The practice of drug emergency supply in China from a policy mix perspective (preprint)

Background This study aims to analyze relevant policy texts, explore and determine the focal points and inadequacies of the Chinese government in guaranteeing supplies of medicines, and provide advice on how to make better policies about drug supply when public health emergencies occur.Methods We selected 559 documents that guided the support of drug supply during emergencies issued by governments at both the national and provincial levels from December 1, 2019, to February 28, 2023. In addition, we developed a four-dimensional analysis framework of the issuing agency, issuing period, policy tools, and drug supply chain to analyze specific policy items, determine their basic characteristics, and quantitatively analyze them from a policy mix perspective.Results The analysis using policy tools showed that the national government tended to call on stakeholders in all aspects of drug supply to fulfil their responsibilities, and both national and provincial governments tended to use incentive tools, such as opening up urgent drug supply tracks and applying financial incentives to promote drug supply. However, managing stakeholders’ behaviors in drug supply and the capacity building to guarantee drug supply are still lacking and require improvement. From the perspective of the drug supply chain, the national government has paid much attention to the distribution of drugs, whereas attention to the supply of drug substances has been lacking. As various stages of the COVID-19 pandemic, the number of policies related to drug supply increased slowly after a surge at the beginning of the pandemic and then rapidly decreased. From the policy mix perspective, the analysis showed that incentives were lacking in drug research and development, and capacity building was not discussed much in the drug manufacturing process.Conclusions We suggest enhancing the complementarity and cohesion of the policy content issued by national and provincial governments, strengthening the coordination and connection between policymaking bodies, optimizing the internal structure of policy tools, improving the performance of various policy strategies, and using appropriate policy tools to create policies suited to various stages of emergencies and drug supply chains.

Continuous evolution and emerging lineage of seasonal human coronaviruses: A multicenter surveillance study.

The seasonal human coronaviruses (HCoVs) have zoonotic origins, repeated infections, and global transmission. The objectives of this study are to elaborate the epidemiological and evolutionary characteristics of HCoVs from patients with acute respiratory illness. We conducted a multicenter surveillance at 36 sentinel hospitals of Beijing Metropolis, China, during 2016-2019. Patients with influenza-like illness (ILI) and severe acute respiratory infection (SARI) were included, and submitted respiratory samples for screening HCoVs by multiplex real-time reverse transcription-polymerase chain reaction assays. All the positive samples were used for metatranscriptomic sequencing to get whole genomes of HCoVs for genetical and evolutionary analyses. Totally, 321 of 15 677 patients with ILI or SARI were found to be positive for HCoVs, with an infection rate of 2.0% (95% confidence interval, 1.8%-2.3%). HCoV-229E, HCoV-NL63, HCoV-OC43, and HCoV-HKU1 infections accounted for 18.7%, 38.3%, 40.5%, and 2.5%, respectively. In comparison to ILI cases, SARI cases were significantly older, more likely caused by HCoV-229E and HCoV-OC43, and more often co-infected with other respiratory pathogens. A total of 179 full genome sequences of HCoVs were obtained from 321 positive patients. The phylogenetical analyses revealed that HCoV-229E, HCoV-NL63 and HCoV-OC43 continuously yielded novel lineages, respectively. The nonsynonymous to synonymous ratio of all key genes in each HCoV was less than one, indicating that all four HCoVs were under negative selection pressure. Multiple substitution modes were observed in spike glycoprotein among the four HCoVs. Our findings highlight the importance of enhancing surveillance on HCoVs, and imply that more variants might occur in the future.

