Coronavirus Disease 2019 Lockdown Research Articles

Effect of COVID-19 lockdown on glycated haemoglobin testing and utilisation in KwaZulu-Natal, South Africa

Background: Diabetic monitoring and treatment guidelines are easily accessible, but compliance is poor in KwaZulu-Natal. The coronavirus disease 2019 (COVID-19) pandemic had a devastating impact on diabetic healthcare, both directly and through public health interventions.Objective: This study aimed to close the gaps in knowledge concerning glycated haemoglobin (HbA1c) test utilisation and how this was affected by the COVID-19 lockdown in KwaZulu-Natal.Methods: We reviewed HbA1c test volumes and results from public health facilities in the 11 health districts in KwaZulu-Natal, South Africa. We compared testing trends and glycaemic control between two 10-month study periods before (March 2019 – December 2019) and during (March 2020 – December 2020) the COVID-19 pandemic.Results: The number of HbA1c tests performed decreased 6.1% during the pandemic period, with 173 760 HbA1c tests performed in 2019 and 163 236 HbA1c tests performed in 2020. There was a statistically significant increase in the average HbA1c level during the pandemic (mean HbA1c level in the pre-pandemic period: 70.5 mmol/mol [8.6%] versus mean HbA1c level in the pandemic period: 72.7 mmol/mol [8.8%]; p-value 0.001). Of patients with suboptimal HbA1c results (83 421 in 2019, 83 259 in 2020), 11 656 (14.0%) in 2019 and 10 086 (12.1%) in 2020 had more than one HbA1c test performed during the study period.Conclusion: The COVID-19 pandemic impacted glycaemic monitoring in KwaZulu-Natal with lower HbA1c test volumes and worse glycaemic control seen during the pandemic. HbA1c testing practices are not in keeping with recommended guidelines.What this study adds: The study demonstrates that the COVID-19 pandemic impacted HbA1c utilisation in KwaZulu-Natal. Importantly, HbA1c testing practices in KwaZulu-Natal are not in keeping with Society for Endocrinology, Metabolism and Diabetes of South Africa guidelines regarding the monitoring of diabetic patients, and this requires more attention for future diabetic healthcare interventions.

Gender-based violence perpetrated against migrant women during lockdowns: A pastoral care challenge

Background: The article unpacks the complexities of gender-based violence (GBV) against illegal migrant women during lockdowns and contributes to the broader discourse on gender equality, human rights and social justice within the Pentecostal or Charismatic pastoral praxis. The geographical demography was a semi-formal area located between South Africa’s Gauteng and Northwest provinces. The period for the inquiry was South Africa’s coronavirus disease 2019 (COVID-19) induced lockdowns that began on 27 March 2020 until 05 April 2022.Objectives: The study aimed to shed light on the unique challenges faced by this vulnerable population, exploring the intersectionality of their undocumented status, gender and the socio-economic impacts of restrictive measures and the challenges to pastorally care for them.Method: The qualitative approach and case study were used to select two sets of participants; 13 illegal Zimbabwean Migrant Women (ZMW) and 3 Pentecostal or Charismatic clergy.Results: There was a disturbing prevalence of GBV incidents, ranging from physical, sexual to psychological abuse. The illegal status of migrant women exacerbated their vulnerability and reluctance to seek help due to fear of deportation and societal stigmatisation. The lockdown-induced economic strain further compounded their susceptibility to GBV.Conclusion: There was nonexistent pastoral care policy or praxis within the Pentecostal or Charismatic church for illegal ZMW who were victims of GBV during the lockdowns. These themes emerged: (1) high incidents of GBV perpetrated against illegal ZMW during lockdowns; (2) barriers to seeking pastoral care were lack of trust, migration status, fear of deportation, fear of infection and (3) no physical virtual pastoral care.Contribution: This article is embedded in the Pentecostal or Charismatic practice of care; postmodern, using the interpretive narrative framework to highlight the narratives of illegal Zimbabwean Migrant Women (ZMW) who were victims of gender-based violence (GBV) during South Africa’s COVID-19 lockdowns and the challenges of pastorally caring for them.

