A Critical Analysis of UK Media Characterisations of Long Covid in Children and Young People (preprint)

Long Covid is the continuation or development of symptoms related to a SARSCoV2 infection. Those with Long Covid may face epistemic injustice, where they are unjustifiably viewed as unreliable evaluators of their own illness experiences. Media articles both reflect and influence perception and subsequently how people regard children and young people (CYP) with Long Covid, and may contribute to epistemic injustice.? We aimed to explore how the UK media characterises Long Covid in CYP through examining three key actor groups: parents, healthcare professionals, and CYP with Long Covid, through the lens of epistemic injustice. A systematic search strategy resulted in the inclusion of 103 UK media articles. We used an adapted corpus-assisted Critical Discourse Analysis in tandem with thematic analysis. Specifically, we utilised search terms to locate concordances of key actor groups. In the corpus, parents highlighted minimisation of Long Covid, barriers to care, and experiences of personal attacks. Mothers were presented as also having Long Covid. Fathers were not mentioned once. Healthcare professionals emphasised the rarity of Long Covid in CYP, avoided pathologizing Long Covid, and overemphasised psychological components. CYP rarely were consulted in media articles but were presented as formerly very able. Manifestations of Long Covid in CYP were validated or invalidated in relation to adults. Media characterisations contributed to epistemic injustice. The disempowering portrayal of parents promote stigma and barriers to care. Healthcare professionals' narratives often contributed to negative healthcare experiences and enacted testimonial injustice, where CYP and parents credibility was diminished due to unfair identity prejudice, in their invalidation of Long Covid. Media characterisations reveal and maintain a lack of societal framework for understanding Long Covid in CYP. The findings of this study illustrate the discursive practices employed by journalists that contribute to experiences of epistemic injustice. Based on our findings, we propose recommendations for journalists.

The asymptomatic proportion of SARS-CoV-2 Omicron-variant infections in households: A systematic review (preprint)

Background Understanding the clinical spectrum of SARS-CoV-2 infection, including the asymptomatic fraction, is important as asymptomatic individuals are still able to infect other individuals and contribute to ongoing transmission. The WHO Unity Household transmission investigation (HHTI) protocol provides a platform for the prospective and systematic collection of high-quality clinical, epidemiological, serological, and virological data from SARS-CoV-2 confirmed cases and their household contacts. These data can be used to understand key severity and transmissibility parameters - including the asymptomatic proportion - in relation to local epidemic context and help inform public health response. Methods We aimed to estimate the asymptomatic proportion of SARS-CoV-2 Omicron-variant infections in Unity-aligned HHTIs. We conducted a systematic review and meta-analysis in alignment with the PRISMA 2020 guidelines and registered our systematic review on PROSPERO (CRD42022378648). We searched EMBASE, Web of Science, MEDLINE, and bioRxiv and medRxiv from 1 November 2021 to 22 August 2023. Results We identified 8,368 records, of which 98 underwent full text review. We identified only three studies for data extraction, with substantial variation in study design and corresponding estimates of the asymptomatic proportion. As a result, we did not generate a pooled estimate or I2 metric. Conclusions The limited number of quality studies that we identified highlights the need for improved preparedness and response capabilities to facilitate robust HHTI implementation, analysis and reporting, to better inform national, regional and global risk assessments and policy making.

Understanding Human-COVID-19 Dynamics using Geospatial Big Data: A Systematic Literature Review (preprint)

