Digital learning in nursing education: lessons from the COVID-19 lockdown.

BACKGROUND: The COVID-19 pandemic necessitated a swift transition to e-learning, significantly impacting nursing education due to its reliance on practical, hands-on experiences and the critical role nurses play in healthcare. Nursing students need to achieve high levels of clinical competence through experiences traditionally obtained in clinical settings, which e-learning had to replicate or supplement. Understanding the unique challenges faced by nursing students in e-learning environments is crucial for developing educational strategies that enhance learning outcomes and contribute to improved patient care. This study aimed to explore the experiences of nursing students and newly qualified nurses (as students) with e-learning during the COVID-19 lockdown, focusing on how it influenced their learning and professional development. METHOD: This exploratory and descriptive study employed qualitative interviews with 31 participants, including full-time nursing students, part-time nursing students, and newly qualified nurses (as nursing students). Conducted online via Zoom during February and March 2022. RESULTS: The findings suggest that integrating small group interactions and employing strategic pedagogical support can enhance e-learning effectiveness. However, barriers such as technological difficulties, psychological challenges, and social isolation were also identified. Understanding these unique opportunities and challenges can help educational institutions optimize e-learning strategies, ensuring nursing students are well-prepared for their crucial roles in healthcare. CONCLUSION: The rapid shift to e-learning due to the COVID-19 pandemic presented challenges such as technological, psychological and social aspects, but also opportunities to rethink and enhance nursing education delivery. Implementing appropriate pedagogical e-learning strategies, such as scaffolding and small group learning, can better prepare nursing students for their essential roles in healthcare. This study contributes to the body of knowledge on digital education and provides a foundation for future research aimed at optimizing e-learning in nursing education.

Impact of the Pandemic was Minor Compared to Systemic Decrease in Fidelity of Assertive Community Treatment Services- A Provincial Study in Ontario, Canada.

Assertive Community Treatment (ACT) model is the gold standard in community psychiatry serving people with severe mental illness. With its outreach-based design, the pandemic has profoundly affected the operations and functioning of ACT. The Dartmouth ACT Scale (DACTS) provides a standardized comprehensive and quantitative way to evaluate ACT quality. Results could inform nature of impact and identify areas for improvement. Current online survey used DACTS during the pandemic in April-May 2021. Clinical and administrative leadership of the 80 ACT teams in Ontario, Canada cross-sectionally rated ACT quality one-year pre-Covid (2018-2019) and one-year post the start of Covid (2020-2021). The overall pre-Covid Ontario ACT DACTS fidelity was 3.65. The pandemic led to decreases in all domains of DACTS (Human Resources: -4.92%, p < 0.001, 95% CI [0.08-0.27]; Organizational Boundary: -1.03%, p < 0.013,95%CI [0.01-0.07]; and Nature of Services: -6.18%, p < 0.001, 95%CI [0.16-0.26]). These changes were accounted by expected lower face-to-face encounters, time spent with clients, reduction in psychosocial services, less interactions with hospitals and diminished workforces. The magnitude of change was modest (-3.84%, p < 0.001, 95%CI [0.09-0.19]). However, the Ontario ACT pre-Covid DACTS was substantially lower (-13.5%) when compared to that from a similar survey 15 years ago (4.22), suggestive of insidious systemic level loss of fidelity. Quantitative fidelity evaluation helped to ascertain specific pandemic impact. Changes were significant and specific, but overall relatively modest when compared to the larger system level drop over the last decade. There is both evidence for model adaptability and resilience during Covid disruption, and concerns over larger downward drift in ACT fidelity and quality.

Comparison of work efficiency in factory workers: pre & post covid lockdown - a cross sectional study.

