关键词： Adolescents   health   loneliness   well-being   young adults   MENTAL-HEALTH   STRESS   IMPACT   ADJUSTMENT   SYMPTOMS   CHILDREN   YOUTH  

摘要： Large gaps exist in the literature on COVID-19 pandemic-related mental health outcomes and after-effects specific to adolescents and young adults. The aim was to explore adolescents' and young adults' experiences of well-being, health and loneliness during the COVID-19 pandemic. A qualitative exploratory design with qualitative content analysis was used. Twenty-three participants (aged 19-27; four men and 19 women) were interviewed in Finland in 2021. Four main categories emerged: Changed social networks - fewer and closer contacts, Changed mental and physical health, Increased isolation and social loneliness, and Well-being, internal growth and need for support. Adolescents' and young adults' experiences of well-being, health and loneliness are subtle and complex. Participants experienced changed social networks, mental and physical health, and well-being. Internal growth, need for support and increased loneliness were also seen. Clear information on how to seek help and support from professionals should be made available.

关键词： COVID-19   epidemiology   future strategies   vaccination   vaccine   SARS-COV-2 VARIANTS   SOUTH-AFRICA   SEVERITY   HESITANCY  

摘要： Introduction: COVID-19 was an unprecedented challenge worldwide; however, disease epidemiology has evolved, and COVID-19 no longer constitutes a public health emergency of international concern. Nonetheless, COVID-19 remains a global threat and uncertainties remain, including definition of the end of the pandemic and transition to endemicity, and understanding true rates of SARS-CoV-2 infection/transmission. Areas covered: Six international experts convened (April 2023) to interpret changing COVID-19 epidemiology and public health challenges. We report the panel's recommendations and knowledge gaps in COVID-19 epidemiology, SARS-CoV-2 evolution, and future vaccination strategies, informed by peer-reviewed publications, surveillance data, health authority assessments, and clinical experience. Expert opinion: High population SARS-CoV-2 immunity indicates the likely end to the pandemic's acute phase. Continued emergence of variants/sublineages that can evade the vaccine-induced antibody response are likely, but widespread immunity reduces the risk of disease severity. Continued surveillance is required to capture transition to endemicity, seasonality, and emergence of novel variants/sublineages, to inform future vaccination strategies. COVID-19 vaccination should be integrated into routine vaccination programs throughout life. Co-circulation with other respiratory viruses should be monitored to avoid a combined peak, which could overrun healthcare systems. Effective, combined vaccines and improved education may help overcome vaccine hesitancy/booster fatigue and increase vaccination uptake.

关键词： Digital fluency   sociodigital practices   sociodigital competence   sociodigital mindset   sociodigital profiles   COVID-19   SELF-EFFICACY   TECHNOLOGY   EQUITY  

摘要： Digital fluency is a central 21st-century competence. Schools are responsible for ensuring that all students cultivate sophisticated sociodigital competences and mindsets needed for studying and collaborating through and around technology and overcoming digital challenges encountered. Although some schools have successfully integrated digital technologies into traditional schoolwork, students are not provided sufficient structured training in creative and academic practices of using digital technologies. This study explored changes before and after the COVID-19 pandemic in Finnish primary and middle school students' perceived sociodigital study practices, competences, mindsets, and profiles. Participants were asked to respond to the Sociodigital Practices Inventory (SDPi), which assessed their sociodigital study practices, competences, and mindset. The participants consisted of 947 cohort 1 students (5th grade in 2019 and 6th grade in 2020) and 771 cohort 2 students (7th grade in 2019 and 8th grade in 2020). The results revealed subtle changes in students' perceptions regarding schools' digital practices; primary school students experienced an increase in basic practices while middle schoolers experienced a decrease in perceived advanced practices. Both boys' and girls' self-evaluated academic sociodigital competences increased from 2019 to 2020, while their artistic and technical competences decreased. Primary school boys' sociodigital mindsets increased, while that of middle school girls decreased. The analyses revealed four latent profiles of digital fluency: Inexperienced, Enthusiastic, Humble, and Driven. We propose that it is vital to build a multidimensional view of students' digital fluency by exploring interrelations between their sociodigital practices, competences, mindsets, and profiles.

关键词： Proteinuria   omicron   risk factors   risk model   CHRONIC KIDNEY-DISEASE   PROGNOSIS   INJURY   TRENDS  

摘要： Background: To explore the risk factors of proteinuria in Omicron variant patients and to construct and verify the risk predictive model. Methods: 1091 Omicron patients who were hospitalized from August 2022 to November 2022 at Tianjin First Central Hospital were defined as the derivation cohort. 306 Omicron patients who were hospitalized from January 2022 to March 2022 at the same hospital were defined as the validation cohort. The risk factors of proteinuria in derivation cohort were screened by univariate and multivariate logistic regression analysis, and proteinuria predicting scoring system was constructed and the receiver operating characteristic(ROC)curve was drawn to test the prediction ability. The proteinuria risk model was externally validated in validation cohort. Results: 7 factors including comorbidities, blood urea nitrogen (BUN), serum sodium (Na), uric acid (UA), C reactive protein (CRP) and vaccine dosages were included to construct a risk predictive model. The score ranged from -5 to 16. The area under the ROC curve(AUC) of the model was 0.8326(95% CI 0.7816 to 0.8835, p < 0.0001). Similarly to that observed in derivation cohort, the AUC is 0.833(95% CI 0.7808 to 0.9002, p < 0.0001), which verified good prediction ability and diagnostic accuracy in validation cohort. Conclusions: The risk model of proteinuria after Omicron infection had better assessing efficiency which could provide reference for clinical prediction of the risk of proteinuria in Omicron patients.

