[Vaccination willingness and educational level]. / Vaccinatiebereidheid en opleidingsniveau.

Vaccination is an important part of the fight against COVID-19 virus. A predictor of the proportion of people who will actually take a vaccination is the willingness to vaccinate among the population. Literature shows that vaccination willingness among people with lower socioeconomic status is lower than among other groups. In this contribution we describe to what extent this is also the case in the Netherlands and show how risk perception, trust in the effects and safety of the vaccine, and health literacy may be related to this. Finally, we highlight a number of intervention strategies that can make a positive contribution to vaccination willingness among lower educated groups.

The impact of the COVID-19 pandemic on the use of Emergency Departments in Italy.

Background: During 2020, COVID-19 had a diversified distribution in Italy, the first nation in Europe to experience the outbreak of the epidemic. This was linked to geographical differences in population density and distribution of healthcare facilities, including Emergency Departments (EDs). This study aims to assess the impact of the pandemic on ED utilization in 2020 across different subpopulations and geographical locations in Italy. Methods: We used anonymized data from a survey conducted by the Italian National Institute of Statistics on 25,000 families to analyze the yearly rate of people who used EDs from 2015 to 2020. The rate of persons who accessed ED services in 2020 per 1,000 population was compared with those of the previous non-pandemic years. Results: The number of people accessing EDs in 2020 was 32.3% lower, although this reduction was not uniform across the 21 regions / autonomous provinces. People aged 0-14 years experienced the highest reduction in ED visits. In 2020, low educational level people exhibited a steeper reduction in the use of EDs. Conclusions: This study shows a significant drop in EDs use especially by children; the population section mostly affected by the effects of the pandemic. This study also confirms that education and socio-economic status are important determinants of ED use. The heterogeneous reduction in ED use across the regions of Italy highlights the need to further investigate the impact of this pattern on the health of the population, as well as to define adequate preparedness strategies to face future emergencies.

Factors Associated with Anti-SARS-CoV-2 Vaccine Acceptance among Pregnant Women: Data from Outpatient Women Experiencing High-Risk Pregnancy.

Pregnant women are at higher risk of severe Coronavirus disease 2019 (COVID-19) complications than non-pregnant women. The initial exclusion of pregnant women from anti-SARS-CoV-2 vaccines clinical trials has caused a lack of conclusive data about safety and efficacy for this vulnerable population. This cross-sectional study aims to define the factors related to vaccination adherence in a sample of women experiencing high-risk pregnancies. The recruited women completed a questionnaire based on the Health Belief Model. Data were analyzed to evaluate the associations between socio-demographic variables and vaccination acceptance through descriptive, univariate and multivariate logistic analyses. Among the 233 women enrolled, 65.2% (n = 152) declared that they would accept the anti-SARS-CoV-2 vaccine. Multivariate analysis showed that vaccination acceptance was associated with a high educational level (aOR = 4.52, p = 0.001), a low perception of barriers to vaccination (aOR = 1.58, p = 0.005) and the gynecologist's advice (aOR = 3.18, p = 0.01). About a third of pregnant women are still hesitant about the anti-SARS-CoV-2 vaccine, probably because of the conflicting information received from media, friends, acquaintances and health institutions. Determining factors linked to vaccine hesitancy among pregnant women is useful for creating vaccination strategies that increase vaccination uptake.

The difference of primary school teachers' online teaching satisfaction in subject and educational level.

The growth of online education requires high-quality online teaching. Teachers' satisfaction with online teaching is of great significance for improving online teaching effectiveness. This study was to explore the primary school teachers' online teaching satisfaction during the spread of COVID-19 from Shanghai, who have experienced online teaching, and explore whether there were differences of teachers' online teaching satisfaction in subject and educational level. 939 teachers from Shanghai participated in the study. The non-parametric Mann-Whitney U test and Kruskal-Wallis test of variance were performed. Results showed that teachers' online teaching satisfaction was at a high level. Moreover, there was a significant difference in teachers' subject and educational level on online teaching satisfaction. In terms of subject differences of teachers, there were significant differences in resource suitability (RS) among teachers of different subjects. Therefore, it is recommended that each subject should develop the online teaching resources to support teachers' online teaching. In terms of the differences in teachers' educational levels, there were no significant differences between the satisfaction of college-level teachers on non-technical variables such as content selectivity (CS) and teachers with undergraduate and graduate degrees, and only on technical variables such as self-efficacy (SE), resource suitability (RS), ease of use (EU), and intention to use (IU). Given the national context in China, the difference in educational levels may be more reflected in the age of the teachers. For teachers with college educational level, due to their older age, rather than simply enhancing motivation and improving learning ability to increase online teaching satisfaction, emphasis should be placed on providing appropriate teaching service support to help improve online teaching effectiveness. The findings provide new empirical evidence, strategies and Chinese experience for promoting teachers' online teaching satisfaction.