Characteristics of viral shedding in people infected with SARS-CoV-2 during difference stages

Viral shedding of SARS-CoV-2 is a continuous dynamic process, which can be divided into latent stage, initial stage, peak stage and decreasing stage according to the characteristics of viral shedding. After being infected with SARS-CoV-2, the infected person generally stays in the latent period for 1-3 days, which is characterized by continuous negative nucleic acid test results and no infectiousness, and the risk of infection for close contacts is very low. At the initial stage of viral shedding is characterized by a rapid decline in the Ct value of nucleic acid tests in a short time, and clinical symptoms gradually appear. The infectiousness of the infected person gradually increases during this period, and the risk of infection for close contacts also gradually increases, but it is still in the early stage of infection, the possibility of viral shedding is low, and the risk of infection of secondary close contacts is low. The peak of viral shedding is characterized by low Ct value in nucleic acid test and obvious clinical symptoms;during this period, the infected person is the most infectious, and the risk of infection of the contact is the highest, so the scope of close contacts should be expanded appropriately. The decreasing period is characterized by the gradual increase of Ct value of nucleic acid test and the gradual disappearance of clinical symptoms;during this period, the infectiousness of the infected person gradually decreases to disappear. In an outbreak, an infected person in the decreasing phase is more likely to be an early infected person in the transmission chain. If infected individuals in the decreasing phase are found in an area without a SARS-CoV-2 epidemic, it suggests that the local outbreak epidemic has been spreading for some time and may be larger in scale. According to the characteristics of viral shedding, risk personnel can be determined more scientifically and accurately, so as to minimize the risk and reduce the waste of epidemic prevention resources.

Identification of potential targets against SARS-CoV-2 of antiviral drugs based on photoaffinity probes.

Facing the sudden outbreak of coronavirus disease 2019 (COVID-19), it is extremely urgent to develop effective antiviral drugs against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Drug repurposing is a promising strategy for the treatment of COVID-19. To identify the precise target protein of marketed medicines, we initiate a chemical biological program to identify precise target of potential antivirus drugs. In this study, two types of recombinant human coronavirus SARS-CoV-2 RdRp protein capturing probes with various photoaffinity labeling units were designed and synthesized based on the structure of FDA-approved drugs stavudine, remdesivir, acyclovir, and aladenosine. Fortunately, it was found that one novel photoaffinity probe, RD-1, could diaplayed good affinity with SARS-CoV-2 RdRp around the residue ARG_553. In addition, RD-1 probe also exhibited potent inhibitory activity against 3CLpro protease. Taken together, our findings will elucidate the structural basis for the efficacy of marketed drugs, and explore a rapid and efficient strategy of drug repurposing based on the identification of new targets. Moreover, these results could also provide a scientific basis for the clinical application of marketed drugs.

Reconceptualising digital pedagogy during the COVID-19 pandemic: A qualitative inquiry into distance teaching in China

Digital pedagogy was used as a contingency plan to achieve teaching and learning during the COVID-19 pandemic. This study aimed to observe digital pedagogy in lecturers' online teaching practices and instructional supervisors' evaluations of teaching outcomes. A sample of 32 lecturers and instructional supervisors from three Chinese universities participated in the in-depth interviews. The thematic analysis approach of grounded theory was used in data analysis. The results show that pedagogical dimensions were extended. Besides technology, innovative pedagogy, and learning environments, this study added two constructs: sustained support and cyber safety. Collaboration is required at different levels;meanwhile, cyber safety is highlighted to ensure healthy digital learning environments. [ FROM AUTHOR] Copyright of Innovations in Education & Teaching International is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Financial resilience of two-worker households from a health perspective

The COVID-19 pandemic highlighted the significant impact of health conditions on household finance. Traditional measures of financial resilience ignored households' ability to adjust to labor income disruptions. We proposed a more comprehensive two-tier measure of financial resilience by accounting for nonlabor income and spending adjustments in the face of income loss associated with health situations. Using this measure, we evaluated the financial resilience of two-worker households with members having COVID-19 health risk conditions and other mental and physical chronic diseases. Our findings showed that households with cancer patients were more financially resilient yet those having obese members were less financially resilient. Decomposition of the financial resilience measure revealed differences in financial resources allocation-households with cancer patients allocated more wealth to noncash financial assets, whereas households with obese members saved less and spent more. Our findings shed light on financial planning practices and public policies of emergency assistance. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

The Multifaceted Role of Glutathione S-Transferases in Health and Disease.

