Search Results (598)

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

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

Background/Objectives: During the first COVID-19 lockdown, the sudden disruption of formal care services substantially increased reliance on informal caregiving. Emerging evidence suggests that increased caregiving demands may have contributed to a higher burden of mental-health-related temporary work disability; however, population-based data from occupational health systems remain limited. This study aimed to quantify and characterise, descriptively, the sociodemographic, clinical, and territorial characteristics of mental-health-related temporary work disability among workers with informal caregiving responsibilities in Spain during the first COVID-19 lockdown, and to descriptively examine differences between episodes occurring among workers with and without caregiving responsibilities. Methods: A retrospective descriptive study was conducted using anonymised nationwide occupational health records from Mutua Asepeyo. All episodes of temporary work disability certified for mental and behavioural disorders (ICD-10 F00–F99) between 14 March and 21 June 2020 were analysed. Caregiver status was determined based on documented informal caregiving responsibilities recorded within the occupational disability records. Sociodemographic, occupational, clinical, and territorial variables were examined using descriptive statistics and non-parametric tests. Results: A total of 2857 caregiver-associated episodes were identified, representing 55.6% (95% CI: 54.2–57.0) of all mental-health-related temporary work disability episodes during the study period. The majority involved women (68.1%) and caregivers of older dependent adults (59.3%). Generalised anxiety disorder was the most frequent diagnosis, followed by adjustment disorders and acute stress reactions, with significant differences by sex and employment regime. Marked territorial variability was observed, as well as longer durations of temporary work disability in specific regions and among women. Conclusions: A substantial proportion of mental-health-related temporary work disability episodes during the lockdown occurred among workers with informal caregiving responsibilities, particularly women and those caring for older dependents. These findings suggest that informal caregiving may be a determinant of occupational mental health during crises. However, given the descriptive and unadjusted nature of the study, no causal inferences can be drawn. Further research is needed to understand these associations better and inform future occupational health strategies. Full article

The COVID-19 pandemic brought global tourism to a near standstill, rapidly shifting many destinations from overtourism to a temporary state of non-tourism due to lockdowns and border closures. As travel resumed between 2021 and 2022, ‘revenge tourism’ emerged, characterised by a surge in travel as people sought to compensate for lost experiences. This resurgence has reignited overtourism, a phenomenon marked by excessive tourist numbers and negative impacts on host communities, including environmental degradation, infrastructure strain and socio-cultural disruption. While overtourism has been extensively studied in the global North, its manifestations in the global South, particularly in South Africa, remain underexplored. This study addresses the existing gap by exploring the potential of digital technologies, namely, artificial intelligence (AI), virtual reality (VR) and social media platforms, as instruments for managing visitor flows and alleviating overtourism in selected hotspots throughout South Africa. Using a qualitative, literature-based design, this study evaluates the contextual relevance and multi-dimensional scalability of these technologies. The findings aim to advance discussions on overtourism and propose innovative, technology-driven strategies, as well as research opportunities tailored to the unique challenges of the global South. Full article

Background: The COVID-19 pandemic triggered unprecedented mobility disruptions worldwide as governments imposed strict lockdowns to contain the spread of the virus. In India, prolonged restrictions severely affected economic activity, particularly for migrant workers, leading to a large-scale and unplanned exodus from urban employment centres to native places. This sudden population movement undermined containment efforts and contributed to the spatial diffusion of infections. Understanding evacuees’ behavioural responses during such crises is therefore critical for effective emergency logistics and evacuation planning. Methods: This study examines the determinants of transport mode and shelter choice decisions made by migrants during the COVID-19-induced evacuation in India. Using primary survey data, a multinomial logistic regression model is developed to analyze how socio-economic characteristics influence evacuees’ choices of travel mode and shelter type. Results: The results reveal significant heterogeneity in decision-making, highlighting the role of economic vulnerability and accessibility constraints in shaping evacuation behaviour. Conclusions: The findings offer actionable insights for policymakers and emergency planners to design inclusive evacuation strategies, improve crisis-responsive transportation planning, and enhance shelter provisioning in future pandemics or large-scale disruptions. The study contributes to the logistics and humanitarian operations literature by providing empirical evidence on evacuation behaviour under public health emergencies. Full article

