COVID-19 Pandemic Risk Assessment: Systematic Review.

Background: The COVID-19 pandemic presents the possibility of future large-scale infectious disease outbreaks. In response, we conducted a systematic review of COVID-19 pandemic risk assessment to provide insights into countries' pandemic surveillance and preparedness for potential pandemic events in the post-COVID-19 era. Objective: We aim to systematically identify relevant articles and synthesize pandemic risk assessment findings to facilitate government officials and public health experts in crisis planning. Methods: This study followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and included over 620,000 records from the World Health Organization COVID-19 Research Database. Articles related to pandemic risk assessment were identified based on a set of inclusion and exclusion criteria. Relevant articles were characterized based on study location, variable types, data-visualization techniques, research objectives, and methodologies. Findings were presented using tables and charts. Results: Sixty-two articles satisfying both the inclusion and exclusion criteria were identified. Among the articles, 32.3% focused on local areas, while another 32.3% had a global coverage. Epidemic data were the most commonly used variables (74.2% of articles), with over half of them (51.6%) employing two or more variable types. The research objectives covered various aspects of the COVID-19 pandemic, with risk exposure assessment and identification of risk factors being the most common theme (35.5%). No dominant research methodology for risk assessment emerged from these articles. Conclusion: Our synthesized findings support proactive planning and development of prevention and control measures in anticipation of future public health threats.

The continued financial effect of COVID: Increasing costs for non-elective major lower extremity amputations.

Background: The COVID-19 pandemic necessitated changes in processes of care, which significantly impacted surgical care. This study evaluated the impact of these changes on patient outcomes and costs for non-elective major lower extremity amputations (LEA). Methods: The 2019-2021 Florida Agency for Health Care Administration database was queried for adult patients who underwent non-elective major LEA. Per-patient inflation-adjusted costs were collected. Patient cohorts were established based on Florida COVID-19 mortality rates: COVID-heavy (CH) included nine months with the highest mortality, COVID-light (CL) included nine months with the lowest mortality, and pre-COVID (PC) included nine months before COVID (2019). Outcomes included in-hospital patient outcomes and hospitalization cost. Results: 6132 patients were included (1957 PC, 2104 CH, and 2071 CL). Compared to PC, there was increased patient acuity at presentation, but morbidity (31%), mortality (4%), and length of stay (median 12 [8-17] days) were unchanged during CH and CL. Additionally, costs significantly increased during the pandemic; median total cost rose 9%, room costs increased by 16%, ICU costs rose by 15%, and operating room costs rose by 15%. When COVID-positive patients were excluded, cost of care was still significantly higher during CH and CL. Conclusions: Despite maintaining pre-pandemic standards, as evidenced by unchanged outcomes, the pandemic led to increased costs for patients undergoing non-elective major LEA. This was likely due to increased patient acuity, resource strain, and supply chain shortages during the pandemic. Key message: While patient outcomes for non-elective major lower extremity amputations remained consistent during the COVID-19 pandemic, healthcare costs significantly increased, likely due to increased patient acuity and heightened pressures on resources and supply chains. These findings underscore the need for informed policy changes to mitigate the financial impact on patients and healthcare systems for future public health emergencies.

COVID-19 impacts and inequities among underserved communities with diabetes.

