Effect of digital gap on virtual care in the time of COVID-19 pandemic: empirical evidence in Taiwan

Decent internet usage rates make Taiwan a case to succeed in virtual care practices during the pandemic. We investigate how internet usage rates across regions condition Taiwan's varieties, concerns, and expectations for virtual care. During the semi-lockdown, we fielded an online census of the managers of care programs for people with disabilities (PWDs). 70% of the PWDs care programs provide three to four virtual care types. Concerned about the PWDs' degeneration and their family caregivers' capacity, respondents expect empowerment of their programs. High internet usage rates facilitate more diversified virtual care, fewer concerns, and various expected assistance. © 2023 Department of Social Work, National University of Singapore, Singapore.

Potential of Bike Sharing During Disruptive Public Health Crises: A Review of COVID-19 Impacts

With public transport (PT) continuing to be negatively affected by the coronavirus pandemic and private car usage surging, alternative modes need to be considered. In this study, we review the available evidence (from academic and gray literature sources) on the performance of bike sharing systems (BSSs) during COVID-19 around the world, with the goal of assessing their potential contribution to improving the resilience of transport systems during pandemics and similar disruptive events. We found BSS usage followed a decrease-rebound pattern, with BSSs overall sustaining lower ridership declines and faster recoveries compared with PT. During lockdowns especially, the average duration of BSS trips increased, following a rise in casual users and leisure trips, while commuting trips decreased. Evidence has also been found for a possible modal shift from some PT users to BSSs, with a decline in the share of multimodal trips conducted between PT and BSSs. Bike sharing is perceived as safer than other shared modes (e.g., PT, taxis, and ride-hailing/sharing) but as having a higher infection risk than personal modes (e.g., private car, walking, and personal bike). Moreover, the BSS was an important transport alternative for essential workers, with several operators providing waivers especially to healthcare staff, leading to ridership increases near healthcare facilities and in deprived neighborhoods. Findings from this research support policies for promoting bike sharing, namely through fee reductions, system expansions, and symbiotic integration with PT, as BSSs can increase the sustainability and resilience of transport systems during disruptive public health events like COVID-19.

Social Media App Usage in Relation with PHQ-9 Depression Scores during the COVID-19 Pandemic

With about 300 million affected people, major depressive disorder (MDD) is one of the most common diseases worldwide. During the COVID-19 pandemic, the number of cases increased even further, by 28%. Many factors may be correlated with MDD, including the excessive use of social media apps. In this paper, we investigated the relationship between the use of social media and communication apps and depressive symptoms during the COVID-19 pandemic. The pandemic and social distancing like lockdowns probably changed smartphone usage times and usage patterns. While previous studies have shown an association between depression and social media usage, we report about the situation during these special circumstances. We employed a log-linear regression to examine the association of social media and communication app usage and depression. To quantify the usage, we applied the total usage time in hours of social media apps (e.g., WhatsApp, Facebook) as well as communication apps (Phone and Messaging) within one week. To measure depressive symptoms, we used the PHQ-9 score. We discovered a significant association between the usage time and the PHQ-9 score (beta=0.0084, p-value=0.010). We conclude that social media usage is a robust marker for depression severity and future research should focus on a better understanding of the underlying causality and potential counter-measures. © 2022 ACM.

The Influence of Mass Media on the COVID-19 Vaccination Decision-making Process: Prospective Survey-Based Study.

BACKGROUND: Vaccine hesitancy during the COVID-19 pandemic was exacerbated by an infodemic of conflating accurate and inaccurate information with divergent political messages, leading to varying adherence to health-related behaviors. In addition to the media, people received information about COVID-19 and the vaccine from their physicians and closest networks of family and friends. OBJECTIVE: This study explored individuals' decision-making processes in receiving the COVID-19 vaccine, focusing on the influence of specific media outlets, political orientation, personal networks, and the physician-patient relationship. We also evaluated the effect of other demographic data like age and employment status. METHODS: An internet survey was disseminated through the Western Michigan University Homer Stryker MD School of Medicine Facebook account. The survey included questions on media sources for COVID-19 information, political affiliation, presidential candidate choice, and multiple Likert-type agreement scale questions on conceptions of the vaccine. Each respondent was assigned a media source score, which represented the political leaning of their media consumption. This was calculated using a model based on data from the Pew Research Center that assigned an ideological profile to various news outlets. RESULTS: The sample consisted of 1757 respondents, with 89.58% (1574/1757) of them choosing to take the COVID-19 vaccine. Those employed part-time and the unemployed were at 1.94 (95% CI 1.15-3.27) and 2.48 (95% CI 1.43-4.39) greater odds of choosing the vaccine than those employed full-time. For every 1-year increase in age, there was a 1.04 (95% CI 1.02-1.06) multiplicative increase in odds of choosing to receive the vaccine. For every 1-point increase in media source score toward more Liberal or Democrat, there was a 1.06 (95% CI 1.04-1.07) multiplicative increase in odds of choosing to take the COVID-19 vaccine. The Likert-type agreement scale showed statistically significant differences (P<.001) between respondents; those who chose the vaccine agreed more strongly on their belief in the safety and efficacy of vaccines, the influence of their personal beliefs, and the encouragement and positive experiences of family and friends. Most respondents rated their personal relationship with their physician to be good, but this factor did not correlate with differences in vaccine decision. CONCLUSIONS: Although multiple factors are involved, the role of mass media in shaping attitudes toward vaccines cannot be ignored, especially its ability to spread misinformation and foster division. Surprisingly, the effect of one's personal physician may not weigh as heavily in one's decision-making process, potentially indicating the need for physicians to alter their communication style, including involvement in social media. In the era of information overload, effective communication is critical in ensuring the dissemination of accurate and reliable information to optimize the vaccination decision-making process.