In humans, the cytosolic glutathione S-transferase (GST) family of proteins is encoded by 16 genes presented in seven different classes. GSTs exhibit remarkable structural similarity with some overlapping functionalities. As a primary function, GSTs play a putative role in Phase II metabolism by protecting living cells against a wide variety of toxic molecules by conjugating them with the tripeptide glutathione. This conjugation reaction is extended to forming redox sensitive post-translational modifications on proteins: S-glutathionylation. Apart from these catalytic functions, specific GSTs are involved in the regulation of stress-induced signaling pathways that govern cell proliferation and apoptosis. Recently, studies on the effects of GST genetic polymorphisms on COVID-19 disease development revealed that the individuals with higher numbers of risk-associated genotypes showed higher risk of COVID-19 prevalence and severity. Furthermore, overexpression of GSTs in many tumors is frequently associated with drug resistance phenotypes. These functional properties make these proteins promising targets for therapeutics, and a number of GST inhibitors have progressed in clinical trials for the treatment of cancer and other diseases.

Subgroups of self-directed learning ability and their differences in professional identity among nursing undergraduates during the COVID-19 pandemic: a latent profile analysis.

BACKGROUND: Promoting self-directed learning (SDL) among nursing undergraduates is crucial to meet the new requirements of the healthcare system and to adapt to online learning contexts during the COVID-19 pandemic. Therefore, identifying the classification features of SDL ability and developing targeted interventions are both critical. Professional identity (PI) may contribute to the cultivation of SDL ability, but their relationship remains relatively unknown. This study aimed to explore the subgroups of SDL ability and their differences in PI among nursing undergraduates during the COVID-19 pandemic. METHODS: A total of 2438 nursing undergraduates at four universities in China were enrolled in this cross-sectional study from November 2021 to February 2022. The Self-Directed Learning Scale of Nursing Undergraduates (SLSNU) and the Professional Identity Scale for Nursing Students (PISNS) were administered. A latent profile analysis was performed to explore SDL ability latent profiles. Multinomial logistic regression analysis was conducted to examine the predictors of profile membership, and a one-way analysis of variance was applied to compare the PI scores in each latent profile. RESULTS: Three latent profiles were identified and labeled 'low SDL ability' (n = 749, 30.7%), 'low initiative of help-seeking' (n = 1325, 54.4%) and 'high SDL ability' (n = 364, 14.9%). Multinomial logistic regression analysis suggested that nursing undergraduates who voluntarily chose a nursing major, had served as a student cadre, and had participated in clinical practicum were less likely to be included in the "low SDL ability" group. The average PI score was statistically different across the three profiles (F = 884.40, p < 0.001). CONCLUSION: The SDL ability among nursing undergraduates was divided into three profiles, and results show that promoting PI may effectively foster SDL ability. This study highlights the importance of targeted interventions by considering their distinct SDL ability patterns, especially during the COVID-19 pandemic.

The epidemiological features of respiratory tract infection using the multiplex panels detection during COVID-19 pandemic in Shandong province, China.

Respiratory tract infection is one of the most common reasons for both morbidity and mortality worldwide. High attention has been paid to the etiological tracing of respiratory tract infection since the advent of COVID-19. In this study, we aimed to evaluate the epidemiological features of pathogens in respiratory tract infection, especially during COVID-19 pandemic. A total of 7668 patients with respiratory tract infection who admitted to Qilu Hospital of Shandong University from March 2019 to Dec 2021 were retrospectively included. The respiratory tract specimens were detected using a commercial multiplex PCR-based panel assay for common respiratory pathogens including influenza A virus (Flu-A), influenza A virus H1N1 (H1N1), influenza A virus H3N2 (H3N2), influenza B virus (Flu-B), parainfluenza virus (PIV), respiratory syncytial virus (RSV), adenovirus (ADV), Boca virus (Boca), human Rhinovirus (HRV), Metapneumovirus (MPV), Coronavirus (COV), Mycoplasma pneumoniae (MP), and Chlamydia (Ch). The positive rates were compared using a chi-square test. Compared with 2019, the positive rate of pathogen detection during from January 2020 to December 2021 was significantly lower, especially the detection of Flu-A. The positive rate of respiratory pathogen strains was 40.18% during COVID-19 pandemic, and a total of 297 cases (4.69%) of mixed infection with two or more pathogens were detected. There was no statistical difference in the positive rate between male and female patients. However, the positive rates of infection were different among different age groups, with higher incidence of RSV in infancy and toddler group, and MP infection in children and teenager group. While, HRV was the most common pathogen in the adult patients. Moreover, Flu-A and Flu-B were higher in winter, and MP and RSV were higher in spring, autumn and winter. The pathogens such as ADV, BOCA, PIV, and COV were detected without significant seasonal distribution. In conclusion, respiratory pathogen infection rates may vary by age and season, regardless of gender. During the COVID-19 epidemic, blocking transmission routes could help reduce the incidence of respiratory tract infection. The current prevalence of respiratory tract infection pathogens is of great significance for clinical prevention, diagnosis and treatment.

