COVID-19 Epidemic Research Articles

A proposed social media adoption model for enhancing the survival and growth of rural SMMEs during the Covid-19 crisis in KwaZulu-Natal

This study investigates the critical factors influencing social media adoption by rural Small, Medium, and Micro Enterprises (SMMEs) in KwaZulu-Natal (KZN), South Africa, with a focus on supporting business survival and growth during the Covid-19 crisis. The Covid-19 crisis intensified existing challenges such as limited digital connectivity, financial constraints, and poor market access, highlighting the need for adaptive, cost-effective solutions. Social media became a vital tool for these businesses, enabling expanded market reach, improved customer engagement, and continued product promotion during uncertain times. A quantitative research approach was employed, gathering data from 374 rural SMMEs using a structured 5-point Likert scale questionnaire. Analysis revealed a strong positive correlation (r = 0.779, p < 0.001) between broadband internet access, financial resources, and social media use, all critical factors for maintaining digital engagement and ensuring business continuity. The study advocates for increased public and private investment in rural broadband infrastructure to address the digital divide and emphasises capacity building programmes to enhance digital literacy and social media marketing skills among rural entrepreneurs. The findings offer actionable insights for policy and practice, supporting the long-term sustainability of rural SMMEs and promoting inclusive digital development in rural KZN. A Social Media Adoption Model is proposed to enhance the survival and growth of rural SMMEs during the Covid-19 crisis in KZN.

Psychological burden and burnout among midwives: An epidemiological study in Thessaly, Greece

The COVID-19 pandemic has had a profound psychological impact on healthcare workers worldwide, including midwives across various levels of the healthcare system. This study aims to evaluate the psychological strain experienced by midwives in the region of Thessaly, Greece, due to the pandemic. Specifically, it examines levels of burnout while considering perceived stress, depression, and psychological resilience, as well as demographic, socio-economic, and occupational factors. This epidemiological study explores the extent of psychological distress among midwives in Thessaly during the COVID-19 crisis. Data collection was conducted between February and March 2021, involving 102 midwives, with a primary focus on burnout symptoms. Data were collected from three electronic databases: PubMed, MEDLINE, and PsycINFO. Information was gathered through a structured questionnaire covering sociodemographic and professional characteristics, alongside validated assessment tools, including the Spielberger State-Trait Anxiety Inventory, the Connor–Davidson Resilience Scale, the Beck depression inventory, and the Copenhagen Burnout Inventory. Statistical analysis was conducted using multifactorial linear regression to identify factors influencing midwives’ mental health during the pandemic. Midwives experiencing high stress and burnout had an increased risk of depression, whereas psychological resilience was identified as a crucial protective factor against depressive symptoms. Midwives in Thessaly, Greece, have faced substantial psychological distress, with their overall mental well-being significantly impacted by the COVID-19 pandemic. These findings emphasize the need for targeted psychological support and preventive interventions for midwives, particularly in ongoing or future public health crises.

Effectiveness of an online mindfulness based stress reduction intervention on psychological distress among patients with COVID19 after hospital discharge

