Search results for: Covid 19 pandemic
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1414

Search results for: Covid 19 pandemic

994 How Obesity Sparks the Immune System and Lessons from the COVID-19 Pandemic

Authors: Husham Bayazed

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Purpose of Presentation: Obesity and overweight are among the biggest health challenges of the 21st century, according to the WHO. Obviously, obese individuals suffer different courses of disease – from infections and allergies to cancer- and even respond differently to some treatment options. Of note, obesity often seems to predispose and triggers several secondary diseases such as diabetes, arteriosclerosis, or heart attacks. Since decades it seems that immunological signals gear inflammatory processes among obese individuals with the aforementioned conditions. This review aims to shed light how obesity sparks or rewire the immune system and predisposes to such unpleasant health outcomes. Moreover, lessons from the Covid-19 pandemic ascertain that people living with pre-existing conditions such as obesity can develop severe acute respiratory syndrome (SARS), which needs to be elucidated how obesity and its adjuvant inflammatory process distortion contribute to enhancing severe COVID-19 consequences. Recent Findings: In recent clinical studies, obesity was linked to alter and sparks the immune system in different ways. Adipose tissue (AT) is considered as a secondary immune organ, which is a reservoir of tissue-resident of different immune cells with mediator release, making it a secondary immune organ. Adipocytes per se secrete several pro-inflammatory cytokines (IL-6, IL-4, MCP-1, and TNF-α ) involved in activation of macrophages resulting in chronic low-grade inflammation. The correlation between obesity and T cells dysregulation is pivotal in rewiring the immune system. Of note, autophagy occurrence in adipose tissues further rewire the immune system due to flush and outburst of leptin and adiponectin, which are cytokines and influencing pro-inflammatory immune functions. These immune alterations among obese individuals are collectively incriminated in triggering several metabolic disorders and playing role in increasing cancers incidence and susceptibility to different infections. During COVID-19 pandemic, it was verified that patients with pre-existing obesity being at greater risk of suffering severe and fatal clinical outcomes. Beside obese people suffer from increased airway resistance and reduced lung volume, ACE2 expression in adipose tissue seems to be high and even higher than that in lungs, which spike infection incidence. In essence, obesity with pre-existence of pro-inflammatory cytokines such as LI-6 is a risk factor for cytokine storm and coagulopathy among COVID-19 patients. Summary: It is well documented that obesity is associated with chronic systemic low-grade inflammation, which sparks and alter different pillars of the immune system and triggers different metabolic disorders, and increases susceptibility of infections and cancer incidence. The pre-existing chronic inflammation in obese patients with the augmented inflammatory response against the viral infection seems to increase the susceptibility of these patients to developing severe COVID-19. Although the new weight loss drugs and bariatric surgery are considered as breakthrough news for obesity treatment, but preventing is easier than treating it once it has taken hold. However, obesity and immune system link new insights dispute the role of immunotherapy and regulating immune cells treating diet-induced obesity.

Keywords: immunity, metabolic disorders, cancer, COVID-19

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993 The Increasing of Perception of Consumers’ Awareness about Sustainability Brands during Pandemic: A Multi Mediation Model

Authors: Silvia Platania, Martina Morando, Giuseppe Santisi

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Introduction: In the last thirty years, there is constant talk of sustainable consumption and a "transition" of consumer lifestyles towards greater awareness of consumer choices (United Nation, 1992). The 2019 coronavirus (COVID-19) epidemic that has hit the world population since 2020 has had significant consequences in all areas of people's lives; individuals have been forced to change their behaviors, to redefine their owngoals, priorities, practices, and lifestyles, to rebuild themselves in the new situation dictated by the pandemic. Method(Participants and procedure ): The data were collected through an online survey; moreover, we used convenience sampling from the general population. The participants were 669 Italians consumers (Female= 514, 76.8%; Male=155, 23.2%) that choice sustainability brands, aged between 18 and 65 years (Mₐ𝓰ₑ = 35.45; Standard Deviation, SD = 9.51).(Measure ): The following measures were used: The Muncy–Vitell Consumer Ethics Scale; Attitude Toward Business Scale; Perceived Consumer Effectiveness Scale; Consumers Perception on Sustainable Brand Attitudes. Results: Preliminary analyses were conducted to test our model. Pearson's bivariate correlation between variables shows that all variables of our model correlate significantly and positively, PCE with CPSBA (r = .56, p <.001). Furthermore, a CFA, according to Harman's single-factor test, was used to diagnose the extent to which common-method variance was a problem. A comparison between the hypothesised model and a model with one factor (with all items loading on a unique factor) revealed that the former provided a better fit for the data in all the CFA fit measures [χ² [6, n = 669] = 7.228, p = 0.024, χ² / df = 1.20, RMSEA = 0.07 (CI = 0.051-0.067), CFI = 0.95, GFI = 0.95, SRMR = 0.04, AIC = 66.501; BIC = 132,150). Next, amulti mediation was conducted to test our hypotheses. The results show that there is a direct effect of PCE on ethical consumption behavior (β = .38) and on ATB (β = .23); furthermore, there is a direct effect on the CPSBA outcome (β = .34). In addition, there is a mediating effect by ATB (C.I. =. 022-.119, 95% interval confidence) and by CES (C.I. =. 136-.328, 95% interval confidence). Conclusion: The spread of the COVID-19 pandemic has affected consumer consumption styles and has led to an increase in online shopping and purchases of sustainable products. Several theoretical and practical considerations emerge from the results of the study.

Keywords: decision making, sustainability, pandemic, multimediation model

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992 The Role of Psychological Resilience in Predicting Psychological Distress in Kuwaiti Adults during Corona Varies Pandemic

Authors: Al-Tammar M. Shahah

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Background and Objective: A novel pneumonia caused by coronavirus disease 2019 (COVID-19), which is spreading domestically and internationally, has been identified by the Chinese city of Wuhan since the end of December 2019. Limited studies examined the psychological experience such as anxiety, depression, and stress during Corona pandemic. Moreover, to the best of author's knowledge, there is no study to date has examined the psychological resilience and mental health during Corona pandemic in Kuwait. Therefore, the present research investigates the role of psychological resilience in predicting psychological distress among Kuwaiti adults during Corona pandemic. Method: Kuwaiti citizens (N = 735) completed an online survey, which includes four scales the Hospital Anxiety and Depression Scale HADS (anxiety and depression), the Connor-Davidson Resilience Scale (CD-RISC-25), and the Perceived Stress Scale (PSS). A cross-sectional correlational design was used. Results: A high level of stress was observed, with 59% reported moderate to severe stress. In contrast, low levels of anxiety and depression were observed; with 70% reporting no anxiety symptoms and 74% report no depression symptoms. Psychological resilience was negatively correlated with anxiety, depression, and stress, consistent with previous studies. As expected, resilience was found to account for significant variance in anxiety and stress after controlling for quarantine variables and demographic variables. Conclusion: The findings suggest that increasing psychological resilience might help reduce psychological distress after confronting with stressful live events in Kuwaiti citizen.

