IntroductionEven though the long-term effects of the COVID-19 pandemic on healthcare workers’ mental health remain unknown, such effects might negatively impact health services and patient safety, especially in countries like Brazil, where there is little investment in public health policies.ObjectivesTo assess how the mental health indicators of Brazilian healthcare workers progressed between the beginning and 2 years after the pandemic (at the end of the third wave when there was a significant decrease in the number of new cases and deaths).MethodsThe sample comprised healthcare workers whose mental health indicators have been monitored since the beginning of the pandemic in Brazil. The potential participants were addressed via social media and contacted through class councils and health institutions across Brazil. A total of 165 participants answered instruments at the baseline and 2 years after the pandemic. Data were collected online using the Redcap platform and addressed symptoms of anxiety, depression, post-traumatic stress, insomnia, and burnout (emotional exhaustion, depersonalization, and professional fulfillment).ResultsBrazilian healthcare workers faced three periods of intensified incidence of new cases and deaths due to COVID-19 for 2 years. Approximately one-third of the sample still experiences high levels of anxiety, depression, and post-traumatic stress. Insomnia indicators remained the most prevalent compared to the baseline assessment, while post-traumatic stress symptoms (p = 0.04) and professional fulfillment (p = 0.005) decreased.ConclusionThe lack of positive changes in mental health indicators coupled with decreased professional fulfillment over time highlights the pandemic’s chronic effects and the need for organizations to monitor these workers’ mental health, especially in developing countries like Brazil, where there is a high demand for health services and public policies are poorly structured and unstable.

Introduction/background: The COVID-19 pandemic continues to have a significant global impact on the health and wellness of the population. Limited published literature exists on the information-seeking behaviour during the pandemic, of young adults, who were at start of the pandemic thought to be less susceptible to COVID-19. This study sought to bridge this gap by administering a survey among postsecondary students in Alberta. The study examined health-related information needs, preferred information sources, and behavioural efforts to prevent COVID-19 and maintain a healthy lifestyle during the pandemic. Methods: A cross-sectional study was conducted in Alberta among postsecondary students in March 2021. Using convenience sampling a link to a pre-validated questionnaire was posted on Alberta based post-secondary institutions online social media platforms (Facebook, LinkedIn). Results and analysis: A total 573 postsecondary students completed the survey. For COVID-19 related information students relied on instant messaging applications such as WhatsApp (52%) and print media (52%). Information on COVID-19 vaccine availability and safety and the changes in by-laws was reported to be vital by 70% of respondents. The preferred COVID-19 information source (60%) was the internet, namely official health websites (e.g., Alberta Health Services). Challenges to accessing COVID-19 information were too many conspiracy theories about COVID-19 (60%) and contradicting information from online sources (53%). Students reported an increase in consumption of fast food (38%); sitting and screen time (82%), time spent in searching for general health-related information (50%); use of natural health products (32%) and a decrease in the time dedicated to physical activities (49%). Over 23.7% of students reported being unsure or would not get the COVID-19 vaccine, while 35% of responded were either unsure or believed vaccines were unsafe. Conclusions and implications for policy, practice or additional research: As post-secondary institutions and public health professionals prepare for in-person classes, after a year of predominantly online learning these results provide baseline information that can be used to plan and communicate appropriate interventions (e.g., targeted vaccination campaigns) and support strategies that mitigate COVID-19 outbreaks and keep students informed and healthy.

