关键词： COVID-19   mortality   people with disability   South Korea   infection   MORBIDITY   RISK  

摘要： Objective To investigate temporal trends in mortality rates and underlying causes of death in persons with disabilities before and during the coronavirus disease 2019 (COVID-19) *** Annual mortality rates and causes of death were analyzed using data covering the 2017-2022 *** The mortality rate among people with disabilities increased from 2017 to 2022; the rate was five times higher during COVID-19 in this population than in the general population. When analyzing the cause of death, the incidence of infectious diseases and tuberculosis decreased after COVID-19. In contrast, the incidence of other bacillary disorders (A30-A49) increased. The incidence of respiratory system diseases (J00-J99), influenza and pneumonia (J09-J18), and other acute lower respiratory infections (J20-J22) decreased before COVID-19, while the incidence of lung diseases due to external agents (J60-J70), other respiratory diseases principally affecting the interstitium (J80-J84), and other diseases of the pleura (J90-J94) increased during the pandemic. The risk of COVID-19 death among people with disabilities was 1.1-fold higher for female patients (95% CI = 1.06-1.142), 1.41-fold for patients aged 70 years and older (95% CI = 1.09-1.82), and 1.24-fold higher for people with severe disabilities (95% CI = 1.19-1.28).Conclusions The mortality rate in people with disabilities significantly increased during COVID-19, compared with that before the pandemic. People with disabilities had a higher mortality rate during COVID-19 compared with the general population. Risk factors must be reduced to prevent high mortality rates in this population.

关键词： COVID-19   Long-COVID   Cluster analysis   Social isolation   Loneliness   SOCIAL-ISOLATION   OLDER-ADULTS   LONELINESS   OUTCOMES   HEALTH   SCALE  

摘要： BackgroundRecent studies have demonstrated that individuals hospitalized due to COVID-19 can be affected by "long-COVID" symptoms for as long as one year after *** study objective is to identify data-driven clusters of patients using a novel, unsupervised machine learning *** study uses data from 437 patients hospitalized in New York City between March 3rd and May 15th of 2020. The data used was abstracted from medical records and collected from a follow-up survey for up to one-year post-hospitalization. Hospitalization data included demographics, comorbidities, and in-hospital complications. The survey collected long-COVID symptoms, and information on general health, social isolation, and loneliness. To perform the analysis, we created a graph by projecting the data onto eight principal components (PCs) and running the K-nearest neighbors algorithm. We then used Louvain's algorithm to partition this graph into non-overlapping *** cluster analysis produced four clusters with distinct health and social connectivity patterns. The first cluster (n = 141) consisted of patients with both long-COVID neurological symptoms (74%) and social isolation/loneliness. The second cluster (n = 137) consisted of healthy patients who were also more socially connected and not lonely. The third cluster (n = 96) contained patients with neurological symptoms who were socially connected but lonely, and the fourth cluster (n = 63) consisted entirely of patients who had traumatic COVID hospitalization, were intubated, suffered symptoms, but were socially connected and experienced *** cluster analysis identified social isolation and loneliness as important features associated with long-COVID symptoms and recovery after hospitalization. It also confirms that social isolation and loneliness, though connected, are not necessarily the same. Physicians need to be aware of how social characteristics relate to long-COVID and pat

关键词： Government support   Innovation   Firm survival   COVID-19   SMEs   D24   G33   H12   O38   FIRM PERFORMANCE   ENTERPRISES   RESILIENCE  

摘要： PurposeThere is a need for research examining how governments and firms responded to the coronavirus disease (COVID-19) pandemic. This study investigates the interdependence between governments and innovative small and medium-sized enterprises (SMEs) during the pandemic in relation to the dynamic capabilities and resource dependence ***/methodology/approachWe use World Bank survey data collected immediately before and after the COVID-19 outbreak and a generalized structural equation model to examine the mediating role of government support in the relationship between firm innovation, resilience and *** SMEs exhibited higher resilience and a better chance of survival during the pandemic, partly due to attracting more government ***/valueThis study offers a novel understanding of the government's role in supporting innovative SMEs during the pandemic. The findings have implications for how government support policies can limit the deadweight effect and the substitution effect.