Self-management challenges of adults with type 2 diabetes mellitus in Ekurhuleni district primary health care facilities amid COVID-19 lockdown.

Self-management is highly recommended in managing type 2 diabetes mellitus (T2DM). Amid the coronavirus disease 2019 (COVID-19) lockdown, many restrictions were imposed, which might have affected the continuum of care and self-management. However, little is known about how people with T2DM experienced self-management during COVID-19 lockdown within the primary health care (PHC) facilities. The study explored and described the self-management challenges of adults with T2DM in Ekurhuleni PHC facilities amid COVID-19 level 5 and 4 lockdowns. The study was conducted in three community health centres in Ekurhuleni which are rendering PHC services. A phenomenological, qualitative, exploratory, and descriptive design was utilised. Purposive sampling was used to select adult patients with T2DM. Data were collected telephonically between July 2022 and August 2022 using semi-structured interviews. Inductive content analysis was used to analyse data. Two themes emerged from the interviews, namely, uncontrolled blood glucose levels and financial challenges. The patients with T2DM experienced uncontrolled blood glucose levels and financial challenges during the COVID-19 lockdown. Guidelines to improve self-management programmes during restrictions are needed to promote good health during future pandemics to prevent complications and mortality. The telehealth model can be designed to monitor chronic patients at home during lockdown as a two-way communication.Contribution:More knowledge and insight into self-management and health promotion of patients with T2DM was provided by this study. Increased training needs arose for PHC nurses in managing and monitoring patients.

COVID-19 experience of people with severe mental health conditions and families in South Africa.

People with severe mental health conditions, such as schizophrenia, and their family caregivers are underserved in low- and middle-income countries where structured psychosocial support in the community is often lacking. This can present challenges to recovery and for coping with additional strains, such as a pandemic. This study explored the experiences and coping strategies of people with lived experience of a severe mental health condition, and family caregivers, in South Africa during the initial stages of the coronavirus disease 2019 (COVID-19) pandemic. This qualitative study was conducted in the Nelson Mandela Bay District, Eastern Cape, South Africa, in the most restrictive period of the COVID-19 lockdown. Telephonic qualitative interviews were conducted with people with lived experience (n = 14) and caregivers (n = 15). Audio recordings were transcribed and translated to English from isiXhosa. Thematic analysis was conducted with NVivo 12. Participants described negative impacts including increased material hardship, intensified social isolation and heightened anxiety, particularly among caregivers who had multiple caregiving responsibilities. Coping strategies included finding ways to not only get support from others but also give support, engaging in productive activities and taking care of physical health. The main limitation was inclusion only of people with access to a telephone. Support needs for people with severe mental health conditions and their families should include opportunities for social interaction and sharing coping strategies as well as bolstering financial security. These findings indicate that current support for this vulnerable group is inadequate, and resource allocation for implementation of additional community-based, recovery-focused services for families must be prioritised.

Psychological status of residents at the onset of nationwide COVID-19 lockdown in low- and medium-risk areas of China.

The coronavirus disease 2019 (COVID-19), a dual threat to public physical and mental health, prompted an investigation into the psychological well-being of residents in low- to medium-risk areas of China during the initial stages of the pandemic. We administered WeChat-based questionnaire surveys and employed chi-square tests and multiple logistic regression to analyze correlations between residents' age, gender, education, symptoms, COVID-19 close contact history, information sources, and anxiety, depression, and attitudes toward lockdown measures. We received 10,433 valid questionnaires, revealing 26% anxiety and 19.5% depression. Support for lockdown measures reached 98.2%. Factors such as female gender, self-diagnosed pneumonia symptoms, close contact history, and higher education levels increased anxiety risk. Having a doctorate posed a severe anxiety risk, at 4.5 times (P = .019, 95% CI 1.29-15.73). Older age acted as a protective factor, reducing severe anxiety risk to 0.98 and 0.22 times (P < .001, 95% CI 0.14-0.34). Females with a master degree or below and those receiving COVID-19 information from multiple channels faced higher depression risk. Pneumonia symptoms were a risk for all anxiety and depression degrees. Attitudes toward lockdown measures had no significant impact on psychological status, nor did any of the analyzed factors affect residents' overall attitude toward lockdown. Our findings underscore the need for increased psychological counseling, particularly for young females with lower educational backgrounds or self-suspected infection symptoms, to mitigate mild to moderate anxiety and depression in future epidemics or pandemics. The public, especially those of working age with doctorates or higher education, bears the highest risk of severe anxiety. Lockdown measures enjoy strong support in low- to medium-risk areas of China.