Given the high prevalence of psychological complications during pandemics such as COVID-19, it is imperative to identify effective psychological interventions that can improve the mental health of patients and community members. The effectiveness of mindfulness-based intervention in discharged patients with infectious respiratory diseases, particularly during pandemics, has been examined in a limited number of studies. This study aimed to investigate the effectiveness of an online Mindfulness-Based Stress Reduction (MBSR) training program in alleviating psychological distress, depression, anxiety, and stress among patients who have passed the acute phase of COVID-19 and have been discharged from the hospital. This was a quasi-experimental study included 70 hospitalized patients with COVID-19 (29 [41.4%] men and 41 [58.6%] women) who were discharged from three teaching hospitals in Tehran, Iran, between September 11, 2021, and January 10, 2022 were selected by convenience sampling. Participants were randomly assigned to either the control or intervention group (35 per group). The intervention group received a 4-week online MBSR training program based on Jon Kabat-Zinn’s recommendations (2003), while the control group followed the routine hospital discharge plan. Research data were collected using the Lovibond (1995) Depression, Anxiety, and Stress Scale (DASS). The results were compared before and after the intervention. Data analysis was conducted using SPSS version 21, employing descriptive statistics as well as paired and independent sample t-tests. Cohen’s d was used to determine effect sizes. The post-test score of stress after the online MBSR training program for 4 weeks significantly decreased in the MBSR group to 12.59 ± 6.77 compared with the control group which had a score of 22.60 ± 10.82(p < 0.001). The total anxiety score significantly decreased, with scores of 8.68 ± 6.52 for the MBSR group versus 18.16 ± 13.37 for the control group (p < 0.001). The depression score in the intervention group (8.68 ± 6.52) was significantly lower compared to the depression score in the control group (18.16 ± 13.37) after the intervention (p < 0.001). This study provides preliminary evidence that online MBSR intervention can serve as an effective measure to reduce depression, stress and anxiety during pandemics such as the COVID-19 crisis. Policymakers and healthcare managers can integrate public mindfulness-based intervention training into crisis management planning to reduce psychological complications and enhance resilience during disasters such as the COVID-19 pandemic.Trial registration. The current study was approved by the Research Ethics Committee of the Faculty of Pharmacy, Nursing and Midwifery of Shahid Beheshti University of Medical Sciences on 10/08/2021 with the registration code IR.SBMU.PHARMACY.REC.1400. 108. In addition, the study protocol was registered with the Iranian Clinical Trial Registration Center on 03/06/2022 under the code IRCT20210715051896N1.

Frequency of interstitial lung diseases in inpatient rheumatology : Retrospective analysis of inpatient diagnoses 2005-2023 in Germany

Interstitial lung disease (ILD) in inflammatory rheumatic diseases (IRD) is of great importance in the diagnostics and treatment. Due to the often complex and severe courses, inpatient care is often necessary. New data are needed regarding the frequency of lung involvement in general and the development of the proportion of inpatients in Germany. Aretrospective analysis of the inpatient diagnoses published by the Federal Statistical Office according to the International Classification of Diseases (ICD-10) from 2005 to 2023 in Germany was carried out. Atotal of 11main rheumatological diagnoses were analyzed, in particular rheumatoid arthritis (RA, M05, M06), connective tissue disease (M32-M35), ANCA-associated vasculitis (M30.1, M31.3, M31.7) and axial spondylarthritis (M45). The frequency of additionally coded secondary diagnoses of lung involvement (J84.1, J84.8, J84.9, J99.0*, J99.1*) was presented over atotal observational period of 19years. There were between 50,540 and 64,004 inpatient stays per year with oneof the main rheumatological diagnoses examined. The number rose to as high as 64,000 from 2005 to 2019, collapsed in 2020-2022 and stood at 54,077 in 2023. The proportion with coded lung involvement rose from 7% (3524 in 2005) to 17% (9398 in 2023). Lung involvement was most common in granulomatosis with polyangiitis (46%), systemic sclerosis (44%), Sjögren's syndrome (27%) and Sharp's syndrome (24%). In seropositive RA 8% and in seronegative RA 1% had lung involvement (data from 2023). During the period under study, the number of inpatient stays with amain rheumatological diagnosis in Germany increased, with aslump during the SARS-CoV2 pandemic. The continuously increasing proportion of patients with lung involvement indicates the inpatient interdisciplinary care needs of this growing rheumatological patient group.

Why did China persist with a zero-COVID policy? A cultural interpretation of Confucianism

From the initial outbreak in Wuhan to December 2022, China maintained a zero-COVID policy to control the pandemic. This article examines the policy persistence through a Confucian lens, focusing on three cultural indicators derived from a combination of the open public value account and Hofstede’s national culture dimensions. China’s high long-term orientation index prioritized people’s lives and health over short-term economic impacts, while its elevated power distance and strong collectivism supported paternalistic governance and societal compliance. These cultural factors suggest that Confucian values provided a degree of moral legitimacy to the strict containment measures, reinforcing the policy’s endurance. The study constructs a theoretical framework of Confucianism’s open public value account and links it to three national culture indicators, offering a foundation for comparative cross-cultural research. However, further exploration is needed into Confucianism’s modern transformation within China’s governance modernization.

