Child, adolescent, and parent mental health in general population during a year of COVID-19 pandemic in belgium: a cross-sectional study

Background: This study aims to evaluate the mental health status of children, adolescents and their parents during the first year of COVID-19 pandemic in Belgium. Method(s): Analysis compared results before and during the second national lockdown, which started on November 2nd 2020. A cross-sectional online survey was conducted between May 2020 and April 2021. Result(s): Two hundred and eighteen adults and 273 children fully completed the survey. Almost one in five children (17.9%) presented moderate-to-severe scores of depression. Adolescents presented a higher level of depression than children (p = 0.007). The rate of moderate-to-severe depression scores (10.8% to 21%, p = 0.007) and internalized symptoms increased during the second lockdown (p < 0.001). Parents' depression (p < 0.001) and anxiety (p = 0.027) levels also increased during the second lockdown. Logistic regression showed that the use of psychotropic medication in parents and parents' depression scores were risk factors for children to have worse depression scores. Conclusion(s): The second lockdown appears to worsen the effects of the pandemic on children's and parents' mental health. There is a need to implement specific interventions targeting both children/adolescents and their parents to support them during lockdown periods and improve mental health outcomes.Copyright © 2022, The Author(s).

Impact of COVID-19 Lock Down on Quality of Life among Primary Caregivers of Individuals with Schizophrenia in Rural Areas

BACKGROUND: The lockdown would become the primary strategy for facing covid-19 as it quickly mutates which might cause repeated pandemics;however, it negatively affects individuals' quality of life (QOL). The schizophrenia caregivers experience considerable stress. The research on the impact of the COVID-19 lockdown on QOL of schizophrenia caregivers is essential, especially for those who reside in rural areas. AIM: This study aimed to investigate the impact of lockdown-related COVID-19 on QOL among primary caregivers of schizophrenia patients living in a rural area. METHOD(S): This study recruited 204 primary caregivers (15-79 years). This study used the World Health Organization Quality of Life instrument (WHOQOL-BREF) to asses QOL's primary caregiver. Evaluate the possible change in caregivers' QOL before and during the COVID-19 lockdown using paired t-test for repeated measures. RESULT(S): The mean age of the caregivers was 46.61 years (SD = 12.79), ranging from 15 to 79 years, with a preponderance of male (54.5%), aged 38-47 years old (29.7%), married (81.2%), employed (57.4%), and had senior high school level of education (34.7%). Majority were parents (26.2%) of the ill relative, and took care of the patients more than 5 years (52.5%). There was a statistical difference (p < 0.05) in caregivers' QOL between before and during the COVID-19 lockdown, including in physical health, psychological, social relationships, and environment domain. CONCLUSION(S): Implementing a lockdown policy related to COVID-19 has negatively impacted the caregivers' QOL. The degradation of caregivers' QOL showed from before to during COVID-19 lockdown. Further study needs to explore the QOL of other mental illness caregivers regarding COVID-19 lockdown. This finding becomes a reference for a government to modify some policy-related lockdowns to minimize their negative impact.Copyright © 2023 Utomo Utomo, Eko Mulyadi, Endang Fauziyah.

Finding new purpose for vacancies in rural areas: a taxonomy of coworking space business models

As a result of the rural exodus over the last decades, unused vacancies in rural areas are at risk of falling into disrepair. Given the current trends of flexible workplaces and people returning to rural areas, their repurposing as coworking spaces (CWSs) by entrepreneurs poses a potential for sustainable future-oriented workplace solutions. However, there is little to no guidance on the structural configuration and business models of CWSs in rural areas available for these entrepreneurs. We apply a structured empirical research approach to create a comprehensive and specialized taxonomy, including a literature review and eleven interviews with operators of rural CWSs in Germany. The resulting taxonomy of business models of CWSs in rural areas based on an extension of the business model canvas contributes to the knowledge base on rural CWSs. We evaluate its usability through a case study and an entrepreneurial operator of a rural CWS, underlining its entrepreneurial and practice-oriented purpose. The study addresses several urgent topics, such as the future of work and new work (places), which enable and accelerate the development of CWSs outside agglomerations consequential to the COVID-19 pandemic. It also promotes social and sustainable entrepreneurship and the revitalizing, enhancing, and increasing of digital accessibility of rural regions.