Physical Activity and Psychological Wellbeing Among Healthcare Students During the COVID-19 Pandemic.

Regular physical activity (PA) contributes to physicaland mental wellbeing.Due to coronavirus disease 2019 (COVID-19)-related lockdowns in 2020, regular PA had been adjusted. Furthermore, students became accustomed to studying at home. Students in the healthcare field, in particular, have a better understanding of the link between PA and mental health. This study aimed to assess the association between psychological wellbeingand PA among healthcare studentsat one public university in Saudi Arabiaduring the COVID-19 pandemic period. This was a cross-sectional study conducted between November 2021 and February 2022. Healthcare students at one public university in Saudi Arabia were invited to participate in an online survey, consisting of three sections. The first section contained questions about demographic data. The second section was the International Physical Activity-Short Form (IPAQ-SF), which is composed of seven questions designed to assess the level of PA. The third part isThe Center for Epidemiological Studies Depression Scale (CES-D), which is a self-reported questionnaire comprising 20 questions that assessed depressive symptoms on a four-point scale. Descriptive statistics,Chi-square test, Mann-Whitney U test, and Kruskal Wallis test were used to analyze the collected data using IBM SPSS Statistics for Windows, Version 28.0 (Released 2021; IBM Corp., Armonk, New York, United States). The total responses received were 197 (response rate=60%). The majority of students in this sample were performing inadequate PA and reported depressive symptoms. No association was found between the amount of PA practiced and psychological wellbeing. There was a significant difference between specialties in relation to PA. The majority of students in this sample were performing inadequate PA and reported depressive symptoms during the COVID-19 lockdown. The importance of PA should be promoted among healthcare students.

Meaning of life and death during COVID-19 pandemic: A cultural and religious narratives

The sudden arrival of the coronavirus disease 2019 (COVID-19) pandemic in South Africa drastically changed the normal way of life in all sectors. It compelled everyone to look at the meaning of life and death differently and more painfully than before. This article investigates the cultural theories and religious narratives on the meaning of life and death, associated with the pervasiveness of the COVID-19 pandemic. The coronavirus affected individuals, families and communities, some directly or indirectly, no one is or was immune to the virus. The article argues that due to COVID-19 restrictions and lockdowns, culture, religious practices and protocols have been upended. The COVID-19 pandemic challenged inkcubeko nenkolo yabantu [culture, people’s religious belief systems and practices]. This article consists of in-depth qualitative interviews with four religious leaders from the Christian and Muslim faiths. Because of the interviews with persons, oral historians conduct open-ended interviews, as a form of social inquiry. Oral history narratives thus connect the individual and the social, drawing on cultural and religious expressions to tell one’s story.Contribution: The scholarly contribution of this article adds value and significance to oral history research, as a way of collecting and interpreting human memories and experiences on the meaning of life and death during the COVID-19 crisis. It discusses the dreadfulness of the COVID-19 scourge concerning religious and cultural effects, social sciences and people’s narrative reflections.

