关键词： COVID-19   critical disability theory   equity   universal design   public service   DISABILITY   NORMALIZATION   WORK  

摘要： The needs of disabled people are often insufficiently recognized by mainstream society, causing this population to be excluded from society and activities of daily life. This problem is clearly reflected in the obstacles that intellectually disabled people have encountered in their use of public services during the COVID-19 pandemic. In this qualitative study, we conducted focus group sessions with 17 social workers and 12 carers supporting individuals with intellectual disabilities in Hong Kong. Using a thematic analysis, we found that (a) the social-emotional needs of intellectually disabled people were intensified by the disruption of social services; (b) they received limited benefit from the use of video conferencing services; and (c) they encountered significant difficulties in complying with preventive measures. To achieve equity in public service, universal design should be emphasized during the planning stage, and the experiences of disabled people should be carefully considered from the outset. Points of interestIntellectually disabled people in Hong Kong experienced more difficulties using public services during the COVID-19 pandemic than before the *** from the social model of disability and the Convention on the Rights of Persons with Disabilities, critical disability theory can explain how society protects the rights of disabled persons pertaining to social participation.A sole emphasis on equality fails to facilitate effective planning of public services that address the needs of intellectually disabled people; the notion of equity must also be *** concept of universal design, which is often discussed in the context of the physical environment, can be meaningfully applied to the design of public services to alleviate problems of exclusion faced by disabled *** and service providers must improve their awareness and knowledge of the distinct needs of intellectually disabled people.

摘要： The COVID-19 pandemic disrupted health systems around the globe. Lessons from health systems responses to these challenges may help design effective and sustainable health system responses for future challenges. This study aimed to 1/ identify the broad types of health system challenges faced during the pandemic and 2/ develop a typology of health system response to these challenges. Semi-structured one-on-one online interviews explored the experience of 19 health professionals during COVID-19 in a large state health system in Australia. Data were analysed using constant comparative analysis utilising a sociotechnical system lens. Participants described four overarching challenges: 1/ System overload, 2/ Barriers to decision-making, 3/ Education or training gaps, and 4/ Limitations of existing services. The limited time often available to respond meant that specific and well-designed strategies were often not possible, and more generic strategies that relied on the workforce to modify solutions and repair unexpected gaps were common. For example, generic responses to system overload included working longer hours, whilst specific strategies utilised pre-existing technical resources (e.g. converting non-emergency wards into COVID-19 wards). During the pandemic, it was often not possible to rely on mature strategies to frame responses, and more generic, emergent approaches were commonly required when urgent responses were needed. The degree to which specific strategies were ready-to-hand appeared to dictate how much a strategy relied on such generic approaches. The workforce played a pivotal role in enabling emergent responses that required dealing with uncertainties.

摘要： Grit, a non-cognitive skill that indicates perseverance and passion for long-term goals, has been shown to predict academic achievement. This paper provides evidence that grit also predicts student outcomes during the challenging period of the Covid-19 pandemic. We use a unique dataset from a digital learning platform in the United Arab Emirates to construct a behavioral measure of grit. We find that controlling for baseline achievement, students who were grittier according to this measure before the pandemic, register lower declines in math and science scores during the coronavirus period. Using machine learning, behavioral data obtained from the platform prior to the pandemic can explain 77% of the variance in academic resilience. A survey measure of grit coming from the same students, on the other hand, does not have significant predictive power over performance changes. Our findings have implications for interventions on non-cognitive skills, as well as how data from digital learning platforms can be used to predict student behavior and outcomes, which we expect will be increasingly relevant as AI-based learning technologies become more common.