Perceptions of COVID-19 Vaccines Side Effects

BACKGROUND: Vaccines are one of the best interventions developed for eradicating COVID-19. In Albania, COVID-19 vaccination uses different types of vaccines: Pfizer, AstraZeneca, CoronaVac, and Sputnik V. Like any other vaccine, these have side effects too. AIM: This study was carried out to identify the perception of the side effects of vaccines. METHOD(S): A quantitative study using a cross-sectional survey was conducted between April and September 2021 to collect data on the effects of the COVID-19 vaccine among individuals in Shkodra region. Data were collected online through a self-administered survey created on Google Forms which had been randomly delivered to individuals (aged >=18 years) using social media sites (Email and WhatsApp). All data collected were analyzed with Microsoft Office Excel 2010, using the exact Fisher's test and x2 test. RESULT(S): This study included 292 citizens, out of which 200 were female and 92 were male;62% were from urban areas and 38% from rural areas of Shkodra region. The random sample of the citizens who took part in this study is 44.5% (18-30 years old). A massive percentage of the participants, 66.4%, had received the second dose of the vaccine. Our study shows that 55.8% of these citizens have had side effects after the first vaccination dose, and only 43.8% have had side effects after the second dose. About 80.6% of the participants were well informed about the type of vaccine they got. CONCLUSION(S): Side effects from vaccines were reported. Injection site pain and fatigue were the most common first dose side effects (55.8%). The same side effects were reported for the second dose. The side effects were presented during the first 12 h after the vaccination in most cases. Side effects were more prevalent in people >50 years old. Older people have a higher probability to have more side effects from the COVID vaccine. There is no statistically significant relationship between gender and the presence of the side effect from the COVID vaccine. People living in urban areas have a higher probability to have side effect from COVID vaccine comparing with people living in rural areas. People being vaccinated with Pfizer vaccine have a higher probability to admit the presence of side effects.Copyright: © 2022 Zamira Shabani, Arketa Guli, Julian Kraja, Arlinda Ramaj, Nertila Podgorica.

Determinants of domestic violence against women: Evidence from Khulna District of Bangladesh

Domestic violence against women is a major social problem in Bangladesh. This paper examines the determinants of domestic violence in Bangladesh during the COVID-19 pandemic. The project was carried out in selected areas of Khulna district of the country and followed survey research design. A total of 312 ever married female respondents who experienced domestic violence at any stage of their life were surveyed. The respondents were selected through simple random sampling as a semi-structured questionnaire/ interview schedules was used as the primary tool for data collection. The data were collected in two stages between the months of May-October, 2021 through face-to-face interviews. Results from the chi-square analysis show that, respondents' residence, educational status, age at first marriage, duration of marriage life, husband's income, husband's occupation, and a demand for dowry were all associated with domestic violence against women (p <.01). The study concludes that creation of awareness and empowerment of women through income generating activities particularly in the rural areas of Bangladesh is necessary to reduce the prevalence of domestic violence.Copyright © Nova Science Publishers, Inc.

Lung cancer screening use before & during the COVID-19 pandemic in the US: Population-based evidence from 2019-2021

