Psychological impact during COVID-19 pandemic: A web-based cross-sectional study among students studying at College of Science and Technology (CST), Phuentsholing, Bhutan.

The unprecedented experience of national lockdowns and uncertainty of academic career due to the COVID-19 pandemic has multifaceted impacts on mental health among university students worldwide. This study determined its impact on depression and anxiety level, and associated risk factors among engineering students studying at College of Science and Technology (CST), Phuentsholing, Bhutan during the first lockdown in the country. Self-reported depression and anxiety levels were assessed using Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) respectively. Data was collected using an e-questionnaire link generated in Google form and the link was shared with students via the student's official email group. A total of 278 students (response rate, 26.9%) completed the questionnaire. The majority of respondents were male (69.8%) and were aged from 18 to 30 (Mean: 21.7 ±SD 2.07) years. The prevalence of self-reported moderate to severe depression and anxiety were 44.2% (95% CI, 38.5-49.6) and 27.3% (95% CI, 22.3-32.4) respectively. Participants having their family members as frontline workers reported a significantly higher level of anxiety (χ2 = 4.85, p = 0.028). In multivariable logistic regression analysis, students who were academically lagging showed a higher risk of depression (AOR = 5.36, 95% CI = 2.86-10.04) and anxiety (AOR = 3.83, 95%CI = 1.86-7.88) as compared to students who were not academically behind. A high percentage of depression and anxiety was reported by students of CST during the COVID-19 pandemic. Findings from the study highlight the importance of adopting appropriate online-based teaching and learning methods to ensure timely academic and professional achievements. Moreover, the relevant stakeholders should put health system strategies in place to provide psychological support to university students during the COVID-19 pandemic.

The intensive use of the internet by children and adolescents in the context of COVID-19 and the risks for self-inflicted violence. / O uso intensivo da internet por crianças e adolescentes no contexto da COVID-19 e os riscos para violências autoinflingidas.

This essay aimed to discuss the implications of social isolation due to the COVID-19 pandemic for the intensive use of the internet among children and adolescents and its possible consequences for the practice of self-inflicted violence. We briefly discussed the anxiogenic potential and the reproduction of a "global fear" that are consolidated with the massive and unmediated exposure of the content consumed, which can increase the vulnerabilities to stress and suicidal ideas. We centered our debate on "recreational" practices, called "challenges" with self-harm power, carried out by teenagers on the YouTube website. This practice has been shown to increase with the social isolation measures. Our reflection on these risks builds on the theoretical perspective of digital sociability, and its implications for the internet-mediated interactions of adolescents.

O presente ensaio busca discutir as implicações do isolamento social devido à pandemia do COVID-19 para o uso intensivo da internet entre crianças e adolescentes e suas possíveis consequências para a prática de violências autoinflingidas. Discutimos brevemente o potencial ansiogênico e a reprodução de um "medo global" que se consolidam com a exposição maciça e sem mediação dos conteúdos consumidos, que podem aumentar as vulnerabilidades para estresse e ideações suicidas. Centramos nosso debate sobre práticas "recreativas", denominadas de "desafios" com poder autolesivo, realizados por adolescentes no site Youtube. Essa prática revelou-se crescente a partir das medidas de isolamento social. Nossa reflexão sobre esses riscos é feita a partir da perspectiva teórica da sociabilidade digital, e suas implicações nas interações de adolescentes mediadas pela internet.

Memory advantage for untrustworthy faces: Replication across lab- and web-based studies.

The Covid-19 pandemic imposed new constraints on empirical research and forced researchers to transfer from traditional laboratory research to the online environment. This study tested the validity of a web-based episodic memory paradigm by comparing participants' memory performance for trustworthy and untrustworthy facial stimuli in a supervised laboratory setting and an unsupervised web setting. Consistent with previous results, we observed enhanced episodic memory for untrustworthy compared to trustworthy faces. Most importantly, this memory bias was comparable in the online and the laboratory experiment, suggesting that web-based procedures are a promising tool for memory research.

Can auxiliary indicators improve COVID-19 forecasting and hotspot prediction?

