponding isolates from neighboring countries. These findings provide an update on the nature of DENV cases detected in the Lao PDR and underscore the critical importance of sustaining a robust surveillance network to track infections. Full article

Background and Objectives: The study purpose was to analyze possible health consequences of self-isolation during the COVID-19 pandemic, aiming to evaluate diagnostics methods. Specifically, we analyzed perceived stress of self-isolation with the aim of evaluating the suitability of psychological and laboratory diagnostics methods for routine clinical practice. In order to achieve the aim of the study, the following objectives were formulated: to compare the results of psychological and laboratory diagnostic methods between case and control groups; and to evaluate associations between psychological and laboratory stress indicators separately in case and control groups. Materials and Methods: The research study consisted of control and case groups of 28 volunteers each. The main selection criterion for the case group was self-isolation due to COVID-19 and a maximum period of 3 months after post-isolation, while the control group had to be of a similar age but did not have to be isolated or self-isolated. Both groups consisted of young (18–24 years) individuals. All participants had to fill out a Perceived Stress Scale (PSS) questionnaire and were subjected to a laboratory test for stress indicators (alpha-amylase, secretory cortisol, and immunoglobulin A) from a saliva sample. Results: A comparison of the laboratory stress indicator scores for both study groups revealed statistically significant differences between the clinical subgroups, i.e., the distributions of the control and case groups were significantly different within the affected case group and control. The values obtained for study groups and PSS scores showed no discrepancies between the two investigation methods, i.e., PSS assessment and laboratory stress indicators results. The PSS values between the clinical groups were significantly different from each other, suggesting that the laboratory stress indicator scores differed but were consistent or complementary to the PSS results. A separate comparison of age and stress indicator levels in the control group revealed a correlation between age and PSS scores, indicating that younger individuals were more prone to subjective perception of moderate stress. Conclusions: The results showed that COVID-19 self-isolation during quarantine affected people’s psychological health. Using psychological examination and laboratory stress indicators, the results of the case group reliably differed from the results of the control group, allowing us to conclude that self-isolation more often caused moderate chronic stress, with or without decompensation. Besides the main study objective, we observed that laboratory stress biomarkers may be acceptable for broader clinical application during routine psychological treatment. The clinical application of laboratory stress biomarkers had been validated previously by another method, i.e., psychological investigation using PSS. Full article

The SARS-CoV-2 virus infection, the most severe pandemic in recent human history, found healthcare systems around the world more or less unprepared. Adjusting to this challenge involved changes in the daily routines of healthcare systems, as well as the patients, once again highlighting the importance of primary care (family physician or general practitioner). In the context of the COVID-19 pandemic, the family doctor in Romania played a crucial role in patient management, rapidly adapting to the changes and challenges imposed by the state of emergency. Their involvement quickly evolved from in-person consultations to online assessments, as they took on responsibilities such as monitoring patients in isolation or quarantine and issuing necessary medical leaves. Moreover, family doctors were directly involved in the COVID-19 vaccination process, facing challenges related to access to scheduling platforms and limited resources of protective equipment. Although they were on the front line of the healthcare response, recognition through incentives or compensations came late and incompletely, and their efforts in combating the pandemic were often overlooked. Designating family doctors’ offices as public utility medical units (regardless of their organisational form) and supporting their activities through increased equipment and medical devices provided by local or central authorities are the keys to fighting for human lives in critical situations. Implementing clear and universal rules regarding the competencies (skills) and duties of family doctors, both in normal life situations and in exceptional circumstances, is of utmost importance. Little is known about the dedicated work and dedication of family physicians to their patients. Few studies have been carried out on the activity of the family doctor and their professional difficulties during the pandemic period. Some studies, on a small number of subjects, tried to evaluate the psychological adaptation of the family doctor to the new epidemiological situation. The aim of this narrative review is to highlight the difficulties to which family doctors had to adapt, comparing the data from the Romanian medical system with those discovered in the medical literature regarding family doctors from all over the world. Full article