The COVID-19 pandemic has obliged Governments all around the world to implement confinement and social distancing measures. Leisure and business activities on beaches and in ports have restricted direct and indirect contamination from, for example, plastics, hydrocarbon spillage, microbiological loads, and noise levels. This has led to temporarily improved environmental conditions, and the beaches having conditions closer to Marine Protected Areas. Here we report some impacts that have been studied using local surveys and qualitative observations in Ecuador at the popular beaches and ports of Salinas, Manta, and Galapagos. Satellite data support this information. Online surveys were carried out at critical moments of the pandemic: May (15th) and just after when measures were relaxed a little, but within lockdown in July (21st) 2020. Respondents were asked to compare conditions before and during the pandemic lockdown. Most (97–99%) suggested that beaches had significantly improved from visual observations during confinement. On a scale from 1 (worst) to 5 (best), the beaches of Salinas and Manta respectively were rated 2.2 and 2.8 (less than acceptable) before quarantine, and 4.5 and 4.3 after; results from the second survey (after 18 weeks of restrictions) were much the same. Replies from Galapagos showed a similar trend but with less marked differences. In addition to the beaches having less plastic and garbage, more fish, and large marine organisms, including humpback whales (Megaptera novaeangliae), dolphin (bottlenose, Tursiops truncatus), and manta ray (Manta sp.) were observed near to shore. At Galapagos beaches, turtles, sea lions, and sharks were observed many more times than pre COVID. Quantitative satellite data on Chlorophyl and attenuation coefficient (Kd, 490 nm) support the qualitative survey data that there is an improvement in coastal environment quality. Here we recommend that this unique opportunity resulting from the COVID-19 pandemic is used locally, regionally and globally to construct baseline data sets that include information on physical, chemical, biological, and microbiological factors in coastal zones. These parameters can then help establish an effective Coastal Zone Management Plan based on beach description and quality (water standards, noise pollution), as well as the human dimension (tourist load, cultural heritage, and economic value indices). This data and information gathering ideally should be done before the beaches become more heavily used again as the pandemic recedes.

IntroductionSupplements sold with claims to promote weight loss, cleansing/detoxing, increased energy, or boosted immunity can be dangerous, and consumers experiencing extreme stressors may be especially vulnerable to deceptive claims. The purpose of our study was to investigate associations of financial strain and psychological distress during the COVID-19 pandemic with use of supplements sold for weight loss, cleanse/detox, energy, or immunity.MethodsWe used repeated-measures data gathered over five survey waves from April/May 2020–April 2021 from the COVID-19 Substudy (N = 54,951), within three prospective US national cohorts (Nurses' Health Study 2, Nurses' Health Study 3, and Growing Up Today Study), to investigate longitudinal associations between financial strain and psychological distress and risk of use of potentially dangerous types of supplements. Surveys assessed use of supplements prior to and during the first year of the pandemic, as well as financial precarity, food insecurity, depressive and anxiety symptoms, perceived stress, and daily hassles. We fit sociodemographic-adjusted modified Poisson GEE models to estimate risk ratios (RRs) and 95% confidence intervals (CIs) for associations between baseline or lagged time-varying predictors and prevalent or incident (i.e., new-onset) use of each supplement type.ResultsAt baseline in April/May 2020, soon after pandemic onset, current use of supplement types was: weight loss 2.7%; cleanse/detox 3.2%; energy 4.4%; immune 22.6%. By the end of the study period, cumulative incidence was: weight loss 3.5%; cleanse/detox 3.7%; energy 4.5%; immune 21.3%. In prevalent-use analyses, financial precarity, food insecurity, and psychological distress were associated with up to 2.4 times the risk of use of these types of supplements across the study period. Similarly, in incident-use analyses, financial precarity and psychological distress were associated with up to 2.1 times the risk of initiating use; whereas, high food insecurity was associated with nearly 1.8 times higher risk of onset of weight-loss supplements use but was not associated with onset of use of other types of supplements.DiscussionWe found consistent evidence that during the first year of the pandemic, participants experiencing elevated financial strain and psychological distress were at heightened risk of initiating use of potentially dangerous types of supplements. Our findings raise concerns about deceptive claims about the safety and product effectiveness by manufacturers of these supplements to profit from vulnerable consumers during the pandemic.

This is a full data set to accompany our study, presently in submission.

Abstract

Objective. The restrictions brought about by Covid-19 pandemic have substantially affected people’s health and rapidly changed their daily routines. This is a prospective study that investigated the impact of the pandemic on primary school children with Type 1 diabetes and their parents during the first lockdown in Kuwait.

Methods. A questionnaire battery related to mental health, well-being, and lifestyle was administered at baseline in Summer 2019 (face-to-face, at a diabetes outpatient clinic) and at follow-up during lockdown in Summer 2020 (via telephone, in adherence with Covid-19 restrictions). Data were collected for 70 dyads with children aged 9-12 years.