Trends of type 2 diabetes with pulmonary tuberculosis patients,2013–2022, and changes after the coronavirus disease 2019 (COVID-19) pandemic

BackgroundTo describe the trends of Type 2 Diabetes with Pulmonary Tuberculosis (T2DM-TB) patients from 2013 to 2022 and to investigate the impact of COVID-19 lockdown on glycemic control and associated factors in T2DM-TB. MethodsIn this population-based study of the First Affiliated Yijishan Hospital of Wannan Medical College in China, we described the 10-year trends of patients diagnosed with T2DM-TB. We included patients diagnosed with TB, T2DM-TB and T2DM-TB patients for comparative analysis, aged 15 years or older. Data were missing, and both multidrug-resistant (MDR) TB patients and non-T2DM patients were excluded from our study. ResultsWe pooled Type 2 Diabetes (T2DM) and Tuberculosis (TB) data from The First Affiliated Yijishan Hospital of Wannan Medical College in China, gathered between January 1, 2013, and December 31, 2022. The data included 14,227 T2DM patients, 6130 TB patients, and 982 T2DM-TB patients. During the past 10 years, the number of inpatients with TB decreased, while the number of patients with T2DM and T2DM-TB increased year by year. To rule out any influence factors, we analyzed the ratio of the three groups. The ratio of TB/T2DM decreased year by year (p < 0.05), while the ratio of TB-T2DM/TB increasing year by year (p = 0.008). During the COVID-19 epidemic period, there was no significant change in the ratio of TB-T2DM/T2DM (p = 0.156). There was no significant change in the proportion of male patients with TB and TB-T2DM (p = 0.325; p = 0.190), but the proportion of male patients with T2DM showed an increasing trend (p < 0.001). The average age of TB patients over the past 10 years was 54.5 ± 18.4 years and showed an increasing trend year by year (p < 0.001). However, there was no significant change in the age of T2DM or TB-T2DM patients (p = 0.064; p = 0.241). Patients data for the first (2013–2017) and the last (2018–2022) five years were compared. We found that the number of T2DM and TB-T2DM in the last five years was significantly higher than in the first five years, but the number of TB was significantly lower than in the first five years. There is a significant statistical difference in the proportion of TB/T2DM and TB-T2DM/TB, which is similar to the previous results. The average age (56.0 ± 17.6 years) of TB patients in the last five years is significantly higher than in the first five years (53.1 ± 18.9) (p < 0.001). The number of male patients with T2DM in the last five years is higher than that in the first five years, with significant difference (p < 0.001). ConclusionThe trends of T2DM-TB among hospitalized TB patients have increased significantly over the past 10 years, which may be related to the increase in the number of T2DM cases. The COVID-19 pandemic has been effective in controlling the transmission of TB, but it has been detrimental to the control of T2DM. Male patients with T2DM and elderly TB patients are the key populations for future prevention and control efforts.

Impact of COVID-19 pandemic on sleep parameters and characteristics in individuals living with overweight and obesity.

Coronavirus disease 2019 (COVID-19) has been very challenging for those living with overweight and obesity. The magnitude of this impact on sleep requires further attention to optimise patient care and outcomes. This study assessed the impact of the COVID-19 lockdown on sleep duration and quality as well as identify predictors of poor sleep quality in individuals with reported diagnoses of obstructive sleep apnoea and those without sleep apnoea. An online survey (June-October 2020) was conducted with two samples; one representative of Canadians living with overweight and obesity (n = 1089) and a second of individuals recruited through obesity clinical services or patient organisations (n = 980). While overall sleep duration did not decline much, there were identifiable groups with reduced or increased sleep. Those with changed sleep habits, especially reduced sleep, had much poorer sleep quality, were younger, gained more weight and were more likely to be female. Poor sleep quality was associated with medical, social and eating concerns as well as mood disturbance. Those with sleep apnoea had poorer quality sleep although this was offset to some degree by use of CPAP. Sleep quality and quantity has been significantly impacted during the early part of the COVID-19 pandemic in those living with overweight and obesity. Predictors of poor sleep and the impact of sleep apnoea with and without CPAP therapy on sleep parameters has been evaluated. Identifying those at increased risk of sleep alterations and its impact requires further clinical consideration.

The effect of the COVID-19 lockdown on women presenting with pelvic organ prolapse.