Background: People with diabetes have higher COVID-19 morbidity and mortality. These risks are amplified for underserved communities including racial/ethnic minorities and people with lower socioeconomic status. However, limited research has examined COVID-19 outcomes specifically affecting underserved communities with diabetes. Methods: From November 2021 to July 2022, adults with insulin-requiring diabetes at federally qualified health centers in Florida and California (n = 450) completed surveys examining COVID-19 outcomes and demographics. Surveys assessed COVID-19 severity, vaccination uptake, mask-wearing habits, income changes, and healthcare access changes. Surveys also included the full Coronavirus Anxiety Scale (CAS-19). Descriptive statistics were computed for all outcomes. Between-group comparisons for state and race/ethnicity were evaluated via Chi-Squared, Fisher's Exact, Cochran-Mantel-Haenszel, One-Way ANOVA, and t-tests. Logistic regression determined factors associated with COVID-19 vaccination uptake. Data were self-reported and analyzed cross-sectionally. Results: Overall, 29.7 % reported contracting COVID-19; of those, 45.3 % sought care or were hospitalized. Most (81.3 %) received ≥ 1 vaccine. Hispanics had the highest vaccination rate (91.1 %); Non-Hispanic Blacks (NHBs) had the lowest (73.9 %; p =.0281). Hispanics had 4.63x greater vaccination odds than Non-Hispanic Whites ([NHWs]; 95 % CI = [1.81, 11.89]). NHWs least often wore masks (18.8 %; p <.001). Participants reported pandemic-related healthcare changes (62 %) and higher costs of diabetes medications (41 %). Income loss was more frequent in Florida (76 %; p <.001). NHBs most frequently reported "severe" income loss (26.4 %; p =.0124). Loss of health insurance was more common among NHBs (13.3 %; p =.0416) and in Florida (9.7 %; p =.039). COVID-19 anxiety was highest among NHBs and Hispanics (IQR = [0.0, 3.0]; p =.0232) and in Florida (IQR = [0.0, 2.0]; p =.0435). Conclusions: Underserved communities with diabetes had high COVID-19 vaccine uptake but experienced significant COVID-19-related physical, psychosocial, and financial impacts. NHBs and those in Florida had worse outcomes than other racial/ethnic groups and those in California. Further research, interventions, and policy changes are needed to promote health equity for this population.

Factors that contributed to Ontario adults' mental health during the first 16 months of the COVID-19 pandemic: a decision tree analysis.

The COVID-19 pandemic has negatively impacted the mental health of individuals globally. However, less is known about the characteristics that contributed to some people having mental health problems during the pandemic, while others did not. Mental health problems can be understood on a continuum, ranging from acute (e.g., depression following a stressful event) to severe (e.g., chronic conditions that disrupt everyday functioning). Therefore, the purpose of this article was to generate profiles of adults who were more or less at risk for the development of mental health problems, in general, during the first 16-months of the COVID-19 pandemic in Ontario, Canada. Data were collected via online surveys at two time points: April-July 2020 and July-August 2021; 2,188 adults (Mage = 43.15 years; SD = 8.82) participated. Surveys included a demographic questionnaire and four previously validated tools to measure participants' mental health, subjective wellbeing, physical activity and sedentary behaviour, and sleep. A decision tree was generated at each time point for those with mental health problems, and those with no mental health problems. Results showed that subjective wellbeing was the biggest contributor to mental health status. Characteristics associated with no mental health problems among adults included having good wellbeing, being a good sleeper (quantity, quality, and patterns of sleep), and being over the age of 42. Characteristics associated with mental health problems included having poor wellbeing and being a poor sleeper. Findings revealed that specific characteristics interacted to contribute to adults' mental health status during the first 16 months of the COVID-19 pandemic. Given that wellbeing was the biggest contributor to mental health, researchers should focus on targeting adults' wellbeing to improve their mental health during future health crises.

Clinician Opinions Regarding the Usefulness of the BOSA for ASD Assessment in a Service for Children Aged Under 12 Years.

