Medical students' perceived stress and perceptions regarding clinical clerkship during the COVID-19 pandemic.

BACKGROUND: It is important to ensure that both the qualitative and quantitative aspects of clinical education are maintained during the pandemic. Understanding students' views on clinical rotations and the extent of their perceived pandemic-related stress would thus be useful for designing and implementing effective clerkship programs. Therefore, this study aimed to investigate perceived stress and perceptions regarding clinical clerkship among incoming clinical students (third year) and senior clinical students (fourth year) during the COVID-19 pandemic. METHODS: After completing orientation programs at the beginning of the academic year, we surveyed students on their perceived stress, their general perspectives regarding the appropriate scope of clinical clerkship, and their preferences regarding level of participation in clerkship. We examined the differences in stress and clerkship-related perceptions based on the students' study year and sex using independent t-test, chi-squared test, and Fisher's exact test. In addition, the influences of stress, sex, and study year on clerkship-related perceptions were examined using multinomial logistic regression. RESULTS: The independent t-test indicated that third-year students experienced lower stress than did fourth-year students. Clerkship-related perceptions also differed significantly between third- and fourth-year students. Multinomial logistic regression analyses on the scope of and participation levels in clinical clerkship revealed that third-year students had significantly lower odds of preferring a limited range of clinical rotations and lower engagement in clerkships compared to fourth-year students. CONCLUSION: The COVID-19 pandemic has affected clinical education and, consequently, medical students' inclination toward active participation in clinical rotations. It is thus essential to understand students' views and provide them with relevant intra-pandemic educational supports.

Perceived China Threat, Conspiracy Belief, and Public Support for Restrictive Immigration Control During the COVID-19 Pandemic

During the COVID-19 pandemic, there has been an unprecedented increase in the level of political blame attributed to China for the health crisis and other associated xenophobic discourses. Although previous research has revealed the effects of perceived outgroup threats on popular support for policies that control outgroups, threats posed by foreign countries have received little empirical attention. This study advances previous research by focusing on the independent effects of the perceived China threat to public support for restrictive immigration control during the COVID-19 pandemic. Using a sample drawn from the 2020 American National Election Studies, the results showed that the perceived China threat substantially heightened public support for restrictive immigration control. More importantly, demand for restrictive immigration control intensified when individuals had stronger perceptions of threats and conspiracy beliefs about the virus leak from a Chinese lab. Taken together, our findings demonstrate the roles of politically constructed threats and conspiracy beliefs during the COVID-19 pandemic, revealing new mechanisms of popular attitudes toward social control.

A Study on the COVID-19 Preventive Behaviors of Automobile Manufacturing Workers in South Korea.

The present study used a cross-sectional, descriptive survey design to investigate the influencing factors of COVID-19-related infection prevention behaviors of workers in the automobile manufacturing sector. An online survey was conducted on 157 workers in the automobile manufacturing sector of a company in Korea. We analyzed the collected data using SPSS to test whether there were significant differences in COVID-19 risk perception, crisis communication, health literacy, and infection prevention behaviors according to the general characteristics of the participants. An independent sample t-test and a one-way analysis of variance (ANOVA) were performed. A Pearson's correlation analysis was performed to identify the correlations among COVID-19 risk perception, crisis communication, health literacy, and infection prevention behaviors. Multiple regression analysis was performed to identify the influencing factors of COVID-19 infection prevention behaviors. The regression model was found to be significant, and the employment period at current job, COVID-19 prevention education, source of information, COVID-19 risk perception, crisis communication, and health literacy were also found to be significant. Among the demographic variables, employment period at current job of 5-10 years showed a higher level of infection prevention behaviors than that of <5 years. Moreover, the level of infection prevention behaviors was also significantly higher when COVID-19-related information was acquired through the KDCA/health center. Higher COVID-19 risk perception, crisis communication, and health literacy were associated with significantly higher levels of infection prevention behaviors. Therefore, based on the results, health managers need to develop programs and educate and improve information comprehension and crisis communication skills in order to promote workers' infection prevention behaviors of emerging infectious diseases in an era of global change.

Smartphone Use Type, Fear of Missing Out, Social Support, and Smartphone Screen Time Among Adolescents in Korea: Interactive Effects.

This study aims to examine the relationship between intrapersonal factors, interpersonal factors, smartphone screen time, and the moderating roles of interpersonal factors, on the basis of the ecological model. This study is a cross-sectional and descriptive study. A total of 428 participants from four public middle schools were selected through convenience sampling (55.1% female; Mean age 13.0 ± 0.78). Data were collected through self-report questionnaires that contained questions about sociodemographic characteristics, intrapersonal factors (types of smartphone use, Fear of missing out-FoMO), interpersonal factors (support from parents, teachers, and peers), and smartphone screen time. The collected data were analysed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and hierarchical regression. The daily smartphone screen time was 4.05 ± 2.16 h. Results showed that social media (ß = 0.155), games (ß = 0.140), and FoMO (ß = 0.227) were positively associated with smartphone screen time, while educational videos (ß = -0.130) and parental support (ß = -0.212) were negatively associated with smartphone screen time. Peers support moderated the association between games and smartphone screen time. Parental support moderated the association between educational videos, videos/movies/TV, and smartphone screen time. The findings highlight the direct and interactive roles of intrapersonal and interpersonal factors in predicting adolescents' smartphone screen time. Based on this study, the intrapersonal and interpersonal factors of adolescents should be comprehensively considered to intervene in their proper smartphone use.

Adverse impact of renin-angiotensin system blockade on the clinical course in hospitalized patients with severe COVID-19: a retrospective cohort study.

The association between angiotensin-converting enzyme inhibitor (ACE-I) or angiotensin II receptor blocker (ARB) and the risk of mortality in hospitalized patients with severe coronavirus disease 2019 (COVID-19) was investigated. This retrospective cohort study was performed in all hospitalized patients with COVID-19 in tertiary hospitals in Daegu, Korea. Patients were classified based on whether they received ACE-I or ARB before COVID-19 diagnosis. The analysis of the primary outcome, in-hospital mortality, was performed using the Cox proportional hazards regression model. Of 130 patients with COVID-19, 30 (23.1%) who received ACE-I or ARB exhibited an increased risk of in-hospital mortality (adjusted hazard ratio, 2.20; 95% confidence interval [CI], 1.10-4.38; P = 0.025). ACE-I or ARB was also associated with severe complications, such as acute respiratory distress syndrome (ARDS) (adjusted odds ratio [aOR], 2.58; 95% CI, 1.02-6.51; P = 0.045) and acute kidney injury (AKI) (aOR, 3.06; 95% CI, 1.15-8.15; P = 0.026). Among the patients with ACE-I or ARB therapy, 8 patients (26.7%) used high equivalent doses of ACE-I or ARB and they had higher in-hospital mortality and an increased risk of ARDS and AKI (all, P < 0.05). ACE-I or ARB therapy in patients with severe COVID-19 was associated with the occurrence of severe complications and increased in-hospital mortality. The potentially harmful effect of ACE-I or ARB therapy may be higher in patients who received high doses.