Physical activity in the era of climate change and COVID-19 pandemic: Results from the South Korea's 2022 Report Card on physical activity for children and adolescents.

Background: With intensifying air pollutant levels and the COVID-19 pandemic, physical inactivity of South Korean children and adolescents may be threatened. Therefore, monitoring and surveillance of physical activity (PA) and relevant indicators are important for policy making pertaining to health promotion. Report Card is a third comprehensive evaluation of PA-related behaviors among and the sources of influence for South Korean children and adolescents. Purpose: To provide the outcome of the South Korea's 2022 Report Card on PA for children and adolescents. Methods: Based on a variety of sources including national surveys collected pre- and during-COVID-19 and information collected from government webpages, 11 indicators were graded by a committee of experts informed by the best available evidence. Data from during-COVID-19 were available for Overall PA, Sedentary Behavior, and Sleep and considered together in generating the overall grades. Results: Grades were assigned to behavioral indicators (Overall PA: D-; Active Transportation: B+; Sedentary Behavior: D; Sleep: F) and sources of Influence (Family and Peers: C-; School: A; Community and Environment: B-; Government: A). Organized Sport and PA, Active Play, and Physical Fitness could not be graded due to the lack of data. The results largely indicated that children and adolescents show unfavorable behavioral grades even with favorable grades observed for the sources of influence indicators. Trivial differences were observed pre- and during-pandemic for Overall PA (≥60 min of MVPA for ≥4 d/wk: 20.8% vs 19.9%) and Sleep (met age-specific recommendation: 14.1% vs 15.0%); however, a marked increase in Sedentary Behavior was observed (≤2 h/d screen time: 28.8% vs 20.1%). A stark weekday vs weekend difference was observed in sleep duration. In terms of PA related sources of influence, high accessibility to PA facilities (81.1%) and high satisfaction of neighborhood public transit (74.6%) and safety (80.7%) were well reflected in our Active Transportation grade (B+). Nonetheless, perception of green environments including outdoor air quality (44.0%), noise (39.6%) and green space (56.5%) showed lower scores, suggesting that new barriers to active lifestyles are emerging for South Korean children and adolescents. Gender differences were also observed for overall PA (≥60 min of MVPA for ≥4 d/wk: 29.1% for boys vs 11.3% for girls) and sleep (met age-specific recommendations: 17.3% for boys vs 11.4% for girls), but not for sedentary behavior (≤2 h/d screen time: 26.4% for boys and 24.9% for girls). Conclusions: Government and school policies/programs and the built environment are, in general, conducive to physically active lifestyles for South Korean children and adolescents; however, behavioural indicators received poor grades except for Active Transportation. A thorough evaluation of policies/programs at government, local, and school levels is needed to ensure that the efforts to have PA-enhancing infrastructure and systems are actually being translated into the behavior of children and adolescents in South Korea. Furthermore, improving PA surveillance, monitoring, and advocacy to ultimately establish healthy lifestyle patterns among children and adolescents is a top priority.

Corrigendum to "Physical activity in the era of climate change and COVID-19 pandemic: Results from the South Korea's 2022 Report Card on physical activity for children and adolescents" [J Exercise Sci Fitness 21(1) (2023) 26-33].

[This corrects the article DOI: 10.1016/j.jesf.2022.10.014.].

Technostress causes cognitive overload in high-stress people: Eye tracking analysis in a virtual kiosk test.