Short-term forecasts of traditional streams from public health reporting (such as cases, hospitalizations, and deaths) are a key input to public health decision-making during a pandemic. Since early 2020, our research group has worked with data partners to collect, curate, and make publicly available numerous real-time COVID-19 indicators, providing multiple views of pandemic activity in the United States. This paper studies the utility of five such indicators-derived from deidentified medical insurance claims, self-reported symptoms from online surveys, and COVID-related Google search activity-from a forecasting perspective. For each indicator, we ask whether its inclusion in an autoregressive (AR) model leads to improved predictive accuracy relative to the same model excluding it. Such an AR model, without external features, is already competitive with many top COVID-19 forecasting models in use today. Our analysis reveals that 1) inclusion of each of these five indicators improves on the overall predictive accuracy of the AR model; 2) predictive gains are in general most pronounced during times in which COVID cases are trending in "flat" or "down" directions; and 3) one indicator, based on Google searches, seems to be particularly helpful during "up" trends.

An open repository of real-time COVID-19 indicators.

The COVID-19 pandemic presented enormous data challenges in the United States. Policy makers, epidemiological modelers, and health researchers all require up-to-date data on the pandemic and relevant public behavior, ideally at fine spatial and temporal resolution. The COVIDcast API is our attempt to fill this need: Operational since April 2020, it provides open access to both traditional public health surveillance signals (cases, deaths, and hospitalizations) and many auxiliary indicators of COVID-19 activity, such as signals extracted from deidentified medical claims data, massive online surveys, cell phone mobility data, and internet search trends. These are available at a fine geographic resolution (mostly at the county level) and are updated daily. The COVIDcast API also tracks all revisions to historical data, allowing modelers to account for the frequent revisions and backfill that are common for many public health data sources. All of the data are available in a common format through the API and accompanying R and Python software packages. This paper describes the data sources and signals, and provides examples demonstrating that the auxiliary signals in the COVIDcast API present information relevant to tracking COVID activity, augmenting traditional public health reporting and empowering research and decision-making.

Effects of the SARS-CoV-2 pandemic on women affected by endometriosis: a large cross-sectional online survey.

INTRODUCTION: The SARS-CoV-2 pandemic has forced healthcare providers to reorganize their activities to protect the population from infection, postponing or suspending many medical procedures. Patients affected by chronic conditions were among the most affected. In the case of catastrophes, women have a higher lifetime prevalence of post-traumatic stress disorder (PTSD), and those with endometriosis have higher anxiety levels, making them fragile in such circumstances. MATERIALS AND METHODS: In this cross-sectional study, conducted in May 2020, we considered all women aged ≥18 years, followed up at our referral centre for endometriosis. Patients were sent an anonymous 6-section questionnaire via email, containing different validated tools for the evaluation of anxiety levels and the risk of PTSD. A multivariable linear regression was performed to assess the impact of patients' characteristics on the distress caused by the SARS-COV-2 pandemic. RESULTS: Among the 468 women recruited, 68.8% were quite-to-extremely worried about not being able to access gynaecologic care, with almost one-third of them scoring ≥33 on the IES-R. Older age and increased levels of anxiety were associated with higher risks of PTSD (age: b = 0.28, 95% CI = 0.12 - 0.44; GAD-7: b = 1.71, 95% CI = 1.38 - 2.05), with up to 71.8% of patients with severe anxiety (GAD-7 > 15) having an IES-R score ≥33 suggestive for PTSD. Women who could leave home to work showed lower levels of PTSD (b = -4.79, 95% CI = -8.44 to - 1.15, ref. unemployed women). The implementation of telemedicine in routine clinical practice was favourably viewed by 75.6% of women. DISCUSSION: Women with endometriosis are particularly exposed to the risk of PTSD during the SARS-CoV-2 pandemic, especially if they are older or have higher levels of anxiety. Gynaecologists should resort to additional strategies, and telemedicine could represent a feasible tool to help patients cope with this situation.KEY MESSAGESThe COVID-19 pandemic significantly impacted the lives of women with endometriosis, who appeared to have a considerable risk of PTSD.Older age, higher anxiety levels and unemployment were independently associated with the risk of developing PTSD.Clinicians should develop successful alternative strategies to help patients cope with this situation, and telemedicine might represent an applicable and acceptable solution.

