Search Results (573)

Promoting sustainable development requires a clear understanding of how short-term fluctuations in anthropogenic emissions affect urban environmental quality. This is especially relevant for cities experiencing rapid industrial changes or emergency policy interventions. Among key environmental concerns, variations in ambient pollutants like ozone (O₃) are closely tied to both public health and long-term sustainability goals. However, traditional chemical transport models often face challenges in accurately estimating emission changes and providing timely assessments. In contrast, statistical approaches such as the difference-in-differences (DID) model utilize observational data to improve evaluation accuracy and efficiency. This study leverages the synthetic difference-in-differences (SDID) approach, which integrates the strengths of both DID and the synthetic control method (SCM), to provide a more reliable and accurate analysis of the impacts of interventions on city-level air quality. Using Shanghai’s 2022 lockdown as a case study, we compare the deweathered ozone (O₃) concentration in Shanghai to a counterfactual constructed from a weighted average of cities in the Yangtze River Delta (YRD) that did not undergo lockdown. The quasi-natural experiment reveals an average increase of 4.4 μg/m³ (95% CI: 0.24–8.56) in Shanghai’s maximum daily 8 h O₃ concentration attributable to the lockdown. The SDID method reduces reliance on the parallel trends assumption and improves the estimate stability through unit- and time-specific weights. Multiple robustness checks confirm the reliability of these findings, underscoring the efficacy of the SDID approach in quantitatively evaluating the causal impact of emission perturbations on air quality. This study provides credible causal evidence of the environmental impact of short-term policy interventions, highlighting the utility of SDID in informing adaptive air quality management. The findings support the development of timely, evidence-based strategies for sustainable urban governance and environmental policy design. Full article

Background and Objectives: Preterm birth and stillbirth are primary adverse pregnancy outcomes. Research during the COVID-19 pandemic revealed reductions in preterm birth in some countries, while stillbirth rates increased or remained unchanged. These findings suggest the presence of preventable risk factors associated with changes in physical activity and lower exposure to community-acquired infections due to lockdown measures, altered social interaction patterns or reduced access to antenatal care. Assessing seasonal variation may offer insights into whether lifestyle changes during the COVID-19 lockdown period influenced preterm birth rates. Materials and Methods: This retrospective cohort study used data from the electronic medical records of Bihor and Sibiu counties. Preterm deliveries (<37 weeks) and stillbirths during the COVID-19 pandemic (2020 and 2021) were compared with the corresponding pre-pandemic (2018 and 2019) and post-pandemic (2022 and 2023) period. Preterm birth rates during summer and winter in the pre-pandemic, pandemic, and post-pandemic years were analyzed. A comparison with rates during strict lockdown was made. Results: Out of 52,021 newborn infants, 4473 were born preterm. Preterm birth rates remained stable across all three periods (p = 0.13), and no significant seasonal pattern was identified (p = 0.65). In contrast, stillbirth rates increased notably during the strict lockdown period, with the median incidence almost doubling compared to other periods (0.87%, p = 0.05), while remaining unchanged during the rest of the pandemic (p = 0.52). Conclusions: Our study found that preterm birth rates remained unaffected by the pandemic and lockdown periods, while stillbirths increased significantly during the strict lockdown. These findings highlight the importance of maintaining access to timely antenatal care during public health emergencies to prevent adverse perinatal outcomes. Full article

The COVID-19 pandemic has exposed and intensified structural tensions surrounding work−life balance, precarity, and gender inequalities in academia. This paper examines the spatial, temporal, and emotional disruptions experienced by early-career and precarious researchers in Italy during the first national lockdown (March–April 2020) and their engagement in remote academic work. Adopting an exploratory and qualitative approach, the study draws on ten narrative video interviews and thirty participant-generated images to investigate how structural dimensions—such as gender, class, caregiving responsibilities, and the organizational culture of the neoliberal university—shaped these lived experiences. The findings highlight the implosion of boundaries between paid work, care, family life, and personal space and how this disarticulation exacerbated existing inequalities, particularly for women and caregivers. By interpreting both visual and narrative data through a sociological lens on gender, work, and organizations, the paper contributes to current debates on the transformation of academic labor and the reshaping of temporal work regimes through the everyday use of digital technologies in contemporary neoliberal capitalism. It challenges the individualization of discourses on productivity and flexibility and calls for gender-sensitive, structurally informed policies that support equitable and sustainable transitions in work and family life, in line with European policy frameworks. Full article