The COVID-19 pandemic has changed human life. To mitigate the pandemic's impacts, different regions implemented various policies to contain COVID-19 and residents showed diverse responses. These human responses in turn shaped the uneven spatial-temporal spread of COVID-19. Consequently, the human-pandemic interaction is complex, dynamic, and interconnected. Delineating the reciprocal effects between human society and the pandemic is imperative for mitigating risks from future epidemics. Geospatial big data acquired through mobile applications and sensor networks have facilitated near-real-time tracking and assessment of human responses to the pandemic, enabling a surge in researching human-pandemic interactions. However, these investigations involve inconsistent data sources, human activity indicators, relationship detection models, and analysis methods, leading to a fragmented understanding of human-pandemic dynamics. To assess the current state of human-pandemic interactions research, we conducted a synthesis study based on 67 selected publications between March 2020 and January 2023. We extracted key information from each article across six categories, e.g., research area and time, data, methodological framework, and results and conclusions. Results reveal that regression models were predominant in relationship detection, featured in 67.16% of papers. Only two papers employed spatial-temporal models, notably underrepresented in the existing literature. Studies examining the effects of policies and human mobility on the pandemic's health impacts were the most prevalent, each comprising 12 articles (17.91%). Only 3 papers (4.48%) delved into bidirectional interactions between human responses and the COVID-19 spread. These findings shed light on the need for future research to spatially and temporally model the long-term, bidirectional causal relationships within human-pandemic systems.

The effect of home-based and remote exercises on low back pain during the COVID-19 pandemic: a systematic review (preprint)

Purpose: The prevalence of low back pain (LBP) surged during the COVID-19 pandemic, posing challenges to face-to-face treatment. Therefore, this systematic review aims to determine the effectiveness of various digital solutions for controlling and treatment of LBP during the COVID-19 pandemic. Methods: The systematic review was performed from 2019 until 2023 across databases, including Google Scholar, ScienceDirect, Scopus, and PubMed, according to the eligibility criteria. This review fulfilled the following criteria according to the PICO system: population (individuals using virtual exercises at home for LBP), interventions (distance rehabilitation and digital application), comparison (intervention group performing exercises virtually at home, and control group receiving in-person services), outcome (methods used in the diagnosis of LBP). Only high-quality randomized controlled trial studies were included and assessed using the PEDro scale. All the studies were assessed to be of high quality. Results: After the final review, 15 articles with 3789 subjects met the inclusion criteria. Digital tools such as video calls, Artificial Intelligence programs, Virtual Reality Exercises, and video-based programs were commonly used in studies addressing LBP management. The included articles' scores ranged from 6.2 on the PEDro scale, which has a maximum of 10 points. Conclusions: The COVID-19 pandemic prompted heightened attention to digital treatments, yielding relatively acceptable results for patients and therapists. However, recent technological advances indicate future expansion in this field. Key aspects of this method include training individuals in self-management of LBP and promoting adherence. Nonetheless, the high diversity in the use of digital methods poses limitations on conclusive outcomes. Registration: The systematic review has been registered on the International Prospective Register of Systematic Reviews (PROSPERO) [CRD42022377172;28/11/2022].

Access to Library Information Resources by University Students during COVID-19 Pandemic in Africa: A Systematic Literature Review (preprint)

The study examined access to library information resources by university students during the outbreak of the COVID-19 pandemic in 2020. Specifically, the study sought to identify the measures adopted by academic libraries to ensure the smooth delivery of library information resources to patrons, particularly students, identify technological tools that were employed by libraries to facilitate access to library information resources. Not only that but also, the study investigated the challenges faced by students in accessing library information resources. A systematic literature review approach following PRISMA guidelines was employed to investigate the findings of the relevant literature on the subject. The keyword search strategy was employed to search for relevant literature from four scholarly databases Scopus, Emerald, Research4life and Google Scholar. The relevant 23 studies were included fulfilling the set inclusion criteria. The presentation of the findings was arranged in a tabular form to provide a summary of each article to facilitate easy analysis and synthesis of results. The findings of this study revealed that the majority of the reviewed studies indicate that, during the COVID-19 pandemic many academic libraries in Africa adopted different approaches to facilitate access to library information resources by university students including expanding access to electronic resources off- campus, virtual reference services, circulation and lending services. To support access to different library services and information resources academic libraries in Africa used various digital technological tools like social media, library websites, email and video conferencing. Moreover, the study revealed that limited access to internet services and ICT devices, inadequate electronic library collection and inadequate digital and information literacy were the major challenges faced by many university students in accessing library resources during the pandemic. This study recommends investment in ICT infrastructures and expanding electronic resource collections which are vital resources in the digital era. 