Introduction: Lung cancer is the leading cause of cancer-related death in the US with an estimated 236,740 new cases and 130,180 deaths expected in 2022. While early detection with low-dose computed tomography reduces lung cancer mortality by at least 20%, there has been a low uptake of lung cancer screening (LCS) use in the US. The COVID-19 pandemic caused significant disruption in cancer screening. Yet, little is known about how COVID-19 impacted already low use of LCS. This study aims to estimate LCS use before (2019) and during (2020 and 2021) the COVID-19 pandemic among LCS-eligible population in the US. Method(s): We used population-based, nationally representative, cross-section data from the 2019 (n=4,484), 2020 (n=1,239) and 2021 (n=1,673) Behavioral Risk Factor Surveillance System, Lung Cancer Screening module. The outcome was self-reported LCS use among eligible adults in the past 12 months. For 2019 and 2020, the eligibility was defined based on US Preventive Services Task Force (USPSTF) initial criteria-adults aged 55 to 80 years old, who were current and former smokers (had quit within the past 15 years) with at least 30 pack years of smoking history. For 2021, we used the USPSTF updated criteria- adults aged 50 to 80 years, current and former smokers (who had quit within the past 15 years) with at least 20 pack years of smoking history. We applied sampling weights to account for the complex survey design to generate population estimates and conducted weighted descriptive statistics and logistic regression models. Result(s): Overall, there were an estimated 1,559,137 LCS-eligible respondents from 16 US states in 2019 (AZ, ID, KY, ME, MN, MS, MT, NC, ND, PA, RI, SC, UT, VT, WV, WI), 200,301 LCS-eligible respondents from five states in 2020 (DE, ME, NJ, ND, SD), and 668,359 LCS-eligible respondents from four states in 2021 (ME, MI, NJ, RI). Among 2,427,797 LCS-eligible adults, 254,890;38,875;and 122,240 individuals reported receiving LCS in 2019, 2020 and 2021, respectively. Overall, 16.4% (95% CI 14.4-18.5), 19.4% (95% CI 15.3-24.3), and 18.3% (95% CI 15.6-21.3) received LCS during 2019, 2020, and 2021, respectively. In all years, the proportion of LCS use was higher among adults aged 65-74, insured, those with fair and poor health, lung disease and history of cancer (other than lung cancer). In 2020, a higher proportion of adults living in urban areas reported receiving LCS compared to those living in rural areas (20.36% vs. 12.7%, p=0.01). Compared to non-Hispanic White adults, the odds of receiving LCS was lower among Hispanic adults and higher among Non-Hispanic American Indian/Alaskan Native adults in 2020 and 2021, respectively. Conclusion(s): LCS uptake remains low in the US. An estimated 2,011,792 adults at high-risk for developing lung cancer did not receive LCS during 2019, 2020 and 2021. Efforts should be focused to increase LCS awareness and uptake across the US to reduce lung cancer burden.

Simulation to Educate Practicing Urologists in Rural Locations: Identifying Strategies to Increase Procedural Adoption

Introduction: The COVID-19 pandemic necessitated proliferation of telesimulation. This pedagogy may be useful in rural areas to increase procedural adoption and reduce healthcare disparities. Our aim was to determine the current status of surgical simulation education to retool rural practicing Urologists. Method(s): Literature search was performed with a trained librarian for PubMed, EMBASE and Web of Science. Title/ screening were performed to include all studies of surgical simulation involving rural surgical learners to identify simulation education opportunities for practicing rural Urologists. Data was then extracted: simulation event, skills focus, MERSQI score, type/number of learners, learner assessment and event evaluation. Result(s): Seven manuscripts met inclusion criteria. Most were published 2019-2020 and were cross sectional (5/7, 71%). Mean adjusted MERSQI score was 13 (range 6-15.5). A wide range of surgical skills were taught (incl. laparoscopy, cricothyroidotomy, chest tube insertion, damage control laparotomy), but no Urological surgical skills. Two articles described mobile simulation units for rural areas. A total of 232 learners were identified including 69 medical students. One fifth of rural learners were non-medical or non-physicians. Only one study involved faculty, who were general surgeons. Conclusion(s): Telesimulation education for practicing Urologists in rural areas is lacking. Current in-operating room telementoring for rural Urologists requires surgeons to travel and perform their first cases utilizing this new technique on patients. Telesimulation to teach Urological skills in rural areas of the US may increase dissemination of techniques with no patient risk and has significant potential to redress current healthcare disparities.

Mental health status of college students during coronavirus disease 2019 epidemic.

Objective To investigate the psychological characteristics of college students during the outbreak of coronavirus disease 2019 (COVID-19), so as to provide a basis for psychological intervention. Methods From May 17, 2020 to Jun. 17, 2020, the adjusted psychological questionnaires for emergent events of public health (PQEEPH) was surveyed among the college students of Beijing Union University. The questionnaire included 5 dimensions: depression, neurasthenia, fear, obsessive-compulsive anxiety, and hypochondriasis. Four grades were scored according to the degree and frequency of emotional responses: 0 means no symptoms, 1 means mild symptoms, 2 means moderate symptoms, and 3 means severe symptoms. Results A total of 3 019 valid questionnaires were collected. During the COVID-19 epidemic, the emotional responses of college students, from the most serious to the least, were fear, neurasthenia, depression, obsessive-compulsive anxiety, and hypochondriasis, with the incidences being 87.7% (2 648/3 019), 44.8% (1 353/3 019), 37.4% (1 129/3 019), 17.3% (522/3 019), and 11.6% (350/3 019), respectively. The fear scores of female students were higher than those of male students (P<0.001), the fear scores of college students from towns/suburbs were higher than those from rural and urban areas (both P<0.017), the scores of depression, neurasthenia and obsessive-compulsive anxiety of college students with confirmed COVID-19 cases around them or their relatives participated in the epidemic prevention and control as medical staff or logistics support personnel were higher than those without such conditions (all P<0.017), and the scores of depression, obsessive-compulsive anxiety and hypochondriasis of college students with suspected COVID-19 cases around them were higher than those without such condition (all P<0.017). Females were more likely to have moderate to severe fear than males (odds ratioOR=1.53, 95% confidence intervalCI1.25-1.88, P<0.001), those with confirmed or suspected COVID-19 cases around them were more likely to have moderate to severe fear than those without such conditions (OR=2.03, 95% CI 1.29-3.20, P=0.002), and those living in towns/suburbs were more likely to have moderate to severe fear than those living in rural and urban areas (OR=0.72, 95% CI 0.56-0.94, P=0.015;OR=0.78, 95% CI 0.63-0.97, P=0.025). Conclusion COVID-19 epidemic has impact on the psychology of college students. It is necessary to pay attention to the mental health of college students and provide targeted psychological counseling for them.Copyright © 2022, Second Military Medical University Press. All rights reserved.