The COVID-19 pandemic and the subsequent social distancing policies forced healthcare teams to drastically alter the way they deliver services. This was particularly challenging for clinicians involved in diagnosing autism spectrum disorder (ASD), as assessment tools and methods required face-to-face social interactions between clinicians and children. To address this, the Brief Observation of Symptoms of Autism (BOSA) was developed to ensure that people suspected of ASD can receive diagnostic assessments during the pandemic. This project aimed to explore clinicians' opinions on the BOSA, particularly regarding the usefulness of the assessment for clinicians to clarify diagnostic outcomes of ASD assessments. Both quantitative and qualitative data was gathered within an NHS community paediatric team. This included a questionnaire for clinicians to complete, and data from the BOSA assessments done in the service. Thematic analysis and descriptive statistics revealed that many clinicians felt that the BOSA can be beneficial in certain cases, such as selective mutism, and found the BOSA particularly helpful for observing parent-child interactions. These findings highlighted important information that the Autism Diagnostic Observation Schedule Second Edition (ADOS-2) does not give opportunities to observe. Clinicians reported that at times, the BOSA materials, brevity and parental administration created barriers to gathering information for diagnostic decisions. As may be expected, clinicians showed a clear preference for the more familiar and validated ADOS-2. However, the study highlights perceived limitations of the ADOS-2 and strengths of the BOSA, with recommendations made for future practice and research.

The impact of COVID-19 pandemic on the world's major economies: based on a multi-country and multi-sector CGE model.

Objective: To quantitatively assess the impact of COVID-19 pandemic on public health, as well as its economic and social consequences in major economies, which is an international public health concern. The objective is to provide a scientific basis for policy interventions. Subject and methods: This study utilizes a multi-country, multi-sector CGE-COVID-19 model to analyze the repercussions of the pandemic in 2022. The re-search focuses on quantifying the effects of COVID-19 on the macroeconomy and various industry sectors within six economies: the United States, China, the EU, the United Kingdom, Japan, and South Korea. Results: The COVID-19 pandemic shock had the most significant impact on China and the EU, followed by notable effects observed in the United States and the United Kingdom. In contrast, South Korea and Japan experienced relatively minimal effects. The reduction in output caused by the pandemic has affected major economies in multiple sectors, including real industries such as forestry and fisheries, and the services such as hotels and restaurants. Conclusion: The overall negative macroeconomic impact of the epidemic on major economies has been significant. Strategic interventions encompassing initiatives like augmenting capital supply, diminishing corporate taxes and fees, offering individual subsidies, and nurturing international cooperation held the potential to mitigate the detrimental economic consequences and enhance the global-economic amid the pan-demic. Consequently, this study contributes to the advancement of global anti-epidemic policies targeting economic recovery. Moreover, using the CGE-COVID-19 model has enriched the exploration of general equilibrium models in PHEIC events.

Mortality risk factors in the dependent population of Castilla-La Mancha (Spain) before and during the first COVID-19 wave.

The coronavirus disease pandemic has had an important impact worldwide. The population aged over 65 years and aged dependent persons are the population groups which have suffered in a highest level the consequences of the pandemic in terms of cases and death. In Spain, the situation is similar to other countries, but regional studies are needed because competencies on long-term care depend on regional public administration. Thus, the aim of this work is to analyse social and individual factors associated with the risk of mortality of legally recognised dependent people during the pandemic compared to a non-pandemic period. The data were extracted from the administrative database on individuals included in Castilla-La Mancha's long-term care system and it was merged with the information from the Spanish National Death Index administered by the Ministry of Health, Consumption and Social Welfare. The results show that the risk of mortality between March and June 2020 was positively associated with being male; being older than 65, with an especially high impact in the group aged over 90; having a higher level of dependency; living in a nursing home; and living in a place with more population density. Intraregional differences related to health areas also exists in both pandemic and non-pandemic periods. These findings are critical with a view to enhancing protocols for the care of the most vulnerable population groups.

Effect of the COVID-19 pandemic on utilization of essential health services in Iran evidence from an interrupted time series analysis.