Ambient Assisted Living: Identifying New Challenges and Needs for Digital Technologies and Service Innovation.

BACKGROUND: The ambient assisted living (AAL) market is rapidly becoming fundamental to the delivery of health and social care services for the elderly. Worldwide many different steps have been taken to increase the engagement of older adults with these technologies. Much of this work has focused on the development of novel digital services that increase wellbeing or tackle social challenges. AIM: The aim of the study was to identify and describe the demands for AAL-services from the perspective of older adults. We also examine the challenges and needs of the ambient assisted living market using a needs based approach. METHOD: An exploratory case study was conducted with an aim to capture information about older adults' demands for AAL services. A survey was used to collect the data. The survey study respondents validated the results. RESULTS: The results of the study indicate that the area of AAL needs be studied from a multiple-sided market perspective. Our research suggests there is a need to describe and understand the factors that facilitate or constrain the implementation of services with focus on health and social care. There is also a need to describe and analyze the relationship between policy and practice and its effects on the AAL market. It is necessary to capture expressed demand, to identify market challenges at the macro level and to be able to understand how services should operate and serve older adults in practice. Such research is critical to the development of guidance for policy makers, suppliers and service providers. DISCUSSION: Older adults are asking for intelligent, assistive living solutions that help them to continue to live independent lives and remain socially included in their networks, associations, and communities. The elderly need services that stimulate and maintain their physical and intellectual capital. The development of innovative AAL environments is, however, a complex social process that involves the use and delivery of innovative ICT-based services. The implementation and use of AAL to support older adults involve service providers and elderly consumers. CONCLUSIONS: The results of the study may be of interest to policy makers, entrepreneurs, technology suppliers, service providers and health and social care organizations, who are willing to innovate and influence the development of the AAL market through their choices and decisions.

Spatio-temporal characteristics of the novel coronavirus attention network and its influencing factors in China.

The outbreak of a novel coronavirus pneumonia (COVID-19), wherein more than 200 million people have been infected and millions have died, poses a great threat to achieving the United Nations 2030 sustainable development goal (SDGs). Based on the Baidu index of 'novel coronavirus', this paper analyses the spatial and temporal characteristics of and factors that influenced the attention network for COVID-19 from January 9, 2020, to April 15, 2020. The study found that (1) Temporally, the attention in the new coronavirus network showed an upward trend from January 9 to January 29, with the largest increase from January 23 to January 29 and a peak on January 29, and then a slow downward trend. The level of attention in the new coronavirus network was basically flat when comparing January 22 and March 4. (2) Spatially, first, from the perspective of regional differences, the network attention in the eastern and central regions decreased in turn. The network users in the eastern region exhibited the highest attention to the new coronavirus, especially in Guangdong, Shandong, Jiangsu and other provinces and cities. The network attention in Tibet, Xinjiang, Qinghai and Ningxia in the western region was the lowest in terms of the national network attention. Second, from the perspective of interprovincial differences, the attention in the new coronavirus network was highly consistent with the Hu Huanyong line of China's population boundary. The east of the Hu Huanyong line is densely populated, and the network showed high concern, mostly ranking at the third to fifth levels. (3) The number of Internet users in the information technology field, the population, and the culture and age characteristics of individuals are important factors that influence the novel coronavirus attention network.

COVID-19 Vaccine Perception in South Korea: Web Crawling Approach.