Access to Library Information Resources by University Students during COVID-19 Pandemic in Africa: A Systematic Literature Review (preprint)

The study examined access to library information resources by university students during the outbreak of the COVID-19 pandemic. The study investigated measures that were adopted by academic libraries for smooth delivery of library information resources to their patrons. It also identified technological tools that were employed by libraries to facilitate access to library information resources. We also investigated the challenges faced by students in accessing library information resources. A systematic literature review approach using PRISMA guidelines was employed to investigate the relevant literature on the subject. The keyword search strategy was employed to search for relevant literature from four scholarly databases Scopus, emerald, Research4life, and Google Scholar. In this study, 23 studies that fulfilled the criteria were included. The findings revealed that the majority of the reviewed studies indicate that, during the COVID-19 pandemic many academic libraries in Africa adopted different approaches to facilitate access to library information resources by university students including expanding access to electronic resources off-campus, virtual reference services, circulation and lending services. To support access to different library services and information resources academic libraries in Africa used various digital technological tools like social media, library websites, email and video conferencing. Moreover, the study revealed that limited access to internet services and ICT devices, inadequate electronic library collection and inadequate digital and information literacy were the major challenges faced by patrons during the pandemic. This study recommends investment in ICT infrastructures and expanding electronic resource collections which are vital resources in the digital era.

Excess mortality in low-and lower-middle-income countries: A systematic review and meta-analysis (preprint)

Background: The COVID-19 pandemic caused a massive death toll, but its effect on mortality remains uncertain in low- and lower-middle-income countries (LLMICs). This review summarized the available literature on excess mortality in LLMICs, including methods, data sources, and factors that might have influenced excess mortality. Methods: The protocol was registered in PROSPERO (ID: CRD42022378267). We searched PubMed, Embase, Web of Science, Cochrane Library, Google Scholar, and Scopus for studies conducted in LLMICs on excess mortality. These included studies with at least a one-year non-COVID-19 period as the comparator in estimating excess mortality and with publication dates from 2019 to date. The meta-analysis included studies with extractable data on excess mortality, methods, population size, and observed and expected deaths. We used the Mantel-Haenszel method to estimate the pooled risk ratio of excess mortality with 95% confidence intervals. Results: The review included studies from 29 countries, of which 10 were included in the meta-analysis. Of 1,405,128,717 individuals, 2,152,474 deaths were expected, and 3,555,880 deaths were reported. The pooled excess mortality was 100.3 deaths per 100,000 population per pandemic period. The excess risk of death was 1.65 (95% CI: 1.649, 1.655 p<0.001). Data sources included civil registration systems, obituary notifications, surveys, public cemeteries, funeral counts, burial site imaging, and demographic surveillance systems. Techniques used to estimate excess mortality were mainly statistical forecast modelling and geospatial analysis. Of the 24 studies, only one found higher excess mortality in urban settings. Conclusion: Our results show that excess mortality in LLMICs during the pandemic was substantial. There is uncertainty around excess mortality estimates given comparatively weak data. Further studies are needed to identify the drivers of excess mortality by exploring different methods and data sources.

Effect of online peer support on mental health among patients of post-acute sequelae of SARS-CoV-2 infection: A systematic review (preprint)