In the midst of the COVID-19 pandemic, the use of non-face-to-face information and communication technology (ICT) such as kiosks has increased. While kiosks are useful overall, those who do not adapt well to these technologies experience technostress. The two most serious technostressors are inclusion and overload issues, which indicate a sense of inferiority due to a perceived inability to use ICT well and a sense of being overwhelmed by too much information, respectively. This study investigated the different effects of hybrid technostress-induced by both inclusion and overload issues-on the cognitive load among low-stress and high-stress people when using kiosks to complete daily life tasks. We developed a 'virtual kiosk test' to evaluate participants' cognitive load with eye tracking features and performance features when ordering burgers, sides, and drinks using the kiosk. Twelve low-stress participants and 13 high-stress participants performed the virtual kiosk test. As a result, regarding eye tracking features, high-stress participants generated a larger number of blinks, a longer scanpath length, a more distracted heatmap, and a more complex gaze plot than low-stress participants. Regarding performance features, high-stress participants took significantly longer to order and made more errors than low-stress participants. A support-vector machine (SVM) using both eye tracking features (i.e., number of blinks, scanpath length) and a performance feature (i.e., time to completion) best differentiated between low-stress and high-stress participants (89% accuracy, 100% sensitivity, 83.3% specificity, 75% precision, 85.7% F1 score). Overall, under technostress, high-stress participants experienced cognitive overload and consequently decreased performance; whereas, low-stress participants felt moderate arousal and improved performance. These varying effects of technostress can be interpreted through the Yerkes-Dodson law. Based on our findings, we proposed an adaptive interface, multimodal interaction, and virtual reality training as three implications for technostress relief in non-face-to-face ICT.

Twenty-Four-Hour Central Hemodynamic Load in Adults With and Without a History of COVID-19.

BACKGROUND: Although hypertension is a risk factor for severe Coronavirus Disease 2019 (COVID-19) illness, little is known about the effects of COVID-19 on blood pressure (BP). Central BP measures taken over a 24-hour period using ambulatory blood pressure monitoring (ABPM) adds prognostic value in assessing cardiovascular disease (CVD) risk compared with brachial BP measures from a single time point. We assessed CVD risk between adults with and without a history of COVID-19 via appraisal of 24-hour brachial and central hemodynamic load from ABPM. METHODS: Cross-sectional analysis was performed on 32 adults who tested positive for COVID-19 (29 ± 13 years, 22 females) and 43 controls (28 ± 12 years, 26 females). Measures of 24-hour hemodynamic load included brachial and central systolic and diastolic BP, pulse pressure, augmentation index (AIx), pulse wave velocity (PWV), nocturnal BP dipping, the ambulatory arterial stiffness index (AASI), and the blood pressure variability ratio (BPVR). RESULTS: Participants who tested positive for COVID-19 experienced 6 ± 4 COVID-19 symptoms, were studied 122 ± 123 days after testing positive, and had mild-to-moderate COVID-19 illness. The results from independent samples t-tests showed no significant differences in 24-hour, daytime, or nighttime measures of central or peripheral hemodynamic load across those with and without a history of COVID-19 (P > 0.05 for all). CONCLUSIONS: No differences in 24-hour brachial or central ABPM measures were detected between adults recovering from mild-to-moderate COVID-19 and controls without a history of COVID-19. Adults recovering from mild-to-moderate COVID-19 do not have increased 24-hour central hemodynamic load.

Physical activity in the era of climate change and COVID-19 pandemic: Results from the South Korea's 2022 Report Card on physical activity for children and adolescents