BACKGROUND: The US Centers for Disease Control and Prevention and the World Health Organization emphasized vaccination against COVID-19 because physical distancing proved inadequate to mitigate death, illness, and massive economic loss. OBJECTIVE: This study aimed to investigate Korean citizens' perceptions of vaccines by examining their views on COVID-19 vaccines, their positive and negative perceptions of each vaccine, and ways to enhance policies to increase vaccine acceptance. METHODS: This cross-sectional study analyzed posts on NAVER and Instagram to examine Korean citizens' perception of COVID-19 vaccines. The keywords searched were "vaccine," "AstraZeneca," and "Pfizer." In total 8100 posts in NAVER and 5291 posts in Instagram were sampled through web crawling. Morphology analysis was performed, overlapping or meaningless words were removed, sentiment analysis was implemented, and 3 public health professionals reviewed the results. RESULTS: The findings revealed a negative perception of COVID-19 vaccines; of the words crawled, the proportion of negative words for AstraZeneca was 71.0% (476/670) and for Pfizer was 56.3% (498/885). Among words crawled with "vaccine," "good" ranked first, with a frequency of 13.43% (312/2323). Meanwhile, "side effect" ranked highest, with a frequency of 29.2% (163/559) for "AstraZeneca," but 0.6% (4/673) for "Pfizer." With "vaccine," positive words were more frequently used, whereas with "AstraZeneca" and "Pfizer" negative words were prevalent. CONCLUSIONS: There is a negative perception of AstraZeneca and Pfizer vaccines in Korea, with 1 in 4 people refusing vaccination. To address this, accurate information needs to be shared about vaccines including AstraZeneca, and the experiences of those vaccinated. Furthermore, government communication about risk management is required to increase the AstraZeneca vaccination rate for herd immunity before the vaccine expires.

Measuring Public Concern About COVID-19 in Japanese Internet Users Through Search Queries: Infodemiological Study.

BACKGROUND: COVID-19 has disrupted lives and livelihoods and caused widespread panic worldwide. Emerging reports suggest that people living in rural areas in some countries are more susceptible to COVID-19. However, there is a lack of quantitative evidence that can shed light on whether residents of rural areas are more concerned about COVID-19 than residents of urban areas. OBJECTIVE: This infodemiology study investigated attitudes toward COVID-19 in different Japanese prefectures by aggregating and analyzing Yahoo! JAPAN search queries. METHODS: We measured COVID-19 concerns in each Japanese prefecture by aggregating search counts of COVID-19-related queries of Yahoo! JAPAN users and data related to COVID-19 cases. We then defined two indices-the localized concern index (LCI) and localized concern index by patient percentage (LCIPP)-to quantitatively represent the degree of concern. To investigate the impact of emergency declarations on people's concerns, we divided our study period into three phases according to the timing of the state of emergency in Japan: before, during, and after. In addition, we evaluated the relationship between the LCI and LCIPP in different prefectures by correlating them with prefecture-level indicators of urbanization. RESULTS: Our results demonstrated that the concerns about COVID-19 in the prefectures changed in accordance with the declaration of the state of emergency. The correlation analyses also indicated that the differentiated types of public concern measured by the LCI and LCIPP reflect the prefectures' level of urbanization to a certain extent (ie, the LCI appears to be more suitable for quantifying COVID-19 concern in urban areas, while the LCIPP seems to be more appropriate for rural areas). CONCLUSIONS: We quantitatively defined Japanese Yahoo users' concerns about COVID-19 by using the search counts of COVID-19-related search queries. Our results also showed that the LCI and LCIPP have external validity.

Reported health and social consequences of the COVID-19 pandemic on vulnerable populations and implemented solutions in six West African countries: A media content analysis.

Coronavirus has spread worldwide with over 140 million cases and resulting in more than 3 million deaths between November 2019 to April 2021, threatening the socio-economic and psychosocial stability of many families and communities. There has been limited research to understand the consequences of COVID-19 on vulnerable populations in West Africa, and whether such consequences differ by countries' previous experience with Ebola. Using a media analysis of leading online news sources, this study identified the populations particularly vulnerable to the threats of the COVID-19 pandemic, described the consequences of COVID-19 experienced by these populations, and reported on the solutions to address them. All articles from the selected news sources published between January 1 and June 30, 2020 on 6 West African countries were imported into Dedoose. A total of 4,388 news articles were coded for excerpts on vulnerable populations, only 285 excerpts of which mentioned the existing effects of COVID-19 on vulnerable populations or implemented solutions. News articles from countries with past experience with Ebola were more likely to mention the pandemic's effects on vulnerable populations, especially on incarcerated people. Vulnerable groups were reported to have experienced a range of effects including economic disruptions, heightened domestic and sexual abuse, arbitrary arrests, health care inaccessibility, and educational challenges throughout the pandemic. With implications for the achievement of the Sustainable Development Goals (SDG) for 2030 in West Africa, these countries should consider and focus more strategic efforts on vulnerable populations to overcome their fight against the COVID-19 pandemic and to achieve the SDG for 2030.