Background: The novel coronavirus (SARS-CoV-2) led to gastrointestinal manifestations in up to 50% of cases, with diarrhea being common, and probiotics have been suggested as a potential treatment. Aim: This study aimed to assess changes in the microbiome and the effects of a multispecies probiotic in patients with COVID-19 in home quarantine through a fully remote telemedical approach. Methods: Thirty patients were randomized to receive either the Ecologic AAD probiotic (Winclove Probiotics, Amsterdam, The Netherlands), on the market as OMNi-BiOTiC 10 (Allergosan, Austria), or a placebo for 30 days in a 2:1 ratio. Respiratory and gastrointestinal symptoms were monitored in 2–10-day intervals via online surveys, and five stool samples were collected during the 30-day study period for microbiome and metabolomics analyses. Twenty-four healthy volunteers served as controls. Results: Of the 30 patients, 26 completed this study (10 placebo, 16 probiotic). Patients reported respiratory symptoms and a diminished gastrointestinal quality of life, both of which improved significantly during the study period, irrespective of the intervention. Compared to controls, infected patients showed significant alterations in the fecal microbiome (p = 0.002), including an increase in Bacteroidetes and decreases in Christensenellaceae, Ruminococcaceae, and Gammaproteobacteria, along with metabolomic changes. Probiotic treatment significantly modulated the patients’ microbiome beta diversity (p = 0.001) and introduced the Enterococcus faecium W54 strain. Symptoms, COVID-19-related taxa, and the fecal metabolome were not affected by the intervention. Conclusions: Patients with mild COVID-19 disease in home quarantine exhibited respiratory symptoms, a reduced gastrointestinal quality of life, and changes in the fecal microbiome and metabolome. Full article

In the post-pandemic context, data-driven design interventions that can endow architectural spaces with mixed-use and open characteristics that are adaptable and environmentally resilient are increasingly important. Ubiquitous semi-public architecture, such as hotel buildings, plays a crucial role in public health emergencies. Many hotels adopt mixed-use and open room spatial layouts, integrating diverse daily functions into a single tiny space, fostering flexible utilization and micro-scale space sharing; however, these also introduce potential health risks. This study offers a comprehensive evaluation of the indoor environmental quality (IEQ) of a hotel room space and discusses feasible intervention strategies for healthier renovation and rehabilitation. Taking a hotel in Shenzhen as a case, a multi-domain environmental assessment was conducted during the COVID-19 quarantine period in the summer of 2022. The study examines the health risks inherent in the hotel’s guest room and the varying patterns of IEQ factors across the hotel’s domains, including volatile organic compound concentrations, physical environmental parameters, and heat stress indices. The results illustrate diverse change trends in the chemical, physical, and heat stress factors present in the tested quarantined hotel room space throughout a typical summer day. Although most of the examined environmental factors meet local and global standards, some problems draw attention. In particular, the PM2.5 concentration was generally observed to be above the World Health Organization (WHO) air quality guideline (AQG) standards, and the interior lighting did not meet required standards most of the time. Moreover, correlation and multiple regression analyses uncover significant influence by physical environmental conditions on the concentrations of chemical pollutants in the hotel room. The study preliminarily identifies that higher relative humidity could lead to a lower concentration of CO₂ while a higher PM2.5 concentration. Wet bulb globe temperature (WBGT) was observed to positively affect CO₂ concentration. Further, the results suggest that even with relatively rigorous initial adjustment and re-renovation, multi-domain environmental quality in air-conditioned quarantine hotel rooms should be monitored and ameliorated from time to time. Overall, this study offers a scientific foundation for healthier upgrades of existing hotel buildings as well as provides insights into achieving environmental resilience in newly constructed hotel buildings for the post-pandemic era. Full article

Quarantine policies during the coronavirus disease 2019 (COVID-19) pandemic prolonged time spent at home, leading to an unintended occurrence of sick building syndrome (SBS) symptoms. The aim of this study was to investigate the prevalence of SBS symptoms among residents in Suzhou, China, during the COVID-19 pandemic. A questionnaire survey was conducted online from February to May 2022. A total of 442 adults were included in this study. The prevalence of SBS symptoms was much higher during the COVID-19 pandemic, and the proportions of general, mucosal, and skin symptoms were 59.3%, 45.5% and 49.1%, respectively. The influences of building characteristics, occupant lifestyle, indoor environment and perception of indoor environment were analysed using a multivariate logistic regression model. Neighbourhood pollutant sources, older residences, non-ownership and humidity indicators were significant risk factors for SBS symptoms. Frequent use of air fresheners was significantly associated with general (adjusted odds ratio (AOR): 4.9, 95% confidence interval (CI: 2.4–10.0), mucosal (AOR: 5.3, 95% CI: 2.4–11.5), and skin symptoms (AOR: 4.6, 95% CI: 1.6–13.1), while the use of disinfectants was significantly correlated with skin symptoms (AOR: 4.0, 95% CI: 1.5–10.7). Residents’ perception of an uncomfortable indoor environment was a significant predictor of general (AOR: 2.2, 95% CI: 1.2–4.0) and mucosal symptoms (AOR: 3.1, 95% CI: 1.6–6.0). The use of air cleaners can reduce the prevalence of general symptoms. An important finding of this study is that the psychological impact of staying at home for a long time was associated with general symptoms (AOR: 1.3, 95% CI: 1.1–1.7), which means that attention should also be paid to the mental health of residents during the COVID-19 pandemic. Although the quarantine period has now ended, our results can still serve as a reference for the impact of the indoor environment on the health of people with SBS, especially for those who stay at home for a long time, such as the elderly. Full article