Results. Significant differences were found in most scores for both children and parents. Their mental health worsened to a higher level of depression, anxiety, stress, and a poor level of wellbeing. The average scores on the follow-up tests fell within a clinical range on these measures. Significant differences in their lifestyle, compared to before the lockdown, included decreased levels of physical activity and lower healthy core nutritional intake.

Conclusions. Our findings indicate that the Covid-19 lockdown has had a significant psychological and possibly physiological impact on children with Type 1 diabetes and their parents. We conclude that there is a need for mental health support services focusing on these groups. Although full lockdown restrictions will have stopped in the past year, post-pandemic stressors may be expected to continue to adversely affect this cohort.

Objectives: This study investigated perceived loneliness, anxiety, and depression among young adults in the UK across five timepoints: pre-pandemic (December 2019), two coronavirus disease (COVID-19) lockdowns (March–June 2020, January–April 2021), and two post-lockdown phases (November–December 2021, May 2022). It aimed to assess mental health resilience, defined as a return to baseline levels post-lockdown, and identify critical timepoints where loneliness predicted mental health outcomes.Methods: A total of 158 participants (aged 18–82, predominantly under 25) completed online questionnaires measuring mental health (Patient Health Questionnaire-8 (PHQ-8); General Anxiety Disorder-7 (GAD-7)) and loneliness (DeJong Gierveld Loneliness Scale) at two data collection points, under a cross-sectional design. Retrospective data were collected for pre-pandemic and lockdown periods, while prospective data were gathered post-lockdown. Linear mixed models and regression analyses were used to examine changes in mental health and loneliness over time and to identify predictive relationships.Results: Loneliness and mental health significantly deteriorated during lockdowns, with depression and anxiety scores worsening from pre-pandemic levels. Partial recovery was observed post-lockdown, but scores remained above baseline. Loneliness emerged as a key predictor of mental health outcomes, particularly during post-lockdown phases. The immediate post-lockdown period was identified as a critical window for interventions.Conclusions: COVID-19 lockdowns were associated with heightened loneliness and mental health challenges, with sustained effects post-lockdown. Timely interventions targeting loneliness, especially after periods of social restriction, are essential to mitigate long-term mental health impacts and inform future responses to global crises.

Using Life Cycle Assessment (LCA) methodology, this study analysed the university's direct and indirect emissions during a regular year of operation (2019) and compared them with those generated during the lockdown periods in 2020. For the activity areas mobility, energy, waste, IT & paper, gastronomy, and water, specific, primary bottom-up inventory data was gathered before and during the pandemic. The data was assessed with 15 environmental impact assessment methods of the environmental footprint framework. The purpose of this study is to evaluate the environmental footprint of a University of Applied Sciences in 2019 and 2020, including the effects of the lockdown periods. The study identifies the main sources of emissions and assesses the pandemic-related effects. The results of a regular year of operation (2019) depict that student and employee commuting, and business travel contributed with 86% largely to the total global warming potential of 2’572 t CO2-eq. The pandemic-induced changes in commuting and business travel resulted in a 60% reduction leading to a drop to 1’075 t CO₂-eq (2020). In contrast, the environmental footprint due to energy consumption remained almost on the same level, irrespective of the absences on-site in 2020. This study has the potential to shape post-pandemic environmental efforts in Higher Education Institutions and contribute to a much-needed baseline against which mitigation efforts can be compared to. Unlike other studies, this study goes beyond the carbon footprint and expands the discussion to additional environmental and human health impact categories by applying the environmental footprint framework.