Multi-stakeholder perspective of courier service quality in B2C e-commerce.

Under conditions of the rapidly developing e-commerce sector especially during pandemic, ensuring high quality of courier service is essential both for clients, as well as courier companies. However, the literature lacks research linking the perspective of clients and organization in the context of courier service quality. The study aims to identify the factors determining courier service quality, their functions and interrelationships in business-to-customer (B2C) e-commerce. The main effect of research is the relational model, which is an original and complex approach to courier service quality considering the multi-stakeholder perspective of an online shop, a courier company and an e-customer. Apart from scientific contribution, the model can be used into managerial practice to formulate the recommendations for e-commerce and courier service sector. The research process involved using the quantitative method (electronic surveys conducted among e-shops and e-clients) and the qualitative method (in-depth-interviews carried out among courier enterprises). Finally, based on the empirical research results, the structural analysis was used to develop the model. As a result, the following groups of factors were distinguished that determine the quality of courier services: crucial, determinant, result, autonomous and external factors.

Influences of digital media use on children and adolescents with ADHD during COVID-19 pandemic.

OBJECTIVE: To explore the influences of digital media use on the core symptoms, emotional state, life events, learning motivation, executive function (EF) and family environment of children and adolescents diagnosed with attention deficit hyperactivity disorder (ADHD) during the novel coronavirus disease 2019 (COVID-19) pandemic. METHOD: A total of 192 participants aged 8-16 years who met the diagnostic criteria for ADHD were included in the study. Children scoring higher than predetermined cut-off point in self-rating questionnaires for problematic mobile phone use (SQPMPU) or Young's internet addiction test (IAT), were defined as ADHD with problematic digital media use (PDMU), otherwise were defined as ADHD without PDMU. The differences between the two groups in ADHD symptoms, EF, anxiety and depression, stress from life events, learning motivation and family environment were compared respectively. RESULTS: When compared with ADHD group without PDMU, the group with PDMU showed significant worse symptoms of inattention, oppositional defiant, behavior and emotional problems by Swanson, Nolan, and Pelham Rating Scale (SNAP), more self-reported anxiety by screening child anxiety-related emotional disorders (SCARED) and depression by depression self-rating scale for children (DSRSC), more severe EF deficits by behavior rating scale of executive function (BRIEF), more stress from life events by adolescent self-rating life events checklist (ASLEC), lower learning motivation by students learning motivation scale (SLMS), and more impairment on cohesion by Chinese version of family environment scale (FES-CV). The ADHD with PDMU group spent significantly more time on both video game and social media with significantly less time spend on physical exercise as compared to the ADHD without PDMU group. CONCLUSION: The ADHD children with PDMU suffered from more severe core symptoms, negative emotions, EF deficits, damage on family environment, pressure from life events, and a lower motivation to learn. Supervision of digital media usage, especially video game and social media, along with increased physical exercise, is essential to the management of core symptoms and associated problems encountered with ADHD.

Assessing Public Interest Based on Wikipedia's Most Visited Medical Articles During the SARS-CoV-2 Outbreak: Search Trends Analysis.