关键词： Immune checkpoint inhibitors (ICIs)   immune-related pancreatic toxicity   pancreatic enzymes   COVID-19 vaccine  

摘要： To investigate immune checkpoint inhibitors (ICIs) induced pancreatic injury (ICIPI), the prognostic effect of COVID-19 vaccine on cancer patients, and whether COVID-19 vaccine increases the incidence of ICIPI. We conducted a retrospective study of 256 stage IV cancer patients treated with ICIs at The First Affiliated Hospital of Anhui Medical University from January 2020 to November 2022. Data collected included pancreatic enzyme levels, treatment outcomes, and vaccination status. Statistical significance was determined using the chi 2 test and Kaplan-Meier method (p < .05). Compared to the control group, the vaccinated group (p < .0001) and the group with elevated pancreatic enzyme levels (p = .044) demonstrated higher disease control rates, indicating a direct benefit of vaccination and enzyme monitoring on treatment outcomes. Additionally, vaccinated patients demonstrated longer overall survival versus unvaccinated patients (23.9 months [95% CI, 22.3-25.5] vs 23.6 months [95% CI, 21.1-26.2], HR = 0.45 [95% CI, 0.24-0.86], p = .015) and progression-free survival (17.2 months [95% CI, 14.3-20.1] vs 13.7 months [95% CI, 11.3-16.1], HR = 0.54 [95% CI, 0.36-0.82], p = .004). Importantly, the analysis revealed no significant association between vaccination and pancreatic injury (p = .46). Monitoring pancreatic enzymes can effectively evaluate the therapeutic impact in patients using ICIs. Patients vaccinated against COVID-19 experience better immunotherapy outcomes without an increased risk of ICIPI.

关键词： exaptation   supply chain resilience   ambidextrous   capabilities   DYNAMIC CAPABILITIES   MEDIATING ROLE   BIG DATA   INNOVATION   AMBIDEXTERITY   EXPLORATION   PERSPECTIVE   PERFORMANCE   MANAGEMENT   EXPLOITATION  

摘要： What happens to newly built resilience capabilities when the pandemic is over? Using the concept of exaptation, we investigate how supply chain organizations have repurposed supply chain resilience capabilities post-pandemic. In particular, we examine the degree of ambidexterity capabilities to identify the exaptation potential from the newly acquired supply chain resilience capabilities during a disruptive event. In this paper, we (1) adopt a framework that depicts four types of different exaptation potential for supply resilience based on the management constructs of exploitation and exploration capabilities and (2) use the results from a related survey among 447 supply chain managers in Australia to subsequently analyse the exaptation potentials post COVID-19. The integration of the exaptation potential into supply chain literature opens a new chapter on how resilience capabilities are utilized, and we found that the majority of supply chains are able to simultaneously pursue and develop exploitative and exploratory capabilities.

关键词： COVID-19 pandemic   Primary Health Care   qualitative   experiences   health providers   Greece  

摘要： Background Primary Health Care (PHC) was the cornerstone of the pandemic response. Objectives We aimed to explore the positive and negative impact of the pandemic, during its final wave, through 'PHC providers' eyes', as well as their recommendations towards restructuring and enhancing PHC services. Methods A two-phase qualitative study was conducted, pursuing data triangulation from Focus Groups (FGs) and individual, semi-structured interviews for the purposes of data completeness and confirmation (summer 2022 and spring 2023, respectively). A purposive sample of settings was employed, including in total five PHC units according to location with different population distribution; one in Athens (FGs) and four in Northern Greece (interviews). Inductive content analysis was used. Results In total, 24 PHC professionals participated in FGs, whereas 17 were individually interviewed. Our findings reflect a general understanding of the pandemic's positive imprint, namely acceleration of digitalisation, establishment of health protection measures, recognition of PHC's role, raise in public awareness of primary prevention, team-cooperation, increase in providers' self-efficacy, appointment of health professionals and re-organisation of accessibility. The negative impact is summarised in fatigue/burnout in PHC providers, patient safety concerns and changes in patients' behaviour. To increase resilience, participants suggest restructuring PHC, recruiting PHC personnel and enhancing digital infrastructure, maintenance of sanitary protection measures, investment in quality, and empowering patients through health literacy. Conclusion Based on the lessons learnt, building further on the pandemic-accelerated digitalisation, emphasising on quality improvement and patient safety, ensuring providers' well-being, and empowering citizens through health literacy could be key in promoting PHC resilience.

