In the spring of 2020, the COVID-19 pandemic mandated closures of thousands of schools across the United States. Students dependent upon the support, guidance, and community of their schools became disconnected from these resources while encountering the challenges created by the COVID-19 pandemic. This case study represents a time capsule of the school community of one Los Angeles County public middle school from March 16 to May 28, 2020. Semi-structured interviews of school staff and parents grounded the study’s analysis. Public documents and participant researcher protocol responses collaborated the participants’ narratives. Results provide a snapshot of the school community before emergency mandated COVID-19 closure, participants’ recollections of the school community during the closure, and their reflections and reactions to the closures. Data analysis utilized a conceptual framework developed to capture e-school community access and engagement. Outcomes from this study illustrate the need for additional supports for student mental health, investment in universal access to reliable internet service, and the importance of physical school outreach during times of crisis.

Yes / The incidence of mental health problems is increasing in the United Kingdom and may be associated with lower dietary quality. Food expenditure is a marker of food insecurity with potential implications for mental health. This analysis considers data collected as part of the United Kingdom Household Longitudinal Survey (UKHLS), also known as ‘Understanding Society’ (2009-2021) (N=388,944) to determine the extent to which food expenditure within and outside the household, is associated with mental health, whilst controlling for demographic factors. Mental health was measured using the General Health Questionnaire (GHQ-12) for which responses were on a 4-point scale and reverse-scored so that a higher score represented more favourable mental health. Household food expenditure and food expenditure outside the home were the outcomes. Controlling for socioeconomic and demographic factors, fixed-effects models indicated that better mental health was associated with greater household food expenditure and with greater food expenditure outside the home and that this association persisted post-lockdown. Among those on lower incomes better mental health was associated with lower food expenditure. When people who identified as white and non-white were modelled separately, better mental health was associated with lower food expenditure within and beyond the household only in those who identified as white. These findings imply that the mental health of people residing in the UK, particularly those on lower incomes and those who identify as white, may benefit from spending less of the household budget on food. In achieving United Nations General Assembly (2012) Sustainable Development Goals related to poverty, hunger and in promoting mental health, policies are needed to render food more affordable and to reduce other aspects of expenditure that impact upon food budgeting.

This dissertation comprises three papers introducing strategies, models, and frameworks to guide pandemic response. The first paper uses a novel mathematical model to analyze the coordination between government and humanitarian non-governmental organizations (NGOs) in response to pandemics. This is a vital form of public-private partnership between governments as the primary source for the humanitarian supplies required during a crisis and aid organizations. This coordination involves the equitable distribution of personal protective equipment, including face masks and face shields among health workers, patients, and the public in hospitals. Considering social costs such as deprivation and equity costs in the model, in addition to the other important classic cost terms, enables managers to organize the best possible response when such outbreaks happen. The second paper introduces a decision support framework designed to assist healthcare managers, and clinical informatics specialists in analyzing and selecting the most appropriate consensus algorithm for their organization's blockchain-based health platforms, with a specific focus on managing pandemic-related information. Blockchain technology holds great potential in addressing pandemics by enhancing security and transparency in various aspects of pandemic tracking and mitigation while promoting public engagements by facilitating real-time exchange of electronic health information. By improving information sharing and coordination among healthcare organizations, it offers more effective response efforts and helps reduce the spread of viruses. However, the performance of consensus algorithms, which are a crucial component of blockchain architecture, can vary, posing a challenge in selecting the appropriate algorithm. To address this, the framework incorporates two techniques: data envelopment analysis (DEA) and the ranking distribution technique. DEA enables the analysis of efficiency without relying solely on expert judgment, providing a more objective assessment. The ranking distribution technique enhances differentiation among algorithms, providing decision-makers with a robust basis for selecting the most suitable blockchain architecture and its associated properties. The third paper focuses on the challenges of disseminating guidance-related information to the public during a pandemic, specifically the role of opinion leaders as reliable sources of information. The study determines the practical characteristics of pandemic opinion leaders on public attitudes using surveys and identifies domain-sensitive pandemic opinion leaders on Twitter based on the discovered characteristics using social network analysis and text mining. The framework's results show that pandemic opinion leaders are active in eight different domains on the Twitter platform. Results also demonstrate that trust is the most influential characteristic of pandemic opinion leaders, while expertise, uniqueness, innovation, and reputation also play important roles. / Doctor of Philosophy / This dissertation presents a collection of three research papers that offer insights and practical techniques and strategies to effectively tackle the challenges posed by pandemics through enhanced information sharing, public engagement, and robust public-private partnerships. The first paper introduces a novel mathematical model that thoroughly examines the collaboration between governments and humanitarian non-governmental organizations (NGOs) during crises such as the Covid-19 pandemic. The model's primary focus is on the equitable distribution of vital supplies, including face masks and shields, to healthcare workers as well as the public. By incorporating considerations of social costs, fairness, and other critical factors, this model aids managers in organizing the most efficient response to initial impacts of outbreaks within a short-term planning horizon. Our primary objective is to ensure the prompt and equitable delivery of essential supplies to individuals in need, achieved primarily through establishing strong public-private partnerships. The second paper proposes a decision support framework for healthcare managers, IT analysts, and clinical informatics specialists to help them effectively analyze consensus algorithms, as the most important layer of blockchain architecture. The framework further helps them select the most suitable algorithm for their organization's blockchain-based health platforms, aligning with specific policies, needs, requirements, and goals in managing pandemic-related information. Blockchain technology offers potential in tracking medical supplies, identifying virus hotspots, and verifying protective equipment authenticity to manage pandemics. By enhancing information sharing and coordination among healthcare organizations, blockchain can minimize virus spread and improve overall response efforts. The proposed framework reduces reliance on expert judgment and addresses data uncertainty when selecting proper algorithms for blockchain-based information management systems in mitigating the effects of pandemics. The third paper delves into the intricate challenges associated with effectively disseminating guidance-related information to the public during a pandemic, placing particular emphasis on the pivotal role played by opinion leaders (OLs) as reliable sources. This study thoroughly examines the distinctive characteristics of pandemic OLs and their profound influence on public attitudes. By employing surveys, social network analysis, and text mining techniques on Twitter data, the research successfully identifies OLs within distinct pandemic-related domains. The study's significant findings provide insights into the dynamic role assumed by pandemic OLs on Twitter and their consequential impact on public perception and behavior across various domains. Ultimately, the dissertation findings strive to support decision-makers and public health officials in their efforts to effectively manage pandemics and protect public health. The research emphasizes facilitation of seamless, rapid, and dependable information sharing across various planning horizons.