Health care workers (HCWs) faced more stressors during the COVID-19 pandemic, potentially increasing depression, anxiety and post-traumatic stress disorder (PTSD). Insight into mental health dynamics and determinants in HCWs during the pandemic could help to maintain and improve mental health and resilience in future pandemics. In this longitudinal cohort study, HCWs received five surveys from November 2020 to March 2023 assessing self-reported symptoms of depression (PHQ-9), anxiety (GAD-7), PTSD (PCL-5), stress (PSS), burn-out (UBOS-EE), insomnia (ISI), resilience (RS) and work engagement (UWES). In addition to the longitudinal analysis, mental health symptoms were assessed in relation to possible predictors, e.g. patient care roles or prior SARS-CoV-2 infection. A total of 384 HCWs (95% of HCWs given consent) completed at least one survey, 326 (81%) completed two or more. Mental health significantly declined in December 2021 compared to November 2020, with mean increases of 1.16 (95% CI 0.73 to 1.58, d = 0.48), 0.79 (95% CI 0.41 to 1.17, d = 0.37) and 1.96 (95% CI 0.95 to 2.97, d = 0.35) on the PHQ-9 (range 0–27), GAD-7 (range 0–21) and PCL-5 (range 0–80), respectively, with similar results in multivariable analysis. Symptoms returned to November 2020 levels in March 2023. No differences were found regarding patient care roles, prior SARS-CoV-2 infection, years of work experience, or hospital workdays per week. Mental health significantly declined during the COVID-19 pandemic, after which mental health symptoms returned to baseline as the burden of COVID-19 patients decreased and public measures were lifted. This demonstrates this population’s ability to successfully adapt to challenging experiences and emphasizes the need for support strategies tailored to the critical phases of any future healthcare crises.

According to the source, in the baseline scenario, the coronavirus epidemic lowers Poland's GDP growth by 0.4 percentage points in 2020. In this scenario, the most important are disruptions in supply chains, which lower GDP growth by 0.20 percentage points. In the pessimistic scenario, the coronavirus epidemic lowers Poland's GDP growth by 1.3 percentage points in 2020. In this scenario, the problems in the internal market, such as a drop in domestic demand, are estimated to lower GDP growth by 0.57 points. The implementation of the pessimistic scenario would mean that Poland's economic growth in 2020 would decrease from 3.7 percent previously forecast to around 2.0 percent. It is worth to notice that one of the biggest banks in Poland - mBank, estimated that GDP will reach 1.6 percent in 2020. The key assumption in both situations was that the epidemic is a temporary phenomenon, i.e., it would last for a maximum of several weeks, after which the economy would gradually recover.

The global market for pleated disposable masks experienced significant growth from 2019 to 2024, driven primarily by the COVID-19 pandemic. While precise figures for market size and CAGR are unavailable, it's reasonable to estimate a market value exceeding $10 billion in 2024, given the surge in demand. Post-pandemic, the market is expected to consolidate, with a projected CAGR of around 5-7% from 2025 to 2033. This moderate growth reflects a shift from the exceptionally high demand during the pandemic to a more stable, albeit elevated, baseline. Key drivers include the increasing awareness of respiratory hygiene, ongoing concerns about infectious diseases, and the rising prevalence of chronic respiratory conditions. Trends indicate a growing preference for higher-filtration masks (N95 and KN95 equivalents) and a focus on sustainability with the introduction of biodegradable materials. However, restraints include price fluctuations in raw materials, increased competition from new entrants, and potential oversupply in certain regions. Market segmentation reflects variations in mask types (surgical, N95, etc.), materials (SMS, meltblown), and end-users (healthcare, industrial, general public). Leading players like 3M, Honeywell, and Cardinal Health maintain a strong market presence, but smaller regional players also contribute significantly, especially in emerging markets. The competitive landscape is characterized by both established multinational corporations and smaller regional manufacturers. While the pandemic fueled rapid growth, the market is evolving towards a more sustainable and differentiated approach. The focus is shifting to product innovation, such as improved filtration efficiency, enhanced comfort, and eco-friendly materials. Furthermore, regulatory compliance and stringent quality standards are key factors shaping the industry's future trajectory. Geographic variations in market dynamics exist, with North America and Europe maintaining a significant share, while Asia-Pacific is expected to experience substantial growth owing to its large population and expanding healthcare infrastructure. Long-term growth will hinge on effective marketing strategies highlighting the importance of respiratory protection, aligning with public health initiatives, and meeting the evolving demands of consumers and healthcare professionals.

Clinical characteristics of 87 SARS-CoV-2-positive individuals admitted to St Thomas’ Hospital in March and April 2020.

Abstract

Nigeria was among the first few countries in Sub-Saharan Africa to identify cases of COVID-19. Reported cases and fatalities have been increasing since it was first identified. The government implemented strict measures to contain the spread of this virus (such as travel restrictions, school closures and home-based work). While the Government is implementing these containment measures, it is important to understand how households in the country are affected and responding to the evolving crises, so that policy responses can be designed well and targeted effectively to reduce the negative impacts on household welfare.