The COVID-19 pandemic posed unprecedented challenges, requiring compliance with public health measures. Notably, guilt is a powerful motivator for rule adherence; however, different types of guilt could have fueled the decision to stay home. This study investigated how guilt propensity influenced Italians’ self-reported motivations for adhering to containment rules. The propensity to different types of guilt, namely deontological and altruistic, was assessed in a total of 393 participants (261 females, 66.4%; 132 males, 33.6%; M age = 34.4, SD = 12.6) in May 2020, between the first and the second phases of Italian lockdown. The survey assessed four guilt dispositions—Moral Norm Violation (MNV), Moral Dirtiness (MODI), Harm-based guilt (HARM), and Empathy-based guilt (EMPATHY)—alongside fear of COVID-19, trust in authorities, and motivations for rule compliance (e.g., protecting one’s own and others’ well-being, respecting authorities, and avoiding sanctions). MNV emerged as a positive predictor of prosocial, authority-based and personal motivations, whereas MODI predicted lower prosocial motivation. HARM selectively predicted prosocial motivation and was negatively associated with authority-based motivations, while EMPATHY negatively predicted self-focused motivations. Moderation analyses revealed small but significant interaction effects, indicating that fear of COVID-19 slightly amplified the influence of EMPATHY and attenuated the effect of HARM, whereas trust in authorities strengthened the link between EMPATHY and prosocial compliance and reduced the association between MNV and prosocial motivations. These findings suggest that compliance during the pandemic was shaped by distinct emotional–moral pathways and that the motivational impact of guilt depends on perceived threat and institutional trust, highlighting the relevance of specific guilt profiles in promoting cooperative and health-protective behaviors. Full article

Background and Clinical Significance: Parkinson’s disease (PD) is a neurodegenerative condition characterized by motor and non-motor symptoms, which significantly impact patients’ autonomy and quality of life levels. Basically, the PD diagnosis is clinical and, in some cases, can be challenging to diagnose due to the heterogeneity of the symptoms. Case Presentation: A 58-year-old woman who, during the COVID-19 lockdown, referred to experiences of slight tremor and stiffness in her left hand at rest, but without any other associated symptoms. Firstly, after consulting a general practitioner (GP), the patient was diagnosed with cervical radiculopathy (CR), presented as essential tremor and stiffness to the hand. Nevertheless, during the initial physiotherapy evaluation, the motor symptoms did not fully align with the diagnosis of CR. For this reason, the presence of non-motor symptoms was thoroughly investigated. Notably, hyperhidrosis was identified as a significant non-motor symptom, leading to the patient’s subsequent referral to a neurologist, who finally diagnosed PD. Conclusions: This case report highlights the essential role of physiotherapists in conducting independent assessments and comprehensive investigations of all patients’ symptoms, even when a medical diagnosis has already been established. This is particularly crucial when there is suspicion that musculoskeletal symptoms may be indicative of neurodegenerative diseases such as PD, which is well-known for its extensive array of non-motor symptoms. Especially in women with PD, non-motor symptoms tend to emerge earlier and in a more subtle manner than motor symptoms, making diagnosis challenging. Therefore, meticulous anamnestic data collection is essential, especially by physiotherapists working in direct-access settings. Full article

Gun violence in U.S. schools not only causes loss of life and physical injury but also leaves enduring psychological trauma, damages property, and results in significant economic losses. One way to reduce this loss is to detect the gun early, notify the police as soon as possible, and implement lockdown procedures immediately. In this project, a novel gun detector Internet of Things (IoT) system is developed that automatically detects the presence of a gun either from images or from gunshot sounds, and sends notifications with exact location information to the first responder’s smartphones using the Internet within a second. The device also sends wireless commands using Message Queuing Telemetry Transport (MQTT) protocol to close the smart door locks in classrooms and announce to act using public address (PA) system automatically. The proposed system will remove the burden of manually calling the police and implementing the lockdown procedure during such traumatic situations. Police will arrive sooner, and thus it will help to stop the shooter early, the injured people can be taken to the hospital quickly, and more lives can be saved. Two custom deep learning AI models are used: (a) to detect guns from image data having an accuracy of 94.6%, and (b) the gunshot sounds from audio data having an accuracy of 99%. No single gun detector device is available in the literature that can detect guns from both image and audio data, implement lockdown and make PA announcement automatically. A prototype of the proposed gunshot detector IoT system, and a smartphone app is developed, and tested with gun replicas and blank guns in real-time. Full article