Keywords: anxiety, corona, depression, psychological resilience, stress

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991 Trump’s COVID-19 Discourse: Downgrading the Fundamentals of the Political Fair Play

Authors: Gustavo Naranjo Maroto, Dolores Fernandez Martinez

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Context has always been essential to understand any reaction from every human being, and words, whether written or spoken, are definitely a powerful representative sample of human reaction. This study starts with an accurate breakdown of the context in which the current president of the US, Mr. Donald J. Trump is conveying his discourses in order to be able to judge them from a critical discourse analysis point of view. The present world’s scenario with a pandemic disease in form of Covid-19 that is threatening the world and certainly putting at risk the so called 'Welfare State', the role of the United States as the first superpower on earth nowadays, the very peculiar profile of President Trump not only as a politician but as a persona, and the fact of being on the verge of a very controversial presidential elections are without doubt a great and undeniable opportunity for the implementation of the critical discourse analysis methodology. Hence, this research will primarily analyze in detail some of the most interesting discourses delivered by Trump in different media since the very beginning of the outbreak of the coronavirus pandemic in the United States of America (February, 2020), sadly very often downplayed by President Trump, until the final result of the upcoming presidential election scheduled for Tuesday, November 3, 2020, where the political discourse has been dramatically downgraded to a very dangerous state, putting in jeopardy the fundamentals of the political fair play in terms of speech. Finally, the study will hopefully conclude with the final outcome of the data analyzed, allowing to picture how significant the context can be concerning linguistics on the one hand, in terms of shaping or altering the message that the issuer thought to convey in the first place, and on the other hand, generously assessing to what extend the recipients of the message are influenced by the message in terms of receptiveness.

Keywords: Covid-19, critical discourse analysis, Donald J. Trump, political discourse

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990 Management Strategies for Risk Events in Construction Industries during Economic Situation and COVID-19 Pandemic in Nigeria

Authors: Ezeabasili Chibuike Patrick

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The complex situation of construction industries in Nigeria and the risk of failures involved includes cost overrun, time overrun, Corruption, Government influence, Subcontractor challenges, Political influence and Instability, Cultural differences, Human resources deficiencies, cash flow Challenges, foreign exchange issues, inadequate design, Safety, low productivity, late payment, Quality control issues, project management issues, Environmental issues, Force majeure Competition amongst others has made the industry prone to risk and failures. Good project management remains effective in improving decision-making, which minimizes these risk events. This study was done to address these project risks and good decision-making to avert them. A mixed-method approach to research was used to do this study. Data collected by questionnaires and interviews on thirty-two (32) construction professionals was used in analyses to aid the knowledge and management of risks that were identified. The study revealed that there is no good risk management expertise in Nigeria. Also, that the economic/political situation and the recent COVID-19 pandemic has added to the risk and poor management strategies. The contingency theory and cost has therefore surfaced to be the most strategic management method used to reduce these risk issues and they seem to be very effective.

Keywords: strategies, risk management, contingency theory, Nigeria

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989 Bibliometric Measures on Leveraging Technology to Mitigate the Impact of Covid-19 on Business

Authors: Olanrewaju Johnson Akinduntire

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This paper investigates the statistical evaluation of books, citations, articles, journals and other publications in accounting and finance on leveraging technology to mitigate the impact of COVID-19 on business. The research proffers an appraisal of the impact of computerized accounting systems in pre and post pandemic era on activities of the formal and informal sectors, it analyzes the concept of computerized accounting systems, and it seeks to determine the impact of computerized of the overall activities of the informal sector. A special focus of this ICT strategy should be to demystify and promote the diffusion of ICT as a general-purpose technology to the informal sector. It is believed that the use of new technologies can be crucial to meeting the Millennium Development Goals (MDGs) in a timely and effective fashion. Consequent to these, there is a need to prevent the further marginalization of the informal sector by availing ICT services which are mixed appropriately and also properly located. By implication, this will help them access markets and other business information, which can enable or make their economic activities more vibrant and facilitate the availability of information about new opportunities. Conclusively, for one to understand the application of ICT and their locational dynamics in informal sector clusters, there is a need to comprehend and acknowledge the drivers and pressures leading to the adoption of new technology.

Keywords: COVID-19 , (MDGs) , ICT, bibliometric

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988 Going Viral: Expanding a Student-Run COVID-19 Journal Club to Social Media

Authors: Joseph Dodson, Robert Roth, Alexander Hodakowski, Leah Greenfield, Melissa Porterhouse, Natalie Maltby, Rachel Sadowsky

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Introduction: Throughout the COVID-19 pandemic, countless research publications were released regarding SARS-CoV-2 and its variants, suggested treatments, and vaccine safety and efficacy. Daily publication of research became overwhelming for health professionals and the general public to stay informed. To address this problem, a group of 70 students across the four colleges at Rush University created the “Rush University COVID-19 Journal Club.” To broaden the available audience, the journal club then expanded to social media. Methods: Easily accessible and understandable summaries of the research were written by students and sent to faculty sponsors for feedback. Following the revision, summaries were published weekly on the Rush University COVID-19 Journal Club website for clinicians and students to use for reference. An Instagram page was then created, and information was further condensed into succinct posts to address COVID-19 “FAQs.” Next, a survey was distributed to followers of the Instagram page with questions meant to assess the effectiveness of the platform and gain feedback. A 5-point Likert scale was used as the primary question format. Results: The Instagram page accrued 749 followers and posted 52 unique posts over a 2 year period. Preliminary results from the surveys demonstrate that over 80% of respondents strongly agree that the Instagram posts 1) are an effective platform for the public presentation of factual COVID-19-related information; 2) provide relevant and valuable information; 3) provide information that is clear, concise, and can be easily understood. Conclusion: These results suggest that the Rush COVID-19 Journal Club was able to successfully create a social media presence and convey information without sacrificing scholarly integrity. Other academic institutions may benefit from the application of this model to help students and clinicians with the interpretation and evaluation of research topics with large bodies of evidence.