The COVID-19 pandemic and its associated lockdowns had widespread psycho-social implications globally. However, the unique experiences of young adults in under-researched rural communities, such as Lonely Park in South Africa’s North West Province, remain poorly documented. This study explores the psycho-social well-being of young adults aged 18–24 in the Lonely Park community during the national COVID-19 lockdown from 23 March 2020 to 30 April 2020, with a particular focus on their emotional, psychological, and social experiences. Using a qualitative, phenomenological design rooted in Bronfenbrenner’s Ecological Systems Theory (EST), data were collected from 14 purposively sampled participants through two focus group discussions. Thematic analysis was conducted following Braun and Clarke’s six-phase framework. Ethical clearance was obtained from the Health Research Ethics Committee, and participants provided informed consent. Two main themes emerged, (1) psychological and (2) social well-being. Six sub-themes were identified: (1) negative emotions linked to lockdown, (2) fear of COVID-19 and its consequences, (3) rumination and anxiety, (4) disruption of social and educational routines, (5) coping strategies, and (6) structural limitations of healthcare and support systems. Participants experienced intense fear, boredom, isolation, and a sense of helplessness. Yet, coping mechanisms such as communication, spirituality, exercise, and adherence to public health regulations provided resilience. Some reported depression and financial strain due to job loss and school disruptions. The findings highlight the complex interplay of psychological, emotional, and social stressors in rural young adults during the pandemic. Policymakers and mental health practitioners must prioritise targeted psycho-social interventions for youth in under-resourced rural settings. A call is made for culturally responsive mental health programmes that incorporate local voices, especially in rural African contexts. Full article

Background/Objectives: Children with sickle cell disease (SCD) often experience limited access to care, contributing to poor health outcomes. Patient-level predictors and outcomes associated with telehealth use among Medicaid-enrolled children with SCD remain unknown. This study aims to (1) analyze telehealth trends before and during the pandemic (March 2020–March 2022), (2) identify patient-level predictors of telehealth use, (3) assess its association with care continuity and health outcomes, and (4) identify physician specialties involved in telehealth visits. Methods: Using Texas Medicaid claims (March 2017–March 2022), we conducted a retrospective analysis of children aged 1–18 with ≥3 SCD-related claims. Monthly trends in outpatient visits (in-person and telehealth) were visualized from March 2019 to March 2022. Multivariable regression models examined predictors of telehealth use and associations with ≥10 hydroxyurea fills, emergency department (ED) visits, and hospitalizations, adjusting for age, sex, regions with SCD clinics, and prior healthcare utilization. Results: Among 903 included patients (mean [SD] age = 10.4 [4.1], 52.6% male), 59.4% had ≥1 telehealth visits between March 2019 and March 2022. Telehealth use peaked between March 2020 and May 2020, then gradually declined. Children with ≥10 SCD-related outpatient visits 1 year before the lockdown (March 2019–February 2020) had 77.4% higher odds of using telehealth compared to those with 0–4 visits (OR = 1.774, 95% CI = 1.281–2.457, p = 0.0006), while controlling for sociodemographic characteristics. However, SCD-related telehealth use during the pandemic was not associated with either ≥10 hydroxyurea fills or reduced ED visits. Prior healthcare utilization remained a strong predictor of both outcomes. The majority of telehealth visits were conducted at multispecialty clinics (74%). Conclusions: Telehealth use surged early in the pandemic but later declined among Texas Medicaid-enrolled children with SCD. Children with high healthcare needs adopted telehealth, but this did not impact care continuity or extensive healthcare utilization. While maintaining telehealth access, other measures should be implemented to improve access and outcomes for this vulnerable population. Full article