To determine whether there is a difference in pelvic organ prolapse (POP) stage at time of presentation after lifting coronavirus disease (COVID-19) lockdown restrictions, as compared to before the lockdown. Enhancing our understanding of how healthcare utilization for pelvic floor disorders may be affected by limited accessibility, such as the COVID-19 pandemic, could prove invaluable for similar future circumstances. This is a retrospective study of women with POP at their initial visit. Patients were grouped into two cohorts based on their initial presentation time: pre-COVID-19 lockdown (before March 2020) and post-COVID-19 lockdown (after December 2020). The cohorts were compared using demographic, clinical, and surgical variables. A logistic regression controlling for confounders was used to evaluate the influence of the COVID-19 lockdown on prolapse stage. There were 656 (50.3%) patients in the pre-COVID-19 lockdown cohort and 648 (49.7%) in the post-COVID-19 lockdown cohort. All baseline characteristics were similar between both cohorts except for race (p = 0.015). Treatment choices differed with the post-COVID-19 lockdown cohort having a lower proportion (26.5%) opting for surgery and a higher proportion (50.5%) of patients opting for nonsurgical interventions compared to the pre-COVID-19 lockdown cohort (p = 0.0005). A higher proportion of women presented with stages I and II prolapse in the post-COVID-19 lockdown (70.4%) cohort as compared to the pre-COVID-19 lockdown (62.5%) cohort (p = 0.002). Women in the post-COVID-19 lockdown cohort presented with early stage prolapse with preference for more conservative treatment options.

Impacts of COVID-19 lockdown period on the Algerian power grid demand

The coronavirus disease-2019 (COVID-19) spread out at the end of 2019 has sadly caused millions of human losses and hundreds of millions of cases and stressful health situations. As a result, governments forced the worldwide population to stay confined and change their social activities and working behaviors. Under such conditions all economic sectors have been impacted, therefore global electricity consumption pattern has changed consequently. The object of this study is to calculate energy drop for such circumstances to make strategies to face such events in the future. The study we conducted during the period of confinement aims to identify the effects of the Corona epidemic on electricity consumption in Algeria by emphasizing four months (March, April, May, and June) for four years (2018, 2019, 2020, and 2021) by comparing monthly load curves and calculating load deviation for each month.

Incidence, severity, and clinical characteristics of lower respiratory tract infections in children before and after the coronavirus disease 2019 lockdown: a Dutch single-center study

Purpose: Coronavirus disease 2019 (COVID-19) public health measures reduced the incidence of pediatric lower respiratory tract infections (LRTIs) in 2020. An inter-seasonal surge in the LRTI has occurred after relaxation of restrictions. We aimed to compare characteristics and disease severity of children with LRTI before, during, and after COVID-19 lockdown. Methods: All LRTI-related visits to emergency department (ED) of a large pediatric hospital in the Netherlands between 2019 and 2021 were included. Variables were compared between 2019 and 2020, and between 2019 and 2021, respectively. The variables included demographic characteristics, condition upon ED arrival, diagnosis, applied treatment, and follow-up.Results: In 2019, 2020, and 2021, numbers of the visits were 573, 280, and 519, respectively, comprising the study population (n = 1,372). In 2020, the patients were older, and showed higher frequencies of preterm birth history, co-occurring symptoms of obstructive lung disease, and salbutamol therapy in the ED, than in 2019. In 2021, the patients were younger, showed higher frequencies of desaturation, bronchiolitis, co-occurring symptoms of obstructive lung disease, salbutamol therapy, and hospitalization, and showed lower frequencies of respiratory ED visits or hospitalization in the past year, and antibiotic therapy. During hospitalization in 2020, the patients were older, and showed shorter duration of oxygen support and length of hospital stay, as well as lower frequencies of nasogastric tube insertion, compared to 2019. In 2021, compared to 2019, the patients showed a higher frequency of bronchiolitis and lower frequencies of underlying medical conditions and antibiotic therapy. Conclusion: The children presenting with LRTIs in 2021 seem to have had a more severe clinical phenotype, possibly explained by immunity debt after the COVID-19 lockdown, stricter referral policy, or changes in healthcare-seeking behavior. Future research is needed to evaluate the long-term consequences of growing up during the lockdown.

Alleviation of PM2.5-associated Risk of Daily Influenza Hospitalization by COVID-19 Lockdown Measures: A Time-series Study in Northeastern Thailand.