The objective of Nigeria COVID-19 NLPS is to monitor the socio-economic effects of this evolving COVID-19 pandemic in real time. These data will contribute to filling critical gaps in information that could be used by the Nigerian government and stakeholders to help design policies to mitigate the negative impacts on its population. The Nigeria COVID-19 NLPS is designed to accommodate the evolving nature of the crises, including revision of the questionnaire on a monthly basis.

The households were drawn from the sample of households interviewed in 2018/2019 for Wave 4 of the General Household Survey—Panel (GHS-Panel). The extensive information collected in the GHS-Panel just over a year prior to the pandemic provides a rich set of background information on the Nigeria COVID-19 NLPS households which can be leveraged to assess the differential impacts of the pandemic in the country.

Each month, the households will be asked a set of core questions on the key channels through which individuals and households are expected to be affected by the COVID-19-related restrictions. Food security, employment, access to basic services, coping strategies, and non-labour sources of income are channels likely to be impacted. The core questionnaire is complemented by questions on selected topics that rotate each month. This provides data to the government and development partners in near real-time, supporting an evidence-based response to the crisis.

Geographic coverage

National

Analysis unit

• Households
• Individuals

Universe

The survey covered all de jure households excluding prisons, hospitals, military barracks, and school dormitories.

Kind of data

Sample survey data [ssd]

Sampling procedure

Wave 4 of the GHS-Panel conducted in 2018/19 served as the frame for the Nigeria COVID-19 NLPS survey. The GHS-Panel sample includes 4,976 households that were interviewed in the post-harvest visit of the fourth wave in January/February 2019. This sample of households is representative nationally as well as across the 6 geopolitical Zones that divide up the country. In every visit of the GHS-Panel, phone numbers are collected from interviewed households for up to 4 household members and 2 reference persons who are in close contact with the household in order to assist in locating and interviewing households who may have moved in subsequent waves of the survey. This comprehensive set of phone numbers as well as the already well-established relationship between NBS and the GHS-Panel households made this an ideal frame from which to conduct the COVID-19 monitoring survey in Nigeria.

Among the 4,976 households interviewed in the post-harvest visit of the GHS-Panel in 2019, 4,934 (99.2%) provided at least one phone number. Around 90 percent of these households provided a phone number for at least one household member while the remaining 10 percent only provided a phone number for a reference person. Households with only the phone number of a reference person were expected to be more difficult to reach but were nonetheless included in the frame and deemed eligible for selection for the Nigeria COVID-19 NLPS.

To obtain a nationally representative sample for the Nigeria COVID-19 NLPS, a sample size of approximately 1,800 successfully interviewed households was targeted. However, to reach that target, a larger pool of households needed to be selected from the frame due to non-contact and non-response common for telephone surveys. Drawing from prior telephone surveys in Nigeria, a final contact plus response rate of 60% was assumed, implying that the required sample households to contact in order to reach the target is 3,000.

3,000 households were selected from the frame of 4,934 households with contact details. Given the large amount of auxiliary information available in the GHS-Panel for these households, a balanced sampling approach (using the cube method) was adopted. The balanced sampling approach enables selection of a random sample that still retains the properties of the frame across selected covariates. Balancing on these variables results in a reduction of the variance of the resulting estimates, assuming that the chosen covariates are correlated with the target variable. Calibration to the balancing variables after the data collection further reduces this variance (Tille, 2006). The sample was balanced across several important dimensions: state, sector (urban/rural), household size, per capita consumption expenditure, household head sex and education, and household ownership of a mobile phone.

Mode of data collection

Computer Assisted Telephone Interview [cati]

Research instrument

BASELINE (ROUND 1): One questionnaire, the Household Questionnaire, was administered to all households in the sample. The Household Questionnaire provides information on demographics; knowledge regarding the spread of COVID-19; behaviour and social distancing; access to basic services; employment; income loss; food security; concerns; coping/shocks; and social safety nets.