Background Psychosocial burdens of the post-acute sequelae of SARS-CoV-2 infection (PASC) are an emerging public health concern. Online peer support is expected to be effective in improving the mental health of PASC patients. However, the effectiveness of these treatments remains unclear. This study investigated the effectiveness of online peer support for improving the mental health of PASC patients.Methods We searched the MEDLINE, PsycINFO/PsycArticles, and Japan Medical Abstracts Society electronic databases for studies on June 12, 2023. The inclusion criteria for studies were as follows: 1) patients with post-COVID-19 conditions over 18 years of age; 2) conducted online peer support exposure or intervention; 3) measured mental health-related outcomes using quantity scales; and 4) peer-reviewed original articles written in English or Japanese. We excluded qualitative studies that did not use quantitative scales to measure outcomes and original peer-reviewed articles. We conducted risk of bias assessments with the Risk of Bias Assessment instrument designed for non-randomized studies (RoBANS).Results A total of 157 studies were retrieved, and two met the inclusion criteria. The total numbers of participants in the two studies were 239 and 47, respectively. One was a cohort study, and the other was a pre-post study; neither had a control group. Most participants in both studies were middle-aged women or female from high-income European countries. Exposure or intervention included sharing sources of support (e.g., experiences, knowledge, and expertise) and peer support combined with workshops for the self-management of physical and mental health facilitated by trained medical experts. The effectiveness of online peer support on mental health outcomes was also assessed. Two studies reported significant improvements in work productivity, functional status, quality of life, self-efficacy, and well-being. Both studies were rated as high or unclear in most risk-of-bias domains. No meta-analysis was performed because of the small number of included studies.Conclusions Few studies examine online peer support for improving mental health-related outcomes among PASC patients, and evidence of its effectiveness is unclear. Well-designed studies are required to conduct meta-analyses to evaluate the effectiveness of online peer support for PASC patients.

Addressing evidence needs during health crises in the province of Quebec (Canada): a proposed action plan for rapid evidence synthesis (preprint)

Background: The COVID-19 pandemic necessitated the rapid availability of evidence to respond in a timely manner to the needs of practice settings and decision-makers in health and social services. Now that the pandemic is over, it is time to put in place actions to improve the capacity of systems to meet knowledge needs in a situation of crisis. The main objective of this project was thus to develop an action plan for the rapid syntheses of evidence in times of health crisis in Quebec (Canada). Methods: We conducted a three-phase collaborative research project. First, we carried out a survey with producers and users of rapid evidence syntheses (n=40) and a group interview with three patient partners to prioritize courses of action. In parallel, we performed a systematic mapping of the literature to identify rapid evidence synthesis initiatives developed during the pandemic. The results of these two phases were used in a third phase, in which we organized a deliberative workshop with 26 producers and users of rapid evidence syntheses to identifying ways to operationalize priorities. The data collected at each phase were compared to identify common courses of action and integrated to develop an action plan. Results: A total of 14 specific actions structured into four main axes were identified over the three phases. In axis 1, actions on raising awareness of the importance of evidence-informed decision-making among stakeholders in the health and social services network are presented. Axis 2 includes actions to promote optimal collaboration of key stakeholders in the production of rapid evidence synthesis to support decision-making. Actions advocating the use of a variety of rapid evidence synthesis methodologies known to be effective in supporting decision-making are presented in axis 3. Finally, axis 4 is about actions on the use of effective strategies to promote the dissemination, sharing, and use of rapid evidence synthesis products to support decision-making. Conclusions: This project led to the development of a collective action plan aimed at preparing the Quebec ecosystem and other similar jurisdictions to meet knowledge needs more effectively in times of health emergency. The implementation of this plan and its evaluation will enable us to continue to fine-tune it.

Exposure to air pollution in epidemiological studies in Kuwait: A systematic review (preprint)