Keywords: SARS-CoV-2, COVID-19, public health, social media, SARS-CoV-2 vaccine, SARS-CoV-2 variants

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987 Smartphones in the (Class) Room in Pandemic and Post-pandemic Times: a Study in an Ecological Perspective

Authors: Junia Braga, Antonio carlos Martins, Marcos Racilan

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Drawing on the ecological approach, this paper reports a qualitative study that aims to understand how mobile technologies were integrated during the pandemic in the context of language teaching and the use of these technologies in post-pandemic times. Seventy-six teachers answered a questionnaire about their experiences. The findings show how the network with peers scaffolded this experience and played a crucial role in their appropriation of those technologies. They also suggest that this network may have contributed to the normalisation of digital technology use.

Keywords: ecological perspective, language teaching, mobile technologies, teacher education

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986 The Financial Impact of Covid 19 on the Hospitality Industry in New Zealand

Authors: Kay Fielden, Eelin Tan, Lan Nguyen

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In this research project, data was gathered at a Covid 19 Conference held in June 2021 from industry leaders who discussed the impact of the global pandemic on the status of the New Zealand hospitality industry. Panel discussions on financials, human resources, health and safety, and recovery were conducted. The themes explored for the finance panel were customer demographics, hospitality sectors, financial practices, government impact, and cost of compliance. The aim was to see how the hospitality industry has responded to the global pandemic and the steps that have been taken for the industry to recover or sustain their business. The main research question for this qualitative study is: What are the factors that have impacted on finance for the hospitality industry in New Zealand due to Covid 19? For financials, literature has been gathered to study global effects, and this is being compared with the data gathered from the discussion panel through the lens of resilience theory. Resilience theory applied to the hospitality industry suggests that the challenges imposed by Covid 19 have been the catalyst for government initiatives, technical innovation, engaging local communities, and boosting confidence. Transformation arising from these ground shifts have been a move towards sustainability, wellbeing, more awareness of climate change, and community engagement. Initial findings suggest that there has been a shift in customer base that has prompted regional accommodation providers to realign offers and to become more flexible to attract and maintain this realigned customer base. Dynamic pricing structures have been required to meet changing customer demographics. Flexible staffing arrangements include sharing staff between different accommodation providers, owners with multiple properties adopting different staffing arrangements, maintaining a good working relationship with the bank, and conserving cash. Uncertain times necessitate changing revenue strategies to cope with external factors. Financial support offered by the government has cushioned the financial downturn for many in the hospitality industry, and managed isolation and quarantine (MIQ) arrangements have offered immediate financial relief for those hotels involved. However, there is concern over the long-term effects. Compliance with mandated health and safety requirements has meant that the hospitality industry has streamlined its approach to meeting those requirements and has invested in customer relations to keep paying customers informed of the health measures in place. Initial findings from this study lie within the resilience theory framework and are consistent with findings from the literature.

Keywords: global pandemic, hospitality industry, new Zealand, resilience

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985 Immunoglobulin G Glycosylation Profile in Influenza and COVID-19 Infected Patients

Authors: Marina Kljaković-Gašpić Batinjan, Tea Petrović, Frano Vučković, Irzal Hadžibegović, Barbara Radovani, Ivana Jurin, Lovorka Đerek, Eva Huljev, Alemka Markotić, Ivica Lukšić, Irena Trbojević-Akmačić, Gordan Lauc, Ivan Gudelj, Rok Čivljak

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Immunoglobulin G has essential role in defense against infectious diseases, but its role cannot be fully recognized without understanding of changes in its N-glycans attached to the Fc domain. We analyzed and compared total IgG glycome in plasma samples of patients with influenza, patients with COVID-19 and healthy controls. We found similarities in IgG glycosylation changes in COVID-19 survivors and influenza patients that could be the consequence of adequate immune response to enveloped viruses, while observed changes in deceased COVID-19 patients may indicate its deviation.

Keywords: COVID-19, glycosylation, immunoglobulin G, influenza, pneumonia, viral infection

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984 Digitial Communication – The Future of Chronic Disease Management Is Healthcare Apps

Authors: Kirstin Griffin

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During a period of increased anxiety and stress, communication became the essential tool to help the public stay informed and feel prepared during the Covid-19 pandemic. However, certain groups of patients were not feeling as reassured. The news and media blasted the message that patients with diabetes were “high-risk" in regards to contracting the Covid-19 infection. Routine clinics were being cancelled, GP practices were closing their doors, and patients with type 1 diabetes were understandably scared. The influx of calls to diabetes specialists nurses from concerned patients highlighted the need for better and more specialised information. An Application specifically for patients with type 1 diabetes was created to deliver this information, and it proved to be the essential communication tool that was desperately needed. The Application for patients with type 1 diabetes aimed to deliver specialist information to patients in regards to their diagnosis, management, and ongoing follow-up commitments. The Application gives practical advice on multiple areas of diabetes management, including sick-day rules and diabetic emergencies, as well as up-to-date information on technology, including setting up Libre devices and downloading glucose meters to facilitate attending virtual clinics. Delivery of this information in an easy-to-understand and comprehensive way is intended to improve patient engagement with diabetes services and ultimately empower patients in the control of their own disease. The application also offers a messaging service to allow the diabetes team to send out alerts to patient groups on specific issues, such as changes to clinics, or respond to recent news updates regarding Covid-19. The App was launched in NHS Fife in June 2020 and has amassed 800 active users so far. There is growing engagement with the App since its launch, with over 1000 user interactions in the last month alone. Feedback shows that 100% of users like the App and have found it useful in the management of their diabetes. The App has proven to be an essential tool in communication with one of the most vulnerable groups during the Covid-19 pandemic, and its ongoing development will continue to increase patient engagement and improve glycaemic control for patients with type 1 diabetes. The future of chronic disease management should involve digital solutions such as apps to further empower patients in their healthcare.

