Comparative study on health behaviors among adolescents with chronic allergic disease before and during COVID-19 using data from the Korean Youth Health Panel Surveys.

BACKGROUND: This study aimed to investigate the changes in the health behaviors and subjective health perception of adolescents with chronic allergic disease, including atopic dermatitis, asthma, and allergic rhinitis, amidst the coronavirus disease 2019 (COVID-19) pandemic in South Korea. METHODS: This study used the 15th (2019) and 17th (2021) raw data obtained from the Korea Youth Risk Behavior Web-based Survey (KYRBWS), conducted by the Ministry of Health and Welfare of South Korea. Data were analyzed using multiple logistic regression with complex sampling using weighted values. Odds ratios with 95% confidence intervals for six health behaviors and subjective health perception were used as the major variables. RESULTS: Six health behaviors (dietary habits, weight gain, smoking, alcohol consumption, sleep time, and physical activity) changed substantially during COVID-19. There was an increase in the duration of sedentary activities, a slight increase in BMI, and improvements in mental health. Concurrently, there was a decrease in alcohol consumption, sleep duration, and the consumption of sweetened beverages. Despite these improvements in big six health behaviors, adolescents with chronic illnesses continue to perceive themselves as unhealthy. CONCLUSIONS: These findings suggest that the follow-up and monitoring of health behaviors and subjective health perception in adolescents with chronic allergic diseases during the COVID-19 pandemic are necessary. Understanding the mechanisms underlying sustained behavioral change can inform the development of interventions to promote healthy behavior after the pandemic has passed.

Impact of the COVID-19 pandemic on teaching and research activities in obstetrics and gynecology: a national two-stage, stratified, cluster sampling survey in China.

BACKGROUND: Few studies quantified the influence of the coronavirus disease 2019 (COVID-19) pandemic on medical teaching and scientific research activities in China. This is the first national study to investigate such topics from the viewpoint of physicians practicing obstetrics and gynecology in China. METHODS: This is a national questionnaire survey with online interviews for respondents. This two-stage, stratified, cluster sampling method was applied based on city categories (categories 1 to 3 correspond to < 10,000, 10,000 to 30,000, and > 30,000 beds, respectively), hospital levels (primary, secondary, and tertiary), and hospital types (general and specialized) in China among physicians practicing obstetrics and gynecology. Physicians documented notable alterations in both overall and specialized teaching and research engagements. Comparative analyses were conducted across diverse municipal and hospital attributes. RESULTS: Data were collected from a representative sample of 11,806 physicians from 779 hospitals across 157 cities and 31 provinces. Notably, except for online seminars, a minimum reduction of 20% in both overall and specialized teaching and research activities was observed among physicians. Up to 61.7% (95% confidence interval 59.3-64.0) of physicians reported either a complete termination or a > 50% decline in resident training. Compared with category 1 cities and primary hospitals, category 3 cities and tertiary hospitals experienced greater reductions in items of resident or graduate education, visiting scholar, clinical trials, and laboratory studies (adjusted p values < 0.05), coupled with notable increases in online seminar participation (adjusted p values of 0.002 and < 0.001, respectively). CONCLUSIONS: Amidst the COVID-19 pandemic in China, activities requiring direct, face-to-face communication were more affected in resource-rich cities and general hospitals compared to resource-limited areas and specialized hospitals. Residency training experienced the most significant decline. Conversely, participation in online seminars increased, providing additional opportunities for continuing medical education.

Nurses' perceptions of medical service robots in negative-pressure isolated wards and in general wards: A cross-sectional survey.