BACKGROUND: The COVID-19 pandemic's impact on economies worldwide has caused changes in work patterns, reduced productivity, and job losses, particularly affecting factory workers. Lockdown measures have also led to reduced physical activity levels, which is a significant risk factor for chronic diseases. This study aims to investigate efficiency of factory workers pre and post lockdown periods. The findings will contribute to identifying evidence-based strategies to minimize the negative impact of lockdown measures on factory workers' productivity and health. MATERIALS AND METHODS: A cross-sectional study was conducted to assess the work performance of employees in a medicine manufacturing unit. Data was collected from factory workers online and study period was January 2021 to April 2022. Survey includes close ended questions regarding work performance of employees before lockdown period (Before 20/03/2020) and performance after lockdown period (After August 2020). The sample size of 196 employees selected through simple random sampling. A questionnaire consisting of demographic factors, work details, and work performance was prepared using pretested standard tools, including the Individual Work Performance Questionnaire (IWPQ), the World Health Organization Health and Work Performance Questionnaire (HPQ), and the Stanford Presenteeism Scale (SPS-6). The collected data was analysed using descriptive statistics and a paired t-test. RESULTS: The study found that prior to lockdown, 99% of employees consistently had higher performance, with 71.4% ranking in the top 10. However, after lockdown, the percentage of employees with high performance decreased to 91.8%, with only 63.3% ranking in the top 10. These differences were statistically significant, indicating a decrease in work efficiency of 8.1%. Before lockdown, employees worked longer hours, including on off days, while after lockdown, a small proportion missed work due to various reasons, resulting in better quality work. CONCLUSION: In conclusion, the study highlights the significant impact of the COVID-19 pandemic on the work efficiency of factory workers. The findings indicate a decrease in work efficiency after the lockdown, coupled with an increase in employee stress. This suggests that the pandemic has brought about unique challenges for factory workers that need to be addressed to maintain their well-being and productivity. This study emphasizes the importance of creating a supportive work environment that prioritizes the mental and physical health of employees, especially during times of crisis.

The Impact of COVID-19 on Plastic Surgery Residents Across the World: A Country-, Region-, and Income-level Analysis.

BACKGROUND: The COVID-19 pandemic has upended graduate medical education globally. We investigated the COVID-19 impact on learning inputs and expected learning outputs of plastic surgery residents across the world. METHODS: We administered an online survey capturing training inputs before and during the pandemic and retrieved residents' expected learning outputs compared with residents who completed their training before COVID. The questionnaire reached residents across the world through the mobilization of national and international societies of plastic surgeons. RESULTS: The analysis included 412 plastic surgery residents from 47 countries. The results revealed a 44% decline (ranging from - 79 to 10% across countries) and an 18% decline (ranging from - 76 to across 151% countries) in surgeries and seminars, respectively, per week. Moreover, 74% (ranging from 0 to 100% across countries) and 43% (ranging from 0 to 100% across countries) of residents expected a negative COVID-19 impact on their surgical skill and scientific knowledge, respectively. We found strong correlations only between corresponding input and output: surgeries scrubbed in with surgical skill (ρ = -0.511 with p < 0.001) and seminars attended with scientific knowledge (ρ = - 0.274 with p = 0.006). CONCLUSIONS: Our ranking of countries based on their COVID-19 impacts provides benchmarks for national strategies of learning recovery. Remedial measures that target surgical skill may be more needed than those targeting scientific knowledge. Our finding of limited substitutability of inputs in training suggests that it may be challenging to make up for lost operating room time with more seminars. Our results support the need for flexible training models and competency-based advancement. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .

Impact of the COVID-19 Pandemic on Canadian Social Connections: A Thematic Analysis.

Background: On March 11, 2020, the World Health Organization declared COVID-19 a worldwide pandemic. Responses to the pandemic response disrupted Canadian social connections in complex ways; because social connections are determinants of health and well-being, their disruption could adversely affect health and well-being. Moreover, understanding how pandemics and public health responses affect social connections could inform pandemic recovery strategy and public health approaches designed for future pandemics. The purpose of this study is to understand experiences of pandemic impact on social connections over the pandemic. Methods: A sample of 343 Canadian adults was recruited through Athabasca University and social media. Participants were predominantly White (81%) and female (88%). After the pandemic onset, participants responded to open-ended questions about the impact of the pandemic on and any changes to social connections at three time points (baseline, and three- and 6 months from study entry). Responses were categorized into epochs by date (April-June 2020 [Spring]; July-August 2020 [Summer]; September 2020-January 2021 [Fall/Winter]). Qualitative thematic analysis was used to code themes for each epoch. Results: Negative impact of the pandemic (37-45%), loss of social connections (32-36%), and alternative means of connection (26-32%) were prominent themes across the epochs. Restrictions to face-to-face connections were largest in spring (9%) and lowest in the Summer (4%). Conversely, participants increasingly reported limited contact or communication into the Fall and Winter (6-12%) as pandemic restrictions in Canada were reinstated. Conclusions: The COVID-19 pandemic threatens social connections, with negative impacts that fluctuated with COVID-19 case rates and subsequent pandemic restrictions. These findings could be used to identify targets for social supports during the pandemic recovery, and to adjust public health strategies for future pandemics that minimize impact on social connections.