Sustainable investment strategies in a pandemic: a comparative study of Islamic and conventional mutual funds in Malaysia

The goal of work is to analyze the differences and similarities in the money flows of Islamic (IMF) and conventional mutual funds (CMF) throughout two intense events: the global financial crisis (GFC), and the COVID-19 pandemic. Pandemics have been extremely uncommon. Therefore, this work offers novel guide on what effect a global infectious malady can have concerned mutual funds’ flow. The entire sample comprises 87 equity IMFs and 83 equity CMFs in Malaysia, encompassing the two crises from January 2005 to October 2020. This work uses panel regression analysis (fixed-effect and random effect). The main findings are both crises led to a decrease in the money flows for both IMFs and CMFs. The outcomes indicate that viral pandemics effect mutual funds, similar to the earlier financial crises. However, the impact of both crises was less on the flows of IMFs than on the flows of CMFs. The implications of this paper provide managers with an overall view about investors behaviour, especially during extreme events. Thus, it helps them to build their strategies based on the behaviour and preferences of investors. The implication to investors is that it allows investors to decide in directing their money to suitable funds, such as Islamic funds, especially during these extreme periods. This work`s novel contribution is that it’s the first research exploring the effect of the COVID-19 crisis as well as the financial crisis and fund flows in Malaysia.

FEATURES OF BUSINESS INNOVATION IMPLEMENTATION IN THE EU ENTERPRISES IN THE CONTEXT OF ECONOMIC INSTABILITY AND RESOURCE CONSTRAINTS

In the context of increased instability in the global economy due to the COVID-19 pandemic and the full-scale war in Ukraine, enterprises in different countries face significant resource constraints. Therefore, the implementation of new organizational, managerial, and marketing methods, which are less costly compared to new products and technologies, is of particular importance. The study of the specific features of business innovation implementation in EU enterprises was conducted based on the results of the Community Innovation Survey and the Oslo Manual recommendations. It was found that during the 2020 crisis associated with the COVID-19 pandemic, and in the context of limited funds for financing innovation activities, EU enterprises reduced the implementation of product innovations and, conversely, more actively implemented business process innovations. The most popular business process innovations were related to information processing and communications, as well as organizational decision-making and the management of external relations. In addition, enterprises have been actively implementing business process innovations related to decision-making and human resource management, as well as marketing methods such as promotion, packaging, pricing, product placement, and after-sales service. At the same time, innovations related to new methods of producing goods and services (technological processes), as well as logistics, supply, or distribution of resources, goods, or services, were much less in demand. Based on the CIS 2020 data, the reasons for the hampering of innovation activity by EU enterprises were revealed. It can be assumed that the most important reason for the reduced implementation of new products and production methods by enterprises during the crisis is their desire to reduce costs in the face of resource constraints and lack of funds to finance innovation activities. In turn, the continuous updating of information technologies necessary for successful business, as well as the implementation of less expensive new organizational, managerial, and marketing methods, allows enterprises to compensate for the temporary halt in the introduction of new products and technological processes. It is concluded that new organizational, managerial, and marketing methods can replace product innovations and new production methods during periods of economic instability and crisis. Therefore, these types of innovations can be considered substitutes. Moreover, during times of economic instability and resource constraints, the introduction of less expensive new organizational, managerial, and marketing methods becomes a priority. A comparison of the innovation activities of EU enterprises during the 2020 COVID-19 crisis with those during the 2007-2009 financial and economic crisis led to the conclusion that the trend mentioned above is long-term. This trend should be taken into account when developing an innovation policy for Ukrainian enterprises, both under martial law and during post-war recovery.