关键词： COVID-19   Probiotics   nutraceuticals   mortality   days of hospitalization   M. Luisa Escudero-Gilete, Universidad de Sevilla, Spain   Nutrition   Nutraceuticals & Functional Foods   MECHANISMS  

摘要： Nutraceuticals have generated an interest among clinicians for their applicability in the prevention and treatment of many ailments. Literature suggests the possible role of nutraceuticals in COVID-19. However, substantial uncertainty related to their safety and efficacy still exists. The aim of this study is to assess the efficacy and safety of nutraceuticals in preventing or treating COVID-19. We searched electronic databases, registries, websites, and e-libraries of development agencies. We included randomized controlled trials (RCTs), quasi-experiments, pre-post studies, and other experimental study designs. We assessed the risk of bias (RoB) using the RoB2 tool for RCTs and the ROBINS-I tool for non-RCTs. We assessed the overall certainty of the evidence using GRADEpro GDT. The outcomes assessed were the number of COVID-19 cases, change in disease severity, days of hospitalization, deaths, and adverse events. We performed the last search on 13th December 2023. After screening 481 studies, our analysis of five revealed one study with 'low risk' and four studies with 'some concerns' regarding bias. Our findings indicated that nutraceuticals did not significantly reduce COVID-19 mortality; their effect on hospitalization duration was uncertain. Furthermore, our assessment found no substantial evidence of increased adverse effects with probiotic use (RR 0.11, 95% CI 0.01 to 1.89, P = 0.13). Importantly, none of the studies investigated nutraceuticals' preventive effects or their role in mitigating COVID-19 severity. There is limited evidence available on the use of nutraceuticals (probiotics, prebiotics, or synbiotics) for the treatment and prevention of COVID-19. Conducting methodologically robust RCTs with large population samples is *** REGISTRATION ID CRD42021284923

关键词： Syndromic surveillance   covid-19   general practice   influenza-like illness   acute respiratory infection   PRIMARY-CARE  

摘要： Background: COVID-19 may initially manifest as flu-like symptoms. As such, general practitioners (GPs) will likely to play an important role in monitoring the pandemic through syndromic surveillance. Objectives: To present a COVID-19 syndromic surveillance tool in Belgian general practices. Methods: We performed a nationwide observational prospective study in Belgian general practices. The surveillance tool extracted the daily entries of diagnostic codes for COVID-19 and associated conditions (suspected or confirmed COVID-19, acute respiratory infection and influenza-like illness) from electronic medical records. We calculated the 7-day rolling average for these diagnoses and compared them with data from two other Belgian population-based sources (laboratory-confirmed new COVID-19 cases and hospital admissions for COVID-19), using time series analysis. We also collected data from users and stakeholders about the syndromic surveillance tool and performed a thematic analysis. Results: 4773 out of 11,935 practising GPs in Belgium participated in the study. The curve of contacts for suspected COVID-19 followed a similar trend compared with the curves of the official data sources: laboratory-confirmed COVID-19 cases and hospital admissions but with a 10-day delay for the latter. Data were quickly available and useful for decision making, but some technical and methodological components can be improved, such as a greater standardisation between EMR software developers. Conclusion: The syndromic surveillance tool for COVID-19 in primary care provides rapidly available data useful in all phases of the COVID-19 pandemic to support data-driven decision-making. Potential enhancements were identified for a prospective surveillance tool.

关键词： Telehealth   COVID-19   human-computer interaction   VULNERABILITY   INTERNET  

摘要： Since the outbreak of the coronavirus 2019 (COVID-19) pandemic, telehealth services are regarded as a good approach to keep health workers and patients safe while simultaneously managing available resources. In this paper, we discuss the impact that COVID-19 has on telehealth services and on telehealth users' opinion of the service. We collected 245 Android telehealth apps, 144 iOS telehealth apps and 86 telehealth websites, and performed a systematic analysis on this dataset. In this analysis, we conducted a comparison analysis and relevant content analysis of the telehealth apps as well as their security risks. Apart from the mobile platforms, we also inspected the telehealth websites' features, particularly those related to the use of metaverse to improve current telehealth solutions. To further understand people's attitude towards telehealth services, we invited users to participate in a user study aimed at revealing what impact COVID-19 has on users' willingness to adopt telehealth services and revealing the gap between the telehealth service and its users. Our result shows that 27.1% new iOS apps and 27.4% new Android apps were released after the COVID-19 announcement, and a surge of updates were noted within 4 weeks after the COVID-19 announcement. We further found that COVID-19 is frequently mentioned in telehealth app reviews in the second and third quarter of 2020, and the most mentioned aspects related to COVID-19 include family, test result and vaccine. According to our user study, COVID-19 has a significant impact on the selection of telehealth services, especially for female participants, people aged 46-55, and students. The investigation also finds out that the use of metaverse will significantly improves the effectiveness of traditional telehealth solutions.