AIM: To evaluate nurses' workload during the coronavirus disease 2019 (COVID-19) pandemic and to identify their perception of medical serviced robots (MSRs) that may help with or replace the tasks of nurses in negative-pressure isolated wards and general wards. DESIGN: Cross-sectional survey. METHODS: A researcher-made questionnaire was applied that assessed nurses' current workload and their attitudes towards and perceptions of MSRs. A visual analogue scale (VAS) from 1 to 10 was used to assess workload. Perceptions evaluated on a 5-point Likert scale ranging from one point for 'strongly disagree' to five points for 'strongly agree'. A higher VAS score indicated a higher workload. On the other hands, a higher Likert score indicated a more positive perception and three points was neutral. The questionnaire was conducted on 150 nurses in negative-pressure isolated wards for the management of COVID-19 and 150 nurses in general wards. Quota sampling technique was used as sampling technique. Data analysis was performed through independent t-tests, chi-square tests and two-tailed tests. The p-value <0.05 was interpreted to statistically significant. RESULTS: Two hundred eighty-two participants responded and 142 belonged to the negative-pressure isolated ward. The overall response rate was 94%, and 94.7% in the negative isolated ward. The mean score ± standard deviation for nursing-related psychological stress at the current work site was 7.18 ± 1.58 points, and the mean score for physical workload was 7.65 ± 1.48. The need for MSRs was rated as 3.66 ± 0.86 out of 5. Overall, a positive attitude towards MSRs was confirmed, with no difference between ward groups. The overall ratings were 3.14 ± 1.15 for perceived availability and 3.26 ± 1.13 for perceived efficiency. Both nurse groups perceived that MSRs were most available and efficient for monitoring and measurements. Nurses in negative-pressure isolated wards perceived MSRs more positively than did nurses in general wards regarding setting of alarms (p = 0.003) and delivery of medical devices/materials (p = 0.013). Based on these results, functional development of MSRs associated with monitoring, measurements, setting of alarms and delivery should be prioritized. No patient or public contribution.

The impact of negative COVID-19 experiences on cancer survivors' health-related quality of life and psychological distress: a moderated mediation model.

Introduction: Cancer survivors experienced poorer health-related quality of life (HRQoL) and greater psychological distress during the COVID-19 pandemic than those without cancer. However, the underlying mechanisms that may explain how negative experiences during the pandemic are associated with distress and HRQoL remain unknown. We examined whether psychosocial risk factors (i.e., healthcare disruption, disruption to daily activities and social interaction [DDASI], and financial hardship) mediated the relationship between negative COVID-19-related experiences and cancer survivors' HRQoL and psychological distress (i.e., depressive symptoms, and anxiety) and whether the mediating effects were moderated by psychosocial protective factors (i.e., stress management ability and social support). Methods: A total of 9,651 cancer survivors completed a questionnaire assessing negative COVID-19-related experiences, psychosocial and practical experiences, and HRQoL. Conditional process analysis was used to evaluate the proposed moderated mediation models. Results: Participants had a mean age of 63.8 years (SD = 12.3) and were mostly non-Hispanic White (82.3%). DDASI and financial hardship mediated the relationship between negative COVID-19-related experiences and cancer survivor's HRQoL and psychological distress. Stress management ability buffered the indirect effect of DDASI on cancer survivors' HRQoL and psychological distress. Social support buffered the indirect effect of financial hardship on HRQoL and depressive symptoms. Conclusion: Financial resources and social interactions may buffer negative effects of major disruptions such as the COVID-19 pandemic. Future studies should assess the longitudinal impact of these associations.

Changes in unhealthy food consumption among vulnerable elementary-aged children in the United States during the COVID-19 pandemic: a serial cross-sectional analysis.

Objective: Several studies suggest that during the early pandemic, amidst socioeconomic instability, children from underserved families were more likely to resort to consuming cheaper, lower-quality foods with longer shelf lives. This study investigated the change in unhealthy food consumption across different phases (pre, early, mid) of the COVID-19 pandemic, and whether the strength of association between unhealthy food consumption and household socioeconomic disadvantage (HSED) varied across phases of the pandemic. Methods: This study utilized serial cross-sectional data collected from low-income families enrolled in a school-based food co-op, Brighter Bites. Secondary data analysis included 5,384 surveys from families who had complete data: 3422 pre-pandemic, 944 from the early pandemic, and 1,018 mid-pandemic. Outcome measures included sugary food intake and convenience/fast food intake, each of which was operationalized as a scale using pre-validated items from the surveys. HSED was operationalized as a composite of parent employment, parent education, food insecurity, and participation in government programs; responses were categorized into low, medium, and high HSED groups for analysis. We examined the interaction between HSED and time period to explore how HSED and its association with dietary measures changed over the course of the pandemic. Results: A significant linear negative trend, i.e., a decrease in consumption from pre-to-mid-pandemic period was seen in sugary food intake (p < 0.001), but not in convenience food intake. In data pooled across time-periods, both sugary food and convenience/fast food consumption were inversely associated with HSED, and low unhealthy food consumption was observed among high-disadvantage groups. No significant interaction between time period and HSED was observed on either scale. However, the post-regression estimates from the adjusted interaction model showed a significant association between convenience/fast food consumption and HSED in pre- and mid-pandemic periods. Conclusion: The study highlights the nuances of socioeconomic dynamics on the diet behaviors of children from low-income families during a natural disaster.