The impact of one-year COVID-19 containment measures in patients with mesial temporal lobe epilepsy: A longitudinal survey-based study.

BACKGROUND: We assessed levels of depression, anxiety, stress, anhedonia, somatization, psychological distress, sleep, and life quality in patients with mesial temporal lobe epilepsy (MTLE) after one year of containment measures started in Italy to stem the COVID-19 pandemic. METHODS: We consecutively enrolled 51 patients with MTLE, administering an online survey that compared the year before and after the COVID-19 propagation. We analyzed clinical data (e.g., seizure frequency, life quality) and neuropsychological assessment through Somatic Symptom Scale-8 (SSS-8), Beck Depression Inventory (BDI-2), State-Trait Anxiety Inventory (STAI-Y), Depression, Anxiety and Stress Scale (DASS-21), Pittsburgh Sleep Quality Index (PSQI), Snaith-Hamilton Pleasure Scale (SHAPS), Impact of Event Scale-Revised (IES-R). The BDI-2 and STAI-Y scores were compared to those acquired in the same patients before the COVID-19 outbreak. RESULTS: Comparing our population with MTLE before and after COVID-19 outbreak, we found a significant worsening in life quality (p = 0.03), SSS-8 (p = 0.001), BDI-2 (p = 0.032), and STAI-Y scores (p < 0.001). After one year of pandemic, 88.2% of patients obtained pathological scores at PSQI, 19.6% at SHAPS, 29.4% at IES-R. Reduction of life quality correlated with anxiety, depression, stress, and somatization. Higher levels of anhedonia correlated with stress, depression, and anxiety. Somatization correlated with depression, anxiety, and sleep quality. Distress levels correlated with anxiety, somatization, and depression. CONCLUSIONS: We demonstrated a significant worsening of depression, anxiety, life quality, and somatization in patients with MTLE after one year of COVID-19 beginning. Concomitantly, results suggest that the pandemic had a negative impact on sleep quality, psychological distress, and anhedonia, but not on epilepsy itself.

Perceptions of US nurses and nurse leaders on authentic nurse leadership, healthy work environment, intent to leave and nurse well-being during a second pandemic year: A cross sectional study.

AIM: The main aim of this study was to determine the perceptions of clinical nurses and nurse leaders about authentic nurse leadership, work environment, pandemic impact, well-being and intent to leave their position and profession during the second year of the pandemic. BACKGROUND: This research team studied the variables pre-pandemic and in year one of the pandemic. As the pandemic continued, subsequent reports of workforce instability, deteriorating work environment and vulnerable well-being called for an understanding of the current state to inform needed actions by leadership. METHODS: This study is a cross-sectional, descriptive, correlational analysis using national survey data from 1795 US clinical nurses and nurse leaders in the fall of 2021. RESULTS: Pandemic impact was high, authentic nurse leadership was present, healthy work environment was not present and nurse well-being was at-risk and negatively correlated to both healthy work environment and authentic nurse leadership. Within our sample, 61.8% of nurses had no intention to leave their positions, and 82.5% had no intention to leave the profession. Compared with clinical nurses, nurse managers had significantly higher scores on all instruments. CONCLUSIONS: The findings of this study support leadership as positively related to a healthy work environment. Authentic nurse leadership, a healthy work environment and nurse well-being are all critical components of efforts to stabilize the nursing workforce as we recover and rebuild post-pandemic. IMPLICATIONS FOR NURSING MANAGEMENT: This is a call to action for leadership that will serve the goals of retaining nurses, rebuilding work environments and improving well-being.

Police, permits and politics: Navigating life on Australia's state borders during the COVID-19 pandemic.