Spike-Independent Infection of Human Coronavirus 229E in Bat Cells.

Bats are the reservoir for numerous human pathogens, including coronaviruses. Despite many coronaviruses having descended from bat ancestors, little is known about virus-host interactions and broader evolutionary history involving bats. Studies have largely focused on the zoonotic potential of coronaviruses with few infection experiments conducted in bat cells. To determine genetic changes derived from replication in bat cells and possibly identify potential novel evolutionary pathways for zoonotic virus emergence, we serially passaged six human 229E isolates in a newly established Rhinolophus lepidus (horseshoe bat) kidney cell line. Here, we observed extensive deletions within the spike and open reading frame 4 (ORF4) genes of five 229E viruses after passaging in bat cells. As a result, spike protein expression and infectivity of human cells was lost in 5 of 6 viruses, but the capability to infect bat cells was maintained. Only viruses that expressed the spike protein could be neutralized by 229E spike-specific antibodies in human cells, whereas there was no neutralizing effect on viruses that did not express the spike protein inoculated on bat cells. However, one isolate acquired an early stop codon, abrogating spike expression but maintaining infection in bat cells. After passaging this isolate in human cells, spike expression was restored due to acquisition of nucleotide insertions among virus subpopulations. Spike-independent infection of human coronavirus 229E may provide an alternative mechanism for viral maintenance in bats that does not rely on the compatibility of viral surface proteins and known cellular entry receptors. IMPORTANCE Many viruses, including coronaviruses, originated from bats. Yet, we know little about how these viruses switch between hosts and enter human populations. Coronaviruses have succeeded in establishing in humans at least five times, including endemic coronaviruses and the recent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In an approach to identify requirements for host switches, we established a bat cell line and adapted human coronavirus 229E viruses by serial passage. The resulting viruses lost their spike protein but maintained the ability to infect bat cells, but not human cells. Maintenance of 229E viruses in bat cells appears to be independent of a canonical spike receptor match, which in turn might facilitate cross-species transmission in bats.

[E-physicians in Hungary: Experiences and opinions related to digital health among Hungarian physicians]. / E-orvosok Magyarországon: Digitális egészséggel kapcsolatos tapasztalatok és vélemények a hazai orvosok körében.

INTRODUCTION: The digitalization of healthcare is one of the most topical issues in terms of the present and future of healthcare. The coronavirus pandemic has shed light on the potential inherent in these technologies, and at the same time brought to the surface countless tasks and problems that need to be solved. OBJECTIVE: In our national survey, our aim is to find out how medical doctors are adapting to digital healthcare solutions. METHOD: Between July 2021 and May 2022, we conducted an online questionnaire survey among doctors working in Hungary. 1774 people answered our questions, including 1576 general practitioners and 198 dentists. In this paper, the 1576 general practitioners' responses are presented. RESULTS: 78.8% of the respondent doctors recommend websites to their patients on a more or less regular basis, 52.8% have recommended apps and 46.0% have recommended social media resources. The respondent doctors perceive a high demand from patients for communication by e-mail (83.7% indicated). 86.4% of doctors are aware of telemedicine solutions and 47.5% of respondents would like to use them intensively in the next 3 years. A significant proportion of respondents would like to use apps (56.2%), sensors, portable diagnostic devices (49.0%) and artificial intelligence (28.3%) in the next 3 years. Websites, apps and social media resources are significantly more frequently recommended by general practitioners and they are the ones who are most in favour of the use of the internet for patient health and telemedicine. CONCLUSION: Our respondents manifest fundamentally positive feelings towards the digitalization of healthcare and are characterized by a cautious openness regarding the implementation and adaptation of technologies. Orv Hetil. 2023; 164(4): 132-139.