关键词： Long COVID   Post-acute sequelae of SARS-CoV-2 infection   herbal medicine   fatigue   cognitive dysfunction   pilot clinical trial   AEs   Adverse events   BDI   Beck’s Depression Inventory   BIT   Bojungikgi-tang   CAM   Complementary and alternative medicine   CFQ   Cognitive Failure Questionnaire   CBD   Cheonwangbosim   ChFS   Chalder Fatigue Scale   CIS   Checklist Individual Strength   COVID   Coronavirus disease   COVID-19   coronavirus infectious disease 2019   K-BNT-15   Korean-Boston Naming Test-15   KM   Korean Medicine   MFDS   The Ministry of Food and Drug Safety   KOG   Kyungok-go   PSQI-K   the Korean version of Pittsburgh Sleep Quality Index   SARS-CoV-2   severe acute respiratory syndrome coronavirus-2   VAS   Visual Analog Scale   WAIS   Digit Span Test in Korean-Wechsler Adult Intelligence Scale  

摘要： Background Infections of Coronavirus Disease-2019 (COVID-19) can cause long-term effects known as long COVID. This pilot study aimed to evaluate the feasibility of a clinical study as well as the efficacy and safety of traditional East Asian herbal medicines in alleviating fatigue and cognitive dysfunction in patients with long COVID. Methods This prospective pilot study investigated the use of three types of herbal medicines, Bojungikgi-tang (BIT), Kyungok-go (KOG), and Cheonwangbosim-dan (CBD), for a 12-week period as potential treatments for fatigue and cognitive dysfunction in patients with long COVID. Forty-five patients with long COVID were recruited, and one of three drugs was given based on the patient’s symptoms and pattern identification. The effect of herbal medications on fatigue and cognitive function outcomes was assessed over a 36-week period, with patient adherence closely monitored. Results After 12 weeks of herbal drug administration, fatigue symptoms improved significantly across all groups, with treatment success rates of 80%, 53.33%, and 46.67% in the BIT, KOG, and CBD groups, respectively. However, cognitive dysfunction symptoms showed less improvement, with treatment success rates of 40%, 46.67%, and 13.33% in the BIT, KOG, and CBD groups, respectively. All adverse events reported were mild and unrelated to the medication. The study design was found to be feasible with high medication adherence. Conclusions This study demonstrated the feasibility of conducting a clinical trial with three herbal medicines to treat long COVID symptoms like fatigue and cognitive dysfunction

摘要： The COVID-19 pandemic challenged universities to maintain teaching, leading to online classes becoming the standard teaching mode and accelerating digitalization. Learning from the influence of these developments on students’ technology commitment may hold valuable information for various stakeholders. The present study investigated the development of three facets of technology commitment in higher education during the first two semesters under the COVID-19 pandemic: technology acceptance, technology competence belief, and technology control belief. The sample consisted of N = 132 graduate students at one German university who filled out questionnaires at two measurement points in two waves. The change in all three facets of technology commitment over time was examined with latent change models. There was a significant increase in technology competence belief. This change was stronger for students in the second COVID-19 semester than those in the first COVID-19 semester. Participants’ age, sex, and the number of webinars attended during the semester of data collection had no significant effect on the change in the three facets of technology commitment. Overall, the present study provides new insights into the development of technology commitment during the COVID-19 pandemic, proposes an explanatory approach for the change in technology commitment, and emphasizes the relevance of direct experience with technology in the development of technology competence belief at different skill levels. The results indicate that students can increase their level of technology competence belief, by engaging directly with new technology.