关键词： COVID-19  

摘要： Throughout human history, epidemics have been a constant presence. Understanding their dynamics is essential to predict scenarios and make substantiated decisions. Mathematical models are powerful tools to describe an epidemic behavior. Among the most used, the compartmental ones stand out, dividing population into classes with well-defined characteristics. One of the most known is the SIR model, based on a set of differential equations describing the rates of change of three categories over time. These equations take into account parameters such as the disease transmission rate and the recovery rate, which both change over time. However, classical models use constant parameters and can not describe the behavior of a disease over long periods. In this work, it is proposed a SIR model with time-varying transmission rate parameter with a method to estimate this parameter based on an optimization problem, which minimizes the sum of the squares of the errors between the model and historical data. Additionally, based on the infection rates determined by the algorithm, the model’s ability to predict disease activity in future scenarios was also investigated. Epidemic data released by the government of the State of Rio Grande do Sul in Brazil was used to evaluate the models, where the models shown a very good forecasting ability, resulting in errors for predicting the total number of accumulated infected persons of 0.13% for 7 days ahead and 0.6% for 14 days ahead. Copyright © 2024, The Authors. All rights reserved.

关键词： Examination disruptions   OSCE   Performance assessment   Validity   Reliability   MEDICAL LICENSING EXAMINATION   VALIDITY   OSCE   CERTIFICATION   SCORES  

摘要： Background The administration of performance assessments during the coronavirus disease of 2019 (COVID-19) pandemic posed many challenges, especially for examinations employed as part of certification and licensure. The National Assessment Collaboration (NAC) Examination, an Objective Structured Clinical Examination (OSCE), was modified during the pandemic. The purpose of this study was to gather evidence to support the reliability and validity of the modified NAC Examination. Methods The modified NAC Examination was delivered to 2,433 candidates in 2020 and 2021. Cronbach's alpha, decision consistency, and accuracy values were calculated. Validity evidence includes comparisons of scores and sub-scores for demographic groups: gender (male vs. female), type of International Medical Graduate (IMG) (Canadians Studying Abroad (CSA) vs. non-CSA), postgraduate training (PGT) (no PGT vs. PGT), and language of examination (English vs. French). Criterion relationships were summarized using correlations within and between the NAC Examination and the Medical Council of Canada Qualifying Examination (MCCQE) Part I scores. Results Reliability estimates were consistent with other OSCEs similar in length and previous NAC Examination administrations. Both total score and sub-score differences for gender were statistically significant. Total score differences by type of IMG and PGT were not statistically significant, but sub-score differences were statistically significant. Administration language was not statistically significant for either the total scores or sub-scores. Correlations were all statistically significant with some relationships being small or moderate (0.20 to 0.40) or large (> 0.40). Conclusions The NAC Examination yields reliable total scores and pass/fail decisions. Expected differences in total scores and sub-scores for defined groups were consistent with previous literature, and internal relationships amongst NAC Examination sub-scores and their external relatio

关键词： Panel analysis   Labour mobility   COVID-19   Short-time work   Working from home   High-frequency establishment data   GERMAN ESTABLISHMENTS   SPECIFICATION   EMPLOYMENT  

摘要： PurposeWe enquire whether short-time work (STW) avoids firings as intended by policymakers and is associated with unintended side effects by subsidising some establishments and locking in some employees. Additionally, where it was feasible, establishments used working from home (WFH) to continue working without risking an increase in COVID-19 infections and allowing employed parents to care for children attending closed ***/methodology/approachUsing 21 waves of German high-frequency establishment panel data collected during the COVID-19 crisis, we investigate how STW and WFH are associated with hirings, firings, resignations and excess labour turnover (or churning).FindingsOur results show the important influences of STW and working from home on employment dynamics during the pandemic. By means of STW, establishments are able to avoid an increase in involuntary layoffs and hiring decreases significantly. In contrast, WFH is associated with a rise in resignations, as can be expected from a theoretical ***/valueWhile most of the literature on STW and WFH is unrelated and remains descriptive, we consider them in conjunction and conduct panel data analyses. We apply data and methods that allow for the dynamic pattern of STW and working from home during the pandemic. Furthermore, our data include relevant establishment-level variables, such as the existence of a works council, employee qualifications, establishment size, the degree to which the establishment was affected by the COVID-19 crisis, industry affiliation and a wave indicator for the period the survey was conducted.