Comparative Study on Socio-Spatial Structures of the Typical Plain Cities of Chengdu and Beijing in Transitional China

China's socioeconomic transformation and rapid urbanization since the end of the 20th Century have had an important impact on the social spatial structure of large cities. Social differentiation within cities is becoming increasingly prominent. Using detailed data gathered by the Fifth National Population Census of 2000, this study compares the social spatial structure and dynamic mechanisms of the core areas of the cities of Beijing and Chengdu. Factorial ecology analysis is used at the mesoscale to explore the following research questions: ‘How did factors shape the social spaces of two cities with similar topography but at different stages of development during China's transition from a planned to a market economy?';and ‘Are the traditional Western theories of socio-spatial interpretation equally applicable to China?'. The results show that Chengdu exhibits a combination of a concentric circle, fan-shaped, and multi-core socio-spatial structure, while Beijing shows a fan-shaped structure. In 2000, influenced by its overall level and stage of socioeconomic development, Beijing was experiencing a faster socio-spatial transformation than Chengdu, and the driving effect of capital on social differentiation and spatial competition was more obvious. The main dynamic mechanisms driving the formation of socio-spatial structures in Beijing and Chengdu include the natural environmental foundation, historical inheritance, urban planning, housing policies, and international influence. The three major variables in the study of traditional Western social spaces, namely economy, family, and ethnic status, were confirmed as applicable to our two case study cities with socioeconomic status as measured by occupation and housing conditions exerting the strongest effect. This perspective of comparing different cities in the same transitional period offers unique insights in identifying the key drivers of socio-spatial differentiation and polarization and their relative magnitude of effect, while enriching the catalog of empirical urban social space research both in China and in the rest of the world.

Reconceptualising digital pedagogy during the COVID-19 pandemic: A qualitative inquiry into distance teaching in China: Journal of the Association for Programmed Learning

Digital pedagogy was used as a contingency plan to achieve teaching and learning during the COVID-19 pandemic. This study aimed to observe digital pedagogy in lecturers' online teaching practices and instructional supervisors' evaluations of teaching outcomes. A sample of 32 lecturers and instructional supervisors from three Chinese universities participated in the in-depth interviews. The thematic analysis approach of grounded theory was used in data analysis. The results show that pedagogical dimensions were extended. Besides technology, innovative pedagogy, and learning environments, this study added two constructs: sustained support and cyber safety. Collaboration is required at different levels;meanwhile, cyber safety is highlighted to ensure healthy digital learning environments.

Impact of the COVID-19 Pandemic on Outpatient Service in Primary Healthcare Institutions: An Inspiration From Yinchuan of China.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has posed a great challenge to the healthcare system. This study evaluated the impact of the pandemic on the utilization of primary healthcare (PHC). METHODS: The outpatient data from 158 PHC institutions in Yinchuan from May 1, 2017 to April 30, 2020 were used. The difference in difference (DID) model was used to analyze the difference in the number of outpatient visits per day, total outpatient expenditure per day, and outpatient expenditure per visit between December 2019 and February 2020 compared with the same periods in two previous years. The autoregressive integrated moving average (ARIMA) modelling was used to investigate the association between the outpatient volume and the number of the last week's new COVID-19 cases in Yinchuan, Ningxia, and China. RESULTS: From December 2019 to February 2020, the decline in the number of outpatient visits per day (DID: -367.21 times, P=.004) was larger than that in two previous years, and a similar trend can be seen in the outpatient expenditure per day. However, the rise in the outpatient expenditure per visit (DID: 19.06 thousand yuan, P=.003) was larger than that in two previous years. In 2020, the outpatient visits for most types of diseases decreased from week 3 and rebounded after week 5. The decline and rebound of outpatient visits in the population aged 45 years and older were steeper than in those younger. The outpatient volume was negatively associated with the number of the last week's new COVID-19 cases. CONCLUSION: This study indicated a significant impact of the pandemic on PHC service utilization. Since PHC service is the foundation of the healthcare system in most developing countries, measures should be taken to make PHC help cope with the crisis and relieve the burden of hospital care.