BACKGROUND: In the current era of widespread access to the internet, we can monitor public interest in a topic via information-targeted web browsing. We sought to provide direct proof of the global population's altered use of Wikipedia medical knowledge resulting from the new COVID-19 pandemic and related global restrictions. OBJECTIVE: We aimed to identify temporal search trends and quantify changes in access to Wikipedia Medicine Project articles that were related to the COVID-19 pandemic. METHODS: We performed a retrospective analysis of medical articles across nine language versions of Wikipedia and country-specific statistics for registered COVID-19 deaths. The observed patterns were compared to a forecast model of Wikipedia use, which was trained on data from 2015 to 2019. The model comprehensively analyzed specific articles and similarities between access count data from before (ie, several years prior) and during the COVID-19 pandemic. Wikipedia articles that were linked to those directly associated with the pandemic were evaluated in terms of degrees of separation and analyzed to identify similarities in access counts. We assessed the correlation between article access counts and the number of diagnosed COVID-19 cases and deaths to identify factors that drove interest in these articles and shifts in public interest during the subsequent phases of the pandemic. RESULTS: We observed a significant (P<.001) increase in the number of entries on Wikipedia medical articles during the pandemic period. The increased interest in COVID-19-related articles temporally correlated with the number of global COVID-19 deaths and consistently correlated with the number of region-specific COVID-19 deaths. Articles with low degrees of separation were significantly similar (P<.001) in terms of access patterns that were indicative of information-seeking patterns. CONCLUSIONS: The analysis of Wikipedia medical article popularity could be a viable method for epidemiologic surveillance, as it provides important information about the reasons behind public attention and factors that sustain public interest in the long term. Moreover, Wikipedia users can potentially be directed to credible and valuable information sources that are linked with the most prominent articles.

Harnessing Social Media in the Modelling of Pandemics-Challenges and Opportunities.

As COVID-19 spreads throughout the world without a straightforward treatment or widespread vaccine coverage in the near future, mathematical models of disease spread and of the potential impact of mitigation measures have been thrust into the limelight. With their popularity and ability to disseminate information relatively freely and rapidly, information from social media platforms offers a user-generated, spontaneous insight into users' minds that may capture beliefs, opinions, attitudes, intentions and behaviour towards outbreaks of infectious disease not obtainable elsewhere. The interactive, immersive nature of social media may reveal emergent behaviour that does not occur in engagement with traditional mass media or conventional surveys. In recognition of the dramatic shift to life online during the COVID-19 pandemic to mitigate disease spread and the increasing threat of further pandemics, we examine the challenges and opportunities inherent in the use of social media data in infectious disease modelling with particular focus on their inclusion in compartmental models.

United States internet searches for "infertility" following COVID-19 vaccine misinformation.

CONTEXT: On December 1, 2020, Drs. Wolfgang Wodarg and Micheal Yeadon petitioned to withhold emergency use authorization of the BNT162b2 messenger ribonucleic acid vaccine for coronavirus disease 2019 (COVID-19) manufactured by BioNTech and Pfizer, raising concern for female infertility risks but acknowledging the lack of evidence. The European Medicines Agency and the US Food and Drug Administration ultimately issued emergency use authorizations, but misinformation claiming that COVID-19 vaccines cause female infertility began circulating on social media, potentially influencing public perception and medical decision making among pregnant patients or those seeking to become pregnant. OBJECTIVES: To determine the potential influence misinformation may have had on public interest in infertility related topics, as analyzed through internet search statistics in the US. METHODS: The Google Trends tool was used to analyze results for the search terms "infertility," "infertility AND vaccine," and "infertility AND COVID vaccine" in the US from February 4, 2020 to February 3, 2021. We applied autoregressive integrated moving average models to forecast expected values, comparing them with actual observed values. RESULTS: At peak interest (100), the forecasted relative search volumes interest for the search terms "infertility," "infertility AND vaccine," and "infertility AND COVID vaccine" were 45.47 (95% CI, 33.27-57.66; p<0.001), 0.88 (95% CI, 2.87-4.63; p<0.001), and 0.29 (95% CI, -2.25-2.82; p<0.001). The actual relative search volumes at peak searching represented 119.9, 11,251, and 34,900% increases, respectively, when compared with forecasted values. CONCLUSIONS: COVID-19 vaccine misinformation corresponded with increased internet searches for topics related to infertility in the US. Dispelling misinformation and informing patients about the risks and benefits of COVID-19 vaccination may prevent unnecessary vaccine hesitancy or refusal, contributing to successful vaccination efforts.