Factors Affecting Users' Continuous Usage in Online Health Communities: An Integrated Framework of SCT and TPB.

BACKGROUND: Online health communities (OHCs) provide a new channel for users to obtain more health-related information and support, playing an important role in alleviating hospital congestion and uneven medical resource distribution, especially during the COVID-19 pandemic in China. An in-depth study of users' continuous usage is of great value for the long-term development of OHCs. OBJECTIVE: The purpose of this study is to explore the factors that influence users' continuous usage in online health communities based on the theory of planned behavior (TPB) and social cognitive theory (SCT). METHODS: Data from 480 users with experience in online health communities were collected through a questionnaire survey, and structural equations were applied to verify the model hypotheses empirically. RESULTS: Self-efficacy and controllability have significant effects on users' continuous intention; attitude has a significant relationship with continuous intention; social norms have a positive effect on continuous intention. Moreover, the relationship between continuous intention and behavior is positive. Self-efficacy and outcome expectations have significant positive associations with continuous usage. Finally, system quality, information quality, and social interaction ties have significant and positive relationships to continuous usage. CONCLUSION: To improve the level of user's continuous usage, online health service providers can improve the quality of the community by organizing the website's page layout, navigation menus, and site elements to ensure users quickly search and find what they want meanwhile try to change people's cognition gradually, in addition, decision and policymakers should provide more favorable policies to stimulate and help provider in building and managing strategic plans for sustaining a thriving online community. A supportive climate in society through public service advertisements and others for the sake of OHCs is necessary. LIMITATIONS: (1) This study collected data through a cross-sectional survey. Thus, it lacked the process of capturing the changes in participants' attitudes toward all variables. (2) The environmental factors in SCT theory need to be more comprehensive, containing online factors without offline factors. (3) The dates were obtained from China, which neglects the different cultural content.

Compliance with face mask use during the COVID-19 pandemic: a community observational study in Singapore.

Introduction: Widespread mask use is an important intervention for control of the coronavirus disease 2019 pandemic. However, data on the factors affecting mask use are lacking. In this observational study, we evaluated the proportion of and factors influencing face mask use and related hygiene practices. Methods: We observed randomly selected members from the public in 367 venues across Singapore, and recorded the proportion of individuals with full compliance with mask use and mask hygiene (hand hygiene before and after touching the mask or face). Logistic regression analyses were used to determine variables associated with mask and hand hygiene compliance. Results: We made 3,821 observations - 2,149 (56.2%) females, 3,569 (93.4%) adults (≥21 years), 212 (5.5%) children (6-20 years) and 40 (1.0%) children (2-5 years). The overall full compliance rate (correct mask use), poor compliance rate (incorrect mask use) and absent mask use were 84.5%, 12.9% and 2.6%, respectively. The factors - male gender, fabric mask usage and crowded indoor venues - were associated with lower mask compliance. Face or mask touching behaviour was observed in 10.7% and 13.7% of individuals observed, respectively. Only one individual performed hand hygiene before and after touching the mask. Conclusion: The rate of mask compliance was high, probably due to legislation mandating mask usage. However, specific factors and crowded indoor venues associated with lower mask compliance were identified. We also noted an issue with the absence of hand hygiene before and after face or mask touching. These issues may benefit from targeted public health messaging.

Assessment on infection prevention and control knowledge among medical professionals in south Indian population.

INTRODUCTION: Healthcare workers are always at higher risk of biological exposure as the healthcare setting is hazardous, and it is impracticable to exclude infection. Poor compliance with standard precautions among healthcare workers is one of the leading causes of healthcare-associated infections. This study analyzed the gaps in knowledge, attitude, and practice of infection control among healthcare workers and the influence of the COVID-19 pandemic, internet, and social media usage on infection control. METHODOLOGY: A cross-sectional study was conducted from 1st to 31st March 2022 among various healthcare professionals using a self-administered structured questionnaire to evaluate knowledge, attitude, and practice on infection control. The impact of COVID-19, Internet, and social media usage on infection control practices was also analyzed. RESULTS: Among 382 healthcare workers who participated in the study, 89.4% of the participants had good knowledge, 55.26% had a neutral attitude, and all showed good practice levels on infection control. Similarly, the result showed that internet and social media usage during COVID-19 had significantly enhanced the knowledge, attitude, and practice on infection control. CONCLUSIONS: Healthcare professionals must be frequently updated on infection control guidelines and routine training programs. The hospital's adherence to the Joint Commission International (JCI) guidelines reduces the risk of healthcare-associated infections. As observed in this study, due to the prominent influence of social media and the internet, these platforms can be exploited to provide training and awareness to healthcare professionals and the public.