BACKGROUND: The COVID-19 disrupted the provision of essential health services in numerous countries, potentially leading to outbreaks of deadly diseases. This study aims to investigate the effect of the COVID-19 pandemic on the utilization of essential health services in Iran. METHODS: An analytical cross-sectional study was conducted using interrupted time series (ITS) analysis. Data about five indicators, including 'childhood vaccination, infant care, hypertension screening, diabetes screening, and breast cancer screening,' were obtained from the electronic health record System in two-time intervals: 15 months before (November 2018 to January 2020) and 15 months after (January 2020 to May 2021) the onset of the COVID-19 pandemic. The data were analyzed by utilizing ITS. In addition, a Poisson model was employed due to the usage of count data. The Durbin-Watson (DW) test was used to identify the presence of lag-1 autocorrelation in the time series data. All statistical analysis was performed using R 4.3.1 software, considering a 5% significance level. RESULTS: The ITS analysis showed that the COVID-19 pandemic significantly affected the utilization of all essential health services (P < 0.0001). The utilization of hypertension screening (RR = 0.51, p < 0.001), diabetes screening (RR = 0.884, p < 0.001), breast cancer screening (RR = 0.435, p < 0.001), childhood vaccination (IRR = 0.947, p < 0.001), and infant care (RR = 1.666, p < 0.001), exhibited a significant decrease in the short term following the pandemic (P < 0.0001). However, the long-term trend for all service utilization, except breast cancer screening (IRR = 0.952, p < 0.001), demonstrated a significant increase. CONCLUSIONS: The COVID-19 pandemic affected utilization of essential health care in Iran. It is imperative to utilize this evidence to develop policies that will be translated into targeted planning and implementation to sustain provision and utilization of essential health services during public health emergencies. It is also vital to raise awareness and public knowledge regarding the consequences of interruptions in essential health services. In addition, it is important to identify the supply- and demand-side factors contributing to these disruptions.

Brief Coping Scale TCS-9: Optimising the Assessment of Coping Strategies. The case of Health Care Workers.

Background: The COVID-19 pandemic has intensified the focus on mental health, particularly on the coping strategies of healthcare workers who have faced unparalleled stress due to their pivotal role in addressing health disparities and determinants of health. Constantly operating in high-risk environments and managing the surge of critically ill patients, these professionals' psychological resilience has been sternly tested, necessitating robust assessment tools. Aim: This study aims to refine the extensive 54-item Toulouse Coping Scale into a more pragmatic and less time-consuming instrument while preserving its statistical integrity, to support the mental well-being of healthcare workers. Setting: The setting for this study was amongst healthcare workers in Greece, during the COVID-19 pandemic, a period marked by significant psychological demands on medical staff. Methods: We conducted an unbiased exploratory factor analysis on the Toulouse Coping Scale's 54 items, drawing from a sample of 144 healthcare workers, adhering to strict methodological criteria. Results: Data completeness was achieved across the sample, which comprised 40 (28%) males and 104 (72%) females, predominantly aged between 31 and 50 years. The final instrument, encapsulating two domains with a total of nine questions, demonstrated strong internal consistency, with an eigenvalue of 3.438 for the first domain and 1.478 for the second, validated by a scree plot. Conclusion: The streamlined TCS-9 scale facilitates a more rapid assessment of coping strategies while reducing redundancy. The two-domain structure ensures that the revised scale retains the original's thoroughness in a more concise form. Contribution: By enabling quicker and more efficient evaluations, the TCS-9 enhances the practicality of assessing coping mechanisms in healthcare settings, thereby contributing to the sustenance of health systems and the promotion of health equity.

Social support and suicidality during the COVID-19 pandemic among Brazilian healthcare workers: a longitudinal assessment of an online repeated cross-sectional survey.

INTRODUCTION: Healthcare workers (HCWs) are at an increased risk of suicide compared to non-healthcare workers. This study aims to investigate the association between social support and suicidal ideation and behavior (SIB) during the COVID-19 pandemic among Brazilian HCWs. METHODS: This study utilizes data from 10,885 participants who answered the first (time point 1 - between May and June of 2020) and second (time point 2 - between December 2020 and February 2021) assessments of an online repeated cross-sectional survey for evaluating mental health and quality of life of HCWs during the COVID-19 pandemic in Brazil. Logistic regression analysis was conducted to investigate the relationship between social support as the independent variable (time point 1) and SIB as the outcomes (time point 2). RESULTS: Higher social support was associated with a significantly lower chance of reporting SIB in the month prior to follow-up assessment (adjusted odds ratio [AOR]: 0.71, CI 95% 0.66 - 0.76 and AOR 0.61, CI 95% 0.54 - 0.68, respectively). These associations were independent of sex, age, feelings of loneliness, and self-reported psychiatric disorders. CONCLUSION: Social support is associated with a lower chance of suicidality among HCWs, a protective role that is probably more evident for suicidal behavior.