Effect of the COVID-19 pandemic on infants' development: analyzing the results of developmental assessments at ages 10-11 and 18-24 months.

The purpose of this study was to determine the effect of the COVID-19 pandemic on infant development. The study investigated the development of infants at 10-11 months of age between 2020 and 2023 by using the Kyoto Scale of Psychological Development-2020 (KSPD2020), an individualized developmental scale, and the Kinder Infant Developmental Scale (KIDS), a developmental questionnaire. We compared the results of the KSPD2020 with those of a pre-pandemic developmental research and compared the developmental age (DA) of KIDS with children's chronological age (CA). Moreover, the same developmental research was conducted again on the same children at 18-24 months of age. DA for receptive language and expressive language was lower in the KIDS compared to CA in the investigation at 10-11 months. However, in the investigation at 18-24 months, there were no areas where KIDS' DA was lower than CA, and DA in the areas of manipulation, receptive language, social relationship with adults, discipline, and eating was higher than CA. On the other hand, using the KSPD2020, there were no differences when compared to pre-pandemic data in the investigation at 10-11 months. Furthermore, the investigation at 18-24 months showed that developmental quotient (DQ) was lower in the Language-Social (L-S) areas than in the investigation at 10-11 months. The lower DQ of L-S in this study was also evident in comparison to the 18-24 months pre-pandemic data. These results suggested that to investigate the medium- and long-term effects of the COVID-19 pandemic on children's development, it is necessary to use not only parent-filled questionnaires but also individualized developmental scales. In addition, the finding that results may differ depending on the method of developmental assessment is considered important not only for developmental researchers but also for professionals involved in supporting children's development.

Kawasaki disease before and during the COVID-19 pandemic: a single-center comparative study in Switzerland.

BACKGROUND: Kawasaki disease is a rare systemic inflammatory syndrome that mainly affects children under five years of age and is the first cause of pediatric acquired cardiovascular disease. The pathogenesis is complex and a viral trigger is suspected, as well as genetic susceptibility. Multiple studies around the world have shown a decrease in the incidence of Kawasaki disease and have hypothesized that the different sanitary measures enforced in each country during the pandemic period could be responsible to a certain extent. The aim of this study is to evaluate the effects of the COVID-19 pandemic on the disease's incidence, defining characteristics, coronary artery outcomes and management in a tertiary center in Switzerland. METHODS: This study is a retrospective analysis of children who have been diagnosed with Kawasaki disease that compares clinical, laboratory, SARS-CoV-2 exposure, and echocardiographic data as well as treatments before (January 1st 2017 to February 24th 2020) and during (February 25th 2020 to December 31st 2022) the COVID-19 pandemic in Switzerland. Statistical significance of differences in the compared parameters was assessed. RESULTS: Of the 90 patients included, 31 belonged to the first group and 59 belonged to the second group. There was a statistically significant (p < 0.05) increase in incidence during the pandemic period (5.91/100,000 children) of 88% compared to the pre-pandemic period (3.14/100,000 children). A lesser seasonal variation was observed during the pandemic. 30% of the patients in the pandemic group had an exposure to SARS-CoV-2. There was no other notable difference in demographic factors, clinical presentation, coronary outcome or administered treatment. CONCLUSIONS: To the best of our knowledge, this is the first prolonged European study comparing Kawasaki disease before and during the COVID-19 pandemic. There was a significant increase in incidence in Kawasaki disease during the COVID-19 pandemic. In contrast, studies done in Japan, South Korea and the USA have shown a decrease in incidence. Differences in methodologies, genetics, ethnicities, environments, microbiome-altering behaviors, sanitary measures and SARS-CoV-2 spread are factors that should be considered. Further studies analyzing the differences between countries with increased incidence of Kawasaki disease could help better understand the relevance of such factors and provide more insight into the etiologies of this particular disease.

Impact of COVID-19 pandemic on greenhouse gas and criteria air pollutant emissions from the San Pedro Bay Ports and future policy implications.