Background and Objectives: In this study, we evaluated clinical factors associated with implementing a rehabilitation program for patients with COVID-19-associated acute respiratory distress syndrome (ARDS) requiring mechanical ventilation (MV) during the quarantine period. Materials and Methods: This observational study was conducted in the National Designated Isolated ICU, a dedicated COVID-19 center with 18 beds, from 30 December 2020 to 30 May 2022. One hundred and fifty-four patients (mean age: 67.3 ± 13.4 years; male: 59.7%) were enrolled. The ICU rehabilitation program included early mobilization, chest physiotherapy, and dysphagia treatment. Results: Forty-five patients (29.3%) participated in the rehabilitation program. Multivariate logistic regression identified three significant factors: tracheostomy (odds ratio [OR], 2.796; 95% confidence interval [CI], 1.238–6.316; p = 0.013), body mass index ≥ 25.0 kg/m² (OR, 2.724; 95% CI, 1.276–5.817; p = 0.010), and extracorporeal membrane oxygenation (OR, 2.931; 95% CI, 1.165–7.377; p = 0.022); patients with all three factors were younger (median 44 vs. 70 years, p < 0.001) and had significantly lower Acute Physiology and Chronic Health Evaluation II scores (median 12 vs. 16, p = 0.002) on the MV day. One-year cumulative mortality rates for patients with 0 to 3 factors were 66.7%, 50.8%, 38.9%, and 15.4%, respectively, with a significant difference among them (log-rank, p < 0.001). Conclusions: Three clinical factors associated with implementing a rehabilitation program during the quarantine period for COVID-19-associated ARDS patients were identified. The program was feasible and beneficial, particularly for younger patients with lower illness severity and fewer comorbidities on the day of MV. Full article

Background: Emergency medical services (EMS) are intended to provide people with immediate, effective, and safe access to the healthcare system. The effects of pandemics on emergency medical services (EMS) have not been studied sufficiently. The aim of this paper is to assess the frequency and structure of calls at an ambulance station in Kazakhstan during the period of 2019–2023. Methods: A retrospective analysis was conducted to estimate the incidence of emergency assistance cases from 2019 to 2023. Results: An analysis of the structure and number of ambulance calls before the pandemic, during the pandemic, and post-pandemic period did not reveal significant changes, except for calls in urgency category IV. Patients of urgency category IV handled by an ambulance decreased by 2 and 1.7 times in 2020 and 2021, respectively, which appears to be related to quarantine measures. In 2022 and 2023, category IV calls were 4.7 and 4.5 times higher than in 2019. Conclusions: This study’s findings suggest no changes in the dynamics of ambulance calls, except urgency category IV calls. The number of category IV urgent calls decreased significantly during the COVID-19 pandemic and increased in the post-pandemic period. Full article

Objective: This study aimed to characterize the changing landscape of circulating SARS-CoV-2 lineages in the local community of Hong Kong throughout 2022. We examined how adjustments to quarantine arrangements influenced the transmission pattern of Omicron variants in a city with relatively rigorous social distancing measures at that time. Methods: In 2022, a total of 4684 local SARS-CoV-2 genomes were sequenced using the Oxford Nanopore GridION sequencer. SARS-CoV-2 consensus genomes were generated by MAFFT, and the maximum likelihood phylogeny of these genomes was determined using IQ-TREE. The dynamic changes in lineages were depicted in a time tree created by Nextstrain. Statistical analysis was conducted to assess the correlation between changes in the number of lineages and adjustments to quarantine arrangements. Results: By the end of 2022, a total of 83 SARS-CoV-2 lineages were identified in the community. The increase in the number of new lineages was significantly associated with the relaxation of quarantine arrangements (One-way ANOVA, F(5, 47) = 18.233, p < 0.001)). Over time, Omicron BA.5 sub-lineages replaced BA.2.2 and became the predominant Omicron variants in Hong Kong. The influx of new lineages reshaped the dynamics of Omicron variants in the community without fluctuating the death rate and hospitalization rate (One-way ANOVA, F(5, 47) = 2.037, p = 0.091). Conclusion: This study revealed that even with an extended mandatory quarantine period for incoming travelers, it may not be feasible to completely prevent the introduction and subsequent community spread of highly contagious Omicron variants. Ongoing molecular surveillance of COVID-19 remains essential to monitor the emergence of new recombinant variants. Full article