Background/Objectives: The outbreak of coronavirus disease 2019 (COVID-19) has restricted access to healthcare, increasing the risk of poor disease control among patients with COPD (Chronic Obstructive Pulmonary Disease). This study aimed to compare adherence to inhalers in patients with COPD before and during the COVID-19 lockdown and determine the characteristics of patients who were adherent to inhaler medications. Method: A retrospective analysis was conducted on a cohort of patients with severe COPD aged 40 or older using South Korea’s National Health Insurance Service (NHIS) database, which documents all healthcare utilization covered for insured individuals. Medication adherence, measured by the proportion of days covered (PDC), was compared before and during the COVID-19 lockdown using a paired t-test. A multivariable logistic regression model was conducted to identify the characteristics of the adherent patients (socio-demographic, including age, sex, income level, insurance type, and residential area), health-conditions (disease severity, underlying diseases, and disability), and pharmacotherapy characteristics (prescriber practice setting, polypharmacy, medication treatment duration, and inhaler type). Result: A total of 15,971 COPD patients were identified (79.2% men). During the COVID-19 lockdown in 2020, there was a significant decrease in medication adherence to COPD inhalers compared to 2019 (49.8% in 2020 vs. 56.3% in 2019, respectively; p < 0.001). Moreover, the proportion of those adherent (≥80%) during the COVID-19 lockdown decreased (22.0% → 18.0%). Patients who remained adherent to inhaler therapy during the COVID-19 lockdown were typically aged in their 60s, beneficiaries of Medical Aid, residents of rural areas, clinic users, and patients without cardiovascular disease. Conclusions: Patients with COPD encountered significant challenges in accessing inhalers during the COVID-19 lockdown. Healthcare authorities should develop targeted strategies to ensure continued medication access for patients at increased risk of poor medication adherence, particularly during periods of restricted healthcare access, such as public health emergencies or pandemic lockdowns. Full article

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

The coronavirus (COVID-19) pandemic has profoundly affected public health and socio-economic structures globally. This research conducted a post-COVID-19 analysis of the role of fiscal support interventions on COVID-19 health regulations such as mandatory non-pharmaceutical interventions like face masks, social distancing, periodic lockdowns which include restrictions on movement, and socio-economic dimensions. This quantitative research obtained 302 responses from different households in the Eastern Cape, Gauteng, Kwa-Zulu Natal, and Limpopo Provinces in South Africa. The results reveal that the relief fund (R350 unemployment grant, unemployment insurance fund claim, and food parcel distribution, among others) mediated the relationship between COVID-19 health regulations and poverty levels and the relationship between COVID-19 health regulations and health and well-being. The relief fund also mediated the relationship between COVID-19 health regulations and employment levels. Support packages from the R500 billion government support, which included loan guarantees, job support, tax and payment deferrals and holidays, social grants, wage guarantees, health interventions, and municipalities support, moderate the relationship between COVID-19 health regulations and the family and social support. These results validate the impact of the fiscal support intervention by the government in mitigating its emergency intervention with COVID-19 health regulations. This strengthens the theory of intervention, highlighting that multiple dynamics make interventions complex as shown by mediation and moderation results. Furthermore, this study highlights intervention being central to the management of the crisis. The study highlights the importance of comprehensive intervention for future preparedness, thus advancing the crisis–intervention perspective. Advances in these areas are critical to mitigate the impact of the next pandemic or similar major events in society. This can be achieved through improved pandemic timely response with effective economic stimulus, social relief, strong legal framework, and anti-corruption policies. Full article

South Africa’s health system was affected by the various mitigation measures implemented to control the rapid spread of the COVID-19 pandemic. However, innovative interventions were introduced to ensure service continuity. This study sought to explore the perspectives of stakeholders regarding the pre-exposure prophylaxis (PrEP) innovative interventions implemented during the COVID-19 lockdown period among adolescent girls and young women (AGYW), as well as their successes and improvements. We selected and interviewed 12 PrEP stakeholders, including professional nurses, case managers, peer educators, and counselors from the TB HIV Care programme in the Dr. Kenneth Kaunda District, in the North-West Province. The qualitative questions explored (1) how PrEP services were disrupted during the lockdown period, (2) how the disruptions were managed, and (3) the challenges and successes of the innovative interventions implemented. The interviews were audio-taped, transcribed, and thematically analyzed through Tesch’s eight steps of analysis. The stakeholders confirmed that COVID-19 disruptions affected the provision of PrEP services in terms of recruitment, counseling, HIV testing, and adherence support offered in different community hotspots. Responding to these difficulties, alternative avenues such as social media platforms were implemented and used for service continuity. The themes that emerged were organized into the following two categories: PrEP services provided during and after the COVID-19 lockdown period, as well as the successes and challenges. The current study provides further insight into COVID-19, aiming to inform preparations for future pandemics. Innovative PrEP interventions alleviated COVID-19 disruptions in some settings and improved HIV services, but this was not the case in the selected study area. Full article