关键词： AOD   BC   Aviation-based emissions   Lockdown   COVID-19   HEALTH IMPACT   SATELLITE   AVIATION   MODIS   AIR   LOCATIONS   EXPOSURE   AERONET   CHINA   MISR  

摘要： Globally, the COVID-19 outbreak has had a devastating impact on both health and economy. In contrast, the reduction in anthropogenic emissions has resulted in a major improvement in air quality. In this study, US National Aeronautics and Space Administration (NASA) satellite datasets and related reanalysis model data were used with validation using ground-based data to evaluate the effects of aviation-based emissions on aerosol optical depth (AOD) and black carbon (BC). The contributions from five airports in Bangladesh were assessed during the pre-lockdown (01 Jan to 22 March), lockdown (23 March to 30 May), and post-lockdown (31 May to 30 Aug) periods in 2019 and 2020. The study's findings show that during the 2020 lockdown, AOD and BC concentrations significantly decreased at all five airports. The overall decline of AOD was similar to 18.5% (13.1% to 22.8%) and BC was similar to 18.1% (16.6% to 22.2%) in 2020 compared to 2019. The three international airports that were examined-Dhaka, Chattagram, and Sylhet-showed an average reduction of about similar to 9.7%, while Jashore and Barisal-two domestic airports-saw a minor increase in AOD of similar to 0.8% over the same period. However, the average BC concentration at both international and domestic airports dropped by similar to 9.8% and similar to 10.2%, respectively. This is the first study to use reanalysis datasets in Bangladesh to evaluate air pollution levels and aviation-based emissions. The results highlight the significant impact of reduced aviation activity on air quality and provide valuable insights for future air pollution management strategies.

关键词： palliative care   COVID-19   clinical characteristics   frailty   hospitalization   outcomes assessment   NEEDS  

摘要： Context: COVID-19 induces complex distress across physical, psychological, and social realms and palliative care (PC) has the potential to mitigate this suffering significantly. Objectives: To describe the clinical characteristics and outcomes of COVID-19 patients with an indication of PC, compared to patients who had no indication, in different pandemic waves. Methods: This retrospective multicenter observational cohort included patients from 40 hospitals, admitted from March 2020 to August 2022. Patients who had an indication of palliative care (PC) described in their medical records were included in the palliative care group (PCG), while those who had no such indication in their medical records were allocated to the non-palliative care group (NPCG). Results Out of 21,158 patients, only 6.7% had indication for PC registered in their medical records. The PCG was older, had a higher frequency of comorbidities, exhibited higher frailty, and had a higher prevalence of clinical complications and mortality (81.4% vs. 17.7%, p < 0.001), when compared to the NPCG. Regarding artificial life support, the PCG had a higher frequency of dialysis (20.4% vs. 10.1%, p < 0.001), invasive mechanical ventilation (48.2% vs. 26.0%, p < 0.001) and admission to the intensive care unit (53.6% vs. 35.4%, p < 0.001). These differences were consistent across all three waves. Conclusion: A low proportion of patients received PC. Patients in PCG were more fragile, had more clinical complications, and had a higher mortality. On the contrary to our expectations, they received more artificial life support in all three waves. Taken together, these findings suggest that decisions regarding PC indication were made too late, within a context of end-of-life and therapeutic failure.

关键词： Perceptions   Mobile teams   Vaccine uptake   Community level  

摘要： BackgroundAs part of the fight against coronavirus disease, Nigeria received nearly 4 million doses of the COVID-19 vaccine via the COVID-19 Vaccines Global Access (COVAX) Facility, marking a historic step towards equitable global distribution of COVID-19 vaccines. Although evidence exists on COVID-19 hesitancy in Nigeria, yet, we are unaware of any study on the optimization of COVID-19 vaccination from the lenses of the mobile *** study seeks to explore the perceptions and experiences of mobile teams in selected communities during the implementation of COVID-19 vaccination in Benue and *** exploratory approach was adopted, and the study was conducted in Niger and Benue states based on poor performance in COVID-19 vaccination. Focus Group Discussions (FDGs) were conducted among 12 mobile vaccination teams from 12 LGAs. The recorded discussions were transcribed and coded (inductively and deductively) using Dedoose software (v9.0). Four themes and seven sub-themes were generated from the participants' ***-two (72) health workers including vaccinators, validators, Electronic Management of Immunization Data (EMID) recorders, social mobilizers, and paper recorders participated in this study. Health workers' perceptions and experiences were thematized using the health building blocks. The mobilization teams in Benue and Niger states perceived that their mobilization efforts contributed to improved coverage, increased accessibility, and reduced hesitancy among the community dwellers. Challenges reported by the teams were vaccine misconceptions, requests for incentives in exchange for vaccine uptake, poor network services, distance to communities, and vaccine *** study concluded that social mobilizers play key roles in vaccine uptake, especially at the community level. Their roles in creating awareness, sensitization, and bringing the vaccine closer to hard-to-reach communities contributed to the success a