The purpose of this literature review is to determine the contributing factors of CLABSI rate increases during the COVID-19 pandemic and identify interventions which restored CLABSI rates to pre-pandemic levels to guide healthcare professionals’ actions during the next pandemic. Background: In the first two decades of the 21st century, CLABSI rates were reduced in United States hospitals by innovating safer patient care practices. However, there was a significant increase in the annual CLABSI rate in 2020 and 2021, increasing the average length of stay, mortality rate, and cost to the U.S. healthcare system. Methods: An extensive search of CINAHL and MEDLINE databases was conducted using key terms “central line-associated bloodstream infection*”, COVID, and coronavirus. After assessment of eligibility, 16 studies were selected for final review. Results: Contributing factors were staffing issues, deviation from central line care standards, patient diagnosis of COVID-19, supply chain issues, and a lack of interdisciplinary collaboration in central line care. Successful interventions were interdisciplinary involvement, nursing education, CLABSI prevention bundle auditing, a new adaptation of a CLABSI prevention toolkit, and IV access point protector cap usage. Discussion: Although the interventions studied were effective, there was a notable misalignment between some contributing factors and interventions. Staffing issues and supply chain issues were two of the most common contributing factors to CLABSI rate increases, yet there is a lack of research surrounding interventions that may alleviate these factors. Further research must be conducted to address these factors to adequately prepare healthcare professionals for a future pandemic.

This comparative case study examining epidemiological practices in Vietnam and the US revealed three pandemic influenza paradoxes: The paradox of attribution which asserts that pandemic influenza comes exclusively from Asia even though historical evidence points to the contrary; the paradox of prevention which encourages industrial methods (i.e., factory farming) for combating influenza even though there is conflicting evidence for any superiority of this method in terms of means of production or disease prevention; and the paradox of action where epidemiologists act in ways not consistent with prevailing epidemiological recommendations.  The existence of these paradoxes may, in fact, impede efforts at stopping and preventing pandemic influenza.  In order to find the root causes of these paradoxes, this study examined indigenous media and historical and contemporary research reports on pandemic influenza.  This archival information was juxtaposed to viewpoints garnered from ethnographic interviews with epidemiologists who have worked in Vietnam, the United States, or in both countries.  This study found that these paradoxes endure because of the dual nature of science " the known and the unknown elements of current knowledge " and assumptions made between the two.  The dual nature of science describes both the information that has been codified and information that has not been codified and the implications between the two. In other words, in between the spaces of known information, there are attempts to fill in the gaps in knowledge, which results in paradoxes. Of particular importance in this gap-filling process are the three "C's" of collaboration, conflict, and competition.  Collaboration is integral to the successful prevention of influenza pandemics; however, it is this same collaboration wherein which epidemiologists are trained to be so highly specialized that they often depend on unvetted external expert information.  Conflict and competition occur from the geopolitical level all they way down to the level of the individual epidemiologist and are influenced by the political and scientific economy along with social and cultural factors. / Ph. D.