Keywords: diabetes, endocrinology, digital healthcare, medical apps

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983 A Qualitative Study of Children’s Experiences of Living with Long-COVID

Authors: Camille Alexis-Garsee, Nicola Payne

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One consequence of the pandemic has been the debilitating health impact that some people experience over a longer period of time, known as long-COVID. This has been predominately researched in adults; however, there is emerging evidence on the effects of long-COVID in children. Research has indicated over half of children who contracted COVID-19 experienced persistent symptoms four months after a confirmed diagnosis. There is little research on the impact of this on children and their families. This study aimed to explore the experiences of children with long-COVID, to enable further understanding of the impacts and needs within this group. Semi-structured interviews, facilitated by children’s drawings, were conducted with 15 children (aged 9-16, 9 females). Inductive thematic analysis was used to analyze the data. The findings tell a story of loss, change and of resilience. Many children were unable to engage in normal daily activities and were unable to attend school, however, all employed self-management techniques to cope with symptoms and were positive for the future. Four main themes were identified: (1) Education challenges: although some schools tried to accommodate the child’s new limitations with provision of flexi-attendance, online classes and a reduced timetable, children struggled to keep up with their schoolwork and needed more support; (2) Disrupted relationships: children felt socially isolated; they were forced to give up co and extra-curricular activities, were no longer in contact with friendship groups and missed out on key experiences with friends and family; (3) Diverse health-related challenges: children’s symptoms affected daily functioning but were also triggers for changes in thoughts and mood; (4) Coping and resilience: children actively engaged in symptom management and were able to ‘self-pace’ and/or employ distraction activities to cope. They were also focused on living a ‘normal’ life and looked to the future with great positivity. A key challenge of the long-term effects of COVID is recognizing and treating the illness in children and the subsequent impact on multiple aspects of their lives. Even though children described feeling disconnected in many ways, their life goals were still important. A multi-faceted approach is needed for management of this illness, with a focus on helping these children successfully reintegrate into society and achieve their dreams.

Keywords: children’s illness experience, COVID-19, long-COVID in children, long-COVID kids, qualitative research

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982 Characterizing Nasal Microbiota in COVID-19 Patients: Insights from Nanopore Technology and Comparative Analysis

Authors: David Pinzauti, Simon De Jaegher, Maria D'Aguano, Manuele Biazzo

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The COVID-19 pandemic has left an indelible mark on global health, leading to a pressing need for understanding the intricate interactions between the virus and the human microbiome. This study focuses on characterizing the nasal microbiota of patients affected by COVID-19, with a specific emphasis on the comparison with unaffected individuals, to shed light on the crucial role of the microbiome in the development of this viral disease. To achieve this objective, Nanopore technology was employed to analyze the bacterial 16s rRNA full-length gene present in nasal swabs collected in Malta between January 2021 and August 2022. A comprehensive dataset consisting of 268 samples (126 SARS-negative samples and 142 SARS-positive samples) was subjected to a comparative analysis using an in-house, custom pipeline. The findings from this study revealed that individuals affected by COVID-19 possess a nasal microbiota that is significantly less diverse, as evidenced by lower α diversity, and is characterized by distinct microbial communities compared to unaffected individuals. The beta diversity analyses were carried out at different taxonomic resolutions. At the phylum level, Bacteroidota was found to be more prevalent in SARS-negative samples, suggesting a potential decrease during the course of viral infection. At the species level, the identification of several specific biomarkers further underscores the critical role of the nasal microbiota in COVID-19 pathogenesis. Notably, species such as Finegoldia magna, Moraxella catarrhalis, and others exhibited relative abundance in SARS-positive samples, potentially serving as significant indicators of the disease. This study presents valuable insights into the relationship between COVID-19 and the nasal microbiota. The identification of distinct microbial communities and potential biomarkers associated with the disease offers promising avenues for further research and therapeutic interventions aimed at enhancing public health outcomes in the context of COVID-19.

Keywords: COVID-19, nasal microbiota, nanopore technology, 16s rRNA gene, biomarkers

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981 Analysis of Big Data on Leisure Activities and Depression for the Disabled

Authors: Hee-Jung Seo, Yunjung Lee, Areum Han, Heeyoung Park, Se-Hyuk Park

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The purpose of this study was to analyze the relationship between happiness and depression among people with disabilities and to analyze the social phenomenon of leisure activities among them to promote physical and leisure activities for people with disabilities. The research methods included analyzing differences in happiness according to depression classification. A total of 281 people with disabilities were analyzed using SPSS WIN Ver. 29.0. In addition, the SumTrend platform was used to analyze terms related to 'leisure activities for the disabled.' The findings can be summarized into two main points: First, there were significant differences in happiness according to depression classification. Second, there were 20 mentions before COVID-19, 34 mentions after COVID-19, and currently 43 mentions, with high positive rates observed in each period. Based on these results, the following conclusions were drawn: First, measures for people with disabilities include strengthening online resources and services, social distancing response policies, improving accessibility, and providing support and financial assistance. Second, measures for non-disabled individuals emphasize the need for education and information provision, promoting dialogue and interaction, ensuring accessibility, and promoting inclusive cultural awareness and attitude change.

Keywords: leisure activities, individuals with disabilities, COVID-19 pandemic, depression

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980 Burden of Cardiovascular Diseases in Dubrovnik- Neretva County 2018-2021

Authors: Tarnai Tena, Strinić Dean

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Chronic non-communicable diseases are today the leading cause of mortality, morbidity and mortality disability at the world level and in Croatia. Among them are the most represented precisely cardiovascular diseases (CVD), so today we are talking about their global card epidemic. From 2018 to 2021, cardiovascular diseases are the leading cause of death for both women and men in the Dubrovnik- Neretva County. With regard to the COVID-19 pandemic, which has taken over, without forgetting how much these patients are additionally affected, we are still talking about the primary cause of sickness and death in the population of this county and region. In this record, we present collected data processed according to gender and disease classification. We also bring a kind of overview because, for years, we have been following how the population of one of the origins of the Mediterranean diet has been struggling with cardiovascular diseases.

Keywords: cardiovascular disease, burden, COVID-19, epidemiology, ishemic heart disease, cardiovascular medicine

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979 Control of Asthma in Children with Asthma during the Containment Period following the Covid-19 Pandemic

Authors: Meryam Labyad, Karima Fakiri, Widad Lahmini, Ghizlane Draiss, Mohamed Bouskraoui, Nadia Ouzennou

