Adjustment to "new normal" after cancer among non-small cell lung cancer survivors: A qualitative study.

OBJECTIVES: Cancer is a life-changing experience, and side effects from treatment can make it difficult for survivors to return to their pre-cancer "normal life." We explored the "new normal" and barriers to achieving it among lung cancer survivors who underwent surgery. METHODS: Semi-structured interviews were conducted with 32 recurrence-free non-small cell lung cancer survivors. We asked survivors how life had changed; how they defined the "new normal"; barriers that prevent them from achieving a "normal" life; and unmet needs or support for normalcy. Thematic analysis was performed. RESULTS: Defining "new normal" subjectively depends on an individual's expectation of recovery: (1) being able to do what they want without pain or discomfort; (2) being able to do activities they could accomplish before their surgery; and (3) being able to work, earn money, and support their family. We found that (1) persistent symptoms, (2) fear of cancer recurrence, (3) high expectations in recovery, and (4) psychosocial stress and guilty feelings were barriers to achieving a "new normal." The needs and support for normalcy were information on expected trajectories, postoperative management, and support from family and society. SIGNIFICANCE OF RESULTS: Survivors defined the "new normal" differently, depending on their expectations for recovery. Informing survivors about the "new normal" so they could expect possible changes and set realistic goals for their life after cancer. Health professionals need to communicate with survivors about expectations for "normality" from the beginning of treatment, and it should be included in comprehensive survivorship care.

Shift from a Zero-COVID strategy to a New-normal strategy for controlling SARS-COV-2 infections in Vietnam.

The aim of this study is to analyse the changing patterns in the transmission of COVID-19 in relation to changes in Vietnamese governmental policies, based on epidemiological data and policy actions in a large Vietnamese province, Bac Ninh, in 2021. Data on confirmed cases from January to December 2021 were collected, together with policy documents. There were three distinct periods of the COVID-19 pandemic in Bac Ninh province during 2021. During the first period, referred to as the 'Zero-COVID' period (01/04-07/04/2021), there was a low population vaccination rate, with less than 25% of the population receiving its first vaccine dose. Measures implemented during this period focused on domestic movement restrictions, mask mandates, and screening efforts to control the spread of the virus. The subsequent period, referred to as the 'Transition' period (07/05-10/22/2021), witnessed a significant increase in population vaccination coverage, with 80% of the population receiving their first vaccine dose. During this period, several days passed without any reported COVID-19 cases in the community. The local government implemented measures to manage domestic actions and reduce the time spent in quarantine, and encouraged home quarantining for the close contacts of cases with COVID-19. Finally, the 'New-normal' stage (10/23-12/31/2021), during which the population vaccination coverage with a second vaccine dose increased to 70%, and most of the mandates for the prevention and control of COVID-19 were reduced. In conclusion, this study highlights the importance of governmental policies in managing and controlling the transmission of COVID-19 and provides insights for developing realistic and context-specific strategies in similar settings.

Instructional media selection principles for online medical education and emerging models for the new normal.

The COVID-19 pandemic, and the resulting need to avoid in-person classes, compelled many faculty members to convert to a completely online instructional format. The literature on selecting media for medical educators, however, provided little assistance for them to make choices that facilitated learning through using alternative online instruction practices. In this study, we addressed the lack of guidance for the use of media to facilitate the effective online medical education. To optimise the transition from face-to-face educational modalities to online learning, we incorporated insights from theories of media synchronicity and learning. We considered the value of existing learning theories in influencing how we could guide entrenched face-to-face educators to online learning practice. Therefore, we employed existing theories and practice to assist in developing an algorithmic approach to guiding these educators. We reassessed the way taxonomies of learning objectives, practice-oriented learning experiences, the social and collaborative features of learning activities, and media synchronicity theory could have augmented face-to-face teaching, and influenced how these could be reconfigured to assist in the transition to online learning. Consequently, we have developed key principles to inform the continuity of design and selection of instructional media in the transition to medical online learning. We have constructed specific criteria for media selection that correspond to the 12 goals of medical learning. We found that the majority of the goals can be more enhanced by synchronous media than asynchronous versions. We discuss the role of instructional media in emergency online medical education as well as emerging models of media selection for the new normal in medical education and future directions for medical education media research.