The Ports of Los Angeles and Long Beach, collectively known as the San Pedro Bay Ports, serve as vital gateways for freight movement in the United States. The COVID-19 pandemic and other influencing factors disrupted freight movement and led to unprecedented cargo surge, vessel congestion, and increased air pollution and greenhouse gas emissions from seaport and connected freight system operations beginning in June 2020. In this study, we conducted the first comprehensive monthly assessment of the excess particulate matter, oxides of nitrogen (NOx), and carbon dioxide (CO2) emissions due to the heightened congestion and freight transport activity from ocean-going vessels (OGVs), trucks, locomotives, and cargo handling equipment (CHE) supporting seaport operations. Excess emissions peaked in October 2021 at 23 tons of NOx per day and 2001 tons of CO2 per day. The strategic queuing system implemented in November 2021 significantly reduced the number of anchored and loitering OGVs and their emissions near the ports, even during continued high cargo throughput until Summer 2022. Looking forward, we analyzed projected emissions benefits of adopted California Air Resources Board regulations requiring cleaner and zero-emission trucks, locomotives, and CHE over the next decade. If a repeated port congestion event were to occur in 2035, NOx emissions from land-based freight transport should be lessened by more than 80%. Our study underscores the potential emissions impacts of disruptions to the freight transport network and the critical need to continue reducing its emissions in California and beyond.

Changes in the Epidemiological Features of Influenza After the COVID-19 Pandemic in China, the United States, and Australia: Updated Surveillance Data for Influenza Activity.

BACKGROUND: There has been a global decrease in seasonal influenza activity since the onset of the COVID-19 pandemic. OBJECTIVE: We aimed to describe influenza activity during the 2021/2022 season and compare it to the trends from 2012 to 2023. We also explored the influence of social and public health prevention measures during the COVID-19 pandemic on influenza activity. METHODS: We obtained influenza data from January 1, 2012, to February 5, 2023, from publicly available platforms for China, the United States, and Australia. Mitigation measures were evaluated per the stringency index, a composite index with 9 measures. A general additive model was used to assess the stringency index and the influenza positivity rate correlation, and the deviance explained was calculated. RESULTS: We used over 200,000 influenza surveillance data. Influenza activity remained low in the United States and Australia during the 2021/2022 season. However, it increased in the United States with a positive rate of 26.2% in the 49th week of 2022. During the 2021/2022 season, influenza activity significantly increased compared with the previous year in southern and northern China, with peak positivity rates of 28.1% and 35.1% in the second week of 2022, respectively. After the COVID-19 pandemic, the dominant influenza virus genotype in China was type B/Victoria, during the 2021/2022 season, and accounted for >98% (24,541/24,908 in the South and 20,543/20,634 in the North) of all cases. Influenza virus type B/Yamagata was not detected in all these areas after the COVID-19 pandemic. Several measures individually significantly influence local influenza activity, except for influenza type B in Australia. When combined with all the measures, the deviance explained values for influenza A and B were 87.4% (P<.05 for measures of close public transport and restrictions on international travel) and 77.6% in southern China and 83.4% (P<.05 for measures of school closing and close public transport) and 81.4% in northern China, respectively. In the United States, the association was relatively stronger, with deviance-explained values of 98.6% for influenza A and 99.1% (P<.05 for measures of restrictions on international travel and public information campaign) for influenza B. There were no discernible effects on influenza B activity in Australia between 2020 and 2022 due to the incredibly low positive rate of influenza B. Additionally, the deviance explained values were 95.8% (P<.05 for measures of restrictions on gathering size and restrictions on international travel) for influenza A and 72.7% for influenza B. CONCLUSIONS: Influenza activity has increased gradually since 2021. Mitigation measures for COVID-19 showed correlations with influenza activity, mainly driven by the early stage of the pandemic. During late 2021 and 2022, the influence of mitigation management for COVID-19 seemingly decreased gradually, as the activity of influenza increased compared to the 2020/2021 season.

Living less safely through the pandemic in England for people with serious mental and physical health conditions: qualitative interviews with service users and carers of Black African, Caribbean, and South-Asian descent.