Abrupt changes in air pollution levels associated with the coronavirus disease 2019 (COVID-19) outbreak present a unique opportunity to evaluate the effects of air pollution on influenza risk, at a time when emission sources were less active and personal hygiene practices were more rigorous. This time-series study examined the relationship between influenza cases (n=22 874) and air pollutant concentrations from 2018 to 2021, comparing the timeframes before and during the COVID-19 pandemic in and around Thailand's Khon Kaen province. Poisson generalized additive modeling was employed to estimate the relative risk of hospitalization for influenza associated with air pollutant levels. Before the COVID-19 outbreak, both the average daily number of influenza hospitalizations and particulate matter with an aerodynamic diameter of 2.5 μm or less (PM2.5) concentration exceeded those later observed during the pandemic (p&lt;0.001). In single-pollutant models, a 10 μg/m3 increase in PM2.5 before COVID-19 was significantly associated with increased influenza risk upon exposure to cumulative-day lags, specifically lags 0-5 and 0-6 (p&lt;0.01). After adjustment for co-pollutants, PM2.5 demonstrated the strongest effects at lags 0 and 4, with elevated risk found across all cumulative-day lags (0-1, 0-2, 0-3, 0-4, 0-5, and 0-6) and significantly greater risk in the winter and summer at lag 0-5 (p&lt;0.01). However, the PM2.5 level was not significantly associated with influenza risk during the COVID-19 outbreak. Lockdown measures implemented during the COVID-19 pandemic could mitigate the risk of PM2.5-induced influenza. Effective regulatory actions in the context of COVID-19 may decrease PM2.5 emissions and improve hygiene practices, thereby reducing influenza hospitalizations.

Analyzing COVID-19 and Air Pollution Effects on Pediatric Asthma Emergency Room Visits in Taiwan.

(1) Background: An asthma exacerbation that is not relieved with medication typically requires an emergency room visit (ERV). The coronavirus disease 2019 (COVID-19) pandemic began in Taiwan in January of 2020. The influence of the COVID-19 pandemic on pediatric ERVs in Taiwan was limited. Our aim was to survey pediatric asthma ERVs in the COVID-19 era; (2) Methods: Data were collected from the health quality database of the Taiwanese National Health Insurance Administration from 2019 to 2021. Air pollution and climatic factors in Taipei were used to evaluate these relationships. Changes in the rates of pediatric asthma ERVs were assessed using logistic regression analysis. Poisson regression was used to evaluate the impact of air pollution and climate change; (3) Results: The rate of pediatric asthma ERVs declined in different areas and at different hospital levels including medical centers, regional and local hospitals. Some air pollutants (particulate matter ≤ 2.5 µm, particulate matter ≤ 10 µm, nitrogen dioxide, and carbon monoxide) reduced during the COVID-19 lockdown. Ozone increased the relative risk (RR) of pediatric asthma ERVs during the COVID-19 period by 1.094 (95% CI: 1.095-1.12) per 1 ppb increase; (4) Conclusions: The rate of pediatric asthma ERVs declined during the COVID-19 pandemic and ozone has harmful effects. Based on these results, the government could reduce the number of pediatric asthma ERVs through healthcare programs, thereby promoting children's health.

Systemic Family Dynamics and Well-Being in Highly Educated Adults During the COVID-19 in China: A Longitudinal Survey

Crisis and stress are threats to family relationships and well-being in highly educated adults. This longitudinal survey evaluated well-being and systemic family dynamics during the early months of the coronavirus disease 2019 (COVID-19) pandemic and 8-month follow-up in highly educated Chinese adults who are more likely to seek and enter psychotherapy. Self-designed sociodemographic characteristic questionnaire, index of well-being and index of general affect, Self-rating Scale of Systemic Family Dynamics at two timepoints (8-month follow-up) during the COVID-19 pandemic were used. Structural equation modeling and analyses of variances were applied. Results indicated a modified model fits well for both data in the early months of COVID-19 and 8-months later. The relationship between systemic family dynamics and well-being ( β = 0.61 vs. 0.57) and the relationship between systemic family dynamics and its subscale individuation ( β = 0.88 vs. 0.80) were moderated by the pandemic ( C.R. = 2.09 vs. 2.48, p &lt; .05). Some subscales of well-being and systemic family dynamics significantly increased overtime during the pandemic ( p &lt;.001). The results suggest that well-being and systemic family dynamics and their associations are changed and influenced by the different stages of the COVID-19 pandemic for highly educated adults. Systemic family dynamics could be a potential protective factor against adverse effect of the COVID-19 pandemic and lockdown on well-being.