RELATIONSHIPS, RIGHTS, AND RESPONSIBILITIES: (RE)VIEWING THE NHS CONSTITUTION FOR THE POST-PANDEMIC 'NEW NORMAL'.

Action needs to be taken to map out the fairest way to meet the needs of all NHS stakeholders in the post-pandemic 'new normal'. In this article, we review the NHS Constitution, looking at it from a relational perspective and suggesting that it offers a useful starting point for such a project, but that new ways of thinking are required to accommodate the significant changes the pandemic has made to the fabric of the NHS. These new ways of thinking should encompass concepts of solidarity, care, and (reciprocal) responsibility, grounded in an acceptance of the importance of relationships in society. To this end, we explore and emphasise the importance of our interconnections as NHS stakeholders and 're-view' the NHS Constitution from a relational perspective, concentrating on the rights and responsibilities it describes for patients and the public as NHS stakeholders. We argue that the NHS Constitution, of which most stakeholders are probably unaware, can be used as a tool to engage us, and to catalyse conversation about how our responsibilities as NHS stakeholders should change in the post-pandemic 'new normal'.

PLANNING TO 'NEW NORMAL' DURING COVID-19 PANDEMIC AT GENERAL SURGERY DEPARTMENT: A TURKEY EXPERIENCE.

Planning of non-postponable treatments for cancer, trauma, emergency diseases, and follow-up and treatment of chronic diseases are inevitable for the ongoing pandemic and future pandemics. In this study, we evaluated the capacity of surgical applications and treatments made to the surgery department in the first 3 months of the onset of the COVID-19 pandemic. A retrospective cohort study was performed from March 12, 2020 to June 1, 2020. COVID-19 negative general surgery patients were included. Demographics, diagnosis and management were recorded, as well as bed turnover and length of stay in the hospital. Similar data were collected on patients admitted during the same period in 2019 and 2018 to allow for comparison. A total of 1764 operations were included. There was a reduction in surgeries when comparing 2020 with 2019 and 2018 (164 vs. 713 and 890); however, there was no difference in the length of stay in the hospital (4.12 vs. 4.37 and 4.07 days, p=0.626). During 2020, appendectomies decreased (53 vs. 102 and 100, p=0.013). There was no difference in the number of emergency oncologic surgeries during 2020 as compared with 2019 and 2018 (16 vs. 8 and 13, p=0.149). In conclusion, COVID-19 significantly impacted the number of admissions to general surgery. However, cancer and emergency operations continued to be required, thus provisions need to be made to enable planning these interventions.

Reopening higher education buildings in post-epidemic COVID-19 scenario: monitoring and assessment of indoor environmental quality after implementing ventilation protocols in Spain and Portugal.

Post-epidemic protocols have been implemented in public buildings to keep indoor environments safe. However, indoor environmental conditions are affected by this decision, which also affect the occupants of buildings. This fact has major implications in educational buildings, where the satisfaction and learning performance of students may also be affected. This study investigates the impact of post-epidemic protocols on indoor environmental conditions in higher education buildings of one Portuguese and one Spanish university. A sensor monitoring campaign combined with a simultaneous questionnaire was conducted during the reopening of the educational buildings. Results showed that although renewal air protocols were effective and the mean CO2 concentration levels remained low (742 ppm and 519 ppm in Portugal and Spain universities, respectively), students were dissatisfied with the current indoor environmental conditions. Significant differences were also found between the responses of Portuguese and Spanish students. Indeed, Spanish students showed warmer preferences (thermal neutrality = 23.3℃) than Portuguese students (thermal neutrality = 20.7℃). In terms of involved indoor factors, the obtained data showed significant correlations (p < 0.001) between acoustic factors and overall satisfaction in the Portuguese students (ρ = 0.540) and between thermal factors and overall satisfaction in the Spanish students (ρ = 0.522). Therefore, indoor environmental conditions should be improved by keeping spaces safe while minimizing the impact of post-epidemic protocols on student learning performance.

Food services in times of uncertainty: Remodeling operations, changing trends, and looking into perspectives after the COVID-19 pandemic.