This study aims to examine how tourism enterprises can ensure their sustainability and elude the negative effects of the COVID-19 crisis via recovery strategies through semi-structured in-depth interviews, focusing on the tourism industry in Antalya, the first and most important destination in Türkiye, in terms of arrivals and nights spent. According to the findings, travel bans and quarantine measures due to the COVID-19 pandemic had devastating effects on Antalya’s tourism sector. In fact, the COVID-19 pandemic caused a shortage of personnel in tourism industry, a persisting problem. In managing this crisis, businesses and the state have attempted various recovery strategies. Despite a recovery period since 2021, vulnerabilities in the national economy and increasing inflation rates since COVID-19 have triggered input and living costs. Furthermore, the Ukraine War has adversely affected the sustainability of tourism activities in Antalya. Moreover, due to new regulations regarding retirement in 2023, some middle-level managers in tourism sector have retired, leading to predictions of a potential crisis in upper-level management in the future. According to the study results, cooperation in tourism sector, public–private–university collaboration, and government support play significant roles in achieving full recovery from the crisis and ensuring sustainability in tourism sector activities. The study may contribute to the literature and help industry representatives and policymakers in terms of sustainability in tourism and crisis management recovery strategies. Full article

The COVID-19 pandemic represents a quintessential public health crisis, profoundly impacting the utilization patterns of urban green spaces through stringent quarantine and lockdown measures. However, existing research inadequately addresses specific concerns regarding future urban green spaces and tends to oversimplify population divisions. This study delves into the needs and preferences of Shanghai residents affected by the pandemic and quarantine measures, focusing on various aspects such as specific types of green spaces, facilities, landscape elements, and landscape and spatial types. Multifactorial population clustering was also performed. This study delineates the following conclusions: (1) It is imperative to afford residents access to green spaces at least once a week, even during quarantine periods. (2) Residents exhibited a preference for accessible green spaces equipped with essential amenities, favoring unobstructed vistas and plant-centric ecological landscapes during the pandemic. Additionally, there is a notable preference for private green spaces among residents. (3) Post-pandemic, the “affluent” group displays a heightened overall demand for green spaces, the “middle-class” group shows a conspicuous inclination towards specific green space landscape elements, while the “low-income” group consistently exhibits a low preference for green spaces during and after the pandemic. This study underscores the necessity of developing human-centric green spaces to promote equity and resilience in the face of future emergencies, rooted in residents’ preferences amidst public health crises. Full article

Background and Objectives: The incidence of osteoporotic hip fractures in Niigata Prefecture, Japan, has been studied approximately every 5 years since 1985. In 2020, as in previous surveys, a prefecture-wide survey was initiated as planned; however, the global outbreak of the coronavirus disease 2019 (COVID-19) began simultaneously. This study aimed to compare the results of the 2015 and 2020 Niigata Prefecture Fragility Hip Fracture Surveys to determine whether the COVID-19 pandemic affected the occurrence and treatment of proximal femoral fractures throughout Niigata Prefecture. Materials and Methods: In this study, data from the 2015 and 2020 Niigata Prefecture Fragility Hip Fracture Surveys were used. Data were obtained from registration forms returned by hospitals and clinics in Niigata Prefecture for patients living therein who were diagnosed with osteoporotic hip fractures over a 1-year period in 2015 and 2020. Results: In Niigata Prefecture, the total annual number of fractures increased from 3181 in 2015 to 3369 in 2020, whereas the age-adjusted fracture rate decreased. Regarding the location of the fractures, the proportion of outdoor fractures was lower than that of indoor fractures. The proportion of outdoor fractures decreased over the year as a whole, but in particular, the proportion of outdoor fractures decreased significantly under the issued emergency declarations. The most common reasons for delayed surgery related to COVID-19 were “waiting for PCR results” and “quarantine for fever,” accounting for approximately 1.9% of all causes. Conclusions: In Niigata Prefecture, Japan, the effect of the COVID-19 pandemic on the number and rate of fractures was minuscule. The proportion of indoor fractures to outdoor fractures increased during the emergency declaration period. Considering that the number of fragility fractures remains the same during an infectious disease pandemic such as COVID-19, it is necessary to ensure that healthcare resources are available to deal with them. Full article