Energy Poverty Response to COVID-19 and Energy Crisis in European NUTS 1 Regions

Energy Poverty Response to COVID-19 and Energy Crisis in European NUTS 1 Regions

Socio‑Economic Determinants of Construction Sector Development

This study investigates the empirical interaction between changing socioeconomic challenges and the construction sector in Cambodia. The empirical analysis applied uses data from the Statistical Yearbook of Cambodia (2021) to analyze the statistical relationship between socioeconomic , economic, demographic variables and construction. To do this, the study conducts a combination of regression analyses, Ordinary Least Squares in conjunction with Methods-of-Moments, while applying rigor to guarantee compliance with the CLR function assumptions. We find that the link between economic development and activity in construction is more complex than previously believed, with the role of the construction industry changing during economic development. Results show that the number of private dwelling construction projects can be explained by the ratio of primary education (-3.4), number of people employed in the educational sector (13.6), road construction (0.8), and net exports (-0.5). Future research should focus on i) potential endogeneity issues. This might emerge because activity might be conditional on the state of construction which, on the other hand, drives overall activity. ii) disentangling the effects of developments within domestic financial markets and their role in efficiently allocating financial capital to the real economy. Lastly, the significant impact of the Covid-19 crisis on the Cambodian economy, particularly the role of FP (fiscal policy) and MP (monetary policy) and efficient resource allocation within the construction industry. This aspect is crucial, as different industries responded variably to the shock and lock-down caused by Covid-19.

A qualitative exploration of principals’ transformational leadership and transactional leadership behaviors during the COVID-19 crisis: the rise of integrated crisis leadership

PurposeThe study seeks to provide insights into the specific leadership behaviors employed by school leaders to navigate the complex challenges posed by the pandemic.MethodsA qualitative research approach was adopted, involving in-depth interviews with a diverse sample of 20 school principals. Thematic analysis was employed to identify recurring patterns in their narratives addressing leadership styles and behaviors.FindingsThe findings vividly portray school principals’ leadership behaviors during the COVID-19 crisis. This study connected these behaviors with the characteristics of transformational and transactional leadership styles. Behaviors identified as transformational leadership emerged as the most prominent during the crisis. The research found that there is an expression for each of these characteristics in practice and demonstrated this through quotes from school principals.DiscussionTaken together, the findings show that principals viewed integrated leadership as crucial and effective during the COVID-19 crisis. This research contributes to the literature by offering a nuanced understanding of how school principals leveraged both transformational and transactional leadership behaviors during an unprecedented crisis.

El papel de los préstamos y del ICAS BE en el marco de colateral del Eurosistema en 2025

Rationale This article analyses how the share of non-marketable assets (basically bank loans) pledged as collateral in the Eurosystem’s monetary policy credit operations has changed over the last 12 months, homing in on the actual and potential contribution of the Banco de España’s in-house credit assessment system (ICAS BE). Takeaways •In the last 12 months the share of non-marketable assets in the collateral pledged by Spanish counterparties in Eurosystem financing operations has held steady, after growing for several years in the wake of the COVID-19 crisis. The proportion of non-marketable assets accounted for by loans to firms assessed using the ICAS BE has continued to grow for the third consecutive year, albeit more moderately. •Counterparties continue to have ample scope to increase the volume of ICAS BE-rated loans pledged, especially in the case of loans to small and medium-sized enterprises (SMEs). •Credit ratings assigned by the ICAS BE to Spanish firms have remained largely unchanged from last year, as higher financing costs have been offset by a slight improvement in the other areas assessed, particularly liquidity.

Growth Erosion in MENAP during 2000–2018: Reasons and Remedies

Abstract The paper examines the reasons for growth erosion in the Middle East, North Africa, Afghanistan, and Pakistan (MENAP) region in the period preceding the Covid-19 crisis. Over the past two decades before the crisis the regions’ growth has been lower relative to its peers, despite facing similar circumstances as those countries, such as low oil prices and weak external demand. The paper argues that key reasons for growth erosion in MENAP have been domestic, primarily negative total factor productivity, weak preparedness for shocks, insufficient fiscal buffers, unsystematic fiscal adjustment with arbitrary cuts in investment, and low investment efficiency. External factors—the decline in oil and other commodity prices, weak external demand, and geopolitical tensions—have also been important, but mainly for oil exporters. Key policy options to reinvigorate growth include leveraging technology and trade to improve productivity, developing a macroeconomic risk management system, implementing growth-friendly fiscal adjustment, improving growth inclusiveness, and fostering the private sector.