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Background: Asthma is the most common chronic disease in children, affecting nearly 235 million people worldwide (OMS). In Morocco, asthma is much more common in children than in adults; the prevalence rate in children between 13 and 14 years of age is 20%.1 This pathology is marked by high morbidity, a significant impact on the quality of life and development of children 2 This requires a rigorous management strategy in order to achieve clinical control and reduce any risk to the patient 3 A search for aggravating factors is mandatory if a child has difficulty maintaining good asthma control. The objective of the present study is to describe asthma control during this confinement period in children aged 4 to 11 years followed by a pneumo-paediatric consultation. For children whose asthma is not controlled, a search for associations with promoting factors and adherence to treatment is also among the objectives of the study. Knowing the level of asthma control and influencing factors is a therapeutic priority in order to reduce hospitalizations and emergency care use. Objective: To assess asthma control and determine the factors influencing asthma levels in children with asthma during confinement following the COVID 19 pandemic. Method: Prospective cross-sectional study by questionnaire and structured interview among 66 asthmatic children followed in pediatric pneumology consultation at the CHU MED VI of Marrakech from 13/06/2020 to 13/07/2020, asthma control was assessed by the Childhood Asthma Control Test (C-ACT). Results: 66 children and their parents were included (mean age is 7.5 years), asthma was associated with allergic rhinitis (13.5% of cases), conjunctivitis (9% of cases), eczema (12% of cases), occurrence of infection (10.5% of cases). The period of confinement was marked by a decrease in the number of asthma attacks translated by a decrease in the number of emergency room visits (7.5%) of these asthmatic children, control was well controlled in 71% of the children, this control was significantly associated with good adherence to treatment (p<0.001), no infection (p<0.001) and no conjunctivitis (p=002) or rhinitis (p<0.001). This improvement in asthma control during confinement can be explained by the measures taken in the Kingdom to prevent the spread of COVID 19 (school closures, reduction in industrial activity, fewer means of transport, etc.), leading to a decrease in children's exposure to triggers, which justifies the decrease in the number of children having had an infection, allergic rhinitis or conjunctivitis during this period. In addition, the close monitoring of parents resulted in better therapeutic adherence (42.4% were fully observant). Confinement was positively perceived by 68% of the parents; this perception is significantly associated with the level of asthma control (p<0.001). Conclusion: Maintaining good control can be achieved through improved therapeutic adherence and avoidance of triggers, both of which were achieved during the containment period following the VIDOC pandemic 19.

Keywords: Asthma, control , COVID-19 , children

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978 High School Youth and College Freshmen Comparison Towards the Psychological Health Status under the Influence of Sleep Hygiene and Quality from a Chinese Second-Tier City Sample during the COVID-19 Pandemic

Authors: Ziyu Zhang, Xuanyu Ren, Fei Wu, Qinfei Lu, Yongmei Li, Xinyue Zhi

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Introduction: Adolescents experience a critical period of physical and psychological growth. Few studies focus on the influence of sleep hygiene on psychological health from the high school period to freshmen year. Also, the influence of the COVID-19 pandemic has public health significance. Methods: Totally 698 students from high school and college were included in the manuscript, and a cross-sectional procedure was conducted; the objective was to make the epidemiological comparison of the social phobia/depression prevalence and discuss the effects of potential determinants. Results: Psychological problems, including social phobia and depression, are prevalent, especially among high school students, with gender differences. The current results indicated that the association between sleep status and social phobia is most obvious among high school students, while the higher MMR risk was found both for high school social phobia students and college depressive freshmen. Moreover, the interaction between social phobia and depression was also obvious for both populations. Conclusions: Psychological problems, including social phobia and depression, are more prevalent among high school girls when compared with their male and freshmen peers. Important influenced factors for the risk of psychological problems among the two populations were different, but media multitasking status should be paid attention to for both.

Keywords: adolescence, psychological health, epidemiology, social culture

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977 A Comparison between Virtual Case-Based Learning and Traditional Learning: The Effect on Undergraduate Nursing Students’ Performance during Covid-19: A Pilot Study

Authors: Aya M. Aboudesouky

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Covid-19 has changed and affected the whole world dramatically in a new way that the entire world, even scientists, have not imagined before. The educational institutions around the world have been fighting since Covid-19 hit the world last December to keep the educational process unchanged for all students. E-learning was a must for almost all US universities during the pandemic. It was specifically more challenging to use online case-based learning instead of regular classes among nursing students who take practical education. This study aims to examine the difference in performance and satisfaction between nursing students taking traditional education and those who take virtual case-based education during their practical study. This study enrolls 40 last-year nursing undergraduates from a mid-sized university in Western Pennsylvania. The study uses a convenient sample. Students will be divided into two groups; a control group that is exposed to traditional teaching strategy and a treatment group that is exposed to a case-based teaching strategy. The module designed for this study is a total parenteral nutrition (TPN) module that will be taught for one month. The treatment group (n=20) utilizes the virtual simulation of the CBL method, while the control group (n=20) uses the traditional lecture-based teaching method. Student evaluations are collected after a month by using the survey to attain the students’ learning satisfaction and self-evaluation of the course. The post-test is used to assess the end of the course performance.

Keywords: virtual case-based learning, traditional education, nursing education, Covid-19 crisis, online practical education

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976 A Cross-Sectional Study of Parents’ Knowledge, Attitude, and Health-Seeking Behaviour Towards Childhood Tuberculosis during COVID-19 Pandemic: Lessons Learned from Indonesia

Authors: Windy Rakhmawati, Suryani Suryani, Sri Hendrawati, Nenden Nur Asriyani Maryam

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Tuberculosis (TB) is one of the leading causes of death in the world. Fear of COVID-19 has made people reluctant to visit health facilities, leading to disruptions to childhood TB control programs, which may increase household transmission and delay diagnosis and treatment. This study aimed to describe parents' knowledge, attitudes, and health-seeking behaviour towards childhood TB during the COVID-19 pandemic. This cross-sectional study was performed on 392 parents with TB children in three provinces with the highest proportion of TB cases in Indonesia. This study was conducted from February to December 2022. The inclusion criteria of respondents were parents with a child aged 0-14 years old with TB diagnosis who live with their parents. Data were collected using the Knowledge, Attitude, and Practice (KAP) survey guidelines from the World Health Organization and analyzed descriptively, as well as Spearman’s correlation. Overall, 392 parents of children with TB had poor knowledge (51.8%) including about causes, risk factors, transmission, symptoms, treatment, and prevention, which about 52.3%, 55.1%, 61.2%, 69.6%, 100%, 59.2%, respectively. Parents' health service-seeking behaviour towards Child TB was not normally distributed (P < 0.05) with knowledge test results (.000) and Seeking Health Services (.000). Health-seeking behaviour of parents in pediatric TB care was self-medication or self-treatment (86.2%), Traditional health seeking behaviour (4.8%), and modern health seeking behaviour (8.9%). The correlation between knowledge and seeking health services (Sig= .609) means there is no correlation between knowledge about TB and parents' health-seeking behaviour. Furthermore, 60.2% of the respondents would be shocked if their child had TB. More than half of the families in this study have poor knowledge and did self-medication or self-treatment regarding health-seeking behaviour for TB disease. Therefore, health workers, especially nurses, must provide TB-related education and health promotion and emphasize the importance of early detection. Health workers can also optimize their role in caring for and providing care to patients by increasing their trust in health workers, which will impact health-seeking behaviour in the future.