OBJECTIVE: To explore the ways in which the Coronavirus disease-19 (COVID-19) pandemic has affected Australians who live and travel in cross-border regions in the course of their daily lives. DESIGN: Semi-structured interviews were undertaken with participants by telephone. The analysis utilised qualitative exploratory methods and provided rich data through immersive and reflexive analysis. SETTING: Interviews of people across Australia. PARTICIPANTS: Of 90 people interviewed in relation to their experiences of the COVID-19 pandemic, 13 described challenges related to border crossing that impacted their usual work and personal life. MAIN OUTCOME MEASURE: Description of challenges faced by Australians living close to state borders due to internal border closures in the early period of COVID-19 (2020). RESULTS: Policy changes surrounding border closures negatively impacted people's wellbeing in Australia with three key interconnected themes identified for Australians living in cross-border regions. First, border closures presented participants of these communities with physical barriers which reduced access to healthcare and employment. Second, participants reported how restrictions on travel to neighboring states and territories impacted their mental wellbeing. Finally, many Australians in cross-border regions faced financial struggles exacerbated by border closures. CONCLUSION: Normally, interstate borders are largely invisible with formalities relevant to few circumstances. Since the emergence of the COVID-19 pandemic, Australians who used to regularly cross these borders in the course of their daily activities were no longer able or willing to do so due to the uncertain circumstances surrounding border policy. This study elaborates on the impact of these closures on people's physical, financial, and emotional state.

Faculty satisfaction and perception regarding emergency remote teaching : An exploratory study.

Background: The COVID 19 pandemic which made its presence felt by March 2020 made the educators and administrators, both of whom had very little experience with alternate teaching and learning methods, look for alternate methods of delivering the teaching learning. Because of the mandates from apex bodies, faculty members were forced to delve into an unknown territory of Emergency Remote Teaching (ERT). This study aimed to explore the factors that contributed to faculty satisfaction for ERT, the challenges faced, and suggestions for improving online teaching. Method: A modified survey tool to suit ERT was developed which demonstrated favourable preliminary factor analysis (Bartlett's Test of Sphericity (p < .001) and the Kaiser- Mayer- Olkin measure of sampling adequacy, KMO = 0.811). Results: The EFA identified four factors, such as faculty-student interaction, faculty and IT-related, faculty training and faculty preparedness with heavy loading on faculty training, as important factors for improving faculty satisfaction for online teaching. Most of the faculty members were satisfied with the ERT. A trend of shared opinion was observed in capacity building and empowering the faculty community with full IT and course development support from the institution in the form of faculty development programmes and infrastructure development in order to equip them with emergency academic transitions. Conclusion: The modified Survey tool was valid in identifying the faculty perceptions regarding the ERT. Faculty felt that they managed to quickly move to online teaching due to the pandemic but felt that they needed better IT support and faculty development programmes to effectively adapt to online teaching. Students, too, need to be trained for online learning, as per faculty members.

Assessing Community Vulnerability over 3 Waves of COVID-19 Pandemic, Hong Kong, China.

We constructed a coronavirus disease community vulnerability index using micro district-level socioeconomic and demographic data and analyzed its correlations with case counts across the 3 pandemic waves in Hong Kong, China. We found that districts with greater vulnerability reported more cases in the third wave when widespread community outbreaks occurred.

The repercussions and challenges of COVID-19 in the hotel industry: Potential strategies from a case study of Indonesia.

The COVID-19 pandemic has hit the tourism and hospitality sector hard. Hotel managers face uncertainty in this environment in order to survive. This study explores the impact of COVID-19 on the hospitality industry, particularly hotels in Indonesia, one of the largest developing countries. It examines the challenges faced by hotel managers and the strategies used to survive. Through the lens of complexity theory, we discuss whether the strategies being deployed are beneficial, redundant, or detrimental for hospitality businesses. Based on semi-structured interviews with 13 hotel managers in Jakarta, Bandung, and Bali, the findings shed light on the various challenges to hotels. We also highlight which challenges could turn into opportunities. The findings show that the strategies that managers are deploying could be detrimental in the future. Potential future research directions are also discussed.

Impact of the COVID-19 Pandemic on Adult Mental Health.

The outbreak of the Novel Coronavirus (COVID-19) in December 2019 has progressed to the status of a global pandemic, with countries across the seven continents adversely affected and the number of human cases exceeding two million. With no available vaccine, the treatment is primarily symptomatic for those affected and preventative for those at risk. Most countries have taken action to curtail the spread of COVID-19 through measures such as lockdowns, social distancing and voluntary self-isolation. Whilst necessary, such measures and the disease itself, may have an adverse impact on mental health. In view of research from previous pandemic crises, it is known that such situations are likely to increase stress levels and have negative psychiatric effects. The impact is likely to be felt by the general public, sufferers of COVID-19, their families and friends, persons with pre-existing mental health conditions and healthcare workers.