Relationship Between Alexithymia, Smartphone Addiction, and Psychological Distress Among University Students: A Multi-country Study.

Objectives: Increasing dependence on smartphones results in the appearance of psychological problems, especially among young people. This study aims to determine the rates of alexithymia and its relationship with smartphone addiction and psychological distress in university students. Methods: A total of 2616 students (mean age = 22.5±3.5 years; 73.1% female) from universities in Egypt, Oman, and Pakistan were included in a cross-sectional and comparative study conducted through a web survey during the COVID-19 pandemic from October to December 2021. The following scales were used: Toronto Alexithymia Scale (TAS-20), Depression Anxiety Stress Scale (DASS-21), and Smartphone Addiction Scale-Short Version (SAS-SV). The survey also included questions related to sociodemographic and smartphone usage patterns.

Association of food insecurity with health, access to care, affordability of care, financial burden of care, and financial hardships among US adults during the COVID-19 pandemic.

OBJECTIVES: To examine the associations between food insecurity and health, access to care, affordability of care, financial burden of care, and financial hardships among US adults during the COVID-19 pandemic and examine whether the associations were less pronounced among adults with safety nets. STUDY DESIGN: We conducted a retrospective longitudinal cohort study using the 2020-2021 Medical Expenditure Panel Survey. METHODS: Linear probability models were used to assess the associations between food insecurity in one year and the outcomes of interest in the following year while adjusting for baseline characteristics. We performed the analyses for the entire population and then conducted stratified analyses for adults with and without Supplemental Nutrition Assistance Program (SNAP) benefits or Medicaid coverage. RESULTS: Compared with food-secure adults, food-insecure adults were 9.1 percentage points less likely to report life satisfaction and 9.9, 10.2, and 13.2 percentage points more likely to experience delays in getting medical care, postpone or forgo medical care because of cost, and struggle with paying medical bills. Food-insecure adults were 30.4, 27.2, and 23.5 percentage points more likely to face challenges in affording necessities, paying utility bills, and meeting rent or mortgage payments on time than food-secure adults. Notably, the strengths of these associations were attenuated among adults with SNAP benefits or Medicaid coverage. CONCLUSIONS: Food insecurity was associated with poor health, limited access to and affordability of care, and a greater financial burden of care among US adults during the pandemic. Nevertheless, safety net programs can play a critical role in alleviating adverse consequences.

Determinants of vaccination decisions and lived experiences of Ghanaians with the COVID-19 pandemic; a qualitative study.

Background: Two years after the WHO declared a state of emergency as a result of the rapid spread of the COVID-19 virus from Wuhan, China, the rate of new infections experienced intermittent flare-ups globally, with vaccinations still ongoing in countries such as Ghana. One year after the implementation of Ghana's COVID-19 vaccine deployment program, Ghanaians have had the opportunity to reflect on their vaccination decisions, albeit the initial vaccine hesitancy. Objectives: The current paper examined the knowledge and lived experiences of Ghanaians during the COVID-19 pandemic, and the factors influencing their vaccination decisions, one year after COVID-19 vaccinations commenced in Ghana, with special focus on the social and geographical histories which influenced their vaccination decisions. Methodology: A qualitative approach using a case study design was used to conduct in-depth interviews among 25 respondents who were 18 years and above, not pregnant, and willing to participate in the study, between 5th and 23rd September 2022. Data was collected in 5 hotspot areas in Ghana with the highest cumulative case counts. A semi-structured interview guide was used to collect data which was analyzed using a thematic approach. Findings: Respondents demonstrated a good level of knowledge on COVID-19 and related vaccines. Fear, panic, and anxiety were some of the experiences lived by respondents during the pandemic. The factors influencing vaccination decisions included conspiracy theories about COVID-19 and related vaccines, subjective notions about the COVID-19 disease, and subjective notions about the vaccine. The type of community one lived in, taboos, and previous successful vaccination programs in the community were geographic factors that informed respondents' decision to vaccinate or not. Social circles, religion, opinion leaders, and media-based campaigns were the social factors that influenced respondents' decision to vaccinate or not.

