Search Results (109)

Background: Although mental health among students has become a pressing public concern over recent years, the COVID-19 pandemic introduced new stressors, which may further increase the mental health burden for them. While past work has investigated links between pandemic related factors and student mental health and wellbeing, there is conflicting evidence around some symptoms (e.g., anxiety) and little work has focused on less common mental health conditions (e.g., eating disorders). Aims: The current study aimed to detail the prevalence of mental distress in the student population at an early stage of the COVID-19 pandemic and compare university students’ mental health before and during the COVID-19 pandemic. Specifically, we aimed to compare levels of depression, anxiety, and eating disorders in a large sample of students. Methods: We analysed data from a repeated cross-sectional survey on different samples of UK university students before the pandemic (n = 4812) and during the pandemic (n = 3817). Results: There were high levels of depression and anxiety during the COVID-19 pandemic, with more than 50% experiencing levels above the clinical cut-offs. Findings revealed a significant increase in symptoms of depression and anxiety from pre- to mid-pandemic as well as a significant increase in the prevalence of eating disorders. Conclusions: By late 2020, mental health in the student population had deteriorated compared to pre-pandemic levels. These findings provide evidence for increased levels of depression, anxiety, and eating disorders related to the COVID-19 pandemic. There is a need for better preparedness for future crises in order to mitigate the impact on student mental health. Full article

SARS-CoV-2 high transmission and genomic mutations result in the emergence of new variants that impact COVID-19 vaccine efficacy and virus transmission by evading the host immune system. Wastewater-based epidemiology is an effective approach to monitor SARS-CoV-2 variants circulation in the population but is a challenge due to the presence of reaction inhibitors and the low concentrations of SARS-CoV-2 in this environment. Here, we aim to improve SARS-CoV-2 variant detection in wastewater by employing nested PCR followed by next-generation sequencing (NGS) of small amplicons of the S gene. Eight SARS-CoV-2 wastewater samples from Alegria Wastewater Treatment Plant, in Rio de Janeiro, Brazil, were collected monthly from February to September 2021. Samples were submitted to virus concentration, RNA extraction and nested PCR followed by NGS. The small amplicons were used to prepare libraries for sequencing without the need to perform any fragmentation step. We identified and calculated the frequencies of 29 mutations matching the Alpha, Beta, Gamma, Delta, Omicron, and P.2 variants. Omicron matching-mutations were detected before the lineage was classified as a variant of concern. SARS-CoV-2 wastewater sequences clustered with SARS-CoV-2 variants detected in clinical samples that circulated in 2021 in Rio de Janeiro. We show that sequencing of selected small amplicons of SARS-CoV-2 S gene allows the identification of SARS-CoV-2 variants matching mutations and their frequencies’ calculation. This approach may be expanded using customizing primers for additional genomic regions, in order to differentiate current variants. Approaches that allow us to learn how variants emerge and how they relate to clinical outcomes are crucial for our understanding of the dynamics of virus variants circulation, providing valuable data for public health management. Full article

This review of the literature examines diseases and pathogen characteristics on military vessels, in order to improve the success of missions on a boat. Our aim is to understand the spread of disease, aiming to maximize biological resilience and hopefully eliminate outbreaks. Keyword research was conducted from various sources of information, including scientific publications, theses, public health organization websites, and clinical trials. A synthesis of bacterial, viral, fungal, and parasitosis characteristics was established, and a risk prioritization index was defined, based on contagiousness (basic reproduction number (R0)) and clinical severity. For instance, COVID-19 was assessed as moderately contagious, with critical severity, and Influenza A H1N1 as having a minor level of contagiousness with critical severity, resulting in a level two out of three risk prioritization index. This approach demonstrates that while diseases have numerous characteristics, a method for classifying them by isolating specific criteria and prioritizing them could be proposed. In conclusion, further work is needed to analyze onboard operator activities and develop simulation models related to pathogen characteristics. Full article