Severe outcomes among adults with TB during COVID-19.

BACKGROUND: The COVID-19 pandemic prompted strict public health measures to reduce SARS-CoV-2 transmission, potentially interrupting TB programmes in the Western Cape, South Africa. METHODS: We conducted a retrospective cohort study, estimating changes in new TB case rates and risk of death during TB-specific admissions within 6 months of TB first evidence, during the pre-pandemic (1 January 2019-26 March 2020) and after the implementation of public health and social measures (PHSM) periods (26 March 2020-30 September 2021), based on PHSM strictness. We used interrupted time series and logistic regression models to adjust for key characteristics. RESULTS: We found an average 22% reduction (95% CI 19-25) in monthly TB cases during the entire PHSM implementation period. Additionally, the risk of death during TB-specific admissions increased, with the adjusted odds ratio ranging across PHSM levels from 1.36 (95% CI 1.17-1.57) on Level 1 to 1.44 (95% CI 1.16-1.79) on Level 2 compared with the pre-pandemic period. CONCLUSIONS: There was a decline in the number of diagnosed TB cases and an increased risk of severe outcomes from 26 March 2020 to 30 September 2021 in the Western Cape. TB programme recovery strategies must be prioritised, and TB management programmes must be integrated into future pandemic responses.

CONTEXTE: La pandémie de COVID-19 a entraîné la mise en place de mesures de santé publique strictes afin de limiter la propagation du SRAS-CoV-2, ce qui risque de perturber les efforts de lutte contre la TB dans la province du Cap-Occidental, en Afrique du Sud. MÉTHODES: Une étude de cohorte rétrospective a été réalisée afin d'évaluer les variations des taux de nouveaux cas de TB et le risque de décès lors des admissions spécifiques à la TB dans les 6 mois suivant la première preuve de la maladie. Cette étude a été menée pendant deux périodes distinctes : la période prépandémique, allant du 1er janvier 2019 au 26 mars 2020, et la période post-mise en œuvre des mesures de santé publique et sociales (PHSM, pour l'anglais « public health and social measures ¼), allant du 26 mars 2020 au 30 septembre 2021. L'objectif était d'évaluer l'impact des PHSM sur ces indicateurs. Pour ce faire, des séries temporelles interrompues et des modèles de régression logistique ont été utilisés afin de prendre en compte les principales caractéristiques. RÉSULTATS: Au cours de la période de mise en œuvre des PHSM, nous avons observé une diminution moyenne de 22% (IC à 95% 19­25) des cas mensuels de TB. De plus, nous avons constaté une augmentation du risque de décès pendant les admissions pour TB, avec un rapport de cotes ajusté variant de 1,36 (IC à 95% ; 1,17­1,57) au niveau 1 des PHSM à 1,44 (IC à 95% ; 1,16­1,79) au niveau 2, par rapport à la période prépandémique. CONCLUSIONS: Entre le 26 mars 2020 et le 30 septembre 2021, il y a eu une baisse du nombre de cas de TB diagnostiqués dans la province du Cap-Occidental, mais le risque de résultats graves a augmenté pendant cette période. Les stratégies de rétablissement des programmes de lutte contre la TB doivent être prioritaires et les programmes de gestion de la TB doivent être intégrés dans les futures réponses à la pandémie.

The learning curve of COVID-19 and organ donation: Potential missed opportunities in the COVID era.

Background: Early in the COVID-19 pandemic, positive COVID-19 status often disqualified potential organ donors due to perceived risks, despite limited evidence. Subsequent studies have clarified that the COVID-19 status of donors, particularly when incidental and not the cause of death, does not adversely affect non-lung transplant outcomes. This study quantifies the potential loss of eligible organ donors and the corresponding impact on organ availability during the initial phase of the pandemic. Methods: In this retrospective analysis, we examined deceased donor referrals to a major organ procurement organization from June 2020 to January 2022. Referrals were categorized as All Referrals, Medically Ruled Out (MRO), or Procured Donors (PD). We used Chi-square tests for categorical comparisons and logistic regression to model additional donors and organs, contrasting COVID-negative and positive cases within age-matched cohorts. Results: Among 9478 referrals, 23.4 % (2221) were COVID-positive. Notably, COVID-positive referrals had a substantially higher MRO rate (80.6 % vs. 29.6 %, p < 0.01) and a markedly lower PD rate (0.2 % vs. 8.2 %, p < 0.01). Potential missed donations of 103 organs from COVID-positive referrals were identified. Conclusion: This OPO-level study demonstrates a substantial impact of COVID-19 status on organ donation rates, revealing significant missed opportunities. Improved management of donor COVID-19 status could potentially increase organ donations nationwide, taking into account evolving evidence and vaccine availability changes.