摘要： To investigate if retinal thickness has predictive utility in COVID-19 outcomes by evaluating the statistical association between retinal thickness using OCT and of COVID-19-related mortality. Secondary outcomes included associations between retinal thickness and length of stay (LoS) in hospital. In this retrospective cohort study, OCT scans from 230 COVID-19 patients admitted to the Intensive Care Unit (ITU) were compared with age and gender-matched patients with pneumonia from before March 2020. Total retinal, GCL + IPL, and RNFL thicknesses were recorded, and analysed with systemic measures collected at the time of admission and mortality outcomes, using linear regression models, Pearson’s R correlation, and Principal Component Analysis. Retinal thickness was significantly associated with all-time mortality on follow up in the COVID-19 group (p = 0.015), but not 28-day mortality (p = 0.151). Retinal and GCL + IPL layer thicknesses were both significantly associated with LoS in hospital for COVID-19 patients (p = 0.006 for both), but not for patients with pneumonia (p = 0.706 and 0.989 respectively). RNFL thickness was not associated with LoS in either group (COVID-19 p = 0.097, pneumonia p = 0.692). Retinal thickness associated with LoS in hospital and long-term mortality in COVID-19 patients, suggesting that retinal structure could be a surrogate marker for frailty and predictor of disease severity in this group of patients, but not in patients with pneumonia from other causes.

摘要： Long-term deterioration in the mental health of healthcare workers (HCWs) has been reported during and after the COVID-19 pandemic. Determining the impact of COVID-19 incidence and mortality rates on the mental health of HCWs is essential to prepare for potential new pandemics. This study aimed to investigate the association of COVID-19 incidence and mortality rates with depressive symptoms over 2 years among HCWs in 20 countries during and after the COVID-19 pandemic. This was a multi-country serial cross-sectional study using data from the first and second survey waves of the COVID-19 HEalth caRe wOrkErS (HEROES) global study. The HEROES study prospectively collected data from HCWs at various health facilities. The target population included HCWs with both clinical and non-clinical roles. In most countries, healthcare centers were recruited based on convenience sampling. As an independent variable, daily COVID-19 incidence and mortality rates were calculated using confirmed cases and deaths reported by Johns Hopkins University. These rates represent the average for the 7 days preceding the participants’ response date. The primary outcome was depressive symptoms, assessed by the Patient Health Questionnaire-9. A multilevel linear mixed model (LMM) was conducted to investigate the association of depressive symptoms with the average incidence and mortality rates. A total of 32,223 responses from the participants who responded to all measures used in this study on either the first or second survey, and on both the first and second surveys in 20 countries were included in the analysis. The mean age was 40.1 (SD = 11.1), and 23,619 responses (73.3%) were from females. The 9323 responses (28.9%) were nurses and 9119 (28.3%) were physicians. LMM showed that the incidence rate was significantly and positively associated with depressive symptoms (coefficient = 0.008, standard error 0.003, p = 0.003). The mortality rate was significantly and positively associated w

摘要： Delivering serious news is usually challenging for healthcare professionals and the pandemic of COVID-19 and related restrictions brought additional challenges in this process. To explore the experience of bereaved relatives with receiving serious news from healthcare professionals during the pandemic COVID-19. A qualitative study using thematic analysis and a codebook approach of data collected in semi-structured interviews with bereaved relatives. Data were collected from July to August 2022 in person/via phone with bereaved relatives who lost their relatives during the pandemic (from March 2020 to March 2022). Participants were recruited using a convenience sample and snowball method through social media and through one university hospital palliative care unit that invited bereaved relatives of deceased patients treated at the unit to participate in this study. A total of 22 participants, consisting of 4 men and 18 women, were interviewed for this study. Most of the participants were sons or daughters of individuals who had died (5 grandchildren, 14 sons/daughters, 2 spouses, 1 great-niece). Six themes were identified: Burden caused by visit ban, Fear of COVID-19, Inappropriate behaviour and communication of healthcare professionals, High need for emotional support, Need for detailed and honest communication, Tendency to make excuses for mistakes and lapses by healthcare professionals. Delivering serious news during a pandemic was negatively influenced by a lack of contact with patients and a lack of support and empathetic communication with staff. Overcoming these circumstances can be achieved by frequent communication using various communication tools (such as videoconferences or phone calls), and maintaining empathy and honesty in the communication process. This article describes results from a qualitative study with bereaved relatives focused on their experience with communication with physicians during the COVID-19 pandemic. Relatives lacked empathetic