Changes in the rate of do-not-attempt-resuscitation orders in out-of-hospitalcardiac arrest: a comparative study between 2019 and 2023

Objective Japan has the highest aging rate globally, with 29.1% of its population aged ≥65years; however, the concepts of do-not-attempt-resuscitation (DNAR) and advance careplanning (ACP) are less prevalent than in other countries. We aimed to survey DNARorders in out-of-hospital cardiac arrest (OHCA) and compare them with previous surveysto examine changes in end-of-life care.Methods This prospective study examined all OHCA cases attended to by the Sagamihara City FireDepartment between May 30, 2023, and February 15, 2024. Data were collected throughemergency services and compared with those of a similar 2019 survey.Results The 2023 OHCA survey included 513 patients, a 25.9% increase from 2019. The mean agewas 75.9 ± 15.1 years, similar to 2019 (74.9±17.7 years, P=0.986). Asubgroup analysis of patients with DNAR orders revealed a significant decrease in DNARorders, from 45 patients (11.4%) in 2019 to 27 patients (5.3%)(P=0.000). No significant differences were found in ambulance treatmentservices (airway security, peripheral intravenous route security, and drugadministration) (7.4% vs. 8.9%, P=1.000). Emergency transport differedsignificantly (P=0.001), with non-transport cases (death confirmed by ahouse-call doctor on site) increasing from 2.2% to 33.3% in 2019.Conclusion This study revealed a decrease in OHCA cases involving DNAR declarations during theCOVID-19 pandemic, reflecting a positive shift toward respecting individual dignityowing to increased ACP. However, certain DNAR cases still undergo resuscitation andtransport, highlighting the need for legal DNAR protocol implementation to reduceemergency-setting challenges.

Is a friend in need a friend indeed? How relationship borrowers fare during the COVID-19 crisis

Is a friend in need a friend indeed? How relationship borrowers fare during the COVID-19 crisis

Perceptions of Secondary School Students in Mafraq Governorate towards Distance Learning and Self-Learning in Light of the Corona Pandemic

Perceptions of Secondary School Students in Mafraq Governorate towards Distance Learning and Self-Learning in Light of the Corona Pandemic

Effects of the COVID-19 crisis on work-life balance, mental health, and perceived health status among Hungarian defense employees: a cross-sectional study

The COVID-19 pandemic impacted profoundly on the mental and physical health of defense personnel, due to their involvement in the enforcement of COVID-19 measures and confined work environments. This cross-sectional study assessed the effects of the pandemic on work-life balance, mental health, and perceived health status among Hungarian defense employees. Data was collected from 300 employees of a Hungarian defense company using an online questionnaire that included demographics, work-related observations, mental health scales (DASS), and perceived health status (SF-12). Data was analyzed using descriptive and inferential statistics. The results indicated that work type, flexibility, and workload remained stable before, during, and after the pandemic. Compensation satisfaction (p = 0.025) showed a slight increase post-COVID-19, while organizational support did not significantly change (p &gt; 0.05). Work-life balance significantly decreased during the pandemic (p = 0.012), and the mental health indicators stress (p = 0.005), anxiety (p &lt; 0.001), and depression (p &lt; 0.001) increased significantly. Reliability analysis (Cronbach’s alpha) demonstrated good internal consistency across the scales. These findings underscore the significant negative impact of the COVID-19 pandemic on the mental health of defense employees, reinforcing the need for sustained support mechanisms to promote both physical and mental well-being in this workforce.

Dynamics of COVID-19 crisis management in hospitals and its long-term effects: An analysis using organizational resilience.

Dynamics of COVID-19 crisis management in hospitals and its long-term effects: An analysis using organizational resilience.