Uncovering the Dynamics of Consumption-Based Household Water Footprint in Response to Pandemic: The Hysteresis Effect of Disruption

The socioeconomic disruption of COVID-19 has strong implications for water management. However, it remains unclear how water use related to urban and rural household consumption responded to the outbreak. Taking 15 provincial regions in China for a case study, we quantified the variations of consumption-based household water footprint induced by the first outbreak of the pandemic and tracked the responsive changes of interregional virtual water flows and control relationships. We found in many regions, the most drastic change occurred only a quarter after the major outbreak, when the average water footprint of urban and rural households decreased by 13% and 9%, respectively. This indicates the presence of a hysteretic effect of disruption to household expenditures. With the subsequent recovery of household consumption, the water footprints in many regions rebounded and even surpassed the historical values. Guangdong had a fast rebound in its net virtual water inflow related to urban households because of the fast recovery of its manufacturing and services activities. The pandemic-related water footprint dynamics suggest not only the necessity of timely managing supply chains to prevent shortage of water and water-intensive products, but also the importance of fostering consumption adjustments for conserving water in a post-pandemic era. © 2023 The Authors. Earth's Future published by Wiley Periodicals LLC on behalf of American Geophysical Union.

Epidemiological and Demographic Profile of COVID-19 Suspects in a Tertiary Care Hospital at Jaipur, Rajasthan

Background: The coronavirus disease (COVID-19) was a pandemic which spread to various countries and originated in Wuhan, China. For appropriate response, planning, and allocation of resources demographic data play an important role in understanding the impact of COVID-19 across the country. Aim(s): To estimate epidemiological and demographic parameters like age, sex, area, sample type etc. of samples reported in COVID-19 diagnostic laboratory of RUHS College of Medical Sciences, Jaipur, Rajasthan. Material(s) and Method(s): The study was conducted retrospectively in a tertiary care hospital at Jaipur. Data like age, gender, urban or rural, IPD/ICU or OPD etc. were collected between January 1, 2021 to June 30, 2021. The collected data were expressed in number, counts and percentage. The data of six months were analysed using Microsoft Excel. Result(s): From January to June 2021, April and May 2021 showed highest positivity 13084 (27.42%) and 10968 (23.06%) respectively. February 2021 and June 2021 showed least positivity 156 (2.39%) and 163 (0.8%) respectively. Total COVID-19 positive cases during 6 months were 25134 and deaths were 357 with highest deaths were during May 2021 (n=270). Males (64.28% to 72.20%) were affected most. In April and May 2021 positivity in urban area was 6053 (46.26%) and 5712 (52.07%) respectively, while in rural area 7031 (53.74%) and 5256 (47.93%) respectively. The positivity in OPD patient during April and May was 93.58% (12245) and 95.26 % (10449) respectively. Nineteen to forty years was most affected age group. Conclusion(s): During second wave both urban and rural population was affected. Males and working age group were affected more. Among COVID-19 suspects' positivity rate was low in IPD patients as compared to OPD patients. Critical factors for an effective public health response are surveillance and contact tracing.Copyright © 2023, Dr Yashwant Research Labs Pvt Ltd. All rights reserved.