Variation in synonymous evolutionary rates in the SARS-CoV-2 genome.

Introduction: Coronavirus disease 2019 is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Influential variants and mutants of this virus continue to emerge, and more effective virus-related information is urgently required for identifying and predicting new mutants. According to earlier reports, synonymous substitutions were considered phenotypically silent; thus, such mutations were frequently ignored in studies of viral mutations because they did not directly cause amino acid changes. However, recent studies have shown that synonymous substitutions are not completely silent, and their patterns and potential functional correlations should thus be delineated for better control of the pandemic. Methods: In this study, we estimated the synonymous evolutionary rate (SER) across the SARS-CoV-2 genome and used it to infer the relationship between the viral RNA and host protein. We also assessed the patterns of characteristic mutations found in different viral lineages. Results: We found that the SER varies across the genome and that the variation is primarily influenced by codon-related factors. Moreover, the conserved motifs identified based on the SER were found to be related to host RNA transport and regulation. Importantly, the majority of the existing fixed-characteristic mutations for five important virus lineages (Alpha, Beta, Gamma, Delta, and Omicron) were significantly enriched in partially constrained regions. Discussion: Taken together, our results provide unique information on the evolutionary and functional dynamics of SARS-CoV-2 based on synonymous mutations and offer potentially useful information for better control of the SARS-CoV-2 pandemic.

Effect of COVID-19 on non-performing loans in China.

We examine the resilience of Chinese banks during the COVID-19 pandemic by investigating non-performing loan (NPL) ratios. We find that despite the reduction in the growth rate of total bank lending, bank NPL ratios significantly increase during the COVID-19 crisis. Banks with high-quality capital are more effective in controlling their NPL ratios during the Crisis. Big Five banks, state-owned banks and domestic banks have lower NPL ratios than their counterparts during the Crisis.

Decade-low aerosol levels over the Bohai and Yellow Seas amid the COVID-19 lockdown.

Coronavirus disease 2019 (COVID-19) has crucially influenced anthropogenic activities, which in turn impacts upon the environment. In this study, we investigated the variations on aerosol optical depth (AOD) at 550 nm over the Bohai Sea and Yellow Sea during the COVID-19 lockdown (from February to March in 2020) of China mainland based on Moderate-resolution Imaging Spectroradiometer (MODIS) observation by comparing with historical AOD records (2011-2019). Our results show that with the lockdown implementation, the decade-low AOD levels are achieved in February and March 2020 (0.39 ± 0.18 and 0.37 ± 0.19, respectively), which are 22% and 28% (p < 0.01) lower than the average AOD between 2011 and 2019 (0.50 ± 0.08 and 0.52 ± 0.05, respectively). After the lockdown restrictions were relaxed and industrial production gradually resumed, the AOD in April 2020 rebounded to the historical average level. Besides, compared with historical observations (2011-2019), the AOD temporal variability from February to April 2020 showed different pattern, with the decade-high increase from March to April (+0.11) and decade-low increase from February to March (-0.01). Independent observations and simulation, including fine particulate matter (PM2.5) from ground-based measurements, wind field from Cross-Calibrated Multi-Platform, satellite-derived aerosol type, and back trajectories calculation by Hybird Single Paricle Lagrangian Intergrated Trajectory (HYSPLIT) model, indicated that the above abnormal AOD variation can be attributed to reduction of anthropogenic emissions during the COVID-19 lockdown period. The results of this paper, therefore, indicate that aerosols over the Bohai and Yellow Seas are strongly influenced by human activities, and the public health events such as the epidemic may alter the intensity of human activities and thus the spatio-temporal pattern of aerosol over ocean. With the global spread of the epidemic and the corresponding significant changes in human behavior patterns (restrictions on human activities, etc.), more studies should be carried out in the future about the aerosol variability and its potential impact on the marine environment.