Objective To systematically review the epidemiological studies of human exposure to air pollution in Kuwait. Methods Specific keywords related to air pollution and health effects in Kuwait were systematically searched using PubMed and BASE search engines for published research in English language from the year 1990 up to June 2020. Non eligible studies were those which published in non-English studies, studies on animals, plants, exposure to pollutants other that air pollutants, studies related to oil fires caused by Iraqi invasion to Kuwait in 1991. After duplicates were removed, titles and abstracts of eligible studies were screened and full text of publications meeting the inclusion criteria was read. Non-epidemiological studies were included only to compare their numbers to the epidemiological studies, and to help in future studies. Results Total of 85 studies including epidemiological and non-epidemiological studies, only 8 of them found to be an epidemiological study, which 4 of them concerned with mortality and 3 with morbidity, and 1 with both morbidity and mortality. Two of these studies concern with respiratory disease, 1 of them concerned with atopic dermatitis and was the only study measured indoors (i.e. house), and 1 study concerned with rheumatoid arthritis. One study measured ETS, 4 studies measured dust, 2 studies measured PM10 and PM2.5, and 1 study measured NO2, SO2, O3, CO. All studies found that exposure to air pollution has adverse effect on health problems (i.e. respiratory problems, atopic dermatitis, rheumatoid arthritis) and mortality except one study found no significant correlation between exposure to air pollution (i.e. dust) and mortality. Conclusion Epidemiological studies related to human exposure to air pollution in Kuwait are underestimated and insufficient, there are extremely limited studies that cannot be compared to each other. Since currently Kuwait have many major constructions in major roads in and out the capital which alters the air pollution, adding to that the new study which found that the new current global epidemic namely coronavirus COVID-19 is correlated to air pollution (i.e. NO2), new researches need to be done measuring the different pollutants in both indoor and outdoor exposure examining different health problems, these researches need to be done during and after these circumstances for comparison.

A Review of Graph Neural Networks in Epidemic Modeling (preprint)

Since the onset of the COVID-19 pandemic, there has been a growing interest in studying epidemiological models. Traditional mechanistic models mathematically describe the transmission mechanisms of infectious diseases. However, they often fall short when confronted with the growing challenges of today. Consequently, Graph Neural Networks (GNNs) have emerged as a progressively popular tool in epidemic research. In this paper, we endeavor to furnish a comprehensive review of GNNs in epidemic tasks and highlight potential future directions. To accomplish this objective, we introduce hierarchical taxonomies for both epidemic tasks and methodologies, offering a trajectory of development within this domain. For epidemic tasks, we establish a taxonomy akin to those typically employed within the epidemic domain. For methodology, we categorize existing work into \textit{Neural Models} and \textit{Hybrid Models}. Following this, we perform an exhaustive and systematic examination of the methodologies, encompassing both the tasks and their technical details. Furthermore, we discuss the limitations of existing methods from diverse perspectives and systematically propose future research directions. This survey aims to bridge literature gaps and promote the progression of this promising field. We hope that it will facilitate synergies between the communities of GNNs and epidemiology, and contribute to their collective progress.

Mapping of Public Approach towards COVID-19 Vaccine for Preparedness and Resilience of Emerging Threats to Facilitate Cross-Country Systematic Roll-Out of Resources (preprint)

Background: Vaccine hesitancy was one of India's problems after the COVID-19 vaccine roll-out. Earlier studies carried out to understand people's perception of the vaccine were mainly based on online or offline community-based surveys. These studies do not help to understand the actions taken by people towards vaccination. Hence, this study has been designed to understand the exact behavior of people toward the vaccine. Methods: Age-wise, the population was sub-grouped into three groups, above 18 years, 12-14 years, and 15-18 years. The data analysis has been done using cumulative coverage of vaccines in the said age groups. Results: The study shows a substantial population has missed second and booster doses of vaccine at the state, regional, and national levels in all three age groups. Even for the states that have shown the smallest number of people who missed their dose, their number is in the thousands. Conclusion: Further research is needed to know, in total population, how many people have not even taken a single dose of vaccine. Policy-level efforts are needed to cover the entire population of the country for at least a single dose and vulnerable populations, for additional booster doses after primary doses.