Keywords: attitude, child, health seeking behaviour, knowledge, tuberculosis

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975 Qualitative Study of Organizational Variables Affecting Nurses’ Resilience in Pandemic Condition

Authors: Zahra Soltani Shal

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Introduction: The COVID-19 pandemic marks an extraordinary global public health crisis unseen in the last century, with its rapid spread worldwide and associated mortality burden. Healthcare resilience during a pandemic is crucial not only for continuous and safe patients care but also for control of any outbreak. Aim: The present study was conducted to discover the organizational variables effective in increasing resilience and continuing the work of nurses in critical and stressful pandemic conditions. Method: The study population is nurses working in hospitals for patients with coronavirus. Sampling was done purposefully and information was collected from 15 nurses through In-depth semi-structured interviews. The interview was conducted to analyze the data using the framework analysis method consisting of five steps and is classified in the table. Results: According to the findings through semi-structural interviews, among organizational variables, organizational commitment (Affective commitment, continuous commitment, normative commitment) has played a prominent role in nurses' resilience. Discussion: despite the non-withdrawal of nurses and their resilience, due to the negative quality of their working life, the mentioned variable has affected their level of performance and ability and leads to fatigue and physical and mental exhaustion. Implications for practice: By equipping hospitals and improving the facilities of nurses, their organizational commitment can be increased and lead to their resilience in critical situations. Supervisors and senior officials at the hospitals should be responsible for nurses' health and safety. A clear and codified program in critical situations and comprehensive management is effective in improving the quality of the work-life of nurses. Creating an empathetic and interactive environment can help promote nurses' mental health.

Keywords: organizational commitment, quality of work life, nurses resilience, pandemic, coronavirus

Procedia PDF Downloads 126
974 Tourist Behavior Towards Blockchain-Based Payments

Authors: A. Šapkauskienė, A. Mačerinskienė, R. Andrulienė, R. Bruzgė, S. Masteika, K. Driaunys

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The COVID-19 pandemic has affected not only world markets and economies but also the daily lives of customers and their payment habits. The pandemic has accelerated the digital transformation, so the role of technology will become even more important post-COVID. Although the popularity of cryptocurrencies has reached unprecedented heights, there are still obstacles, such as a lack of consumer experience and distrust of these technologies, so exploring the role of cryptocurrency and blockchain in the context of international travel becomes extremely important. Research on tourists’ intentions to use cryptocurrencies for payment purposes is limited due to the small number of research studies. To fill this research gap, an exploratory study based on the analysis of survey data was conducted. The purpose of the research is to explore how the behavior of tourists has changed making their financial transactions when paying for the tourism services in order to determine the intention to pay in cryptocurrencies. Behavioral intention can be examined as a dependent variable that is useful for the study of the acceptance of blockchain as cutting-edge technology. Therefore, this study examines the intention of travelers to use cryptocurrencies in electronic payments for tourism services. Several studies have shown that the intention to accept payments in a cryptocurrency is affected by the perceived usefulness of these payments and the perceived ease of use. The findings deepen our understanding of the readiness of service users to apply for blockchain-based payment in the tourism sector. The tourism industry has to focus not only on the technology but on consumers who can use cryptocurrencies, creating new possibilities and increasing business competitiveness. Based on research results, suggestions are made to guide future research on the use of cryptocurrencies by tourists in the tourism industry. Therefore, in line with the rapid expansion of virtual currency users, market capitalization, and payment in cryptographic currencies, it is necessary to explore the possibilities of implementing a blockchain-based system aiming to promote the use of services in the tourism sector as the most affected by the pandemic.

Keywords: behavioral intention, blockchain-based payment, cryptocurrency, tourism

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973 Household Choice of Working from Home before and after COVID-19

Authors: Ravipa Rojasavachai, Li Yang

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Working from home has become a global phenomenon after the coronavirus outbreak, and most employees have a choice to choose between working from home or the office. In this paper, we examine the demographics and socio-economics factors influencing individuals’ decision to choose working from home rather than the office before and after the coronavirus outbreak based on Australian household data. We find that all factors impact the working from home choice before the coronavirus outbreak, but the number of children turns to an uninfluenced factor on individuals’ choices after the outbreak. We also find that female employees have a higher probability of choosing to work from home after the coronavirus outbreak. This is because they have less concern for their career opportunities and higher wage premium of working from home due to the changing in cultural norms and advanced working from home technologies in companies after the coronavirus outbreak.

Keywords: work from home, telework, remote working, COVID-19, pandemic, wage

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972 A Comparison of Clinical and Pathological TNM Staging in a COVID-19 Era

Authors: Sophie Mills, Leila L. Touil, Richard Sisson

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Introduction: The TNM classification is the global standard for the staging of head and neck cancers. Accurate clinical-radiological staging of tumours (cTNM) is essential to predict prognosis, facilitate surgical planning and determine the need for other therapeutic modalities. This study aims to determine the accuracy of pre-operative cTNM staging using pathological TNM (pTNM) and consider possible causes of TNM stage migration, noting any variation throughout the COVID-19 pandemic. Materials and Methods: A retrospective cohort study examined records of patients with surgical management of head and neck cancer at a tertiary head and neck centre from November 2019 to November 2020. Data was extracted from Somerset Cancer Registry and histopathology reports. cTNM and pTNM were compared before and during the first wave of COVID-19, as well as with other potential prognostic factors such as tumour site and tumour stage. Results: 119 cases were identified, of which 52.1% (n=62) were male, and 47.9% (n=57) were female with a mean age of 67 years. Clinical and pathological staging differed in 54.6% (n=65) of cases. Of the patients with stage migration, 40.4% (n=23) were up-staged and 59.6% (n=34) were down-staged compared with pTNM. There was no significant difference in the accuracy of cTNM staging compared with age, sex, or tumour site. There was a statistically highly significant (p < 0.001) correlation between cTNM accuracy and tumour stage, with the accuracy of cTNM staging decreasing with the advancement of pTNM staging. No statistically significant variation was noted between patients staged prior to and during COVID-19. Conclusions: Discrepancies in staging can impact management and outcomes for patients. This study found that the higher the pTNM, the more likely stage migration will occur. These findings are concordant with the oncology literature, which highlights the need to improve the accuracy of cTNM staging for more advanced tumours.