Widening Disparities in COVID-19 Mortality and Life Expectancy Among 15 Major Racial and Ethnic Groups in the United States, 2020-2021.

Persistent and often widening racial/ethnic and socioeconomic inequalities in health have long existed in the US. Although racial/ethnic disparities in COVID-19 mortality are well documented, COVID-19 mortality risks and resultant reductions in life expectancy during the pandemic for detailed racial and ethnic groups in the US, including Asian and Hispanic subgroups, are not known. We used 2020-2021 US mortality data to estimate age-adjusted COVID-19 mortality rates, life expectancy, and the consequent declines in life expectancy due to COVID-19 overall and for the 15 largest racial/ethnic groups. We used standard life table methodology, cause-elimination life tables, and inequality indices to analyze trends in racial/ethnic disparities. The number of COVID-19 deaths increased from 350,827 in 2020 to 416,890 in 2021. COVID-19 death rates varied 7-fold among the racial/ethnic groups; Japanese and Chinese had the lowest mortality rates and Mexicans and American Indians/Alaska Natives (AIANs) had the highest rates. In 2021, life expectancy ranged from 70.3 years for Blacks and 70.6 years for AIANs to 85.2 years for Japanese and 87.7 years for Chinese. The life-expectancy gap was wide- 22.4 years in 2020 and 23.2 years in 2021. COVID-19 mortality had the greatest impact in reducing the life expectancy of Mexicans (3.53 years in 2020 and 3.78 years in 2021), Central/South Americans (4.86 years in 2020 and 3.50 years in 2021), and AIANs (2.51 years in 2020 and 2.38 years in 2021). Racial/ethnic inequalities in COVID-19 mortality, life expectancy, and resultant reductions in life expectancy during the pandemic widened between 2020 and 2021.

Four Years Since COVID-19 Day Zero: A Time to Evaluate Past and Future Pandemic Control Policies and Practices in Sub-Saharan Africa?

Four years after the first case of COVID-19, the world is still determining how best to prevent and control the long-term effects of SARS-CoV-2 infection. Non-pharmaceutical interventions (NPIs) were employed at the start of the pandemic as the only available options, prior to effective vaccines and antiviral agents. The World Health Organization recommended dual vaccination for 70% worldwide as the threshold for a return to "normal" community life. Immunization rates needed to increase in all global regions, irrespective of socioeconomic status, necessitating more equitable access. During the pandemic, wealthier countries hoarded vaccine supplies even when their citizens were immunized. This highlights the already enormous difficulties in healthcare provision faced by low-income sub-Saharan African countries, which remain at risk as industrialized nations have progressed to a post-pandemic era. Thus, in addition to redoubling vaccination efforts public health policymakers should consider ongoing and future use of NPIs. In this narrative account, we advocate that various NPI practices should not be shelved; rather, more research is needed to evaluate their impact in parallel with booster vaccination. This especially applies to so-called "long COVID". Lessons learned from implementing best practices in resource-limited settings should be incorporated into preparedness guidelines for future infectious disease outbreaks.

Analyzing Subnational Immunization Coverage to Catch up and Reach the Unreached in Seven High-Priority Countries in the Eastern Mediterranean Region, 2019-2021.