Knowledge, attitude, and practice towards COVID-19 among students in Kirkuk Medical College, Iraq

On March 11, 2020, the World Health Organization (WHO) designated the new coronavirus COVID-19 to be epidemic. Adherence to infection control methods is strongly affected by an individual's knowledge, attitudes, and practices (KAP). The study aimed to evaluate medical students' understanding, and attitudes toward COVID-19 at the Kirkuk Medical College in Iraq. From October 16 to October 26, 2020, a cross-sectional online study was conducted, among a sample of students in Kirkuk Medical College, one of the Iraqi governorates. A total of 214 students were included in this research, and the age varied between 20-25 years. The questionnaire was divided into demographic data, knowledge, attitudes, and practices, modified from an online questionnaire regarding COVID-19 previously used. Descriptive statistics and t-tests were conducted. Among the study sample (n=214), age ranged between 20-25 years, 72.9% were females, and 86.9% resided in urban areas. The learning questionnaire's total accuracy rate was 96.3%. 98.1% of the students know that the virus is spreading by respiratory droplets from infected individuals, 30.4% have a good attitude towards COVID-19, and 100% have good practice dodging crowded places and practicing appropriate hand hygiene. The majority of students are knowledgeable of disease transference prevention and good practices. Female gender and urban residency play a positive role in knowledge and practice in respect to COVID-19 but not in what concerns the attitude. It is recommended to continue health education programs to correct the negative attitude among students, especially those who reside in rural areas.Copyright © 2023, Codon Publications. All rights reserved.

Mode of Hospital Rheumatology Appointments in People with Rheumatoid Arthritis: The Impact of the Pandemic in England

Background/Aims During the COVID-19 pandemic rheumatology services were advised to limit face to face contact, with remote telemedicine used instead. Although suitable for some people, issues have been highlighted with telemedicine. The frequency and proportion of remote appointments during the pandemic has not been described, or the socio-demographic characteristics of those accessing remote or in-person rheumatology care. This study aims to describe rheumatology healthcare utilisation and mode of appointment (remote/in-person) in people with rheumatoid arthritis (RA), prior to, and during the pandemic in England. Methods A retrospective prevalent cohort study of people with RA, identified using a validated algorithm, as of 1st April 2019 using electronic health record data (OpenSAFELY). Outpatient rheumatology appointments between 1st April 2019 and 31st March 2022 were identified. For each year, the number of outpatient appointments, mode of appointment (remote/in-person) and patient socio-demographic characteristics were described. Results 130,884 people with RA were identified. Since the start of the pandemic, the proportion of people without any appointments in a 12-month period increased from 28.5% in 2019/20 to 33.3% in 2020/ 21 and has not recovered. Older people were most frequently not seen (51% of people >80 years in 2020/21 and 2021/22). Of appointments where mode was known, 54.4% of people with appointments in the year from April 2020 were only seen remotely, reducing to 35.1% in the year from April 2021 (Table 1). The proportion with all remote appointments increased with increasing age, comprising 62% of people >80 years in 2020. This age gradient persisted in 2021, though proportions of those >80 years with all-remote appointments was lower (44%). Compared to urban dwellers, a higher proportion of those living in rural areas had all remote appointments in 2020 (58% vs 53%) and 2021 (38% vs 34%). Conclusion During the pandemic, one third of people with RA were not seen at all over a 12-month period and these were more frequently older people. Over half of people were only seen remotely in 2020, decreasing to one-third in 2021. Given the limitations of remote appointments it is unknown whether this increased frequency of remote appointments will impact long-term outcomes.

Utilizing a Decentralized Clinical Study Approach for Expedited and Diverse Recruitment for Clinical Validation of a Novel Non-invasive Multitargeted Stool-based RNA Test