Keywords: COVID-19, head and neck cancer, stage migration, TNM staging

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971 COVID-19: Potential Effects of Nutritional Factors on Inflammation Relief

Authors: Maryam Nazari

Abstract:

COVID-19 is a respiratory disease triggered by the novel coronavirus, SARS-CoV-2, that has reached pandemic status today. Acute inflammation and immune cells infiltration into lung injuries result in multi-organ failure. The presence of other non-communicable diseases (NCDs) with systemic inflammation derived from COVID-19 may exacerbate the patient's situation and increase the risk for adverse effects and mortality. This pandemic is a novel situation and the scientific community at this time is looking for vaccines or drugs to treat the pathology. One of the biggest challenges is focused on reducing inflammation without compromising the correct immune response of the patient. In this regard, addressing the nutritional factors should not be overlooked not only as a matter of avoiding the presence of NCDs with severe infections but also as an adjunctive way to modulate the inflammatory status of the patients. Despite the pivotal role of nutrition in modifying immune response, due to the novelty of the COVID-19 disease, information about the effects of specific dietary agents is limited in this area. From the macronutrients point of view, protein deficiency (quantity or quality) has negative effects on the number of functional immunoglobulins and gut-associated lymphoid tissue (GALT). High biological value proteins or some amino acids like arginine and glutamine are well known for their ability to augment the immune system. Among lipids, fish oil has the ability to inactivate enveloped viruses, suppress pro-inflammatory prostaglandin production and block platelet-activating factors and their receptors. In addition, protectin D1, which is an Omega-3 PUFAs derivation, is a novel antiviral drug. So it seems that these fatty acids can reduce the severity and/or improve recovery of patients with COVID-19. Carbohydrates with lower glycemic index and fibers are associated with lower levels of inflammatory cytokines (CRP, TNF-α, and IL-6). Short-Chain Fatty acids not only exert a direct anti-inflammatory effect but also provide appropriate gut microbial, which is important in gastrointestinal issues related to COVID-19. From the micronutrients point of view, Vitamins A, C, D, E, iron, magnesium, zinc, selenium and copper play a vital role in the maintenance of immune function. Inadequate status in these nutrients may result in decreased resistance against COVID-19 infection. There are specific bioactive compounds in the diet that interact with the ACE2 receptor, which is the gateway for SARS and SARS-CoV-2, and thus controls the viral infection. Regarding this, the potential benefits of probiotics, resveratrol (a polyphenol found in grape), oleoylethanolamide (derived from oleic acid), and natural peroxisome proliferator-activated receptor γ agonists in foodstuffs (like curcumin, pomegranate, hot pepper) are suggested. Yet, it should be pointed out that most of these results have been reported in animal models and further human studies are needed to be verified.

Keywords: Covid-19, inflammation, nutrition, dietary agents

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970 Women Entrepreneurial Resiliency Amidst COVID-19

Authors: Divya Juneja, Sukhjeet Kaur Matharu

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Purpose: The paper is aimed at identifying the challenging factors experienced by the women entrepreneurs in India in operating their enterprises amidst the challenges posed by the COVID-19 pandemic. Methodology: The sample for the study comprised 396 women entrepreneurs from different regions of India. A purposive sampling technique was adopted for data collection. Data was collected through a self-administered questionnaire. Analysis was performed using the SPSS package for quantitative data analysis. Findings: The results of the study state that entrepreneurial characteristics, resourcefulness, networking, adaptability, and continuity have a positive influence on the resiliency of women entrepreneurs when faced with a crisis situation. Practical Implications: The findings of the study have some important implications for women entrepreneurs, organizations, government, and other institutions extending support to entrepreneurs.

Keywords: women entrepreneurs, analysis, data analysis, positive influence, resiliency

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969 Addressing Primary Care Clinician Burnout in a Value Based Care Setting During the COVID-19 Pandemic

Authors: Robert E. Kenney, Efrain Antunez, Samuel Nodal, Ameer Malik, Richard B. Aguilar

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Physician burnout has gained much attention during the COVID pandemic. After-hours workload, HCC coding, HEDIS metrics, and clinical documentation negatively impact career satisfaction. These and other influences have increased the rate of physicians leaving the workforce. In addition, roughly 1% of the entire physician workforce will be retiring earlier than expected based on pre-pandemic trends. The two Medical Specialties with the highest rates of burnout are Family Medicine and Primary Care. With a predicted shortage of primary care physicians looming, the need to address physician burnout is crucial. Commonly reported issues leading to clinician burnout are clerical documentation requirements, increased time working on Electronic Health Records (EHR) after hours, and a decrease in work-life balance. Clinicians experiencing burnout with physical and emotional exhaustion are at an increased likelihood of providing lower quality and less efficient patient care. This may include a lack of suitable clinical documentation, medication reconciliation, clinical assessment, and treatment plans. While the annual baseline turnover rates of physicians hover around 6-7%, the COVID pandemic profoundly disrupted the delivery of healthcare. A report found that 43% of physicians switched jobs during the initial two years of the COVID pandemic (2020 and 2021), tripling the expected average annual rate to 21.5 %/yr. During this same time, an average of 4% and 1.5% of physicians retired or left the workforce for a non-clinical career, respectively. The report notes that 35.2% made career changes for a better work-life balance and another 35% reported the reason as being unhappy with their administration’s response to the pandemic. A physician-led primary care-focused health organization, Cano Health (CH), based out of Florida, sought to preemptively address this problem by implementing several supportive measures. Working with >120 clinics and >280 PCPs from Miami to Tampa and Orlando, managing nearly 120,000 Medicare Advantage lives, CH implemented a number of changes to assist with the clinician’s workload. Supportive services such as after hour and home visits by APRNs, in-clinic care managers, and patient educators were implemented. In 2021, assistive Artificial Intelligence Software (AIS) was integrated into the EHR platform. This AIS converts free text within PDF files into a usable (copy-paste) format facilitating documentation. The software also systematically and chronologically organizes clinical data, including labs, medical records, consultations, diagnostic images, medications, etc., into an easy-to-use organ system or chronic disease state format. This reduced the excess time and documentation burden required to meet payor and CMS guidelines. A clinician Documentation Support team was employed to improve the billing/coding performance. The effects of these newly designed workflow interventions were measured via analysis of clinician turnover from CH’s hiring and termination reporting software. CH’s annualized average clinician turnover rate in 2020 and 2021 were 17.7% and 12.6%, respectively. This represents a 30% relative reduction in turnover rate compared to the reported national average of 21.5%. Retirement rates during both years were 0.1%, demonstrating a relative reduction of >95% compared to the national average (4%). This model successfully promoted the retention of clinicians in a Value-Based Care setting.