Background: Large-scale vaccination was crucial to address the global COVID-19 pandemic and its associated health risks, including fatal and disabling diseases. However, there were significant challenges to be overcome to ensure the safe and effective implementation of the vaccination program. The aim of the present study was to assess patient safety threats related to the anti-COVID-19 large-scale vaccination process. Methods: Between February and May 2021, we conducted a proper analysis to proactively identify risks and potential Failure Modes (FMs) in the COVID-19 vaccination process using the Failure Mode, Effects, and Criticality Analysis (FMECA) technique at an Italian Public Health Authority. A standardized risk scoring system was used to assess the severity, frequency, and detectability of events associated with potential failures. Criticalities were identified in both the preparatory and operational areas of the vaccination process, and several potential FMs were listed in descending order of risk score (Risk Priority Number, RPN) to ensure prioritization of interventions. Results: The most critical steps were found to be in the operational area rather than in the preparatory one. The highest RPNs were associated with failure or inadequate management of severe allergic reactions that can lead to serious harm and even death of the vaccinated person (RPN 60) and failure to keep updated vaccination teams’ knowledge (RPN 36). Conclusions: Ensuring patient safety and effective clinical risk management are crucial in mass vaccination campaigns. By prioritizing these aspects through collaboration with various stakeholders and implementing preventive measures, patient trust—on which vaccination campaign success relies—can be built and maintained. Full article

Introduction: Public health disinformation is a significant problem as demonstrated by the recent scientific literature on the COVID-19 pandemic. However, further studies that analyse the presence of the disinformation mitigation strategies in public health initiatives within specific contexts and which contains a multidimensional approach (gender, social and environmental) are required. Evidence shows that disinformation, information overload, misinformation or fake news on health issues are also influenced by these issues. Objective: The inclusion of the health disinformation dimension within national public implemented by the governments of Argentina and Spain before, during and after the COVID-19 pandemic. Additionally, this paper incorporated a gender-based approach and social and environmental determinants in order to identify the limitations of these initiatives and offer certain recommendations. We conducted a descriptive, qualitative and quantitative study, as well as content analysis. We focused on documents from the websites of the national health ministries of Argentina and Spain, and digital repositories of regulations at the national level. Various strategies for systematic searches on government websites were designed and implemented. This included manual searches on Google. The first step involved a general analysis of all documents found by the searches, followed by a qualitative analysis of the documents that were related to health issues. Based on this work, a comprehensive and flexible framework of (pre-established and emerging) dimensions and categories of health disinformation and infodemics was generated. Results. The work was based on a total of 202 documents (both downloadable information and information included in websites); 117 for Argentina and 85 for Spain. Of the total, 60.9% were published during the COVID-19 pandemic. In the second stage of the analysis, 55 texts were selected for Argentina and 47 for Spain. In both countries, the central communications approach used was disinformation and/or infodemics (although definitions such as fake news were also used). They were mainly linked to the COVID-19 pandemic, but other emerging health problems were also detected to a lesser degree. However, disinformation (or a related concept) was prominently present in only 17 documents in Argentina and 3 documents in Spain. In terms of document type, working materials were foremost in Argentina (44.4%) and Spain (37.6%), with little presence of policy, regulatory and evaluation documents (only 5). Gender binary language was predominantly used in these texts. Vulnerable groups and social determinants were poorly included. Environmental determinants were mentioned in conjunction with health disinformation in only one paper on the use of plastics and its impact on human health in Argentina, and in another paper from the Global Summit on Climate and Health in Spain. Conclusions: Based on the document analysis, the inclusion of health disinformation within public actions in both countries before, during and after the COVID-19 pandemic, was detected. However, different limitations were observed: it was clear that the problem was strongly linked to the health emergency and did not extend much beyond that. Health disinformation was secondary and did not play a key role in public policy nor did it have greater institutional importance. Limitations were also detected in terms of gender perspectives, vulnerable groups and social and environmental determinants linked to health disinformation, displaying a reductionist approach. Based on these results, this paper makes certain policy recommendations. Full article

Background/Objectives: Limited research has examined the theoretical linkages between exposure to COVID-19 vaccine information sources, vaccination-related beliefs, vaccination-induced emotions, and vaccine information engagement. Methods: An online survey was conducted with a national sample of adults (N = 630) residing in the U.S. to test these relationships, guided by the Stimulus–Organism–Response (S-O-R) framework and the Health Belief Model. Results: Study findings showed that exposure to online authority vaccine information sources was positively related to vaccination-benefit beliefs and negatively related to vaccination-barrier beliefs, in addition to hopeful feelings connected to vaccination. Exposure to non-authority sources was positively associated with vaccination-barrier beliefs, hopeful and fearful feelings connected to vaccination, and vaccine information engagement. While vaccination-benefit beliefs and vaccination-barrier beliefs were negatively and positively linked to vaccine information engagement, respectively, these beliefs were each positively connected to hopeful feelings and fearful feelings toward vaccination in that order. Both hopeful and fearful feelings toward vaccination also emerged as positive correlates of vaccine information engagement. Conclusions: This study contributes to our understanding of how cognitive appraisals of and affective responses to risk information disseminated by different types of sources may be related to risk information engagement behavior in a public health crisis. Results bring evidence-based insights to both researchers and health professionals to better equip them to counter vaccine misinformation and reduce vaccination barriers. Full article