Background With intensifying air pollutant levels and the COVID-19 pandemic, physical inactivity of South Korean children and adolescents may be threatened. Therefore, monitoring and surveillance of physical activity and relevant indicators are important for policy making pertaining to health promotion. Report Card is a third comprehensive evaluation of physical activity (PA)-related behaviors and the sources of influence in South Korean children and adolescents. Purpose To provide the results of the South Korea's 2022 Report Card on PA for children and adolescents. Methods Based on a variety of sources including national surveys collected pre- and during-COVID-19 and on-line information collected from government webpages, 11 indicators were graded by a committee of experts informed by the best available evidence. Data from during-COVID-19 were also available for Overall PA, Sedentary Behavior, and Sleep and considered together in generating the overall grades. Results Grades were assigned to behavioral indicators (Overall PA: D-;Active Transportation: B+;Sedentary Behavior: D;Sleep: F) and sources of Influence (Family and Peers: C-;School: A;Community and Environment: B-;Government: A). Organized Sport and PA, Active Play, and Physical Fitness could not be graded due to the lack of data. The results largely indicate that children and adolescents show unfavorable behavioral grades even with favorable grades observed for the sources of influence indicators. No differences were observed pre- and during-pandemic for Overall PA (≥60 min of MVPA for ≥4 d/: 20.8% vs 19.9%) and Sleep (age-specific recommendation: 14.1% vs 15.0%);however, an increase in Sedentary Behavior was observed (≤2 hr/d screen time: 4.1% vs 20.1%). A stark weekday vs weekend difference was observed in sleep duration, as “catch-up sleep” during weekend days is common among South Korean children and youth. In terms of PA related settings and sources of influence, high accessibility to PA facilities (81.1%) and high satisfaction of neighborhood public transit (74.6%) and safety (80.7%) were well reflected in our Active Transportation grade (B+). Nonetheless, perception of environments including outdoor air quality (44.0%), noise (39.6%) and green space (56.5%) showed lower scores, suggesting that new barriers to active lifestyles are emerging for South Korean children and adolescents. Gender differences were also observed for overall PA (≥60 min of MVPA for ≥4 d/: 29.1% for boys vs 11.3% for girls) and sleep (met age-specific recommendations: 17.3% for boys vs 11.4% for girls), but not for sedentary behavior (26.4% for boys and 24.9% for girls). Conclusions Government and school policies/programs and the built environment are, in general, conducive to physically active lifestyles for South Korean children and adolescents;however, behavioural indicators received poor grades except for Active Transportation. A thorough evaluation of policies/programs at government, local, and school levels is needed to ensure that the efforts to have PA-enhancing infrastructure and systems are actually being translated into the behavior of children and adolescents in South Korea. Furthermore, improving PA surveillance, monitoring, and advocacy to ultimately establish healthy lifestyle patterns among children and adolescents is a top priority.

The labor of talking to stay healthy and socially connected: Communication work during the COVID-19 pandemic.

One of the primary means through which people protect themselves and their loved ones from COVID-19 is by communicating with others, as they discuss preventive health behaviors and make decisions about safe social interaction. These conversations are sometimes quite challenging. Guided by the conceptual lens of communication work, this study was an investigation of how communication during the pandemic was experienced by people as work. Findings validated and extended the communication work construct. Communication during the pandemic is effortful because it is high stakes, relentless, and takes an emotional toll. Nonetheless, many people feel a sense of responsibility and obligation to have these conversations. Communication about COVID-19 is divisible labor that can be shared. People engage in strategic preparation and message design to accomplish multiple goals before, during, and after discussions about pandemic topics.

Clinical findings, viral load, and outcomes of COVID-19: Comparison of patients with negative and positive initial chest computed tomography.

Reports detailing the clinical characteristics, viral load, and outcomes of patients with normal initial chest CT findings are lacking. We sought to compare the differences in clinical findings, viral loads, and outcomes between patients with confirmed COVID-19 who initially tested negative on chest CT (CT negative) with patients who tested initially positive on chest CT (CT positive). The clinical data, viral loads, and outcomes of initial CT-positive and CT-negative patients examined between January 2020 and April 2020 were retrospectively compared. The efficacy of viral load (cyclic threshold value [Ct value]) in predicting pneumonia was evaluated using receiver operating characteristic (ROC) curve and area under the curve (AUC). In total, 128 patients underwent initial chest CT (mean age, 54.3 ± 19.0 years, 50% male). Of those, 36 were initially CT negative, and 92 were CT positive. The CT-positive patients were significantly older (P < .001) than the CT-negative patients. Only age was significantly associated with the initial presence of pneumonia (odds ratio, 1.060; confidence interval (CI), 1.020-1-102; P = .003). In addition, age (OR, 1.062; CI, 1.014-1.112; P = .011), fever at diagnosis (OR, 6.689; CI, 1.715-26.096; P = .006), and CRP level (OR, 1.393; CI, 1.150-1.687; P = .001) were significantly associated with the need for O2 therapy. Viral load was significantly higher in the CT-positive group than in the CT-negative group (P = .017). The cutoff Ct value for predicting the presence of pneumonia was 27.71. Outcomes including the mean hospital stay, intensive care unit admission, and O2 therapy were significantly worse in the CT-positive group than in the CT-negative group (all P < .05). In conclusion, initially CT-negative patients showed better outcomes than initially CT-positive patients. Age was significantly associated with the initial presence of pneumonia, and viral load may help in predicting the initial presence of pneumonia.