Keywords: clinician burnout, COVID-19, value-based care, burnout, clinician retirement

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968 Determining the Frequency of Pneumonia Emerging in COVID-19 Infection

Authors: Zoirov Amirdin Olimovich, Akbarov Elbek Elmurodovich

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Introduction: Pneumonia that occurs during COVID-19 infection is common among patients. This research was conducted to determine the frequency of symptoms occurring during pneumonia according to the purpose. Objective and Task: The goal of our research is to develop clinical concepts of pneumonia that occur during COVID-19 infection. Our main task is to analyze the results of blood tests and understand the progression of the disease. Research Materials and Methods: The research was conducted among patients admitted to the Tashkent Medical Academy multi-profile clinic in the department of infectious diseases undergoing stationary treatment with a diagnosis of COVID-19. The analyzed patients had an average age of 46, with a total of 48 patients, 23 of whom were female and 25 were male. Research Results: The research results showed the development of pneumonia within three days in 27 patients after COVID-19 infection. During the observation period, 24 patients (88.8%) recovered completely. The X-ray revealed no signs of pneumonia in those who fully recovered. The remaining three patients showed a persistent form of pneumonia. Conclusion: The conclusion of the research indicates that pneumonia during COVID-19 infection develops in many patients, and 88.8% of patients recover completely without any lingering symptoms.

Keywords: COVID-19, pneumonia, the X-ray, blood, TTA

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967 Resale Housing Development Board Price Prediction Considering Covid-19 through Sentiment Analysis

Authors: Srinaath Anbu Durai, Wang Zhaoxia

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Twitter sentiment has been used as a predictor to predict price values or trends in both the stock market and housing market. The pioneering works in this stream of research drew upon works in behavioural economics to show that sentiment or emotions impact economic decisions. Latest works in this stream focus on the algorithm used as opposed to the data used. A literature review of works in this stream through the lens of data used shows that there is a paucity of work that considers the impact of sentiments caused due to an external factor on either the stock or the housing market. This is despite an abundance of works in behavioural economics that show that sentiment or emotions caused due to an external factor impact economic decisions. To address this gap, this research studies the impact of Twitter sentiment pertaining to the Covid-19 pandemic on resale Housing Development Board (HDB) apartment prices in Singapore. It leverages SNSCRAPE to collect tweets pertaining to Covid-19 for sentiment analysis, lexicon based tools VADER and TextBlob are used for sentiment analysis, Granger Causality is used to examine the relationship between Covid-19 cases and the sentiment score, and neural networks are leveraged as prediction models. Twitter sentiment pertaining to Covid-19 as a predictor of HDB price in Singapore is studied in comparison with the traditional predictors of housing prices i.e., the structural and neighbourhood characteristics. The results indicate that using Twitter sentiment pertaining to Covid19 leads to better prediction than using only the traditional predictors and performs better as a predictor compared to two of the traditional predictors. Hence, Twitter sentiment pertaining to an external factor should be considered as important as traditional predictors. This paper demonstrates the real world economic applications of sentiment analysis of Twitter data.

Keywords: sentiment analysis, Covid-19, housing price prediction, tweets, social media, Singapore HDB, behavioral economics, neural networks

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966 Factors Influencing the General Public Intention to Be Vaccinated: A Case of Botswana

Authors: Meng Qing Feng, Otsile Morake

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Background: Successful implementation of the COVID-19 vaccination ensures the prevention of virus infection. Postponement and refusal of the vaccination will threaten public health, which is now common among the general public across the world. In addition, an acceptance of the COVID-19 vaccine appears as a decisive factor in controlling the COVID-19 pandemic. Purpose: This study's objective is to explore the factors influencing the public intention to be vaccinated (ITBV). Design/methodology/approach: The web-based survey included socio-demographics and questions related to the theory of planned behavior (TPB) and the health belief model (HBM). An online survey was administered using Google Form to collect data from participants of Botswana. The sample included 339 participants, half-half of the participants were female. Data analysis was run using the Statistical Package for the Social Sciences (SPSS). Findings: The study results highlight that perceived severity, perceived barriers, health motivation, and attitude have a positive and significant effect on ITBV, while perceived susceptibility, benefits, subjective norms, and perceived behavior control do not affect ITBV. Among all of the predictors, perceived barriers have the most significant influence on ITBV. Conclusion: Theoretically, this research stated that both HBM and TPB are effective in predicting and explaining the general public ITBV. Practically, this study offers insights to the government and health departments to arrange and launch health awareness programs and provide a better guide to vaccination so that doubts about vaccine confidence and the level of uncertainty can be decreased.

Keywords: COVID-19, Omicron, intention to be COVID-19 vaccine, health behavior model, theory of planned behavior, Botswana

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965 Nursing Education in the Pandemic Time: Case Study

Authors: Jaana Sepp, Ulvi Kõrgemaa, Kristi Puusepp, Õie Tähtla

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COVID-19 was officially recognized as a pandemic in late 2019 by the WHO, and it has led to changes in the education sector. Educational institutions were closed, and most schools adopted distance learning. Estonia is known as a digitally well-developed country. Based on that, in the pandemic time, nursing education continued, and new technological solutions were implemented. To provide nursing education, special focus was paid on quality and flexibility. The aim of this paper is to present administrative, digital, and technological solutions which support Estonian nursing educators to continue the study process in the pandemic time and to develop a sustainable solution for nursing education for the future. This paper includes the authors’ analysis of the documents and decisions implemented in the institutions through the pandemic time. It is a case study of Estonian nursing educators. Results of the analysis show that the implementation of distance learning principles challenges the development of innovative strategies and technics for the assessment of student performance and educational outcomes and implement new strategies to encourage student engagement in the virtual classroom. Additionally, hospital internships were canceled, and the simulation approach was deeply implemented as a new opportunity to develop and assess students’ practical skills. There are many other technical and administrative changes that have also been carried out, such as students’ support and assessment systems, the designing and conducting of hybrid and blended studies, etc. All services were redesigned and made more available, individual, and flexible. Hence, the feedback system was changed, the information was collected in parallel with educational activities. Experiences of nursing education during the pandemic time are widely presented in scientific literature. However, to conclude our study, authors have found evidence that solutions implemented in Estonian nursing education allowed the students to graduate within the nominal study period without any decline in education quality. Operative information system and flexibility provided the minimum distance between the students, support, and academic staff, and likewise, the changes were implemented quickly and efficiently. Institution memberships were updated with the appropriate information, and it positively affected their satisfaction, motivation, and commitment. We recommend that the feedback process and the system should be permanently changed in the future to place all members in the same information area, redefine the hospital internship process, implement hybrid learning, as well as to improve the communication system between stakeholders inside and outside the organization. The main limitation of this study relates to the size of Estonia. Nursing education is provided by two institutions only, and similarly, the number of students is low. The result could be generated to the institutions with a similar size and administrative system. In the future, the relationship between nurses’ performance and organizational outcomes should be deeply investigated and influences of the pandemic time education analyzed at workplaces.

Keywords: hybrid learning, nursing education, nursing, COVID-19

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