Surveillance of SARS-CoV-2 at the Huanan Seafood Market.

SARS-CoV-2, the causative agent of COVID-19, emerged in December 2019. Its origins remain uncertain. It has been reported that a number of the early human cases had a history of contact with the Huanan Seafood Market. Here we present the results of surveillance for SARS-CoV-2 within the market. From January 1st 2020, after closure of the market, 923 samples were collected from the environment. From 18th January, 457 samples were collected from 18 species of animals, comprising of unsold contents of refrigerators and freezers, swabs from stray animals, and the contents of a fish tank. Using RT-qPCR, SARS-CoV-2 was detected in 73 environmental samples, but none of the animal samples. Three live viruses were successfully isolated. The viruses from the market shared nucleotide identity of 99.99% to 100% with the human isolate HCoV-19/Wuhan/IVDC-HB-01/2019. SARS-CoV-2 lineage A (8782T and 28144C) was found in an environmental sample. RNA-seq analysis of SARS-CoV-2 positive and negative environmental samples showed an abundance of different vertebrate genera at the market. In summary, this study provides information about the distribution and prevalence of SARS-CoV-2 in the Huanan Seafood Market during the early stages of the COVID-19 outbreak.

The applicability and efficacy of Micro-Video Psychological Training Camp in groups with mild to moderate symptoms of depression and anxiety: A prospective and randomized controlled trial protocol.

Background: Mental health is a global issue requiring global attention. Depression and anxiety are two of the most common mental disorders (CMDs) and are characterized by high incidence and high comorbidity. In recent years, the prolonged COVID-19 pandemic and exacerbated social instability have posed significant challenges to the mental resilience and mental health outcomes of the global population. Now more than ever, with an increase in mental health needs, it has become even more crucial to find an effective solution to provide universal mental healthcare. Psychotherapy is of vital importance for those coping with symptoms of depression and anxiety and is used to enhance mental resilience. However, such therapy can be difficult to access in reality. In this context, the Micro-Video Psychological Training Camp (MVPTC) platform will be developed. Objectives: As an online self-help platform for psychological intervention, the MVPTC platform was developed for those who suffer from mild to moderate symptoms of depression and/or anxiety and is tasked with the goal of reducing depressive and anxious symptoms while improving mental resilience. Thus, this study will be carried out to verify its efficacy and applicability. Methods: In this parallel-group, randomized controlled trial, a total of 200 mild to moderately depressed and/or anxious adults seeking self-help will be randomly recruited and assigned to either the micro-video psychological intervention group or the wait list control group. Online measurements by self-assessment will be taken at baseline, post-intervention, 1-month, and 3-month follow-up. Results: The primary results will involve symptoms of depression and anxiety. The secondary results will involve mental resilience. An analysis will be conducted based on the intention-to-treat principle. Discussion: This trial will examine whether the MVPTC platform for the relief of symptoms and the enhancement of resilience in a population screened for depression and anxiety symptoms proves effective and applicable. Large-scale resilience enhancement may benefit public mental health in terms of preventive interventions, managing depressive and anxiety symptoms, and promoting mental health. With the MVPTC-based method being applied, a brief, efficient, and structured intervention model can potentially be established, having the potential to provide necessary and accessible mental support for an extensive target group. Clinical trial registration: http://www.chictr.org.cn/, identifier ChiCTR2100043725.

Continuous care needs in patients with cancer receiving chemotherapy during the recent omicron wave of COVID-19 in Shanghai: A qualitative study.