Infectivity of Coronavirus Disease 2019: A Prospective Cohort Study in the Korean Metropolitan Area.

BACKGROUND: Although several characteristics of coronavirus disease 2019 (COVID-19), an ongoing pandemic disease, have been identified, data on the infectivity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are limited. METHODS: This prospective cohort study was conducted to analyze the infectivity of SARS-CoV-2 based on data of all patients diagnosed with COVID-19 confirmed using real-time polymerase chain reaction test from January to April 2020 in Gyeonggi-do, the largest province in Korea. RESULTS: Of the 502 patients, 298 consisting of 106 clusters with 5,909 contacts were included. Of these, 277 (93.0%) were symptomatic, and the most common symptoms were cough, fever, sputum, sore throat, and headache. A total of 94 patients (31.5%) had pneumonia, while 8 (2.7%) died during the follow-up period. The secondary attack rate (SAR) in the study population was 3.5% (204/5,909). In exposure settings, the SAR was higher in religious gathering (13.5% [95% confidence interval, 10.7-16.8%]), workplaces (8.49% [95% CI, 6.08-11.74%]), and schools (6.38% [95% CI, 3.39-11.69%]) than in health care facilities (1.92% [95% CI, 1.45-2.55%]). Sore throat at any period, dyspnea at diagnosis or any period, lower cycle threshold value in the lower respiratory tract samples, leukocytosis, and higher bilirubin levels were associated with higher infectivity of COVID-19. The presence of symptoms was not related to the infectivity. CONCLUSION: In establishing the infection control strategies for COVID-19, the variables associated with high infectivity may be considered.

Weight Loss Outcomes With Telemedicine During COVID-19.

Background: Amidst the COVID-19 pandemic, telemedicine was rapidly implemented to maintain patient care during quarantine. However, there is little data on how this transition may have impacted weight loss outcomes and interventions among patients with overweight or obesity. Methods: This was a retrospective observational study of adults who established care for medically managed obesity at the Weill Cornell Comprehensive Weight Control Center during September-November 2019 and May-July 2020 and who completed 6 months of follow-up. Weight loss outcomes and weight management interventions were explored and stratified by patient-provider interaction: in-person visits only, in-person and video visits, and video visits only. Results: Of 499 charts eligible for review, 245 (49%) returned for their 6-month follow-up visit and were included for analysis. Of 245 patients, 69 had in-person visits only ("in-person"), 85 started in-person and later switched to video visits ("hybrid"), and 91 had video visits only ("video"). All cohorts were predominantly white and female. Median ages were 56, 49, and 49 years; baseline median weights were 98.9, 96.8, and 93.0 kg; and baseline median BMIs were 35.3, 34.4, and 34.0 kg/m2 for in-person, hybrid, and video cohorts, respectively. The median percent weight changes over 6 months were not significantly different among cohorts: -4.3% [-8.5, -1.5] in the in-person cohort, -5.6% [-8.7, -2.2] in the hybrid group, and -5.8% [-9.7, -2.4] in the video cohort. The percent of patients who achieved ≥5% weight loss were also similar: 46.4%, 55.3%, and 59.3%, respectively. The median number of visits in the video cohort was more than in the in-person or hybrid groups (5 vs. 4). Median number of anti-obesity medications (AOMs) prescribed was similar among groups. The most common AOMs were metformin (all cohorts) followed by semaglutide 1.0 mg (in-person and video) or topiramate (hybrid). Conclusion: Patients on anti-obesity medications who were followed for 6 months via video or video plus in-person visits (hybrid) experienced clinically significant weight loss. Median number of AOMs were similar among groups, and the most common AOMs were metformin, semaglutide 1.0 mg, and topiramate. More investigation is required to compare telemedicine models with in-person care.