The impact of Internet use during COVID-19 lockdown in Rwanda: a potential public health threat.

This article discusses impact of the Internet on the populations of sub-Sahara during the lockdown period in Rwanda. The aim is to eradicate the spread of COVID-19 pandemic and devise strategies to minimize the expansion of this virus. The increased misuse of the Internet has challenged the education sector. Initiatives such as broadband Internet to promote free or low-cost digital access have been fully successful. Although the Internet may have discouraged loneliness, it has promoted some risks to vulnerable people. Long-term isolation on the Internet has resulted in endangering younger people by exposing them to pornography, and violent movie films. The Government of Rwanda should address use of Internet during isolation to protect most vulnerable individuals like children and adolescents. The Rwanda Education the Ministry should train "online body guards" to educate the younger population of Rwanda.

Factors Affecting Public Adoption of COVID-19 Prevention and Treatment Information During an Infodemic: Cross-sectional Survey Study.

BACKGROUND: With the spread of COVID-19, an infodemic is also emerging. In public health emergencies, the use of information to enable disease prevention and treatment is incredibly important. Although both the information adoption model (IAM) and health belief model (HBM) have their own merits, they only focus on information or public influence factors, respectively, to explain the public's intention to adopt online prevention and treatment information. OBJECTIVE: The aim of this study was to fill this gap by using a combination of the IAM and the HBM as the framework for exploring the influencing factors and paths in public health events that affect the public's adoption of online health information and health behaviors, focusing on both objective and subjective factors. METHODS: We carried out an online survey to collect responses from participants in China (N=501). Structural equation modeling was used to evaluate items, and confirmatory factor analysis was used to calculate construct reliability and validity. The goodness of fit of the model and mediation effects were analyzed. RESULTS: The overall fitness indices for the model developed in this study indicated an acceptable fit. Adoption intention was predicted by information characteristics (ß=.266, P<.001) and perceived usefulness (ß=.565, P<.001), which jointly explained nearly 67% of the adoption intention variance. Information characteristics (ß=.244, P<.001), perceived drawbacks (ß=-.097, P=.002), perceived benefits (ß=.512, P<.001), and self-efficacy (ß=.141, P<.001) jointly determined perceived usefulness and explained about 81% of the variance of perceived usefulness. However, social influence did not have a statistically significant impact on perceived usefulness, and self-efficacy did not significantly influence adoption intention directly. CONCLUSIONS: By integrating IAM and HBM, this study provided the insight and understanding that perceived usefulness and adoption intention of online health information could be influenced by information characteristics, people's perceptions of information drawbacks and benefits, and self-efficacy. Moreover, people also exhibited proactive behavior rather than reactive behavior to adopt information. Thus, we should consider these factors when helping the informed public obtain useful information via two approaches: one is to improve the quality of government-based and other official information, and the other is to improve the public's capacity to obtain information, in order to promote truth and fight rumors. This will, in turn, contribute to saving lives as the pandemic continues to unfold and run its course.

Stay-at-home policy is a case of exception fallacy: an internet-based ecological study.

A recent mathematical model has suggested that staying at home did not play a dominant role in reducing COVID-19 transmission. The second wave of cases in Europe, in regions that were considered as COVID-19 controlled, may raise some concerns. Our objective was to assess the association between staying at home (%) and the reduction/increase in the number of deaths due to COVID-19 in several regions in the world. In this ecological study, data from www.google.com/covid19/mobility/ , ourworldindata.org and covid.saude.gov.br were combined. Countries with > 100 deaths and with a Healthcare Access and Quality Index of ≥ 67 were included. Data were preprocessed and analyzed using the difference between number of deaths/million between 2 regions and the difference between the percentage of staying at home. The analysis was performed using linear regression with special attention to residual analysis. After preprocessing the data, 87 regions around the world were included, yielding 3741 pairwise comparisons for linear regression analysis. Only 63 (1.6%) comparisons were significant. With our results, we were not able to explain if COVID-19 mortality is reduced by staying at home in ~ 98% of the comparisons after epidemiological weeks 9 to 34.