BACKGROUND: Social distancing and the economic downturn imposed by COVID-19 have significantly affected the food service segment. Therefore, operation recovery and adapting to a new reality must be achieved as quickly and efficiently as possible. Studies on this topic, which have been conceptualized in various parts of the world, have brought new ideas to light to mitigate the negative effects of COVID-19 on food service. SCOPE AND APPROACH: This study aimed to discuss the impact of COVID-19 on food service operations, changes in pre-existing trends, and post-pandemic perspectives. KEY FINDINGS AND CONCLUSIONS: COVID-19 has changed all business segments. When dining rooms were forced to close, many food services had to resort to innovation to survive, and many added deliveries and/or adopted the dark kitchen models in one of their many forms. It is expected that the demand for delivery, dark kitchens, and the adoption of technological solutions, for example, contactless payment, will remain in the post-pandemic scenario. Food quality control measures have become more strictly enforced, not only to prevent SARS-CoV-2 contamination but also to increase credibility with the customer. These long-established food safety practices have returned to the spotlight, been revised, and should be maintained for well into the post-pandemic period. Restaurants are operating again and restrictions on opening hours and capacity have been relaxed or eliminated. Continued studies on this topic are important for supporting creative and scientifically based solutions for socio-economic recovery.

One academic year under COVID-19 conditions: two multicenter cross-sectional evaluation studies among medical students in Bavarian medical schools, Germany students' needs, difficulties, and concerns about digital teaching and learning.

BACKGROUND: Since March 2020, COVID-19 has created a need for adaptation in many areas of life. This study explores medical students' perspectives on digital teaching under conditions of the COVID-19 pandemic. It focuses on expectations and concerns about digital teaching, the evaluation of specific aspects of teaching, and requests for future teaching. METHODS: Six German faculties have joined forces within the Bavarian network for medical education to develop and deploy a common core questionnaire. Cross-sectional surveys were conducted at the end of the summer semester 2020 and winter semester 2020/21. Medical students from different semesters participated in the online survey. Data was analyzed descriptively and/or inferentially. Item differences across semesters were examined using contingency tables and Chi2 tests. Mean values were compared using the independent samples t-test; answer frequencies in retrospective and prospective concerns were compared using contingency tables and Chi2 tests with Yates' correction. RESULTS: In the summer semester 2020, 1565 students and in winter semester 2020/21, 1727 students took part in the survey. Students' main prospective concern was lack of social exchange between fellow students (70%), but also with teachers. Second and third most often concerns were a lack of practical training (68%) and lack of integration of on-site digital teaching (50%). Approximately 7% of the students lacked sufficient access to technical equipment.. Approximately 39% of the students lacked a sufficient internet connection for synchronous digital teaching, 17% for asynchronous digital teaching. On-site teaching was the preferred form of teaching (60%), and there was a preference for asynchronous (24%) over synchronous (15%) digital teaching. Teaching recordings (79%) were particularly popular to complement future on-site teaching. CONCLUSIONS: The following areas of education under COVID-19 conditions are highly important to medical students: adequacy of information sharing, integration of opportunities for exchange with fellow students and teachers, possibility to perform practical trainings. After the normalization of the pandemic situation, on-site teaching should be supplemented with blended learning concepts such as the inverted classroom model. Percentages of results are rounded averages from summer and winter semesters.

Fuzzy covering problem of fuzzy graphs and its application to investigate the Indian economy in new normal.

In this paper, new concepts of covering of fuzzy graphs are introduced. The definitions of fuzzy covering maps and fuzzy covering graphs of fuzzy graphs are given. Some special types of fuzzy covering graphs are discussed. Some important theorems to find out the fuzzy covering maps as well as fuzzy covering graphs for different types of fuzzy graphs are described. On the basis of the present situation during the current pandemic COVID-19, the world economic status is highly disruptive and deeply affected by the lock-down process. So, this topic is catching the eye for being an application part of this paper. Also, there are globally seventeen goals to sustain our development, which contain the eighth goal 'Decent Work and Economic Growth' having effect on the economy of the world. For this reason, the eighth sustainable development goal is combined with the economic impact of the pandemic for the discussion in the application part. Then some strategies are made to overcome this condition in a better way and perform all the steps to get a better situation in near future.