In 2022, under the combined influence of the COVID-19 pandemic and the economic downturn. The employment landscape is grim, particularly for rural migrant workers, who are under immense pressure to secure employment. This study used structural equation modeling and bootstrapping methods to identify the influencing factors of migrant workers’ willingness to return home during public health emergencies and the potential multiple causal relationships, based on 2879 questionnaires on the employment status of migrant workers who are from Chongqing in 2022. The result of this study will be used as a reference by policymakers to formulate employment policies. The results show that: (1) Public health emergencies have no discernible direct impact on people’s willingness to return home. However, they have a significant positive effect on hometown belongings and a significant negative effect on income level and employment stability. These effects are ranked in order of influence: sense of belonging to hometown > income level > employment stability. (2) The willingness to return home is significantly impacted negatively by employment stability and income level, but it is significantly positively impacted by hometown belonging, with employment stability having the biggest impact. (3) There is a substantial inverse relation between income level and sense of belonging to hometown; the higher the income level, the stronger the capacity to withstand outside threats, and the greater the propensity to remain employed. (4) Three pathways exist by which public health emergencies affect migrant workers’ willingness to return home: “PHE→ES→HI”, “PHE→IL→HI”, and “PHE→ES→IL→HI”. (5) Income level and employment stability have multiple chain’mediating effects between public health emergencies and the willingness to return home, while only income level plays a partial mediating role between employment stability and the willingness to return hometown. Full article

In patients with cancer, tumor- and treatment-induced immunosuppression are responsible for a four-fold increase in morbidity and mortality caused by influenza and invasive Streptococcus pneumoniae infections compared to the general population. The main oncology societies strongly recommend vaccination in patients with cancer to prevent these infections. However, vaccine hesitancy is a main concern in this population. The aim of this study was to assess the feasibility of in-hospital vaccination for patients under anticancer treatment and their family members (FMs) against influenza and pneumococcal infections during the COVID-19 pandemic in order to increase vaccine coverage. This was a single-center, prospective, observational study conducted at the Department of Oncology of Luigi Sacco University Hospital (Milan, Italy) between October 2020 and April 2021. The main primary outcome was the incidence of influenza-like illness (ILI) and pneumococcal infections. The main secondary outcome was safety. A total of 341 subjects were enrolled, including 194 patients with cancer and 147 FMs. The incidence of ILI was higher among patients than among FMs (9% vs. 2.7%, OR 3.92, p = 0.02). Moreover, two subjects were diagnosed with pneumococcal pneumonia. The most frequent vaccine-related AEs were pain in the injection site (31%) and fatigue (8.7%). In conclusion, this hospital-based vaccination strategy was feasible during the COVID-19 pandemic, representing a potential model to maximize vaccine coverage during a public health emergency. Full article

The increasing burden of lifestyle-related diseases highlights the need to address unhealthy dietary habits. This study aims to explore the latest dietary patterns in Japan following the COVID-19 pandemic, focusing on trends in health-promoting food choices. A web-based survey was conducted among 27,154 Japanese adults, selected via quota sampling to mirror national demographics. The study evaluated dietary diversity, measured through the Dietary Variety Score (Outcome 1), and the prioritization of nutritional and health considerations in food selection, assessed via a Likert scale (Outcome 2). Uniform Manifold Approximation and Projection (UMAP) and Ordering Points To Identify the Clustering Structure (OPTICS) algorithms were used to delineate patterns in health-centric food selections. OPTICS clustering revealed four distinct clusters for each outcome. Cluster 3, with a diverse diet, comprised older, predominantly female individuals with higher well-being and lower social isolation compared to Cluster 4, which lacked distinct dietary patterns. Cluster 3 also engaged more in snacking, treat foods, home cooking, and frozen meals. Similarly, a divide emerged between those prioritizing dietary considerations (Cluster C) and those indifferent to such aspects (Cluster D). The findings underscore the need for holistic post-COVID-19 public health initiatives addressing socioeconomic and cultural barriers to healthier dietary practices. Full article