Values and preferences in COVID-19 public health guidelines: A systematic review (preprint)

Abstract Background: Internationally accepted standards for trustworthy guidelines include the necessity to ground recommendations in values and preferences. Considering values and preferences respects the rights of citizens to participate in health decision-making and ensures that guidelines align with the needs and priorities of the communities they are intended to serve. Early anecdotal reports suggest that COVID-19 public health guidelines did not consider values and preferences. Objective: To capture and characterize whether and how COVID-19 public health guidelines considered values and preferences. Methods: We performed a systematic review of COVID-19 public health guidelines. We searched the eCOVID19 RecMap platform-a comprehensive international catalog of COVID-19 guidelines-up to July 2023. We included guidelines that made recommendations addressing vaccination, masking, isolation, lockdowns, travel restrictions, contact tracing, infection surveillance, and school closures. Reviewers worked independently and in duplicate to review guidelines for consideration of values and preferences. Results: Our search yielded 129 eligible guidelines, of which 43 (33.3%) were published by national organizations, 73 (56.6%) by international organizations, and 14 (10.9%) by professional societies and associations. Twenty-six (20.2%) guidelines considered values and preferences. Among guidelines that considered values and preferences, most did so to assess the acceptability of recommendations (23; 88.5%) and by referencing published research (24; 92.3%). Guidelines only occasionally engaged laypersons as part of the guideline development group (6; 23.1%). None of the guidelines performed systematic reviews of the literature addressing values and preferences. Conclusion: Most COVID-19 public health guidelines did not consider values and preferences. When values and preferences were considered, it was suboptimal. Disregard for values and preferences in guidelines might have partly contributed to divisive and unpopular COVID-19 policies. Given the possibility of future health emergencies, we recommend guideline developers identify efficient methods for considering values and preferences in crisis situations.

Relevance of Mediterranean diet as a nutritional strategy in diminishing COVID-19 risk: A systematic review (preprint)

BackgroundMediterranean Diet has been reported to possess immunomodulatory and anti-inflammatory properties. These properties are closely associated with the immunopathogenesis of COVID-19. ObjectiveThe present systematic review aimed to determine the association between Mediterranean Diet and COVID-19, COVID-19 symptoms, and COVID-19 severity. MethodsThe protocol for this systematic review was registered in International Prospective Register of Systematic Reviews (PROSPERO) with identification number CRD42023451794. The literature search was conducted through Pubmed, Proquest, and Google Scholar on August 2023. The inclusion criteria were studies with a population of human subjects, reported the association between Mediterranean diet adherence with risk of COVID-19 infection, COVID-19 symptoms, or COVID-19 severity, and full text must be available in English. The exclusion criteria were reviews, editorials, letters, replies, systematic reviews, meta-analyses, studies on animals, and duplicates. Risk of bias in included studies was assessed using Newcastle Ottawa Scale (NOS). Data was synthesized narratively. Each study was compared and a structured summary was developed. ResultsAfter selection process, 6 articles were included, with a sample size of 55,489 patients. All studies were observational studies and assessed Mediterranean diet adherence using food frequency questionnaires (FFQ), with scoring system varied between each study. Four studies found a significant correlation between increased adherence to Mediterranean Diet and reduced COVID-19 risk, while one study indicated non-significant association. One study reported a significant association between higher adherence to Mediterranean Diet and COVID-19 symptoms, but three studies reported non-significant association. One study found that individuals with higher adherence to Mediterranean Diet had reduced likelihood of developing severe COVID-19, however, two studies yielded inconclusive findings. LimitationsAll studies used self-administrated food frequency questionnaires (FFQs), which were prone to biased responses, such as recall and estimation bias. DiscussionLower trends of odds ratios (ORs) were consistently observed in higher Mediterranean diet adherence. In every outcome of the included studies, ORs ranged between 0.06-0.992, however, differing levels of significance were reported in each outcome. ConclusionOverall analyses suggest that high adherence to Mediterranean Diet is a protective factor against COVID-19, with unclear benefits against COVID-19 symptoms and severity. Primary Funding SourceThe author(s) received no specific funding for this work.