BACKGROUND: COVID-19 Ethnic Inequalities in Mental health and Multimorbidities (COVEIMM) is a mixed methods study to explore whether COVID-19 exacerbated ethnic health inequalities in adults with serious mental and physical health conditions. We analysed data from electronic health records for England and conducted interviews in Birmingham and Solihull, Manchester, and South London. Sites were selected because they were pilot sites for the Patient and Carer Race Equality Framework being introduced by NHS England to tackle race inequalities in mental health. Prior to the pandemic people in England with severe mental illnesses (SMIs) faced an 11-17-year reduction in life expectancy, mostly due to preventable, long-term, physical health conditions. During the pandemic there was a marked increase in deaths of those living with an SMI. AIMS: This qualitative interview study aimed to understand the reasons underlying ethnic inequalities in mortality and service use during the COVID-19 pandemic for adult service users and carers of Black African, Black Caribbean, Indian, Pakistani, and Bangladeshi backgrounds living with serious multiple long-term mental and physical health conditions. METHODS: We took a participatory action research approach and qualitative interviews undertaken by experts-by-experience and university researchers Participants were purposively sampled by ethnicity, diagnoses, and comorbidities across three geographically distinct sites in England. Transcriptions were coded inductively and deductively and analysed thematically. RESULTS: Findings indicated multiple points along primary and secondary health pathways for mental and physical health that have the potential to exacerbate the unjust gap in mortality that exists for Black and Asian people with SMIs. Issues such as timely access to care (face-to-face and remote), being treated in a culturally appropriate manner with empathy, dignity and respect, and being able to use services without experiencing undue force, racism or other forms of intersectional discrimination were important themes arising from interviews. CONCLUSION: These poor experiences create systemic and enduring healthcare harms for racialised groups with SMIs that need to be addressed. Our findings suggest a need to address these, not only in mental health providers, but across the whole health and care system and a need to ensure more equitable healthcare partnerships with service users, carers, and communities from racialised backgrounds who are often excluded.

Applied One Health: Nigeria National Veterinary Research Institute COVID-19 pandemic response.

The COVID-19 pandemic has caused the death of 7.1 million people worldwide as of 7 July 2024. In Nigeria, the first confirmed case was reported on 27 February 2020, subsequently followed by a nationwide spread of SARS-CoV-2 with morbidity and mortality reaching 267 173 and 3155, respectively, as of 7 July 2024. At the beginning of the pandemic, only a few public health laboratories in Nigeria had the capacity for SARS-CoV-2 molecular diagnosis. The National Veterinary Research Institute (NVRI), already experienced in influenza diagnosis, responded to the public health challenge for the diagnosis of COVID-19 samples from humans. The feat was possible through the collective utilisation of NVRI human and material resources, including biosafety facilities, equipment, reagents and consumables donated by international partners and collaborators. Within 6 months of the reported COVID-19 outbreak in Nigeria, over 33 000 samples were processed in NVRI facilities covering five states. Thereafter, many field and laboratory projects were jointly implemented between NVRI and collaborating sectors including the Nigerian Centre for Disease Control (NCDC) and the National Institute for Medical Research (NIMR), which brought together professionals in the health, veterinary, education and socio-sciences. In addition, One Health grants were secured to enhance surveillance for coronavirus and other zoonoses and build capacity in genomics. Bio-surveillance for coronaviruses and other emerging zoonotic pathogens at the human-animal interface was activated and continued with sample collection and analysis in the laboratory for coronaviruses, Lassa fever virus and Mpox. One Health approach has shown that inter-sectoral and multinational collaboration for diagnosis, research and development in animals, and the environment to better understand pathogen spillover events at the human-animal interface is an important global health priority and pandemic preparedness.

Mental health of individuals with pre-existing mental illnesses at the beginning of the COVID-19 pandemic: results of the German National Cohort (NAKO).

Background: The COVID-19 pandemic prompted a range of studies on mental health, with mixed results. While numerous studies reported worsened conditions in individuals with pre-existing mental disorders, others showed resilience and stability in mental health. However, longitudinal data focusing on the German population are sparse, especially regarding effects of age and pre-existing mental disorders during the early stages of the pandemic. Objectives: To assess the interplay between psychiatric history, age, and the timing of the pandemic, with a focus on understanding how these factors relate to the severity of depression and anxiety symptoms. Methods: Exploratory analyses were based on 135,445 individuals aged 20-72 years from the German National Cohort (NAKO). Depressive and anxiety symptoms were assessed before and after the first wave of the pandemic. Inferential statistical analyses and negative binomial regression models were calculated. Results: Persons with a self-reported psychiatric history exhibited comparable levels of depression and anxiety symptom severity after the first wave of the pandemic compared to the time before. In contrast, individuals without a psychiatric history, particularly those in their 20s to 40s, experienced an increase in mental health symptom severity during the first wave of the pandemic. Limitations: Analyses focuses on the first wave of the pandemic, leaving the long-term mental health effects unexplored. Conclusion: Future research should consider age-specific and mental-health-related factors when addressing global health crises. Additionally, it is important to explore factors influencing resilience and adaptation, aiming to develop targeted interventions and informed policies for effective mental health management during pandemics.