Introduction: Traditional clinical trials that utilize fixed sites often fail to recruit participants that are representative of the intended use population. Participants, particularly those from minority groups, cite geographical constraints, mistrust, miscommunication, and discrimination as barriers to successful recruitment. A decentralized clinical trial enrollment strategy offers reduced cost, reduced time requirements, and circumvents barriers associated with the recent pandemic outbreak. Method(s): After the mt-sRNA test system entered design-lock, a decentralized clinical trial (CRC-PREVENT) was launched through a digital campaign (https://www.colonscreeningstudy.com/;NCT04739722). Online advertisements were published on multiple social media sites, and engagement with materials directed patients to an online screener. Participants who completed the screener were eligible for enrollment if they met CRC-PREVENT inclusion and exclusion criteria and were willing to complete all clinical trial components, including providing a stool sample before an optical colonoscopy. Result(s): After 12 months of active enrollment, 276,400 individuals engaged with digital advertisements and completed pre-screener surveys to determine eligibility for the clinical trial. In total, 14,264 individuals consented to participate in the CRC-PREVENT clinical trial. Of these individuals, 58% were female (42% were male), and 65% were over 50. Regarding race and ethnicity, eligible individuals directly represented the intended use population: 16% were Black or African American, 0.2% were Native Hawaiian, Pacific Islander, American Indian, or Alaskan Native, and 7% were Hispanic or Latinx. Regarding socioeconomic status, the decentralized approach permitted access to individuals with healthcare inequities: 25% of participants had income under $29,999, 5% of participants were from rural areas (defined as a city center , 10,000 people), and 36.7% of participants were on public insurance. Individuals were derived from 7,644 unique zip codes across all 48 continental United States. (Table) Conclusion(s): A decentralized recruitment strategy permits highly successful enrollment in the face of screening burdens heightened by COVID-19 pandemic. This approach also offered a significantly more diverse population and could mitigate selection bias and attrition bias associated with the cohorts observed in traditional clinical studies.

Virological Investigation in Synanthropic Rodents in North Italy

Intro: Several rodents, including mice and the brown rat, are synanthropic animals usually found in rural and urban environments in contact with other animals and humans. Rodents are natural reservoirs of infectious agents and could harbour a plethora of zoonotic pathogens of public health importance. Taking advantage of a parallel study on presence and distribution of Hantaviruses, we aimed to investigate the occurrence in mice of other viruses with zoonotic or economic impact. Method(s): From May to July 2022, 41 mice (Mus domesticus) were captured and killed by using baited snap traps in 13 selected cattle, goat and poultry farms located in the Piedmont region. Gut and lung samples were homogenised and tested by PCR methods for pan-Coronavirus (CoV) and SARS-CoV-2, pan-Pestivirus, Mammalian orthoreoviruses, Canine Distemper virus (CDV), Flaviviruses, Influenza A (IAV) and D (IDV) viruses. Finding(s): All captured animals did not present at necropsy lesions related to infectious diseases. Virological investigations detected the presence of CoV in six mice. By sequencing Rodent CoVs was identified in two samples (four more pending). Mammalian orthoreovirus was detected in nine animals and typing and characterization are in progress. One mouse, captured in a bovine farm, tested slightly positive for IDV and confirmation of positivity is in progress by complete sequencing with NGS approach. All samples were negative for Flaviviruses, IAV, CDV, pan-Pestivirus and SARS-CoV-2. Conclusion(s): Rodents are well adapted to a wide range of habitats, including peri-urban and rural environments, where they benefit from human activities. These results, although preliminary, underline the importance of enhancing surveillance in rodents in anthropized areas to better assess the presence of zoonotic agents and the potential risk of transmission.Copyright © 2023

Epidemiological characteristics of four times of community transmission of COVID-19 in Hebei

Objective To analyze the epidemiological characteristics of community transmission of the coronavirus disease 2019 (COVID-19) caused by four imported cases in Hebei Province, and to provide a scientific basis for the prevention and control of the disease. Methods Descriptive epidemiological methods were used to analyze the epidemiological characteristics of four community-transmitted COVID-19 outbreaks reported in the China Disease Control and Prevention Information System from January 1, 2020 to December 31, 2021 in Hebei Province. Results From January 1, 2020 to December 31, 2021, four community-transmitted COVID-19 outbreaks caused by imported COVID-19 occurred in Hebei Province, respectively related of Hubei (Wuhan) Province, Beijing Xinfadi market, Overseas cases and Ejina banner of Inner Mongolia Autonomous Region. Total of 1 656 cases (1 420 confirmed cases and 236 asymptomatic cases) were reported, including 375 cases in phase A (From January 22 to April 16, 2020), and phase B (from June 14 to June 24, 2020) 27 cases were reported, with 1 116 cases reported in the third phase (Phase C, January 2 to February 14, 2021), and 138 cases reported in the fourth phase (Phase D, October 23 to November 14, 2021). The 1 656 cases were distributed in 104 counties of 11 districts (100.00%), accounting for 60.46% of the total number of counties in the province. There were 743 male cases and 913 female cases, with a male to female ratio of 0.81:1. The minimum age was 13 days, the maximum age was 94 years old, and the average age (median) was 40.3 years old. The incidence was 64.01% between 30 and 70 years old. Farmers and students accounted for 54.41% and 14.73% of the total cases respectively. Of the 1 420 confirmed cases, 312 were mild cases, accounting for 21.97%;Common type 1 095 cases (77.11%);There was 1 severe case and 12 critical cases, accounting for 0.07% and 0.85%, respectively. 7 patients died from 61.0 to 85.7 years old. The mean (median) time from onset to diagnosis was 1.9 days (0-31 days), and the mean (median) time of hospital stay was 15 days (1.5-56 days). Conclusions Four times in Hebei province COVID-19 outbreak in scale, duration, population, epidemic and type of input source, there are some certain difference, but there are some common characteristics, such as the outbreak occurs mainly during the legal holidays or after starting and spreading epidemic area is mainly in rural areas, aggregation epidemic is the main mode of transmission, etc. To this end, special efforts should be made to strengthen the management of people moving around during holidays, and strengthen the implementation of epidemic prevention and control measures in places with high concentration of people. To prevent the spread of the epidemic, we will step up surveillance in rural areas, farmers' markets, medical workers and other key areas and groups, and ensure early detection and timely response.Copyright © 2022 China Tropical Medicine. All rights reserved.