Mathematical models of COVID-19 vaccination in high-income countries: A systematic review (preprint)

Objectives Since COVID-19 first emerged in 2019, mathematical models have been developed to predict transmission and provide insight into disease control strategies. A key research need now is for models to inform long-term vaccination policy. We aimed to review the variety of existing modelling methods, in order to identify gaps in the literature and highlight areas for future model development. Study design This study was a systematic review. Methods We searched PubMed, Embase and Scopus from 1 January 2019 to 6 February 2023 for peer-reviewed, English-language articles describing age-structured, dynamic, mathematical models of COVID-19 transmission and vaccination in high-income countries that include waning immunity or reinfection. We extracted details of the structure, features and approach of each model and combined them in a narrative synthesis. Results Of the 1109 articles screened, 47 were included. Most studies used deterministic, compartmental models set in Europe or North America that simulated a time horizon of 3.5 years or less. Common outcomes included cases, hospital utilisation and deaths. Only nine models included long COVID, costs, life-years or quality of life-related measures. Two studies explored the potential impact of new variants beyond Omicron. Conclusions This review demonstrates a need for long-term models that focus on outcome measures such as quality-adjusted life years, the population-level effects of long COVID and the cost-effectiveness of future policies -- all of which are essential considerations in the planning of long-term vaccination strategies.

Covid19 and Pregnancy: Infected Mothers and Premature Babies? (preprint)

Introduction: The emergency of the SARS-CoV-2 virus spread and its subsequent global pan-demic have raised significant concerns regarding its impact on pregnancy outcomes. This review aims to summarize the emerging data on the risk of preterm delivery in pregnant women infected with SARS-CoV-2. Materials and Methods: A systematic search was conducted from March 2020 to December 2023 using PubMed, following PRISMA guidelines. Studies correlating maternal COVID-19 infection with preterm birth were included. Results: Thirteen studies were analyzed, indicating a higher incidence of preterm birth in SARS-CoV-2 positive pregnant women compared to controls. The average incidence rate of pre-term birth in infected patients was 18.5%, with a median of 12.75%, while non infected women showed an average incidence of preterm birth of 10% with a median of 8.2%. Discussion: Studies suggest an association between SARS-CoV-2 infection during pregnancy and increased risk of preterm birth and cesarean section. Severity of symptoms and underlying comorbidities further elevate this risk. Notably, infections during the third trimester pose the highest risk of preterm birth. Conclusion: Preventing SARS-CoV-2 infection during pregnancy is crucial to mitigate adverse obstetric outcomes. Close monitoring and tailored interventions for infected pregnant women, particularly those in later trimesters and with comorbidities, are imperative to reduce the risk of preterm birth and improve maternal-fetal outcomes.

The Effectiveness of Socially Assistive Robots in Improving Children’s Pain and Negative Affectivity during Needle-based Invasive Treatment: A Systematic Review and Meta-analysis (preprint)

Background The ability of socially assistive robots (SARs) to treat dementia and Alzheimer’s disease has been verified. Currently, to increase the range of their application, there is an increasing amount of interest in using SARs to relieve pain and negative emotions among children in routine medical settings. However, there is little consensus regarding the use of these robots. Objective This study aimed to evaluate the effect of SARs on pain and negative affectivity among children undergoing invasive needle-based procedures. Design This study was a systematic review and meta-analysis of randomized controlled trials that was conducted in accordance with the Cochrane Handbook guidelines. Methods The PubMed, Embase, EBSCO, Web of Science, Cochrane Library, Embase, CNKI, and WanFang databases were searched from inception to January 2024 to identify relevant randomized controlled trials (RCTs). We used the Cochrane Risk of Bias tool 2.0 (RoB2.0) to assess the risk of bias among the included studies, and we used RevMan 6.3 software to conduct the meta-analysis. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework was used to assess the quality of the evidence. Results Ten RCTs involving 815 pediatric subjects were selected for this review and reported outcomes related to pain and emotions during IV placement, port needle insertion, flu vaccination, blood sampling, and dental treatment. Children undergoing needle-related procedures with SARs reported less anxiety (SMD= -0.36; 95% CI= -0.64, -0.09; P = 0.01) and fewer distressed avoidance behaviors (SMD= -0.67; 95% CI= -1.04, -0.30; P = 0.0004) than did those receiving typical care. There were nonsignificant differences between these groups in terms of in pain (SMD = -0.02; 95% CI = − 0.81, 0.78; P = 0.97) and fear (SMD = 0.38; 95% CI= -0.06, 0.82; P = 0.09). The results of exploratory subgroup analyses revealed no statistically significant differences based on the intervention type of robots or anesthetic use. Conclusions The use of SARs is a promising intervention method for alleviating anxiety and distress among children undergoing needle-related procedures. However, additional high-quality randomized controlled trials are needed to further validate these conclusions. Registrations The protocol of this study has been registered in the database PROSPERO (registration ID: CRD42023413279).