Establishing a New Normal for Hospital Care: A Whole of Hospital Approach to Coronavirus Disease 2019 (COVID-19).

Singapore's hospitals had prepared to receive patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), planning various scenarios and levels of surge with a policy of isolating all confirmed cases as inpatients. The National University Hospital adopted a whole of hospital approach to coronavirus disease 2019 (COVID-19) with 3 primary goals: zero hospital-acquired COVID-19, all patients receive timely necessary care, and maintenance of staff morale. These goals to date have been met. A large influx of COVID-19 cases required significant transformation of clinical and operational processes. Isolation room numbers almost tripled and dedicated COVID-19 cohort wards were established, elective care was postponed, and intensive care units were augmented with equipment and manpower. In the wake of the surge, establishing a new normal for hospital care requires maintaining vigilance to detect endemic COVID-19, establishing contingency plans to ramp up in case of another surge, while returning to business as usual.

Insights on COVID-19 impacts, challenges and opportunities for India's biodiversity research: From complexity to building adaptations.

The COVID-19 pandemic has impacted every sphere of human society. The paradigm shift of focus to COVID-related research and management has significantly affected various scientific domains, including biodiversity conservation. We assessed the perceptions of early-career researchers working for biodiversity conservation across India, to understand the impacts of the ongoing pandemic on their research. We administered an online questionnaire survey to 565 respondents, who identified four key areas that are affected by the pandemic: (1) research, (2) conservation (3) education, and (4) communication and networking. Respondents (89.2%) perceived that their fieldwork, followed by travel for meetings and funding were the most affected due to COVID-19 outbreak and subsequent lockdown. Nonetheless, responses on the impact varied between different professional categories and were disproportionate. Our study highlights that majority of the respondents (80%) advocate for stakeholder-driven policies and management practices as the most effective strategy to promote biodiversity conservation, in the post-COVID-19 world. To this end, as a post-pandemic response, we propose holistic solutions such as optimising research funding and collaborations, and supporting and strengthening them by citizen science and big data analytics. Our findings and recommendations will also serve as a paradigm for post-COVID-19 biodiversity policy, advocacy and implementation of the post 2020 biodiversity action plan that supports eco civilization.

Adapting to the culture of 'new normal': an emerging response to COVID-19.

A year after COVID-19 pandemic has emerged, we have suddenly been forced to adapt to the 'new normal': work-from-home setting, parents home-schooling their children in a new blended learning setting, lockdown and quarantine, and the mandatory wearing of face mask and face shields in public. For many, 2020 has already been earmarked as 'the worst' year in the 21st century. Ripples from the current situation have spread into the personal, social, economic and spiritual spheres. Is this new normal really new or is it a reiteration of the old? A recent correspondence published in this journal rightly pointed out the involvement of a 'supportive' government, 'creative' church and an 'adaptive' public in the so-called culture. However, I argue that adapting to the 'new normal' can greatly affect the future. I would carefully suggest that we examine the context and the location of culture in which adaptations are needed.

A longitudinal investigation of mental health, perceived learning environment and burdens in a cohort of first-year German medical students' before and during the COVID-19 'new normal'.