Co-rumination and intrapersonal cognitive processes predict distress: Longitudinal evidence from the COVID-19 pandemic.

Perseverative thinking and catastrophizing have well established associations with fear and distress. However, less is known about the impact of interpersonal dynamics, such as co-rumination, on these intrapersonal cognitive processes and subsequent stress. The present study addresses this knowledge gap. A sample of 433 adults from across the United States was recruited online and completed measures of co-rumination, perseverative thinking, catastrophizing, and demographic characteristics early in the COVID-19 pandemic, and the COVID Stress Scales (CSS) at six month follow up. Co-rumination, perseverative thinking, catastrophizing, and CSS scores were correlated in the expected direction. Regression analyses revealed all three independently predicted CSS worry about the dangerousness of COVID-19 subscale. Co-rumination was the strongest predictor of CSS worry about the socioeconomic impact and CSS compulsive checking scales. Perseverative thinking and catastrophizing predicted CSS traumatic stress symptoms subscale. Finally, perseverative thinking was the strongest predictor of CSS xenophobia subscale. Structural equation modelling indicated that co-rumination had a significant indirect effect on CSS scores through perseverative thinking and catastrophizing. Interpersonal dynamics, such as co-rumination, are relevant for understanding stress and are promising targets for intervention research to prevent or attenuate fears and distress, in addition to traditional intrapersonal cognitive processes such as perseverative thinking and catastrophizing.

Moderators of the Effects of a Digital Parenting Intervention on Child Conduct and Emotional Problems Implemented During the COVID-19 Pandemic: Results From a Secondary Analysis of Data From the Supporting Parents and Kids Through Lockdown Experiences (SPARKLE) Randomized Controlled Trial.

BACKGROUND: A smartphone app, Parent Positive, was developed to help parents manage their children's conduct and emotional problems during the COVID-19 pandemic. A randomized controlled trial, Supporting Parents and Kids Through Lockdown Experiences (SPARKLE), found Parent Positive to be effective in reducing children's emotional problems. However, app effectiveness may be influenced by a range of child, family, socioeconomic, and pandemic-related factors. OBJECTIVE: This study examined whether baseline factors related to the child, family, and socioeconomic status, as well as pandemic-related disruption circumstances, moderated Parent Positive's effects on child conduct and emotional problems at 1- and 2-month follow-up. METHODS: This study was a secondary exploratory analysis of SPARKLE data. The data set included 646 children (4-10 years of age) with parents randomized to either Parent Positive (n=320) or follow-up as usual (n=326). Candidate baseline moderators included child age, gender, attention-deficit/hyperactivity disorder symptoms, parental psychological distress, family conflict, household income, employment status, household overcrowding, and pandemic-related disruption risk (ie, homeschooling, lockdown status, and isolation status). Child conduct and emotional problem outcomes measured at 1- (T2) and 2-months (T3) post randomization were analyzed using linear mixed-effects analysis of covariance models adjusting for baseline (T1) measure of outcome and including intervention and intervention by time point interaction terms allowing for different effects at the 2 time points. Moderation of intervention effects by baseline factors was assessed by replacing the intervention by time interaction terms with intervention by time point by baseline moderator interaction terms. RESULTS: Child gender was a significant moderator of the Parent Positive versus follow-up as usual effect on emotional problems (B=0.72, 95% CI 0.12-1.33; P=.02). Specifically, the effect of Parent Positive was close to significant (T2: B=-0.41, 95% CI -0.82 to 0.0004; P=.05) or significant (T3: B=-0.76, 95% CI -1.22 to -0.30; P<.001) in males only when compared with females, and males experienced a significantly larger reduction in emotional problems than females in the Parent Positive arm at the 2-month post randomization time point. None of the other investigated baseline factors moderated effects on emotional problems, and no factors moderated effects on conduct problems. CONCLUSIONS: This study highlights Parent Positive's potential for effectively reducing emotional problems in primary school-aged male children across a wide range of families. However, due to limited variability in the demographic background of the families, cautious interpretation is required, and replications are necessary in diverse samples with longer follow-up times. TRIAL REGISTRATION: ClinicalTrials.gov NCT04786080; https://clinicaltrials.gov/ct2/show/NCT04786080.