Exploring the Psychological, Social, and Human Rights Dynamics and Consequences of COVID-19 Control Measures: A Systematic Review (preprint)

This systematic review explores the social and psychological dynamics and consequences of COVID-19 control measures and their implications for human rights. Through a lens of social psychology, the review considers factors such as social influence, obedience, perceived control, social comparison, cognitive dissonance, propaganda, surveillance, fearmongering, incentives, coercion, persuasion, censorship, obfuscation, isolation, and rewards and punishment. By analyzing the influence of these factors on individuals and group responses to the pandemic and the manipulation of social and psychological dynamics by institutions to shape compliance, this review provides insights into the determinants that drive adherence to control measures and their negative consequences. The findings of the 13 selected studies contribute to understanding the multifaceted factors that influence compliance and inform the development of effective public health interventions to avoid consequences. The review emphasizes the importance of upholding human rights during the implementation of control measures, given the reported violations across the world. By providing insights to policymakers, politicians, health practitioners, and researchers, this review enables the formulation of strategies that promote public health while respecting human and individual rights and well-being. In conclusion, this study sheds light on the social and psychological dynamics, human rights, and implications of COVID-19 control measures, providing valuable insights for future interventions.

Comparative content analysis of national health strategies before and after COVID-19: a systematic policy analysis among OECD and BRICS countries (preprint)

Background We aimed to evaluate the National Health Policies, Strategies and Plans (NHPSPs) of the Organization for Economic Cooperation and Development (OECD) and BRICS before and after the COVID-19 pandemic to explore nations' commitment to strengthen their health systems in defense of health threats and analyze the specific changes.Methods We systematically searched NHPSP documents from the WHO document repository and official governmental websites. Data was then extracted using a standardized extraction template. A coding framework was inductively developed to sort qualitative responses into categories, with frequencies calculated and weighting evaluated, followed by organizing underlying content into subthemes.Results The search yielded 154 documents, with 36 retained after screening, encompassing 14 OECD countries and 3 BRICS countries. The most predominant theme was prevention (88.9% pre-pandemic, 99.4% post-pandemic), which was addressed as a primary theme in 26 included NHPSPs. After the COVID-19 pandemic, 6 out of 14 analyzed themes saw higher occurrences, among which infection prevention and control (22.2–50.0%) and resilience to health crisis (22.2–44.4%) increased most significantly. Themes mainstreamed in post-pandemic NHPSPs included prevention (94.4%), health research and technology (61.1%), and One Health (66.7%). Primary healthcare emerged as the most concerned subtheme under prevention. Notably, OECD countries displayed more increased occurrences of themes (13 out of 14) or increased emphasis on themes with similar occurrences before and after COVID-19, while BRICS countries only differed in infection control. The two sets of countries also varied in subthemes and action plans under the same primary theme.Conclusion Many countries are endeavoring to move towards more robust health systems by optimizing NHPSPs, yet only about half of OECD and BRICS countries have introduced new NHPSPs after COVID-19. We hope our findings attract attention to the necessity of global health system reforms and provide other countries with actionable recommendations for NHPSP formulation.