Psychometric properties and measurement invariance of the Vaccination Attitudes Examination Scale (VAX) in a Spanish sample.

In these times of pandemic, the acceptance or rejection of vaccines has become increasingly clear, with a considerable rise in the anti-vaccine movement in Spain. It is important to understand the attitudes that lead a person to refuse vaccination in order to develop more effective public health campaigns. The objective of this study has been to study the psychometric properties and measurement invariance of the Vaccination Attitudes Examination (VAX) scale in a Spanish sample. Confirmatory factor analysis and structural equation modelling have been used to study the psychometric properties of the VAX. Likewise, the measurement invariance by gender and educational level has been studied. The structure of four related factors for VAX is confirmed, as well as its predictive value, since the factor "trust in the benefit of the vaccine" clearly predicts the choice to be vaccinated. The strong measurement invariance by gender and educational level is also confirmed. The comparison of latent means between groups indicates that there are no differences by gender in any factor. However, people with a high educational level present higher scores in factors "concern about unforeseen future effects", "concern about commercial effects and speculation" and "preference for natural immunity". The VAX is presented as a reliable and valid tool to assess four different factors related to attitudes towards vaccines in Spain. Future studies of its cross-cultural invariance may help to determine the main factors that lead people not to be vaccinated in order to develop more effective public health campaigns.

Impact of socioeconomic status on the clinical outcomes in hospitalised patients with SARS-CoV-2 infection: a retrospective analysis.

Aim: A disadvantaged socioeconomic status (SES) was previously associated with higher incidence and poor outcomes both of non-communicable diseases (NCDs) and infectious diseases. Inequalities in health services also have a negative effect on the coronavirus disease 2019 (COVID-19) morbidity and mortality. Subject and methods: The study analysed the role of SES measured by the educational level (EL) in hospitalised patients with COVID-19 between 9 March 2020 and 20 September 2021 at our centre of infectious diseases. Clinical outcomes were: length of hospitalisation, in-hospital mortality and the need of intensive-care-unit (ICU) support. Results: There were 566 patients included in this retrospective analysis. Baseline EL was: illiterate (5, 0.9%), primary school (99, 17.5%), secondary school (228, 40.3%), high school (211, 37.3%), degree (23, 4.1%); median age was higher in low EL (72.5 years vs 61 years, p = 0.003), comorbidity (56% in low EL, 34.6% in high EL, p < 0.001), time from the symptoms and PCR diagnosis (8.5 days in low EL, 6.5 days in high EL, p < 0.001), hospitalisation length (11.5 days in low EL, 9.5 days in high EL, p = 0.011), mortality rate (24.7% in low EL, 13.2% in high EL, p < 0.001). In the multivariate analysis there were predictors of mortality: age (OR = 4.981; 95%CI 2.172-11.427; p < 0.001), comorbidities (OR = 3.227; 95%CI 2.515-11.919; p = 0.007), ICU admission (OR = 6.997; 95%CI 2.334-31.404; p = 0.011), high vs low EL (OR = 0.761; 95%CI 0.213-0.990; p = 0.021). In survival analysis, higher EL was associated with a decreased risk of mortality up to 23.9%. Conclusion: Even though the EL is mainly related to the age of patients, in our analysis, it resulted as an independent predictor of in-hospital mortality and hospitalisation time. Unfortunately, this is a study focused only on hospitalised patients, and we did not examine the possible effect of EL in outpatients. Further analyses are required to confirm this suggestion and provide novel information.

On What Tasks Did Children between the Ages of 3 and 12 Years Spend Their Time during the COVID-19 Pandemic? An International Comparative Study between Ibero-America and Europe.

The pandemic caused by COVID-19 meant, in many countries, the establishment of a period of confinement in which families were forced to restrict movement and social contacts with the consequent risk of inactivity. Our objective as to analyze the degree of psychosocial well-being, sociodemographic aspects and use of technological means depending on the educational level of the parents. The sample consisted of 2316 children aged between 3 and 12 years (M = 7.70; SD = 2.86). For the analysis and treatment of the data, the statistical software SPSS 25.0 (IBM Corp, Armonk, NY, USA) was used. We found that the European participants used more video consoles (M = 0.89 ± 1.33) and tablets (M = 1.30 ± 0.95), while the Ibero-Americans obtained higher values in the use of TV (M = 2.28 ± 1.10) and levels higher in a negative state of psychosocial well-being (M = 7.29 ± 1.07) and in tiredness/fatigue (M = 4.34 ± 2.44). We concluded that, during the period of confinement in European areas, higher values were obtained in the time dedicated to Physical Activity (PA), use of tablets, school task performance, artistic activities, family games, reading, free play and hours of sleep; while in Ibero-America, there were longer times in the use of technological devices and performing domestic tasks.