BACKGROUND: Medical students' propensity to develop mental morbidity has been described for decades but remains unresolved. To assess student mental health person-centred and longitudinally, we have been investigating a cohort of German students since October 2019. After their first semester under 'normal' conditions, rapid changes became necessary due to the COVID-19 situation. In line with the initial aim, we investigated students' change of mental health, perceived learning environment and burdens in the 'new normal'. METHODS: Students in a newly founded German medical study programme (n = 63) answered a questionnaire each semester (October 2019 = entering medical school; December 2019 = 'old normal'; June 2020 = 'new normal'; December 2020 = 'new normal') on their well-being (FAHW-12), burnout (Maslach Inventory), depression (PHQ-9), perception of the learning environment (DREEM), burdens and protective attitudes in the 'new normal' (items designed for the study). RESULTS: Friedman tests reveal overall significant differences (all p < .001) in depression and burnout (emotional exhaustion, depersonalisation, personal accomplishment); changes in well-being were identified as just non-significant (p = .05). The effects were explained by a significant increase in burnout and depression identified post-hoc from October 2019 to December 2019. No increase in severity was identified in the 'new normal' semesters. The learning environment was perceived positively even with a significant improvement for June 2020 (repeated measures ANOVA p < .001). Study-related burdens (e.g. procrastination of online-learning material) took on greater relevance than burdens related to physicians' occupation (e.g. potential for students' recruitment to the healthcare system during their studies). CONCLUSIONS: The 'new' when entering medical school had a greater impact on our students' mental health than the 'new normal'. The readiness for change in the context of a newly designed study programme may have been beneficial with regard to students' positively perceived learning environment during the virtual semesters. Monitoring medical students' mental health longitudinally should be a concern regardless of a pandemic.

A fair allocation approach to the ethics of scarce resources in the context of a pandemic: The need to prioritize the worst-off in the Philippines.

Using a fair allocation approach, this paper identifies and examines important concerns arising from the Philippines' COVID-19 response while focusing on difficulties encountered by various sectors in gaining fair access to needed societal resources. The effectiveness of different response measures is anchored on addressing inequities that have permeated Philippine society for a long time. Since most measures that are in place as part of the COVID-19 response are meant to be temporary, these are unable to resolve the inequities that have led to the magnitude of morbidity and mortality associated with the pandemic. These cannot improve the country's readiness to deal with pandemics and other emergencies in the future. Transition to a new normal recognizes the possibility that other infectious diseases could come and endanger our health security. Our pandemic experiences are proving that having an egalitarian society will serve the interests not only of disadvantaged sectors but also of everybody else, including the privileged. Response measures should thus take the opportunity to promote equity by giving importance to the concerns of the underprivileged and vulnerable while giving preference to initiatives that can be sustained beyond the period of the current pandemic.

Examining K-12 teachers' feelings, experiences, and perspectives regarding online teaching during the early stage of the COVID-19 pandemic.

This mixed-methods study explored K-12 teachers' feelings, experiences, and perspectives regarding online teaching during the COVID-19 pandemic. The study also examined teachers' perspectives of the "new normal" after COVID-19 and of what should be done to better prepare teachers for future emergencies. Both quantitative and qualitative data were collected from an online survey and follow-up interviews. A total of 107 teachers from 25 different states in the United States completed the online survey, and 13 teachers from 10 different states participated in the follow-up interviews. The results revealed teachers' feelings about online teaching and various strategies and tools they used during the early stage of the COVID-19 pandemic. The major challenges faced by teachers during the pandemic included lack of student participation and engagement (or lack of parental support), students without access to technology, concerns about students' well-being, no face-to-face interactions with students, no work-life balance, and learning new technology. Four major themes emerged regarding how to better prepare teachers for future emergencies: (1) professional development for online learning, (2) technology access, (3) technology training for both teachers and students, and (4) action plans and communication. Regarding teachers' perspectives of the "new normal," five major themes emerged: (1) more online or blended learning, (2) rethinking normal, (3) hygiene and social distancing, (4) smaller classes and different school schedules, and (5) uncertainty and concerns about the "new normal."

Reimagining e-leadership for reconfigured virtual teams due to Covid-19.

Driven by an unexpected transition into virtual working worldwide as a result of the Coronavirus disease 2019 (Covid-19) pandemic, in this paper, we examine the extent to which existing knowledge from the literature on virtual teams (VTs) spanning two decades can be used to inform how leadership can be exercised in the Covid-19 'new normal', involving 'reconfigured' VTs which have both similarities with, and differences from, earlier VTs. Drawing on existing literature on VTs pre-Covid-19, we explore what current (and future) VTs might look like and what this means for leadership in this new context with an emphasis on how leadership, or e-leadership, can be exercised to help the leaders of traditional, physically collocated teams that had to transition into VTs. These new e-leaders need to come to grips with a variety of new challenges in order to create high-performing and sustainable VTs. Following a semi-systematic, state-of-the-art literature review, we: (a) identify key themes and explain with a theoretical model how existing knowledge can lead to new insights for newly transitioned e-leaders; (b) discuss what future information systems (IS) researchers should focus on given the reconfiguration and new characteristics of VTs in the Covid-19 context; and (c) 'translate' the findings of our synthesis of the existing literature into prescriptive advice that can be used to inform practitioners.