Urban crises rarely occur in isolation but emerge as interconnected disruptions across space, time, and institutions. The COVID-19 pandemic intensified existing vulnerabilities and intersected with other crises, producing cascading effects. This paper asks how cascading effects analysis can be used as a planning-oriented method to map and govern compound urban crises, drawing on case studies from Cape Town, Dortmund, and São Paulo. In Cape Town, South Africa, the pandemic intersected with high HIV and tuberculosis rates and load shedding, straining health and social services. In Dortmund, Germany, COVID-19’s economic disruptions overlapped with an energy price crisis, while in São Paulo, Brazil, lockdowns coincided with increased gender-based violence and constrained access to support services. Together, these cases show how pre-existing socio-political and economic conditions shape the impacts of crises, exacerbating marginalization and deepening systemic inequalities. Cascading effects analysis is used to visualize and address interdependencies in compound crises, helping planners move beyond sectoral silos, identify key intervention points for crisis management, and support more resilient and equitable urban planning. The paper calls for a methodological shift in urban crisis research toward tools that better communicate systemic risk and bridge risk assessment, social vulnerability, and planning practice. Full article

The COVID-19 pandemic has been one of the most globally disruptive social events in recent history, bringing widespread lockdowns, restrictions on movement, remote work, mass vaccination campaigns, and millions of deaths worldwide. These unprecedented circumstances have reshaped many aspects of social life, including perceptions of safety and firearm ownership. This study examines changes in reported gun ownership before and during the COVID-19 pandemic in the United States, using binary logistic regression analyses of General Social Survey (GSS) data from 2018 and 2021. Analysis revealed that reported gun ownership remained stable at approximately 35% in both years. However, the demographic and social profile of gun owners shifted significantly. Demographic factors such as sex, US birth, marital status, and income consistently predicted ownership in both years, while race, middle-class identification, and political party affiliation emerged as significant predictors only during the pandemic, with Democrats becoming significantly less likely to report gun ownership. The results demonstrate how social crises can reshape the composition of firearm owners rather than overall rates, with implications for public policy and safety. Full article

In recent years, China has made strong national commitments to waste reduction and circular economy, including the implementation of mandatory municipal solid waste separation policies and the rollout of zero-waste city initiatives. These efforts represent a strategic shift toward systemic environmental governance. However, the outbreak of the COVID-19 pandemic in early 2020—and the subsequent implementation of the country’s stringent zero-COVID policy—led to an abrupt disruption of these programs. Under this policy, strict lockdowns, quarantine of both confirmed and suspected cases, and city-wide containment became top priorities, sidelining environmental initiatives such as waste separation and sustainable waste infrastructure development. This study investigates how Chinese residents’ motivations for waste separation evolved across three key phases: pre-pandemic, during the zero-COVID enforcement period, and post-pandemic recovery. Grounded in the Theory of Planned Behavior and pro-environmental behavior theory, we developed an extended model incorporating pandemic-related social, psychological, and policy variables. Based on 526 valid questionnaire responses collected in late 2023 in Shanghai, we conducted structural equation modeling and repeated-measures analysis. Findings reveal a significant shift from externally driven compliance—reliant on governmental enforcement and service provision—to internally motivated behavior based on environmental values and personal efficacy. This transition was most evident after the pandemic, suggesting the potential for sustained pro-environmental habits despite weakened policy enforcement. Our findings underscore the importance of strengthening internal drivers in environmental governance, especially under conditions where policy continuity is vulnerable to systemic shocks such as public health emergencies. Full article

COVID-19 lockdown announcements triggered global waves of panic buying, leading to widespread panic buying of essential goods and supply chain disruptions. Although the acute phase of the pandemic has passed, panic buying continues to emerge during natural disasters, extreme weather events, and other crisis-related disruptions, highlighting the ongoing need for evidence-based strategies to address its psychological drivers. Social cognition constructs, including willingness, intentions, attitudes, subjective norms, and risk perceptions, have been identified as modifiable psychological predictors of panic buying. However, few studies have experimentally tested theory-driven interventions aimed at modifying these mechanisms. This study evaluated the effectiveness of a brief, online intervention based on integrated social cognition models in reducing panic-buying-related cognitions during a hypothetical lockdown scenario. A pre-registered randomized controlled trial was conducted with Australian grocery shoppers (N = 140), who were randomly allocated to an intervention or control condition. Participants completed self-report measures assessing their willingness, intentions, attitudes, subjective norms, and risk perceptions at both pre- and post-intervention times. The hypotheses were partially supported. Compared with the control condition, the intervention group reported greater reductions across targeted psychological constructs. For hygiene products, significant decreases were observed across all five constructs, and for non-perishable foods, willingness, intention, and attitudes significantly decreased. For cleaning products, reductions were evident for attitudes, subjective norms, and intentions. These findings suggest that theory-informed, scalable interventions can effectively modify the social cognition processes underlying panic buying. This study extends existing research and demonstrates the potential for brief, theory-based communication strategies to reduce panic-buying-related cognitions. Future research should evaluate these interventions in real-world settings and explore mechanisms to target automatic cognitive processes. Full article