ROUND 2: One questionnaire, the Household Questionnaire, was administered to all households in the sample. The Household Questionnaire provides information on demographics; access to basic goods and services; employment (including non-farm enterprise and agricultural activity); other income; food security; and social safety nets.

ROUND 3: One questionnaire, the Household Questionnaire, was administered to all households in the sample. The Household Questionnaire provides information on demographics; access to basic goods and services; housing; employment (including non-farm enterprise and agricultural activity); other income; coping/shocks; and social safety nets.

ROUND 4: One questionnaire, the Household Questionnaire, was administered to all households in the sample. The Household Questionnaire provides information on demographics; access to basic goods and services; credit; employment (including non-farm enterprise, crop farming and livestock); food security; income changes; concerns; and social safety nets.

ROUND 5: One questionnaire, the Household Questionnaire, was administered to all households in the sample. The Household Questionnaire provides information on demographics; education; employment (including non-farm enterprise and agricultural activity); and other income.

ROUND 6: One questionnaire, the Household Questionnaire, was administered to all households in the sample. The Household Questionnaire provides information on demographics; education; employment (including non-farm enterprise); COVID testing and vaccination; and other income.

ROUND 7: One questionnaire, the Household Questionnaire, was administered to all households in the sample. The Household Questionnaire provides information on demographics; access to basic services; employment (including non-farm enterprise); food security; concerns; and safety nets.

ROUND 8: One questionnaire, the Household Questionnaire, was administered to all households in the sample. The Household Questionnaire provides information on demographics; employment (including non-farm enterprise and agriculture); and coping/shocks.

ROUND 9: One questionnaire, the Household Questionnaire, was administered to all households in the sample. The Household Questionnaire provides information on demographics; education; early childhood development, access to basic services, employment (including non-farm enterprise and agriculture); and income changes.

ROUND 10: One questionnaire, the Household Questionnaire, was administered to all households in the sample. The Household Questionnaire provides information on demographics; access to basic services; employment (including non-farm enterprise and agricultural activity); concerns and COVID testing and vaccination.

ROUND 11: One questionnaire, the Household Questionnaire, was administered to all households in the sample. The Household Questionnaire provides information on demographics; credit; access to basic services; education; employment (including non-farm enterprise); safety nets; youth contact details; and phone signal.

ROUND 12: One questionnaire, the Household Questionnaire, was administered to all households in the sample. The Household Questionnaire provides information on youth aspirations and employment; and COVID vaccination.

Cleaning operations

COMUPTER ASSISTED TELEPHONE INTERVIEW (CATI): The Nigeria COVID-19 NLPS exercise was conducted using Computer Assisted Telephone Interview (CATI) techniques. The household questionnaire was implemented using the CATI software, Survey Solutions. The Survey Solutions software was developed and maintained by the Data Analytics and Tools Unit within the Development Economics Data Group (DECDG) at the World Bank. Each interviewer was given two tablets, which they used to conduct the interviews. Overall, implementation of survey using Survey Solutions CATI was highly successful, as it allowed for timely availability of the data from completed interviews.

DATA COMMUNICATION SYSTEM: The data communication

Background: The SARS-CoV-2 pandemic poses immense challenges for health care systems and population-wide mental health. The e-mental health intervention “CoPE It” has been developed to offer standardized and manualized support to overcome psychological distress caused by the pandemic. The aim of this study was to assess the effectiveness of “CoPE It” in terms of reducing distress (primary outcome), depression and anxiety symptoms, and improving self-efficacy, and mindfulness (secondary outcomes). Furthermore, the intervention's usability, feasibility, and participants' satisfaction with “CoPE It” was evaluated (tertiary outcome). The study protocol has been published previously.Methods: A bicentre longitudinal study was conducted from April 27th 2020 to May 3rd 2021. N = 110 participants were included in the analyses. The intervention consisted of four modules featuring different media promoting evidence-based methods of cognitive behavioral therapy and mindfulness-based stress reduction. Difference in psychological distress between baseline (T0) and post-intervention (T1) were analyzed by repeated measure analysis of covariance. Mixed linear models were applied to assess moderating effects. Depressive symptoms, generalized anxiety symptoms, self-efficacy, and mindfulness were compared between baseline (T0) and post-intervention (T1) via t-tests. Usability of the “CoPE It” intervention and participants' satisfaction was evaluated by calculation means and frequencies.Results:Primary outcome: A significant effect of time on psychological distress at post-intervention (T1) after controlling for age, gender, education, mental illness and attitudes toward online interventions was found. Depressive and anxiety symptoms, and mindfulness were a significant moderators of the relationship between time and psychological distress for consistent wording. Secondary outcomes: There was a significant decrease in depressive symptoms and generalized anxiety, and a significant increase in self-efficacy and mindfulness between baseline (T0) and post-intervention (T1). Tertiary outcomes: 95.83% of the participants thought the “CoPE It” intervention was easy to use and 87.50% were satisfied with the “CoPE It” intervention in an overall, general sense.Conclusion: The e-mental health “CoPE It” intervention seems to be an effective approach in reducing psychological distress, anxiety and depressive symptoms, and in enhancing self-efficacy and mindfulness during the COVID-19 pandemic. Participants' satisfaction and the program‘s feasibility, and usability were proven to be high.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: DRKS00021301.