Long-term pathways to deep decarbonization of the transport sector in the post-COVID world.

The novel coronavirus disease 2019 (COVID-19) crisis has influenced economies and societies across the globe and will thoroughly reshape our world as it continues to unfold. The pandemic is likely to trigger permanent long-term impacts on the transport sector in the post-COVID world. While a post-COVID "new normal" will be likely to incur negative consequences, it may provide an opportunity to move toward a more sustainable transport sector. This paper is aimed at developing an urban economic model with an energy focus to depict the dynamics of travel demand, energy consumption, and emissions in the post-COVID world. A set of scenarios was created according to model assumptions regarding lifestyle changes and policy interventions accompanied by the expected post-COVID new normal, to explore long-term pathways toward a deep decarbonization of the transport sector. Scenario simulations demonstrated that working from home, online shopping, and a bike-friendly infrastructure will contribute to a reduction in energy consumption and CO2 emissions, whereas a significant shift from bus to car transport and the decreasing use of car-sharing services will adversely affect CO2 emission reductions. The arrival of the post-COVID world may contribute to an 11% reduction in CO2 emissions by 2060, while the maximum reduction potential could be as high as 44%. Supporting policies and strategies for encouraging remote work and online shopping as well as for promoting safe public transport, active transport, and carpooling services are needed to strongly decarbonize the transport sector in the post-COVID world. Moreover, population distribution and urban structure may also be influenced by the arrival of the post-COVID new normal, which warrant further attention for urban planning.

Conclusions: Towards a sociology of pandemics and beyond.

This conclusion revisits the COVID-19 pandemic from the broader perspective of a changing global world. It raises questions regarding the opportunities for global learning under conditions of global divisions and competition and includes learning from the Other, governing within a changing public sphere, and challenging national cultural practices. Moreover, it exemplifies how the society-nature-technology nexus has become crucial for understanding and reconstructing the dynamics of the coronavirus crisis such as the assemblages of geographical conditions, technological means and the governing of ignorance, the occurrence of hotspots as well as living under lockdown conditions. It finishes with some preliminary suggestions how reoccurring pandemics might contribute to long-term changes in human attitudes and behaviour towards the environment and a technologically shaped lifeworld.

Simone de Beauvoir and a period of transition.

This article discusses the global intensification of gender inequality during the time of the Covid-19 pandemic. It reflects on the meaning of being a woman in the recent time of transition and the phenomenon of gender discrimination, which has been a lived experience of women worldwide. The article compares the Covid-19 situation seen through a gender lens with the previous period of transition described by Simone de Beauvoir seventy years ago. It argues that the post-pandemic world should be created from the feminist perspective that calls for social and educational change.

Cardiac surgery in the time of the novel coronavirus: Why we should think to a new normal.

On 11 March 2020, the World Health Organization declared the SARS-CoV-2 outbreak a pandemic. At the time of writing, 24 May 2020 more than 5 million individuals have been tested positive and the death toll was over 330 000 deaths worldwide. The initial data pointed out the tight bond between cardiovascular diseases and worse health outcomes in COVID19-patients. Epidemiologically speaking, there is an overlap between the age-groups more affected by COVID-related death and the age-groups in which Cardiac Surgery has its usual base of patients. The Cardiac Surgery Departments have to think to a new normal: since the virus will remain endemic in the society, dedicated pathways or even dedicated Teams are pivotal to treat safely the patients, in respect of the safety of the health care workers. Moreover, we need a keen eye on deciding which pathologies have to be treated with priority: Coronary artery Disease showed a higher mortality rate in patients affected by COVID19, but it is, however, reasonable to think that all the cardiac pathologies affecting the lung circulation-such as symptomatic severe mitral diseases or aortic stenosis-might deserve a priority access to treatment, to increase the survival rate in case of an acquired-Coronavirus infection later on.