Silent Effects of the COVID-19 Pandemic: Parental Attachment in Pediatric Patients.

AIM: The COVID-19 pandemic led to isolation measures intended to curb the spread of infection, which are believed to have negatively affected children's psychological well-being. This study examines the impact of the pandemic on parental attachment with children. METHOD: A cross-sectional study was conducted with children visiting a general pediatrics clinic between April 1 and 20, 2023. Their COVID-19 infection history was recorded, and the Kern's Attachment Questionnaire was used to assess parental attachment in children who had contracted COVID-19 and those who had not. RESULTS: The study involved 716 patients aged 9-12, divided into two groups: those who had contracted COVID-19 (n=253) and those who had not (n=463). Kern's Attachment Questionnaire scores for mothers were 46.3 for children with COVID-19 and 49.4 for those without. For fathers, the scores were 43.9 and 48, respectively. Children who had contracted COVID-19 showed significantly lower attachment scores to both mothers and fathers compared to the control group (p=0.04, p=0.00). CONCLUSION: The pandemic's long-term biopsychosocial effects are evident, with increased stress and negative experiences posing risks to child development, particularly in terms of parental attachment. While early attachment begins in infancy, it continues to evolve. This study underscores the need for behavioral and psychological follow-up for adolescents in the post-pandemic period.

Gambling on others' health: risky pro-social decision-making in the era of COVID-19.

Introduction: In the early days of the COVID-19 pandemic, individuals were asked to perform costly actions to reduce harm to strangers, even while the general population, including authorities and experts, grappled with the uncertainty surrounding thenovel virus. Many studies have examined health decision-making by experts, but the study of lay, non-expert, individual decision-making on a stranger's health has been left to the wayside, as ordinary citizens are usually not tasked with such decisions. Methods: We sought to capture a snapshot of this specific choice behavior by administering two surveys to the general population in the spring of 2020, when much of the global community was subject to COVID-19-related restrictions, as well as uncertainty surrounding the virus. We presented study participants with fictitious diseases varying in severity that threatened oneself, a loved one or a stranger. Participants were asked to choose between treatment options that could either provide a sure, but mild improvement (sure option) or cure the affected person at a given probability of success (risky option). Results: Respondents preferred gambles overall, but risk-seeking decreased progressively with higher expected severity of disease. This pattern was observed regardless of the recipient's identity. Distinctions between targets emerged however whendecisions were conditioned on a treatment's monetary cost, with participants preferring cheaper options for strangers. Discussion: Overall, these findings provide a descriptive model of individual decision-making under risk for others; and inform on the limits of what can be asked of an individual in service to a stranger.

Perceived Impact of COVID-19 in an Underserved Community: A Natural Language Processing Approach.

AIM: To utilise natural language processing (NLP) to analyse interviews about the impact of COVID-19 in underserved communities and to compare it to traditional thematic analysis in a small subset of interviews. DESIGN: NLP and thematic analysis were used together to comprehensively examine the interview data. METHODS: Fifty transcribed interviews with purposively sampled adults living in underserved communities in the United States, conducted from June 2021 to May 2022, were analysed to explore the impact of the COVID-19 pandemic on social activities, mental and emotional stress and physical and spiritual well-being. NLP includes several stages: data extraction, preprocessing, processing using word embeddings and topic modelling and visualisation. This was compared to thematic analysis in a random sample of 10 interviews. RESULTS: Six themes emerged from thematic analysis: The New Normal, Juxtaposition of Emotions, Ripple Effects on Health, Brutal yet Elusive Reality, Evolving Connections and Journey of Spirituality and Self-Realisation. With NLP, four clusters of similar context words for each approach were analysed visually and numerically. The frequency-based word embedding approach was most interpretable and well aligned with the thematic analysis. CONCLUSION: The NLP results complemented the thematic analysis and offered new insights regarding the passage of time, the interconnectedness of impacts and the semantic connections among words. This research highlights the interdependence of pandemic impacts, simultaneously positive and negative effects and deeply individual COVID-19 experiences in underserved communities. IMPLICATIONS: The iterative integration of NLP and thematic analysis was efficient and effective, facilitating the analysis of many transcripts and expanding nursing research methodology. IMPACT: While thematic analysis provided richer, more detailed themes, NLP captured new elements and combinations of words, making it a promising tool in qualitative analysis. REPORTING METHOD: Not applicable. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

The Impact of Age-Based COVID-19 Pandemic Regulations on Older People in Turkey: A Capability Approach.