Rural and urban education: a virtual perspective, a case study of the miracle of Ecuador

The general objective of this article is to analyze the digital differences between rural and urban areas on how to educate in virtuality during the shutdown caused by the global health crisis COVID-19. A descriptive study was conducted using online survey methodology on a sample of 250 cases. Data from urban and rural groups were compared and analyzed using descriptive statistics, hypothesis testing and qualitative content analysis. The results indicate that, although few, there are still digital gaps in access to means and resources to continue the educational process at home. © 2022, Associacao Iberica de Sistemas e Tecnologias de Informacao. All rights reserved.

Lesson study with sharing and jumping tasks in online mathematics classrooms for rural area students

Due to the poor instruction process during the Covid-19 Pandemic, especially in mathematics, students frequently need help with data literacy. To overcome these obstacles, they must improve their thinking skills. This study aims to enhance the quality of mathematics instruction, especially students' thinking skills, by implementing Lesson Study to develop sharing and jumping tasks. This qualitative descriptive research was conducted at one of the senior high schools and universities in Manokwari, West Papua, with their students as the research subject. The lesson study was implemented in two cycles through instruction at school and lectures at the university. The lesson study consists of three processes: plan, do, and see. The hypothetical learning trajectory was developed at the lesson design stage and then tested at the teaching-learning stage. The open class results were then analyzed during the reflection step to redesign the sharing and jumping tasks. The success of the research was determined through field notes taken from teachers and students. The frequency distribution table is used as the topic matter. The findings revealed that students' thinking skills developed, indicating they were more interested than in the previous teaching and learning process. The learning process was more exciting and enhanced conceptual comprehension. Because learning was communicable, students were more satisfied. They were more engaged and required further thought to comprehend the topic matter. Also, they produce a variety of responses, which is only feasible if they are capable of critical thought. © The Author(s) 2023.