With over 40,000 opioid-related overdose deaths between January 2016 and June 2023, the opioid-overdose crisis is a significant public health concern for Canada. The opioid crisis arose from a complex system involving prescription opioid use, the use of prescription opioids not as prescribed, and non-medical opioid use. The increasing presence of fentanyl and its analogues in the illegal drugs supply has been an important driver of the crisis. In response to the overdose crisis, governments at the municipal, provincial/territorial, and federal levels have increased actions to address opioid-related harms. At the onset of the COVID-19 pandemic, concerns emerged over how the pandemic context may impact the opioid overdose crisis. Using evidence from a number of sources, we developed a dynamic mathematical model of opioid overdose death to simulate possible trajectories of overdose deaths during the COVID-19 pandemic. This model incorporates information on prescription opioid use, opioid use not as prescribed, non-medical opioid use, the level of fentanyl in the drug supply, and a measure of the proportion deaths preventable by new interventions. The simulated scenarios provided decision makers with insight into possible trajectories of the opioid crisis in Canada during the COVID-19 pandemic, highlighting the potential of the crisis to take a turn for the worse under certain assumptions, and thus, informing planning during a period when surveillance data were not yet available. This model provides a starting point for future models, and through its development, we have identified important data and evidence gaps that need to be filled in order to inform future action. Full article

During the COVID-19 pandemic, nonpharmaceutical interventions (NPIs) were implemented in order to control the transmission of SARS-CoV-2, potentially affecting the prevalence of respiratory syncytial virus (RSV). This review evaluated the impact of NPIs on RSV-related hospitalizations in children during the lockdown (2020–2021) compared to the pre-pandemic (2015–2020) and post-lockdown (2021–2022) periods. In this systematic review and meta-analysis, we searched through PubMed, Scopus, and Web of Science for studies published in English between 1 January 2015 and 31 December 2022. Additionally, we conducted hand searches of other records published between 1 January 2023 and 22 January 2024. Our target population was hospitalized children aged 0–18 years with RSV-related lower respiratory tract infections confirmed through immunofluorescence, antigen testing, or molecular assays. We focused on peer-reviewed observational studies, analyzing the primary outcome of pooled RSV prevalence. A generalized linear mixed model with a random-effects model was utilized to pool each RSV prevalence. Heterogeneity was assessed using Cochran’s Q and I² statistics, while publication bias was evaluated through funnel plots and Egger’s tests. We identified and analyzed 5815 publications and included 112 studies with 308,985 participants. Notably, RSV prevalence was significantly lower during the lockdown period (5.03% [95% CI: 2.67; 9.28]) than during the pre-pandemic period (25.60% [95% CI: 22.57; 28.88], p < 0.0001). However, RSV prevalence increased notably in the post-lockdown period after the relaxation of COVID-19 prevention measures (42.02% [95% CI: 31.49; 53.33] vs. 5.03% [95% CI: 2.67; 9.28], p < 0.0001). Most pooled effect estimates exhibited significant heterogeneity (I²: 91.2% to 99.3%). Our findings emphasize the effectiveness of NPIs in reducing RSV transmission. NPIs should be considered significant public health measures to address RSV outbreaks. Full article

Background: Vaccine hesitancy (VH) has increased over the past decade with large geographical variations between countries, posing a threat to global public health. This phenomenon is growing in the general population as well as among healthcare workers (HCWs), who are the most reliable source of vaccine-related information for patients. Special attention must therefore be paid to medical students, who are the future HCWs. Methods: We conducted a cross-sectional study (November 2022–January 2023) on all the Albanian and Italian students attending medical science courses at the Catholic University “Our Lady of Good Counsel” (Tirane, Albania) to investigate VH and the factors contributing to it (using the Vaccination Attitude Examination Scale-VAX), including COVID-19 vaccination. Vaccine knowledge was assessed using the Zingg and Siegrist Scale. Students were asked to voluntarily answer an anonymous questionnaire. Results: 689 questionnaires were collected (58.8% Albanians, 72.3% female; 70.4% aged 20–25 years; 70.4% attending the Medicine and Surgery course). Generally, students showed low VH, especially Italians (p < 0.001); however, some hesitancy was observed regarding the potential long-term effects of vaccines, especially among Albanians (p < 0.05). The results also showed a significant difference in vaccine knowledge scores between different course years (χ²  =  90.058; df  =  40; p = < 0.001) and different degree courses (χ²  =  89.932; df = 40; p  = < 0.001). With regard to COVID-19 vaccination, being of Albanian origin significantly increases the risk of not being vaccinated (OR = 7.215; 95%CI 3.816–13.640, p < 0.001), highlighting possible differences in vaccine coverage and policy between the two countries. Conclusion: Vaccine hesitancy should be addressed at early stages during medical sciences courses, in order to protect future healthcare workers, to preserve essential health services, and reduce the risk of further pandemics. Full article