Older adults all around the world encountered numerous challenges during the COVID-19 pandemic. Some of these challenges were pertinent to biological factors, like the risk of infection, while others resulted from social factors, like ageism and government regulations. Employing a capability approach, this study examined how age-based pandemic regulations that were imposed in Turkey affected the freedom and social environment of older adults. We used Bachhi's What is the Problem Represented to Be? (WPR) approach to analyze the memorandums issued by the central government between March 11, 2020, and June 30, 2021. Our analysis revealed that the problem is represented in these memorandums as older people's increased vulnerability to health risks, which resulted in violations of their mobility and health capabilities, as well as (mis)recognition of diversity within the older population. These findings provide vital insight into how age-based pandemic regulations define the problem based exclusively on chronological age, thereby creating circumstances that compromise older people's capabilities beyond simply maintaining health. Thus, we recommend that policymakers pay closer attention to both the intended and unintended consequences of any proposed regulations, and account for individuals' capabilities rather than merely their functionings.

Parenting Style of Elderly Parents and Its Impact on Adolescent Behavior: A Case Report.

Adolescence is a critical transition period between childhood and adulthood. They experience biological, emotional, and social changes and require constant affection, support, and supervision during this period. Adolescents often face stressors from various sources, which can exacerbate behavioral issues. A 13-year-old boy, born 15 years after marriage by in vitro fertilization (IVF) to parents in their late 40s, was brought to the outpatient department. He had presented with complaints of getting angry, stealing money, lying, and threatening his parents for his demands for the past six months. His behavior intensified during the COVID-19 pandemic due to social isolation and prolonged home confinement. His parents said that lately, he has also gotten difficult to manage at home. He was diagnosed with conduct disorder. Despite initial management with behavioral therapy, the boy experienced frequent exacerbations of symptoms. Further assessment identified parental behavior as a contributing factor to the child's conduct disorder. Interventions incorporating family-focused therapy (FFT) and modifications in parenting techniques were implemented, resulting in an extended period of behavioral remission. Parenting style plays an instrumental role in defining the positive and negative outcomes a child will experience. Hence, the parents were counseled and psycho-educated about effective parenting. This case underscores the crucial role of parenting styles in influencing adolescent behavior and highlights the importance of family-centered interventions in managing behavioral problems during adolescence.

A Digital Health Model for School-Based Implementation to Improve Parent and Child Outcomes: Comparison of Active Versus Light-Touch Coaching Effects.

Online or app-based parenting interventions have become more widely available in recent years. However, challenges related to poor engagement and high attrition have been noted in the literature, and there are important questions regarding ways to enhance parental engagement and improve treatment outcomes through digital health, including through the addition of therapeutic coaches. The current study evaluated differences in the effects of active versus "light-touch" coaching implementations of an enhanced version of Family Check-Up Online (FCU-O) on parent/family and child-level outcomes from pre-treatment to 2-month follow-up assessments. The enhanced version of the FCU-O was adapted to support families in coping with pandemic-related stressors to prevent youth behavioral and emotional problems during middle school and included app-based modules designed to support effective parenting practices as well as virtual coaching. In the "active-coach" condition, parenting coaches were active in efforts to arrange coaching sessions with parents as they worked through the app-based modules, while in the light-touch intervention, parent-coaches enrolled participants in the context of a one-time support session but did not actively pursue families to schedule additional sessions. Parents in the active-coach condition exhibited greater engagement with both the app and coaching sessions than parents in the light-touch condition. Further, stronger improvements in several aspects of parenting and child functioning were observed in the active-coach versus light-touch conditions. However, parents in the light-touch condition showed reductions in stress and comparable levels of dosage when using the app. Implications for prevention and accessibility of digital health interventions are discussed.