The COVID-19 pandemic and the subsequent hard lockdown in South Africa, implemented in March 2020, significantly disrupted disability and rehabilitation services. Persons with disabilities experienced limited access to essential Orthotic and Prosthetic services, particularly in rural provinces such as the Eastern Cape. This study aimed to explore how Medical Orthotists and Prosthetists reconfigured their services during and after the pandemic to inform disability-inclusive emergency responses. A descriptive qualitative study was conducted with 12 Medical Orthotists and Prosthetists practicing in the public sector in the Eastern Cape. Semi-structured interviews were conducted via MS Teams, and the data were analysed by using thematic analysis to identify key themes related to service disruptions and adaptations. Four main themes emerged: (1) disrupted access to Orthotic and Prosthetic services, (2) backlogs and limited services, (3) safety measures and adaptation control, and (4) lingering challenges and gaps. Service delivery was hindered by halted outreach clinics, limited access to materials, budget reallocations, and the deprioritisation of rehabilitation services. This study highlights the challenges faced by Medical Orthotists and Prosthetists in maintaining the functionality of Orthotic and Prosthetic services during the pandemic. These findings emphasise the need for disability-inclusive policies and strategies to ensure the continuity of rehabilitation services during emergencies. Full article

Objectives: Oro-facial trauma affects physical, psychological, and social well-being. This study assesses changes in oro-facial trauma hospitalisation rates among adults during the pre-lockdown period, ‘lockdown year’, and post-lockdown period in Australia and the United Kingdom (UK). The findings provide insights into healthcare delivery and resource allocation during public health emergencies to inform future preventive strategies. Methods: Hospitalisation data for adults (aged 20+) with oro-facial trauma, classified using ICD-10 codes, were collected. Age-standardised rates (ASRs) per 100,000 population were calculated for each period. Comparative analyses evaluated hospitalisation rates during the ‘lockdown year’ relative to three years before and after. The 11 oro-facial trauma ICD codes were grouped into major and minor trauma to evaluate differential impacts. Results: This study highlighted a statistically significant reduction in oro-facial trauma hospitalisation rates during the ‘lockdown year’ in both Australia (38.8%) and the UK (35.7%) compared to the pre-lockdown period. Although rates increased post-lockdown, they remained lower than pre-lockdown levels, with a 35.5% reduction in Australia and a 25.1% reduction in the UK. Additionally, while the ASR significantly increased for major trauma in the post-lockdown years compared to the lockdown year, the increase for minor trauma was not statistically significant in both countries. Conclusions: COVID-19 lockdowns led to a significant reduction in oro-facial trauma hospitalisations. Post-lockdown rates increased as activities resumed but did not return to pre-lockdown levels, suggesting lasting behavioural shifts. These findings highlight the role of external factors (e.g., mobility and social behaviour) in oro-facial trauma rates and can inform targeted preventive strategies for high-risk periods. Full article

Background: In the beginning of the COVID-19 pandemic, the Department of Pediatric Dentistry at the University Dental Clinic Vienna switched from routine medical care to emergency operation mode. The study aims to retrospectively compare the characteristics of pediatric patients’ emergency visits before, during, and after lockdown. Methods: All pediatric emergencies that presented at the Department of Pediatric Dentistry in the period from the 7 January 2020 to the 31 July 2020 were recorded. Patients were subclassified into three groups with regard to their time of presentation (group 1: before lockdown, group 2: during lockdown, group 3: after lockdown). Then, pediatric patients’ purposes for emergency visit, diagnoses, and the treatments practiced were compared. Results: The number of patients was significantly lower during lockdown but increased again afterward. During lockdown, significantly more patients presented with dental pain, the diagnosis “Extraction: tooth not restorable” increased, and extractions were significantly more often the treatment of choice (p < 0.05). Conclusions: The presented study is the first research on pediatric dental emergency visits during the first lockdown of the COVID-19 pandemic in Austria. The results highlight the negative impact of the pandemic on pediatric dental care as the number of treatments decreased, elective treatments were postponed, and the diagnosis and prognosis of teeth deteriorated. Full article