College students are a unique population occupying a distinct life-course and transition period between adolescence and adulthood. Although not monolithic in experiences, knowledge, and demographics, this diverse population is particularly susceptible to immediate, short-term, mid-term, and long-term disaster impacts. Recently, disaster research focusing on college students has rightly focused on the ongoing COVID-19 pandemic. Although the pandemic was a public health disaster interrupting social, developmental, and educational processes for students on a global scale, the climate crisis and related environmental disasters continuously threaten college students’ individual development, health, and well-being. Thus, it is critical to understand current knowledge focusing on environmental disasters and college students in order to determine future research needs. This article used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach to examine research on college students and disasters over the past ten years (2014–2023). We identified 67 articles, which we analyzed through a mixed methods approach, including descriptive statistics and thematic analysis. Results indicate that disaster impacts on college students are an understudied topic in the social sciences, especially in an era of more-frequent and -intense environmental hazards. Our findings demonstrate a need to engage college students in disaster research worldwide so that trade schools, colleges, and universities can collaborate with policymakers to build this unique and disproportionately impacted population’s capacity to mitigate against, respond to, and recover from environmental hazards in an ever-changing climate. Full article

The Single Site Order (SSO)—a policy restricting staff from working at multiple long-term care (LTC) homes—was mandated by the Public Health Agency of Canada to control the spread of COVID-19 in LTC homes, where nearly 70% of COVID-19-related deaths in Canada occurred. This mixed methods study assesses the impact of the SSO on LTC residents in British Columbia. Interviews were conducted (residents (n = 6), family members (n = 9), staff (n = 18), and leadership (n = 10) from long-term care homes (n = 4)) and analyzed using thematic analysis. Administrative data were collected between April 2019 and March 2020 and between April 2020 and March 2021 and analyzed using descriptive statistics and data visualization. Qualitative and quantitative data were triangulated and demonstrated that staffing challenges became worse during the implementation of the SSO, resulting in the mental and physical health deterioration of LTC residents. Qualitative data demonstrated decreased time for personalized and proactive care, increased communication challenges, and increased loneliness and isolation. Quantitative data showed a decline in activities of daily living, increased antipsychotic medication use, pressure ulcers, behavioural symptoms, and an increase in falls. Addressing staff workload and staffing shortages during SSO-related policy implementation is essential to avoid resident health deterioration. Full article

Modified opioid agonist therapy (OAT) guidelines that were initially introduced during the COVID-19 pandemic allow prescribers to increase the number of take-home doses to fulfill their need for physical distancing and prevent treatment discontinuation. It is crucial to evaluate the consequence of administering higher take-home doses of OAT on treatment retention and opioid-related harms among OAT recipients to decide whether the new recommendations should be retained post-pandemic. This study used an agent-based model to simulate individuals dispensed daily or weekly OAT (methadone or buprenorphine/naloxone) with a prescription over a six-month treatment period. Within the model simulation, a subset of OAT recipients was deemed eligible for receiving increased take-home doses of OAT at varying points during their treatment time course. Model results demonstrated that the earlier dispensing of increased take-home doses of OAT were effective in achieving a slightly higher treatment retention among OAT recipients. Extended take-home doses also increased opioid-related harms among buprenorphine/naloxone-treated individuals. The model results also illustrated that expanding naloxone availability within OAT patients’ networks could prevent these possible side effects. Therefore, policymakers may need to strike a balance between expanding access to OAT through longer-duration take-home doses and managing the potential risks associated with increased opioid-related harms. Full article