Baseline demographics and treatment-related characteristics of study participants.

Introduction: Various non-pharmacological interventions to prevent coronavirus dissemination were implemented during the COVID-19 pandemic, including school closures. The effect of these interventions on particular aspects of people’s lives such as sexual and reproductive health outcomes has not been adequately discussed. The objective of the study was to compare the monthly hospital admission rates due to abortion before and during school closure. Methods: We used an interrupted time series (IES) design to estimate the hospital admission rates before and during the school closure (intervention in March 2020) period. The analysis was performed considering all girls from age groups of interest and by stratifying the age groups according to skin color (white and non-white) in which the non-white category comprised both the black and mixed ethnicity together. Coefficients and 95% confidence intervals (95% CIs) were calculated using segmented linear regression models. Results: The results showed positive and statistically significant coefficients, suggesting post-intervention trend changes both in the population as a whole (coefficient: 0.07; 95% CI: 0.02; 0.11) and the non-white population group (coefficient: 0.07; 95% CI: 0.03; 0.11), indicating that the monthly hospital admission rates increased over the post-intervention period compared to baseline pre-intervention period. The ITS analysis did not detect statistically significant trend changes (coefficient: 0.02; 95% CI: −0.01; 0.05) in abortion admission rates in the white girl population group. Conclusion: The hospitalizations in Brazil due to abortions in 10- to 14-year-old girls increased during the COVID-19 pandemic in 2020 compared to 2019, and the number of abortions was higher in the non-white population than the white population. Furthermore, recognizing that the implementation of school closure has affected the minority population differentially can help develop more effective actions to face other future similar situations.

Health care workers (HCWs) faced more stressors during the COVID-19 pandemic, potentially increasing depression, anxiety and post-traumatic stress disorder (PTSD). Insight into mental health dynamics and determinants in HCWs during the pandemic could help to maintain and improve mental health and resilience in future pandemics. In this longitudinal cohort study, HCWs received five surveys from November 2020 to March 2023 assessing self-reported symptoms of depression (PHQ-9), anxiety (GAD-7), PTSD (PCL-5), stress (PSS), burn-out (UBOS-EE), insomnia (ISI), resilience (RS) and work engagement (UWES). In addition to the longitudinal analysis, mental health symptoms were assessed in relation to possible predictors, e.g. patient care roles or prior SARS-CoV-2 infection. A total of 384 HCWs (95% of HCWs given consent) completed at least one survey, 326 (81%) completed two or more. Mental health significantly declined in December 2021 compared to November 2020, with mean increases of 1.16 (95% CI 0.73 to 1.58, d = 0.48), 0.79 (95% CI 0.41 to 1.17, d = 0.37) and 1.96 (95% CI 0.95 to 2.97, d = 0.35) on the PHQ-9 (range 0–27), GAD-7 (range 0–21) and PCL-5 (range 0–80), respectively, with similar results in multivariable analysis. Symptoms returned to November 2020 levels in March 2023. No differences were found regarding patient care roles, prior SARS-CoV-2 infection, years of work experience, or hospital workdays per week. Mental health significantly declined during the COVID-19 pandemic, after which mental health symptoms returned to baseline as the burden of COVID-19 patients decreased and public measures were lifted. This demonstrates this population’s ability to successfully adapt to challenging experiences and emphasizes the need for support strategies tailored to the critical phases of any future healthcare crises.