Monitoring commercial and smallholder production inequalities during South Africa's lockdown using remotely sensed data

AbstractSouth Africa's dualistic agricultural sector consists of many smallholders that operate adjacent to dominant commercial producers. While the smallholder sector contributes to food security, households depend primarily on market food consumption. Poverty reduction is constrained when smallholders have limited access to markets, technology, or cheap capital. We collate remotely sensed data from the South African National Land Cover map and moderate‐resolution imaging spectroradiometer to monitor land use changes as the country entered the coronavirus disease (COVID‐19) lockdown. Production growth sustained aggregate food security, but hunger rose in the poorest households. This inequality in food security is also reflected in growing inequalities in production. Commercially cultivated land areas grew significantly, with more modest gains in smallholder areas. Commercial farmers were better positioned to expand capital in a low interest rate environment during the COVID‐19 crisis. Without using technology and capital to adapt, smallholders can fall further behind during future crises and growth episodes.

Impact of Coronavirus Disease 2019 on Intravitreal Antivascular Endothelial Growth Factor Injection Rates in Nigerians.

To quantify the impact of coronavirus disease 2019 (COVID-19) on the rate of intravitreal antivascular endothelial growth factor (VEGF) injections (IVI) in eye hospitals in Nigeria. A retrospective, observational, comparative study. The IVIs given 12 months before (pre-COVID) and 12 months after the first announcement of the COVID-19 lockdown (COVID) in Nigeria in four hospitals were used as the sample for this study. All eyes were treatment naïve. We determined the total number of all anti-VEGF injections, the number given for each indication, and the number of each type of the three anti-VEGFs given. A comparison of the presenting vision in IVI eyes between the two eras and the visual outcome of the IVI treatment was made. Data were analyzed using the SPSS version 22 to determine statistical significance. Male/female ratio, pre-COVID 63.4%/36.6% and COVID 58.6%/41.4% (P = 0.123). Age, pre-COVID 61.3 (SD 12.9) 9-95 years and COVID 57.5 (SD 16.4) 0.15-95 years. There was a 15.3% (81 eyes) reduction in the number of eyes between pre-COVID and COVID eras (528 and 447 eyes, respectively). Likewise, the number of IVIs reduced by 26% (221 IVIs) from 850 pre-COVID to 629 COVID, P = 0.005. A comparison of the proportion of eyes in the four clinic locations between the two eras was not statistically significant (P = 0.148). The commonest indication was proliferative diabetic retinopathy in both eras, 208 versus 178 eyes (323 versus 226 IVIs). Bevacizumab, Ranibizumab, and Aflibercept were given in the following proportions 60.2%, 22.3%, and 17.4% (pre-COVID) versus 60.2%, 31.5%, and 8.3% (COVID), P = 0.000. Presenting visual acuity was >6/60 in 67.4% of eyes (pre-COVID) versus 59.4% of eyes (COVID), P = 0.039. Vision improved in 51.3% of eyes (pre-COVID) versus 47.7% (COVID); there was no significant difference in visual outcome comparing both eras, P = 0.972. COVID-19 significantly reduced the number of eyes and IVIs. Eyes had worse presenting visual acuity during the COVID era; however, treatment outcome was comparable between COVID and pre-COVID eras.