When Corporate Social Advocacy Meets Controversial Celebrity: The Role of Consumer–Brand Congruence and Consumer-Celebrity Congruence

This study investigates the role of consumer–brand congruence and consumer–celebrity congruence in the formation of consumer attitudes toward brands and their impact on behavioral intentions within the context of corporate social advocacy (CSA) involving controversial celebrities. Using a U.S. sample drawn from a Qualtrics panel (N = 372), the results of mediation analyses indicate that attitude toward a brand positively mediates the effects of consumer–brand congruence on consumers’ behavioral intentions, including purchase intention, brand preference, and boycott recommendation. The consumer–celebrity congruence moderated the indirect effect of consumer–brand congruence on brand preference and boycott recommendations, but not purchase intention. The findings of this study contribute to the CSA literature and practices by highlighting the role of consumers’ congruence with a controversial celebrity in determining consumers’ behavioral responses to CSA. When brands practice CSA, consumer–brand congruence rather than consumer–celebrity congruence could play a more important role in shaping consumer behaviors.

Clinical and Laboratory Factors Associated with Symptom Development in Asymptomatic COVID-19 Patients at the Time of Diagnosis.

In preparation for the surge of coronavirus disease 2019 (COVID-19), it is crucial to allocate medical resources efficiently for distinguishing people who remain asymptomatic until the end of the disease. Between January 27, 2020, and April 21, 2020, 517 COVID-19 cases from 13 healthcare facilities in Gyeonggi province, Korea, were identified out of which the epidemiologic and clinical information of 66 asymptomatic patients at the time of diagnosis were analyzed retrospectively. An exposure-diagnosis interval within 7 days and abnormal aspartate aminotransferase levels were identified as characteristic symptom development in asymptomatic COVID-19 patients. If asymptomatic patients without these characteristics at the time of diagnosis could be differentiated early, more medical resources could be secured for mild or moderate cases in this COVID-19 surge.

Fight the Virus and Fight the Bias: Asian Americans’ Engagement in Activism to Combat Anti-Asian COVID-19 Racism

The global COVID-19 pandemic reinforced anti-Asian biases, accompanied by the rise of violence against Asians. We examined Asian Americans? engagement in activism to combat anti-Asian racism and advance their community using the situational theory of problem solving (STOPS) and two additional factors?past discrimination and subjective norms. Asian American activism includes social media, political, and advocacy actions. Structural equation modeling was conducted with data from online survey responses of 240 Asian Americans. Our results suggest pathways from Asian Americans? past racism experiences to political and advocacy actions via three perceptual factors in STOPS (problem, involvement, constraint recognition), subjective norms, and expression of opinion on social media.

Change of human mobility during COVID-19: A United States case study.

With the onset of COVID-19 and the resulting shelter in place guidelines combined with remote working practices, human mobility in 2020 has been dramatically impacted. Existing studies typically examine whether mobility in specific localities increases or decreases at specific points in time and relate these changes to certain pandemic and policy events. However, a more comprehensive analysis of mobility change over time is needed. In this paper, we study mobility change in the US through a five-step process using mobility footprint data. (Step 1) Propose the Delta Time Spent in Public Places (ΔTSPP) as a measure to quantify daily changes in mobility for each US county from 2019-2020. (Step 2) Conduct Principal Component Analysis (PCA) to reduce the ΔTSPP time series of each county to lower-dimensional latent components of change in mobility. (Step 3) Conduct clustering analysis to find counties that exhibit similar latent components. (Step 4) Investigate local and global spatial autocorrelation for each component. (Step 5) Conduct correlation analysis to investigate how various population characteristics and behavior correlate with mobility patterns. Results show that by describing each county as a linear combination of the three latent components, we can explain 59% of the variation in mobility trends across all US counties. Specifically, change in mobility in 2020 for US counties can be explained as a combination of three latent components: 1) long-term reduction in mobility, 2) no change in mobility, and 3) short-term reduction in mobility. Furthermore, we find that US counties that are geographically close are more likely to exhibit a similar change in mobility. Finally, we observe significant correlations between the three latent components of mobility change and various population characteristics, including political leaning, population, COVID-19 cases and deaths, and unemployment. We find that our analysis provides a comprehensive understanding of mobility change in response to the COVID-19 pandemic.