BackgroundIncreasing evidence indicated a clear association between COVID-19 pandemic and mental health. This study aimed to assess the dynamic change of mental burden during and after the COVID-19 outbreak and related predictive factors among Chinese undergraduate medical students.MethodsThis longitudinal survey was conducted among Chinese undergraduate medical students before, during, and after the COVID-19 outbreak. We focused on COVID-19 related mental burdens including psychological distress, stress reaction, and insomnia symptoms, and defined the sum score of the three specific mental burden indexes as the overall mental burden index. The prevalence of specific and overall mental burdens and their changing patterns at two phases of the pandemic (during vs. after the COVID-19 outbreak) were measured. In addition, multinomial logistic regressions were used to assess the associations between the psychosocial status before the pandemic and specific and overall mental burden changing patterns.ResultsOur findings showed that the prevalence of overall mental burden increased (from 27.46 to 37.28%) after the COVID-19 outbreak among the 863 Chinese undergraduate medical students who participated in the surveys at baseline, during, and after the COVID-19 outbreak. Specifically, the prevalence of stress reaction symptoms decreased (from 10.90 to 3.60%), while the rates of psychological distress (from 28.06 to 37.95%) and insomnia symptoms (from 12.54 to 20.71%) increased. Participants, with obsessive-compulsive symptoms, somatic symptoms, internet addiction, childhood adversity, stressful life events, and being neurotic were found to have a higher risk of developing mental burden in at least one survey (during or after the COVID-19 outbreak). Healthy family function and being extravert were found to positively impact mental burden.ConclusionPsychological distress, stress reaction and insomnia symptoms have been prevalent among Chinese undergraduate medical students during the COVID-19 outbreak, and the prevalence of overall mental burden increased after the COVID-19 outbreak. Some students, especially those with the risk factors noted above, exhibited persistent or progression symptoms. Continued mental health care was in demand for them even after the COVID-19 outbreak.

Caregivers of adolescents living with HIV encounter multiple economic and psycho-social challenges which impair their wellbeing and provision of optimal care. Cash transfers combined with short message service (SMS) nudges may address the financial and mental barriers to caregiver wellbeing in sub-Saharan Africa. We examined the preliminary effectiveness and feasibility outcomes of this multipronged approach for improving caregiver wellbeing. We piloted the Caregiver Wellbeing intervention in the eThekwini municipality, KwaZulu-Natal, South Africa. Participants were randomly assigned to one of the following groups: (i) the intervention arm (n = 50) received three cash payments (of ZAR 350, approximately 21 USD), coupled with behaviourally-informed mobile SMS nudges over a 3-month period; (ii) the control arm (n = 50) received a standard SMS encouraging linkage to health services. The primary outcome was change in psychological wellbeing at four-months follow-up. Secondary outcomes were changes in depressive symptoms and caregiver burden scores, recruitment pace, retention, uptake, acceptability and costs. Trial Registraion Number: PACTR202203585402090. The n = 100 caregivers (mean age = 42.3 years, 87% female) enrolled at baseline were recruited within six weeks. Compared to controls, there was a non-significant increase in psychological wellbeing (β = 3.14, p = 0.319). There was a 1.32 unit (p = 0.085) decrease in depressive symptoms and a reduction in caregiver burden (β = -1.28, p = 0.020) in the intervention arm. Participant retention was 85%, with high intervention uptake (95%). Caregivers expressed appreciation for the intervention as the cash component allowed them to fulfil their carer responsibilities and the SMS brought a sense of belonging and self-acceptance. Total societal cost of the intervention was US$13,549, and the incremental cost per increase in wellbeing score was US$1,080. Results suggest a cash transfer plus SMS nudge package, whilst feasible and acceptable, may require longer duration and an economic empowerment component to enhance caregiver wellbeing as part of post-pandemic recovery efforts.

Baseline demographics for the complete dataset and separate adult and paediatric cohorts.