Yearly national immunization coverage reporting does not measure performance at the subnational level throughout the year and conceals inequalities within countries. We analyzed subnational immunization coverage from seven high-priority countries in our region. We analyzed subnational, monthly immunization data from seven high-priority countries. Five were Gavi eligible (i.e., Afghanistan, Pakistan, Somalia, Syria, and Yemen); these are countries that according to their low income are eligible for support from the Global Alliance on Vaccine and Immunization, while Iraq and Jordan were included because of a recent decrease in immunization coverage and contribution to the regional number of under and unimmunized children. DTP3 coverage, which is considered as the main indicator for the routine immunization coverage as the essential component of the immunization program performance, varied monthly in 2019-2021 before reaching pre-pandemic coverage in the last two months of 2021. Somalia and Yemen had a net gain in DTP3 coverage at the end of 2021, as improvement in 2021 exceeded the regression in 2020. In Pakistan and Iraq, DTP3 improvement in 2021 equaled the 2020 regression. In Afghanistan, Syria and Jordan, the regression in DTP3 coverage continued in 2020 and 2021. The number of districts with at least 6000 zero-dose children improved moderately in Afghanistan and substantially in Somalia throughout the follow-up period. In Pakistan, the geographical distribution differed between 2020 and 2021.Of the three countries with the highest number of zero-dose children, DTP1 coverage reached 109% in Q4 of 2020 after a sharp drop to 69% in Q2 of 2020. However, in Pakistan, the number of zero-dose children decreased to 1/10 of its burden in Q4 of 2021. In Afghanistan, the number of zero-dose children more than a doubled. Among the even countries, adaptation of immunization service to the pandemic varied, depending on the agility of the health system and the performance of the components of the expanded program on immunization. We recommended monitoring administrative monthly immunization coverage data at the subnational level to detect low-performing districts, plan catchup, identify bottlenecks towards reaching unvaccinated children and customize strategies to improve the coverage in districts with zero-dose children throughout the year and monitor progress.

Protective action in the workplace in the time of COVID-19: The role of worker representation.

BACKGROUND: This study addresses the contribution of worker representation to health and safety in the pandemic context. To do so, we examine whether the self-reported presence of representatives in workplaces is associated with the implementation of anti-COVID-19 protective action and with which type of measures their existence is most strongly associated (individual, collective or organizational). The article also explores how the presence of worker representatives and anti-COVID-19 protective measures are distributed according to workers' socio-professional characteristics and company features. METHODS: This is a cross-sectional study based on an online survey conducted in Spain (n = 19,452 workers). Multiple Correspondence Analysis was used for the multivariate description while the association between worker representation and protective measures was assessed by robust Poisson regressions. RESULTS: The maps resulting from the Multiple Correspondence Analysis allow for the identification of patterns of inequalities in protection, with a clear occupational social class divide. The regression models show that protective measures are applied more frequently where worker representatives exist, this association being particularly strong in relation to organizational measures. CONCLUSIONS: The presence of worker representation is systematically associated with a greater presence of protective measures, which could have implications for the reduction of social inequalities resulting from labor-management practices.

Assessment the satisfaction level of faculty members from virtual teaching during corona crisis in Rafsanjan School of Medicine.

BACKGROUND: Evaluating the experiences and the satisfaction level of the academic members is an important parameter in planning for virtual education during COVID-19 pandemic. The present study was designed to evaluate the satisfaction level of faculty members of Rafsanjan School of Medicine regarding virtual education in COVID-19 crisis in two stages between 2019 and 2022. MATERIAL AND METHODS: This descriptive study was conducted on the faculty members of Rafsanjan Medical School. The satisfaction level with virtual education during the COVID-19 pandemic was determined using a researcher-made questionnaire with appropriate validity and reliability. For analysing of quantitative variables, the Kolmogorov-Smirnov test, independent t tests and one-way analysis of variance and multiple linear regression were used. RESULTS: Data showed that only 15.2% of the faculty members had a previous experience of virtual teaching prior to the pandemic and 30.3% had a history of passing the empowerment course on virtual education before the COVID-19 crisis. Moreover, 68.2% passed the empowerment course on virtual education at the same time as the COVID-19 epidemic spread. The overall satisfaction with virtual education in the first and second stages of the study was 49.05 and 49.22 out of 100, respectively. The satisfaction of NAVID learning management system was 66.66 percent among faculty members. The level of satisfaction in non-clinical members was significantly more than clinical members. CONCLUSION: The overall satisfaction of faculty members with virtual education was at an average or medium level. From the point of view of the faculty members, some aspects of virtual education need to be improved. Therefore, it seems necessary to improve the infrastructure and empower the faculty members to enhance the quality of virtual education.