The Impact of Internationalization on Firm Performance of High-Tech Companies in Poland in the Context of Covid-19

This study aims to examine the impact of the internationalization of high-tech companies on their firm performance against the COVID-19 crisis in Poland. The research covers the period of 2018-2020 (3 years) and encompasses 591 firm-year observations, with 192 high-tech firm-year observations (64 companies) and 399 non-high-tech firm-year observations (133 companies). To find out the differences between subsamples, the U Mann-Whitney test was implemented. At the same time, correlation and regression analysis were exploited to highlight the impact of the crisis, internationalization, and the company's status on firm performance. Our research shows that, in Poland, the COVID-19 crisis had a generally weak impact on internationalization and firm performance. However, in a high-tech subsample, we find an increase in profitability during the COVID-19 crisis. Both subsamples show an increase in financial liquidity ratios during the COVID-19 crisis. The study also demonstrated that internationalization has a weak impact on firm performance. At the same time, the company's status (high-tech) positively impacts internationalization, financial liquidity, and company growth.

Ministry of National Health Services Regulation and Coordination (MoNHSRC) Pakistan's Communication Amid the COVID-19 Crisis: An Analysis of Vaccine-Related Social Media Engagement

This research analyses how the Ministry of National Health Services Regulation and Coordination (MoNHSRC) Pakistan utilized Facebook as a channel for crisis communication during the COVID-19 pandemic, with an emphasis on vaccine-related communications. By using a quantitative content analysis method, 375 Facebook posts published between February 1, 2021, and September 23, 2022, were reviewed to identify the most prevalent themes and to determine how frequently specific target audiences were mentioned in vaccine-related call-to-action messages. The data reveals that the most popular theme was "Up to Date Information," followed by "Call for Vaccine" and "Vaccine Supportive" and “Addressing public concerns and side effects” related to vaccine material, underlining Ministry of National Health Services Regulation and Coordination (MoNHSRC)’s importance on transparency and public health promotion. However, "Vaccine Availability" was the least highlighted theme, revealing a potential gap in logistical communication during a period of widespread concern and limited availability. With regard to targeting audience, the general public was targeted in the most of posts, while specific segments such as old citizens, healthcare workers, pregnant and breast-feeding women, and children received very less direct message. These results imply that while MoNHSRC maintained a constant online presence and offered vital information during the COVID-19 crisis, its communication strategy lacked personalized interaction with high-risk or hesitant populations. The study underlines the necessity of integrating focused, accessible, and inclusive messaging into future public health initiatives, especially in developing nations where social media plays a crucial role in crisis response.

Media Religiosity as a Mental Health Stability Factor in the COVID-19 Crisis in Ukraine.

The COVID pandemic has set a precedent where social restrictions and alarming news about the spread and mortality of the virus have kept people in constant emotional tension. Scientists around the world have concluded that society needs psychological support and information assistance to overcome the fear, anxiety, and depression that arise from pandemics. In search of peace, many believers turn to religion. The spiritual institution of the church always takes care of people who need support and hope. However, quarantine restrictions significantly narrowed the church influence on the life of the religious community. At that time, the church significantly expanded its presence in the media space. The phenomenon of media religiosity has emerged as the religion practice using media. The question is, does this new kind of religiosity have an impact on psychological well-being and mental health? So, the purpose of the article is to empirically investigate the relationship and influence of the individual media religiosity level on of the mental health stability indicators. Mental health stability refers to the extent to which individuals reported change in levels of common mental health symptoms (curiosity about life, belonging to a social group, satisfaction with one's personality, etc.). To implement the purpose of the study, we used the questionnaire "Mental health stability-short form" (MHC-SF-UA) adapted by E. Nosenko, A. Chetveryk-Burchak andthe Kostruba Questionnaire for Media Religious Individuals (KQMRI). The research was conducted on a convenience sample which consisted of 685 people (181 male and 504 female), average age 22.7years, from 16 regions of Ukraine. A statistically significant relationship was revealed between: hedonic well-being and the media religiosity cognitive component (r = - 0.116; p < 0.01); social well-being as a component of mental health stability and the individual's media religiosity conative component (r = 0.078; p < 0.05); mental health stability and cognitive component of a person's media religiosity (r = - 0.079; p < 0.05). The implemented regression analysis made it possible to identify only one predictor of media religiosity-hedonic well-being (β = - 0.14, p < 0.05). The results demonstrate that individuals prone to media religiosity have stable mental health, which is most often manifested and supported by social well-being.