Eating behaviors and physical activity during the COVID-19 pandemic lockdown: Experiences of breast cancer patients on adjuvant hormonal therapy

Background/Aim. Since the coronavirus disease 2019 (COVID-19) pandemic led to a strict lockdown in Serbia, the population has experienced drastic lifestyle changes. Physical distancing, self-isolation, limited availability of essential food products, and the stress related to the availability of therapy during the pandemic particularly affected the lives of vulnerable groups, such as breast cancer (BrC) patients. The aim of this study was to examine the changes in eating behaviors and physical activity of postmenopausal BrC patients on adjuvant hormonal therapy under the COVID-19 lockdown conditions. Methods. This observational retrospective pre-post cohort study included 32 women treated with aromatase inhibitors (AIs) who responded to telephone interviews using a structured questionnaire. The questionnaire aims to collect data on eating habits (intake of certain foods on a daily/weekly basis, as well as changes in the usual choice of food), intake of supplements, changes in weight, and physical activity before and during the lockdown. Results. The results showed that, due to problems in obtaining groceries, the patients cooked and consumed homemade sweets and fruit more often (47% of the respondents), while fewer (31%) consumed fresh fish. Nearly 41% of patients reported increased food intake, and 88% reported decreased physical activity, which led to an increase in body weight in as many as 47% of subjects. The intake of supplements was doubled. Conclusion. The COVID-19 lockdown with home confinement exacerbated health risks and affected dietary patterns and physical activity, which may have had a negative impact on the long-term health of BrC patients treated with AIs.

Psychological impact of COVID-19 lockdown period on students of healthcare colleges.

The coronavirus disease 2019 (COVID-19) pandemic globally caused depression, anxiety, and post-traumatic stress. Mental health was affected by social separation, curfews, school and business closures, economic deterioration, and government objectives. This study intends to assess the influence of the post-COVID-19 lockdown period on the psychological health of students enrolled in health colleges at King Saud University, Saudi Arabia. A cross-sectional study was conducted among students of healthcare colleges at King Saud University. We used a validated questionnaire of the Generalized Anxiety Disorder Assessment (GAD-7) and the Perceived Stress Scale (PSS-10). The questionnaire was sent to participants via google forms link through WhatsApp, e-mail, and other social media platforms. A total of 311 participants responded to the questionnaire. Descriptive analysis and a Chi-square test were performed for qualitative data analysis. Among study participants, males were 50.4% and females were 49.6%. About 63% of the students attended a training session on COVID-19 prevention strategies. About 37% of the participants were from the College of Medicine, 27% were from the College of Dentistry, 21% from the College of Pharmacy, 5% from the College of Applied Medical Sciences, and 10% from the College of Nursing. The average anxiety score was 9.84, and the perceived stress score (PSS) was 23.95. 44.1% of students reported mild anxiety, and 1.6% suffered severe anxiety. High stress was perceived by 24.1% of the students, and 75.2% perceived a moderate stress level. No significant association was reported between gender, stress, and anxiety. Similarly, no association was found between stress and the year of study. However, a significant association was found between the year of study and anxiety (P = 0.015). To the limitation of the study, the analysis revealed that COVID significantly influences students' psychological health. Such findings can be used to develop psychological interventions and susceptible populations and execute appropriate mental health policies and programs targeting student communities.

COVID-19 Emergency Remote Teaching: Lessons Learned from Five EU Library and Information Science Departments

Abstract Analysis of the context and response to the coronavirus disease 2019 (COVID-19) lockdown of five European Library and Information Science Departments: University of Barcelona (Spain), University of Hildesheim (Germany), University of Osijek, University of Zagreb (Croatia), and University of Library Studies and Information Technologies in Sofia (Bulgaria). Data about this situation in relation to higher education were collected 1 year after the lockdown when countries had returned to normality. The methodology consisted of holding focus groups with students and individual interviews with teachers. The data were analysed by unifying the information collected from each country into a centralized dataset and complemented with texts from the transcripts highlighted by each partner. The results indicate that each partner experienced a unique situation; as COVID-19 lockdowns were different in every European country, each university or even each teacher responded to the crisis differently. Nevertheless, there are points that are common to all five universities analysed in the study, such as work overload in students and teachers or the replication of face-to-face teaching models in a remote format. Moving in the future to online or hybrid learning activities will require training teachers in a more systematic way and the appropriate infrastructure.