Community case studies: an interpretative phenomenological analysis on sexual abuse in urban Chennai.

This study attempts to explore the lived experiences of sexual abuse during COVID-19 in a big metropolitan city in India, with a special interest in understanding the contemporary problems faced by teenagers. Any Phenomenological enquiry begins with identifying and determining the suitability of the participants. In this case, the participants are teenage girls and boys, who have experienced one or other forms of sexual abuse during the COVID-19 pandemic. By restricting the act of sexual abuse that happened during a pandemic, this research brings attention to the medium (material), social conditions, and the role of the cultural world in the act of sexual abuse. It begins by distributing a questionnaire to 500 participants to identify the participants who had experienced one or other forms of sexual abuse during the aforementioned time. Secondly, brief interviews with the identified participants are conducted to record their lived experience of sexual abuse. Using this collected narrated experience as a reservoir for phenomenological reflection, this research aims to uncover moments of lived experience emphasizing spatial, corporeal, and temporal aspects as well as provide greater depth in understanding sexual abuse in the context of teenage lives. It helps to understand the different forms of sexual abuse experienced by teenagers as well as portrays how space plays a major role in the act. This article aims to highlight the role of the material world in the act as well as how the social, political, and cultural contexts are materialized in the act of sexual abuse. Also, this article analyses how the existing intervention mechanisms support the prevention of sexual abuse in different social settings as well as emphasizes the gaps in the intervention mechanisms apropos the chosen narrative data. To sum up, this study aims to create awareness, provides prevention mechanisms considering the role of the material world, and advocates for SDG 16 (Promote justice, peaceful and inclusive societies) and SDG 5 (Achieve gender equality and empower all women and girls).

A retrospective cohort study analyzing the changes in early childhood development during the COVID-19 pandemic.

OBJECTIVE: To investigate early childhood development (ECD) outcomes in different subgroups before and during the COVID-19 pandemic. STUDY DESIGN: A retrospective cohort study of children 3-58 months of age whose caregivers completed a Survey of Well-being of Young Children (SWYC) as part of a well child visit (WCC). The data were divided into two phases: pre-pandemic (September 2018 - February 2020), and during pandemic (September 2020 - February 2022). The difference in the proportion of forms with Meets Expectations interpreted scores on the SWYC Developmental Milestones pre-pandemic versus during the pandemic timeframe overall and among subgroups were reported. Hypotheses were tested using logistic regression with repeated measures. RESULTS: 14,550 patients were included in the sample for analysis with 52,558 SWYC form observations. There was no difference in the odds of a Meets Expectations interpreted score before and after the pandemic for the entire sample, OR 0.99 (95 % CI: 0.94-1.04). There was evidence of decreased odds of an interpreted score of Meets Expectations for the following subgroups: male, Hispanic/Latino ethnicity, ages of 24, 30 or 36 months at WCC, Medicaid insurance, 2nd HOUSES Quartile, requiring interpreter, single parent household, young maternal age, maternal substance abuse, and race identified as Native Hawaiian/Pacific Islander, American Indian/Native Alaskan or Other. CONCLUSION: Decreased odds of meeting developmental milestones during the pandemic were evident in certain high risk sub-groups revealing unequal distribution of suboptimal developmental outcomes within our population during the pandemic that may be exacerbating existing inequities impacting development in children.