Assessing the Impact of the COVID-19 Pandemic on Maternal and Child Health Services: A Comprehensive Analysis of Government Initiatives in Northern India.

BACKGROUND: The coronavirus disease (COVID-19) pandemic has significantly impacted healthcare services globally, with particular challenges observed in maternal and child health (MCH) care. This study aimed to assess the impact of the pandemic on MCH services in northern India, focusing on key government programs. METHODS: Data were collected from four major MCH programs in India: Janani Suraksha Yojana (JSY), Janani Shishu Suraksha Karyakram (JSSK), Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA), and the Universal Immunization Program (UIP). The study compared MCH service utilization and outcomes during the pandemic period (March-September 2020) with the same period in 2019. RESULTS: Preliminary findings indicated a significant reduction in the utilization of MCH services during the pandemic, with a decrease observed in institutional deliveries, antenatal care visits, and immunization coverage. For instance, institutional deliveries declined by 30% compared with the previous year, with a similar decrease observed in antenatal care visits. Immunization coverage also decreased by approximately 25%, indicating a substantial decline in preventive care services. Challenges in accessing essential treatments for sick infants have also been reported, with a 40% decrease in the utilization of free treatment services under the JSSK program. CONCLUSION: The COVID-19 pandemic has substantially impacted MCH services in northern India, highlighting the vulnerability of these essential health programs during public health emergencies. Addressing the challenges identified in this study is crucial to ensuring the continuity and resilience of MCH services in similar settings.

Investigating the employment motivation, job satisfaction, and dissatisfaction of international high school teachers in China: the impact of the COVID-19 pandemic.

International education has become increasingly challenging to manage in an unpredictable world beset by pandemics, regional disputes, and evolving market practices. The last few decades have seen a huge demand for international education in China, and numerous acclaimed international brand names set up operations in China's K12 schooling sector. However, the COVID-19 pandemic exerted a noticeably negative impact on international high schools and their staff in China, and exacerbated a difficult period of management for these institutions. Interestingly, but perhaps unsurprisingly, the actual operation of these educational workplaces remains under investigated in academic studies. This paper therefore attempts to examine international high schools in China by focusing on their teachers and their associated employment motivation, job satisfaction, and dissatisfaction which has been perceptibly influenced by the impact of the COVID-19 pandemic. Through a qualitative, case-study approach which adopted semi-structured interviews, an acclaimed British high school, now closed, was investigated. The study found that international high school teachers were driven by diverse work motives such as the school's reputation, values, salary, environment, and chances for career development. Their job satisfaction was also multi-faceted, and their dissatisfaction in certain areas concerning. That is, they derived an early satisfaction from a range of facets, such as the students, class sizes, initial workloads, autonomy and collegiality. However, these early feelings were replaced by a sense of dissatisfaction and noticeable unhappiness resulting from leadership changes and subsequent management practices, increased workload, unmet employment package expectations and obligations, as well as limited professional development opportunities. This study highlights the importance of recruiting well, generating the right starting and longer-term conditions, retaining key staff and managing astutely. The work will be of interest to policy makers, investors, leaders, managers and staff alike. It will also extend educational research in the areas of teacher motivation, satisfaction and dissatisfaction, and in particular in China in international K12 settings.

Are we well prepared for public health emergencies? COVID-19 pandemic effect on cancer care in Saudi Arabia: A qualitative study.