Excess of Mortality in Older People during the Covid-19 Pandemic in Mozambique

Background: The impact of COVID-19 pandemic was apparently less severe in African continents, probably underestimated due to the limited testing capacities and access to health facilities, particularly in rural areas. Hospital and community surveillance of COVID-19 was established in Manhica District, rural Mozambique to understand the epidemic curve and natural history of SARSCoV- 2 including age-specific incidence of severe COVID-19 and reproduction number and effects of interventions through mathematical modelling Methods: Suspected cases visiting the Manhica District Hospital were screened for SARS-CoV-2 by qRT-PCR. Four age-stratified (0-19, 20-39, 40-59 and >=60 years, n=300 each) community-based serosurveys were conducted (Apr 2021-Feb 2022) to estimate the prevalence of antibodies (Abs) against SARS-CoV-2. We fitted a statistical model within a Bayesian framework, to estimate the extent to which older people were over-represented in mortality data throughout the pandemic. This involved training the model on data from the pre-pandemic period and then using this model to generate estimates of the expected levels of mortality in the absence of COVID-19 in adults aged 40+ using data from our reference category (15-39 year olds). Result(s): Between Dec 2020 and Aug 2022, 31.2% of 1332 swabs tested positive for SARS-CoV-2, with high proportion among people aged 50-59 years (62.1%, 36/58). Abs against SARS-CoV-2 were detected in 28% (180/666) of subjects enrolled in survey one, which increased two and tri-fold, in surveys 2 (64%, 595/936) and 3 (91%, 700/768);remaining stable (91.3%, 1023/1121) in 4. Age-specific analysis showed consistency on Abs detection over the surveys, including people non-eligible for vaccination (0-17 years) where >80% (165/188) had Abs detected. 93% (359/384) of subjected with Abs in survey 3, remained positive 3 months later. Shifting age-patterns throughout the pandemic are consistent with a high impact of the disease particularly in older ages. Depending on assumptions made in our modelling, we estimate a cumulative excess mortality rates in adults aged 80+ of between 8 and 17% with the largest peak coinciding with the peak in the delta variant wave. Conclusion(s): Our data reveal that people in rural areas were widely exposed across including unvaccinated ones;and there was a signature COVID-19-like shift in mortality patterns towards older ages, suggesting substantial impact, of the pandemic that is largely not reflected in patterns of confirmed COVID-19 deaths. Quantitative estimates of shift in age-patterns throughout the pandemic. (A) Shows the fit of the model to age-patterns of mortality in the pre-pandemic period 2018-2020. This model is then used to generate the expected numbers of deaths in individuals aged 40+ throughout the pandemic (2020-2022). (B) excess deaths in the pandemic relative to the model, shown in (A), black lines and grey shaded regions show estimates assuming that declines in reported mortality in under 40s are due to declines in mortality (assumption 1), coloured show equivalent estimates assuming that declines in mortality in under 40s are due to declines in ascertainment (assumption 2). (C) Shows estimates from (A) as mortality per 1000 individuals within the age strata, (D) shows each excess mortality estimate as a proportion of the population within the age strata, with seroprevalence estimated from the first two cross-sectional surveys highlighted for reference.

The utility of telemedicine in cystic fibrosis clinic visits

Background: Cystic fibrosis (CF) is a progressive, genetic, multisystem disease. Exacerbations lead to long hospital stays and significant morbidity and mortality. At the crux of pulmonary exacerbation prevention is serial monitoring of pulmonary function tests and frequent outpatient follow-up. Patients at the Helen Devos Children's Hospital CF clinic receive quarterly multidisciplinary care from a CF clinic, but this schedule was complicated by the COVID-19 pandemic because of concern of infection precipitating a pulmonary exacerbation. In lieu of in-person visits, telemedicinewas used to continue necessary monitoring. The purpose of this study was to assess the accessibility, efficacy, and comfort of telemedicine visits at the CF clinic from the patient and provider perspective. Method(s): CF clinic parents and providers completed an anonymous survey by mail or email over a 6-month period. Patient surveys used a 5-point Likert scale to assess responses in four categories-accessibility, functionality, safety, and overall satisfaction-and an open-ended question on patient opinions of their telemedicine experience. Descriptive statistics and comparative means were used to interpret the data. Result(s): Average patient agewas 9.7, average years since diagnosis was 9.5, 53% of patients were male, and average one-way distance traveled to the clinic was 70 minutes (range 15-240). Patients reported that they had few difficulties accessing in-person visits at the clinic. They also reported the telemedicine experience to be functional and easy to navigate. In terms of safety (perceived assessment of respiratory status, overall health, and patients concerns), patients reported feeling neutral to moderate. Patients reported being very comfortable with virtual visits and moderately likely to schedule telemedicine visits at the CF clinic in the future. There was no correlation between travel distance to the clinic and likeliness of scheduling virtual visits in the future, although older patients were more likely to schedule virtual visits in the future. A few factors could be in play here;patients reported in-person visits to be very accessible, reporting that they rarely missed scheduled visits. Some patients reported internet connection problems, which may be more prevalent in rural areas farther from the clinic. At the time of this survey, patients did not have in-home spirometry. Provider responses were overwhelmingly positive, with high opinions of effectiveness, safety, and overall satisfaction. Providers also reported a subjective decrease in no-show rates for virtual visits. Conclusion(s): Virtual visits were found to be functional and have no perceived negative effects on safety. Patients reported high levels of comfort with virtual visits, although they were only moderately likely to schedule virtual visits in the future. This data, in conjunction with the open-ended responses, can be used to improve the CF telemedicine experience;patients are currently offered virtual visits every 6 months.Copyright © 2022, European Cystic Fibrosis Society. All rights reserved