Lifestyle Changes that Impact Personal Quality of Life in the COVID-19 Pandemic in South Korea.

OBJECTIVE: We investigated which factors in psychological changes positively or negatively affect the quality of life to suggest desirable directions in the period of the COVID-19 pandemic. METHODS: Online survey was conducted with 1,011 adults more than 19 years old in Busan, South Korea. Quality of life was measured using the World Health Organization Quality of Life-BREF. Questions regarding the psychological changes were about COVID-19-related concerns, distress in complying with quarantine guidelines, and interest in seeking something to do alone. RESULTS: Quality of life was perceived to be below average (mean±SD, 2.86±0.53). The more economic worries there were, the lower the quality of life in psychological, social relationships and environmental domains. The more distress one experienced when maintaining their personal hygiene, the higher the quality of life related to their physical health. Likewise, the more difficult it was to maintain social distances, the higher the quality of life associated with psychological and social relationships. The more interested someone was in how to spend time alone, the higher the quality of life in all domains significantly. CONCLUSION: We can minimize the negative impacts of COVID-19 by maintaining economic stability, maintaining prosocial behaviors related to personal hygiene and making good use of personal time.

The Prevalence of Depression, Anxiety and Associated Factors among the General Public during COVID-19 Pandemic: a Cross-sectional Study in Korea.

BACKGROUND: Since its first case confirmed on January 20, 2020, Korea has been through three waves of the COVID-19 pandemic. Fears of the fourth wave persist as new cases continue to emerge. In such unpredictable times, the mental well-being of people is of crucial importance. This study examined the levels of depression and anxiety and their predictors among the Korean general public in Busan, Korea, during the COVID-19 pandemic. METHODS: We conducted a cross-sectional study via a self-reported questionnaire administered to 2,288 adult residents (aged 19-60 years) of Busan, Korea. Participants' depression and anxiety were assessed using the Korean version of the Patient Health Questionnaire-4 (PHQ-4), which consists of PHQ-2 and Generalized Anxiety Disorder-2 (GAD-2), with the cutoff score of 3. RESULTS: The mean age of the participants was 39.71 years. COVID-19 had several psychosocial impacts on people. It was revealed that 80.3% had restrictions in outside activities, 47.3% reported financial difficulties, and 53.6% had a fear of death or fatal outcome when infected with COVID-19. We performed logistic regression analysis to identify the factors associated with depression and anxiety. A total of 30.7% participants were classified as at risk of depression based on cutoff score of 3 on PHQ-2. Logistic regression analysis revealed that changes in sleep pattern due to COVID-19 were most strongly associated with depression, followed by restrictions in outside activities due to social distancing and increased family conflicts due to COVID-19. Also, 22.6% participants were classified as at risk of anxiety based on a cutoff score of 3 on GAD-2. Analysis revealed that changes in sleep pattern due to COVID-19 were most strongly associated with anxiety, followed by spending a lot of time searching for COVID-19-related information and having a fear of death or fatal outcome when infected with COVID-19. CONCLUSION: The results are alarming; 30.7% had a PHQ-2 score of 3 or higher, indicating depression, and 22.6% had a GAD-2 score of 3 or higher, indicating anxiety. Changes in sleep pattern had the strongest association with both depression and anxiety. Our results can be used to formulate mental health policies tailored to the context of the city. Our findings suggest the high prevalence of depression and anxiety in the society during the COVID-19 pandemic, which places growing importance on early intervention for mental health problems during these times.

Worldwide Survey of COVID-19-Associated Arrhythmias.

[Figure: see text].