BACKGROUND: COVID-19 pandemic has significantly disrupted healthcare systems worldwide, raising concerns about its impact on cancer patients' access to healthcare services. This study aims to explore the experiences of cancer patients and assess effect of restrictions, delays, and changes in healthcare delivery on their health. METHODS: A qualitative study was performed through individual interviews and focus group discussions (FGDs) with cancer patients and key informants (KI). Participants with different cancer types, treatment stages, and residency regions in Saudi Arabia were recruited. Thematic analysis identified four major themes: access to healthcare services; impact on appointments, diagnosis, and treatment; healthcare delivery; and cancer condition deterioration due to the pandemic. RESULTS: Cancer patients reported variable responses to the pandemic and its effects on their healthcare seeking behavior. Several patients faced challenges in accessing healthcare services and experienced difficulties in continuing their treatment, others encountered obstacles in seeking timely diagnosis and care. Lockdown measures and travel restrictions posed barriers, affecting patients' ability to reach treatment centers. Delays in appointments, diagnosis, and treatment were also reported. In contrast, some participants did not report any negative impact but received improved care and condition prioritization. Healthcare delivery underwent a shift towards virtual appointments, online access to lab results and medication's home delivery service. Despite these adaptations, a small group of participants experienced health deterioration due to delays in treatment and difficulties in reaching their treating physicians. CONCLUSION: COVID-19 pandemic has had a multifaceted impact on cancer patients. Some participants faced challenges such as care delays and disruptions in accessing healthcare services. Yet others reported positive experiences such as improved communication and utilization of new healthcare delivery modalities. These findings underscore the need for resilient and adaptable healthcare systems to safeguard the well-being of cancer patients in times of crises and public health emergencies.

Effect of COVID-19 on the prevalence of bystanders performing cardiopulmonary resuscitation: A systematic review and meta-analysis.

BACKGROUND: The importance of bystander cardiopulmonary resuscitation (CPR) during out-of-hospital cardiac arrests is especially important in the context of coronavirus disease 2029 (COVID-19) because it can significantly influence survival outcomes. The objective of this meta-analysis was to examine the primary outcomes of bystander CPR during the pandemic and pre-pandemic periods. METHODS: A search was conducted in the PubMed Central, Scopus, and EMBASE databases, as well as the Cochrane Central Register of Controlled Trials database, up to December 10, 2023. In cases where the value of I² was greater than or equal to 50% or the Q-test indicated that the p-value was less than or equal to 0.05, the studies were considered to be heterogeneous. Sensitivity assessment was performed using the leave-one-out methodology. The study protocol was registered in PROSPERO with the ID number CRD42023494912. RESULTS: Twenty-five articles were included in this meta-analysis. Pooled analysis showed that bystander CPR frequency during the COVID-19 pandemic was 38.8%, compared to 44.8% for the pre-pandemic period (odds ratio: 1.04; 95% confidence interval: 0.93-1.16; p = 0.48). CONCLUSIONS: The article's conclusions indicate that the COVID-19 pandemic influenced a reduction in bystander CPR compared to the pre-pandemic period, but this difference was not statistically significant. Further research is recommended to understand attitudes, including the fears of witnesses, before performing CPR on patients with suspected or confirmed infectious diseases. The study highlights the importance of bystander intervention in emergency situations and the impact of a pandemic on public health response behaviors.

Experiences from the international frontlines: An exploration of the perceptions of airport employees during the COVID-19 pandemic.

The aviation industry is one of the sectors that has been heavily impacted by the pandemic. While the major body of literature has focused on passenger experience and behaviour, this study focuses on airport employees instead-their experiences, perceptions, and preferences following the emergence of COVID-19. More than 1000 participants from 4 major airports-Amsterdam Airport Schiphol, Singapore Changi Airport, Taipei Taoyuan Airport, and Zurich Airport-representing over 10 different occupations, have provided a variety of sentiments about the airport as an employment ecosystem in the wake of COVID-19. Quantitatively and qualitatively surveying four different airports enabled a cross-border analysis of the results to identify interesting geographic contrasts, as well as global themes, among the responses. Regional differences regarding, the feeling of preparedness, confidence in measures, and optimism are presented. A significant difference in confidence in non-pharmaceutical measures between employees from Asian and European airports is shown. Wants and needs such as better physical/IT workplace infrastructure and more flexibility regarding job scope and hours are pointed out. The results of this research provide insights for future airport employee experience research by outlining areas to study in greater detail. Furthermore, practical implications for airport stakeholders and companies arising from the challenges experienced by the workforce are laid out to provide guidance to prepare for similar circumstances in the future and navigate the aftermath of and recovery from the pandemic.