Socio-economic inequalities in physical activity among Japanese adults during the COVID-19 pandemic.

OBJECTIVES: This study aimed to explore the socio-economic inequalities in physical activity (PA) based on domains of daily life, such as work, transport, recreation and sedentary life, among Japanese adults during the COVID-19 pandemic. STUDY DESIGN: This was a cross-sectional study. METHODS: This study used data from the 2020 National Sport and Lifestyle Survey, conducted by the Sasakawa Sports Foundation. Data of 2,296 (1,103 women) participants were analysed. PAs were assessed using the Global Physical Activity Questionnaire. Educational level and household income were used as indicators of socio-economic status. We calculated the slope index of inequality (SII) and relative index of inequality (RII). RESULTS: We detected absolute and relative inequalities for household income in all PA domains, except for work-related PA. The higher the participants' income, the longer they engaged in transport- and recreation-related PA and sedentary behaviour. Recreation-related PA had a larger disparity than other domains, with SII at 20.8% (95% confidence interval [CI] -28.4 to -13.1) and RII at 0.58 (95% CI 0.47-0.71). At the educational level, each inequality was observed in work- and recreation-related PA and sedentary behaviour. The higher the participants' educational level, the longer they engaged in recreation-related PA and sedentary behaviour. However, work-related PA was longer at lower educational levels, with RII at 1.90 (95% CI 1.48-2.44). The inequality in recreation-related PA was also relatively large (SII 23.3%, 95% CI -30.9 to -15.7; RII 0.54, 95% CI 0.45-0.66). CONCLUSION: Our study revealed significant socio-economic disparities in each PA domain, particularly in recreational PA. These results suggest a widening gap because of the COVID-19 pandemic.

& para;EDUCATIONAL LEVEL, TEMPORALITY AND REGULATIONS OF EMPLOYMENT IN SPAIN FOR THE PERIOD 2002-2020. SPECIAL REFERENCE TO THE DIFFERENCES BETWEEN WOMEN AND MEN

This paper focuses on analyzing the differences between women and men in terms of employment, temporary employment and the influence of educational level, in a period covering both the 2008 and the COVID-19 crisis. It also studies the evolution and changes in labor regulations in the Spanish labor market, in order to identify the influence of new regulations on the labor market situation. The analysis is mainly based on Pearson correlations between the different indicators: percentage of employed people in the labor force, the temporary employment rate and the education rate of employed population (IEPO). The results of the analysis allow us to conclude that a higher level of education favors the attainment and maintenance of employment, especially among women. However, although the 2008 crisis has particularly affected those with lower education rate, as it has progressed, those with higher levels of education have also lost their employment. On the other hand, the data shows that temporary employment is associated with low levels of education, both for men and women. However, it has not been possible to demonstrate an increase in temporary employment during the crisis period, since, on the contrary, there has been a decrease in the temporary employment rate, probably due to the destruction of employment among those with temporary contracts, in both the 2008 economic crisis and the COVID-19 crisis. Finally, the growth in the rates of temporary employment and the total employment has been driven mainly by periods of economic expansion.

COVID-19-Related Mental Health Burdens: Impact of Educational Level and Relationship Status Among Low-Income Earners of Western Uganda.

Objective: The study aimed to investigate the relationship between mental health with the level of education, relationship status, and awareness on mental health among low-income earners in Western Uganda. Methods: This was a cross-sectional descriptive study carried out among 253 participants. Anxiety, anger, and depression were assessed using a modified generalized anxiety disorder (GAD-7), Spielberger's State-Trait Anger Expression Inventory-2, and Beck Depression Inventory item tools, respectively. Results: The majority of our respondents were male (n = 150/253, 59.3), had a secondary level of education (104/253, 41.1), and were single (137/253, 54.2). No formal education and primary education (r2 = 47.4% and 6.4%, respectively) had a negative correlation with awareness of mental health care. In addition, no formal education had a positive correlation with anger and depression (r2 = 1.9% and 0.3%, respectively). Singleness in this study had a negative correlation with awareness of mental health care, anger, and depression (r2 = 1.9, 0.8, and 0.3%, respectively), and a positive correlation with anxiety (r2 = 3.9%). Conclusion: It is evident that education and relationship status influenced awareness on mental health care and mental health state among low-income earners in Western Uganda during the first COVID-19 lockdown. Therefore, policymakers should strengthen social transformation through the proper engagement of low-income earners in this COVID-19 era.