Public health emergencies (PHEs) test the crisis response capacity of grassroots organizations like China’s Residential Committees (RCs). While existing research attributes this capacity to factors like resource mobilization or state-society relations, its deeper structural foundations in land regimes and spatial configurations remain underexplored, particularly in Global South urbanization contexts. To fill this gap, this study develops a “Grassroots Organizational Capacity” (GOC) analytical framework, which disaggregates capacity into four dimensions: information, implementation, mobilization and cooperation, and coercion. We then employ this framework in a comparative case study of urban (Jiayi) and rural (Hedong) neighbourhoods in Nanhai, China, during the 2022 lockdown. Drawing on semi-structured interviews with ten key stakeholders in 2022, the findings reveal divergent types of governance. In the rural case, collective land ownership and open spaces foster an “Embedded Autonomy” type, enabling a proactive response through dense social networks. In the urban case, state land dependency and spatial fragmentation lead to a “Reactive Co-Governance” type, which relies on top-down state intervention. This study’s contribution is to provide a case-based illustration of how land and space structures are actively associated with grassroots crisis response effectiveness, rather than serving as passive backdrops. Full article

The COVID-19 pandemic emerging in early 2020 triggered global responses. In China, stringent lockdown measures were implemented to suppress the rapid spread of infection, resulting in substantial reductions in anthropogenic emissions. However, several atmospheric haze episodes still occurred. Previous studies have investigated the cause of these haze events predominantly based on the average concentration obtained from bulk analysis, while the micro-scale structure and composition of the haze particles remain poorly understood. In this study, we analyzed the morphology and elemental composition of individual airborne particles collected from an urban area of Beijing in early 2020 using high-resolution transmission electron microscopy equipped with Energy Dispersive X-ray Spectroscopy. The results show that sulfur-dominant, ultrafine, and mixed particles were the most abundant types during the pollution process. Reduced human activities corresponded with a lower percentage of anthropogenic-derived soot, organic particles, and metal-containing particles. Atmospheric aging analysis demonstrated that secondary aerosols were the most significant component during the haze events. The proportion of core–shell particles increased with the intensification of the pollution, while the core/shell ratio of the particles decreased, suggesting a substantial contribution of secondary aerosols to the haze formation. Despite reductions in anthropogenic emissions, larger proportions of secondary aerosol formation enhanced aerosol aging and thereby caused episodic haze pollution during the lockdown period. Full article

Background/Objectives: The COVID-19 pandemic profoundly disrupted the daily lives of children with neurodevelopmental disorders, particularly Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD). Lockdowns, therapy interruptions, and reduced access to educational and healthcare services significantly affected developmental progress and family functioning. This pilot study aimed to assess the long-term impact of the pandemic on children with ASD and ADHD in Northern Greece and to explore consequences for their families in the post-pandemic period. Methods: Parents or legal guardians of 72 children (ages 2–17 years) with confirmed diagnoses of ASD (n = 57) or ADHD (n = 15) participated. A structured 25-item questionnaire captured information on developmental, psychological, and social functioning, family well-being, therapy disruption, screen use, and access to online support. Data were collected across urban, semi-urban, and rural areas of Northern Greece over six months. Descriptive and inferential analyses were performed. Results: Most participants were boys (77.8%) and in primary school (73.6%). Common co-occurring conditions included learning difficulties (33.3%), anxiety (8.3%), and epilepsy (6.9%). Nearly half of families (45.8%) reported therapy reductions exceeding 70%, while 29.2% accessed online therapy, often with limited perceived effectiveness. New behavioral symptoms emerged in 45.8% of children, including irritability, anxiety, and emotional instability. Parental psychological distress was reported by 29.2% of caregivers. Screen time increased in over 90% of cases, and 87.5% of parents perceived the pandemic as negatively affecting their child. Financial strain was noted by 37.5% of families. Conclusions: The findings highlight the significant developmental, psychological, and social consequences of the COVID-19 pandemic for children with ASD and ADHD and their families. Service disruptions, unmet therapeutic needs, and increased caregiver burden emphasize the urgency of sustainable, flexible care models. Strengthening telehealth, integrating community-based interventions, and enhancing educational accommodations are essential for resilience in the post-pandemic era. Full article