Aims: This study aimed to investigate the care needs, to clarify the factors affecting the quality of homecare, and to provide reference for constructing a homecare system for patients with cancer receiving chemotherapy during the recent omicron wave of COVID-19 in Shanghai. Methods: From March to May 2022 when the omicron wave emerged in Shanghai, 50 consecutive patients who received chemotherapy at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, were enrolled, and underwent face-to-face or telephone-based semi-structured interviews regarding continuous care needs. Some of their homecare-givers, caring nurses, and physicians were also interviewed. The Colaizzi method was used for data analysis. Results: Fifty patients, 4 homecare-givers, 4 nurses, and 4 physicians were interviewed. Three themes and six subthemes emerged from analysis of the interviews: The first theme was "Disease management needs," including needs for knowledge of managing adverse events associated with chemotherapy, and needs for treatment-related information. Patients expressed most concern about not being able to go to the hospital for blood review and disease evaluation in time due to the outbreak. With the COVID-19 pandemic being ongoing, factors such as pandemic panic, inconvenient medical treatment, and worry about hospital cross-infection might reduce disease management for patients with cancer. The second theme was "Medical needs," including needs for mobile healthcare and needs for medical resources. All interviewees emphasized the importance of mobile healthcare during the COVID-19 pandemic, as access to hospitals was difficult. The third theme was "Spiritual needs," including demands for psychological counseling and intervention, and needs for spiritual care. Patients and homecare-givers commonly lacked a feeling of security and needed communication, encouragement, and reassurance that medical care could be delivered to them, and patients reported that they very much wanted psychological advice. Conclusion: For patients with cancer receiving chemotherapy during the COVID-19 pandemic, continuous care is greatly needed. Medical personnel should strengthen the healthcare education for patients and their caregivers during hospitalization, and further improve the patients' information intake rate through Internet-based digital healthcare methods during homecare, to further meet the information needs of patients after discharge from hospital.

Effects of COVID-19 pandemic on mental health among frontline healthcare workers: A systematic review and meta-analysis.

Background: As some countries announced to remove Coronavirus Disease 2019 (COVID-19) border, it indicates that the COVID-19 may have entered its terminal stage. In this COVID-19 pandemic, the mental health of frontline healthcare workers (HCWs) experienced unprecedented challenges. However, the impact of the COVID-19 pandemic on mental health among frontline HCWs lacks a high-quality and long-term systematic review and meta-analysis. Methods: We conducted a systematic review and meta-analysis according to PRISMA guidelines. The system searches EMBASE, MEDLINE, PsycINFO, Cochrane Library, ScienceNet, and ERIC. Analyze the mental health problems of frontline HCWs in different regions and periods, including insomnia, stress, anxiety and depression. This study was registered in PROSPERO under the number CRD42021253821. Results: A total of 19 studies on the effects of COVID-19 pandemic on mental health among frontline HCWs were included in this study. The overall prevalence of insomnia was 42.9% (95% CI, 33.9-51.9%, I 2 = 99.0%) extracted from data from 14 cross-sectional studies (n = 10 127), 1 cohort study (n = 4,804), and 1 randomized controlled trial (RCT; n = 482) in 10 countries. The overall prevalence of stress was 53.0% (95% CI, 41.1-64.9%, I 2 = 78.3%) extracted from data from nine cross-sectional studies (n = 5,494) and 1 RCT study (n = 482) from eight countries. The overall prevalence of anxiety and depression was 43.0% (95% CI, 33.8-52.3%, I 2 = 99.0%) and 44.6% (95% CI, 36.1-53.1%, I 2 = 99.0%) extracted from data from 17 cross-sectional studies (n = 11,727), one cohort study (n = 4,804), and one RCT study (n = 482) from 12 countries. The prevalence of stress and depression was higher in 2020, while the prevalence of insomnia and anxiety was higher in 2021. The prevalence of mental health problems among physicians was higher than that of other frontline HCWs. The prevalence of mental health problems among frontline HCWs is higher in South America and lower in North America. Conclusions: This systematic review and meta-analysis showed that the COVID-19 pandemic have significant effects on mental health among frontline HCWs. The overall prevalence of insomnia, stress, anxiety and depression among frontline HCWs is high. Therefore, the health policy-makers should pay attention to and respond to the mental health problems of frontline HCWs in the context of public health emergencies. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/.