Background/Objectives: The COVID-19 pandemic has significantly affected public health and social behavior, contributing to increased psychoactive substance (PAS) use due to social isolation, economic stress, and uncertainty. This study aims to assess the impact of the pandemic on alcohol, cannabinoid, and opioid consumption among drivers involved in road traffic accidents (RTAs) in Kazakhstan. Understanding these patterns is essential for improving public health policies and road safety measures during crises. Methods: This retrospective cross-sectional study analyzed medical records from the Digital System of Medical Examination, a national database of drivers involved in traffic accidents in Kazakhstan. This study included 157,490 anonymized records from 1 January 2019, to 31 December 2020, categorizing cases into pre-COVID-19 and COVID-19 groups on the basis of the first nationwide lockdown on 16 March 2020. Statistical analyses, including prevalence rates and relative changes, were conducted via SPSS 20, while spatial distributions were visualized via QGIS software. Results: An analysis of all the records revealed a 12.9% decline in traffic accidents during the pandemic, with male drivers predominating during both periods. The mean age of the drivers in the compared groups was 36. Alcohol and cannabinoid use significantly increased during the COVID-19 period by 3.71% and 11.51%, respectively. In contrast, opioid use declined by 10.00%, but the difference was not statistically significant. The greatest increase in positive alcohol tests among drivers was observed in the Atyrau (94.80%), Pavlodar (35.43%), and North Kazakhstan (31.02%) regions, and Atyrau also presented the greatest increase in cannabinoid-positive cases. Conclusions: The results indicate that the COVID-19 pandemic and related lockdown measures have affected PAS consumption patterns among drivers. These findings are crucial for informing policies and developing strategies to improve road safety during future public health emergencies. Full article

Highly Urbanized Cities (HUCs) in the Philippines were at the forefront of public health surveillance and response during the COVID-19 pandemic. With the rapid spread of COVID-19 to Philippine cities, local government units continuously assessed, adapted, and implemented public health interventions (PHIs) and depended on available open-source government data (OSGD). This study consolidated PHIs in selected HUCs in the Philippines using high-quality OSGD to create a timeline of interventions and document good practices in local COVID-19 control. OSGD resources were collected from February 2020 to January 2023, and the data quality of OSGD was evaluated using the Journal of the American Medical Association (JAMA) benchmarks. A total of 180 metadata sources that met at least two core standards (Authorship and Currency) were included in the analysis. COVID-19 control strategies were analyzed vis-à-vis the rise of COVID-19 cases and types of PHIs, including the control of imported cases, case management, contact management, behavioral modification, and pharmaceutical intervention. Travel bans and hard lockdowns in Luzon early in the pandemic delayed the introduction of COVID-19 to other parts of the country. Good practices of LGUs for local COVID-19 control, such as quarantine passes, curfews and liquor bans, using QR-based contact tracing, massive community testing in high-risk communities, and free public swabbing centers, were implemented to slow down the local spread of COVID-19. With the evolving scenarios in city-level COVID-19 epidemics, local risk assessments based on available OSGD drove the adoption of relevant and innovative control strategies in HUCs in the Philippines. Lessons learned must be integrated into epidemic preparedness and response programs against future emerging or re-emerging infectious diseases. Full article

Background: Crises such as pandemics and wars significantly impact cardiovascular health, particularly ST-Elevation Myocardial Infarction (STEMI). The COVID-19 pandemic led to overwhelmed healthcare systems and delayed care, while the October 2023 war in Israel posed unique challenges, including altered patient behavior and access to care. This study compares STEMI outcomes during these two crisis periods, focusing on mortality and care pathways. Methods: This retrospective cohort study, conducted at Soroka University Medical Center, analyzed patients with STEMI during the COVID-19 lockdown (14 March 2020–14 June 2020), the war period (07 October 2023–7 January 2024), and quiet periods in 2022. Patient demographics, arrival methods, and outcomes were compared. Multivariable logistic regression identified mortality predictors. Results: Among 397 patients with STEMI, 30-day mortality was 7.5 times higher during COVID-19 (OR 7.50, p = 0.038), and in-hospital mortality was 10.25 times higher (OR 10.25, p = 0.046) compared to the war. The war period showed an 86% reduction in 30-day mortality (OR 0.14, p = 0.026). More patients arrived by ambulance during COVID-19, while during the war, more were referred via emergency medical centers and admitted directly to the ICCU. Conclusions: The COVID-19 pandemic significantly increased STEMI mortality, while the war’s coordinated care pathways improved outcomes. Tailored crisis management strategies are important to ensure effective acute care during pandemics and conflicts. Full article