Bakgrund: I mitten av mars 2020 deklarerade WHO Covid-19 som en pandemi. Till följd av den snabba smittspridningen av viruset ökade patienttrycket på hälso- och sjukvården, många insjuknade och dödstalen eskalerade. För att möta det ökade behovet av palliativ vård gjordes organisatoriska förändringar. Restriktioner och riktlinjer upprättades för att minska smittspridning vilket påverkade sjuksköterskors arbete med vård i livets slutskede under den globala nödsituationen Covid-19 orsakade. Syfte: Syftet med innevarande studie är att belysa sjuksköterskors upplevelser av att ha arbetat med palliativ vård under Covid-19-pandemins globala nödsituation. Metod: Studien är en allmän litteraturöversikt av tio utvalda vetenskapliga artiklar med kvalitativa och kvantitativa ansatser innehållandes kvalitativ data. Artiklarna analyserades enligt Fribergs (2022a) analysmodell. Resultat: Resultatet genererade fem teman: Känsla av att gå emot professionella värderingar, Stärkt samarbete i team, Hög arbetsbelastning, Teknik skapade förutsättningar och Känsla av otillräcklighet och känslomässigt lidande. Konklusion: Sjuksköterskor upplevde känslomässigt lidande relaterat till hög arbetsbelastning och att gå emot sina professionella värderingar i arbetet med palliativ vård. För att ge god palliativ vård behöver sjuksköterskors hälsa främjas och under pandemin upplevde sjuksköterskor att deras känslomässiga lidande lindrades till följd av stöd från kollegor och av känslan att veta att de gjorde ett värdefullt arbete. / Background: In March 2020, the WHO declared Covid-19 a pandemic. As a result of the rapid spread of the virus, patient pressure on healthcare increased, many got sick and the death toll escalated. To meet the increased need for palliative care, organizational changes were made. Restrictions and guidelines were established to reduce the spread of infection, which affected nurses' work with end-of-life care during the global emergency. Aim: The purpose is to highlight nurses' experiences of working with palliative care during the global emergency of the Covid-19 pandemic. Method: The study is a literature review of ten selected scientific articles containing qualitative data. The articles were analyzed according to Friberg's (2022a) analysis model. Findings: The result generated in five themes: Going against professional values, Strengthened cooperation in teams, High workload, Technology created opportunities and Feeling of inadequacy and emotional suffering. Conclusion: Nurses experienced emotional distress related to a high workload and going against their professional values in palliative care work. To provide good palliative care, nurses' health needs to be promoted and during the pandemic nurses felt that their emotional distress was alleviated by support from colleagues and the feeling of knowing they were doing valuable work.

Public health concerns were prominent during the COVID-19 pandemic, particularly regarding rising cases of anxiety and depression among adults. U.S. healthcare providers were especially affected by the unrelenting demands on their time and service. Psychiatric Mental Health Nurse Practitioners (PMHNPs) provided patient care during the pandemic to meet the increasing need for mental health services as people began experiencing mood disturbances such as anxiety, depression, and grief. The purpose of this qualitative study was to explore the perceived effect of the COVID-19 pandemic on the mental health of PMHNPs. A qualitative design using the interpretive description method allows researchers to use pre-existing knowledge to inform their research and actively participate in knowledge synthesis, focusing on variations in data. Individual interviews with 18 PMHNPs were conducted via video teleconferencing, and their data were evaluated and interpreted for meaning. After a thorough analysis of the interview transcripts, nine themes were identified: adaptive coping, improved access, support, self-care, work strain, complications, maladaptive coping, pandemic strain, and polarization. This study illuminated the challenges PMHNPs faced during the pandemic and the strategies they employed to cope with difficulties and will inform future research and practice in mental health care.

In the wake of COVID-19, educators had to adjust their curriculum and pedagogies to create an environment of learning while their students couldn't come into the classroom. As teachers and students alike adapted to this new distance learning, they encountered many obstacles which made it difficult to teach and to learn compared to what they were used to in a traditional in-person classroom setting. This thesis document compiles my research about the advantages and disadvantages of remote learning before, during, and post-pandemic. The research component of this project consists of the commentary of four art educators who share what they experienced and learned from teaching remotely during the pandemic; what they think can continue in the in-person classroom setting; and how remote learning can continue to evolve and be successful after the pandemic.

Syftet med denna studie är att undersöka sambandet mellan utvalda interna och externa lönsamhetsfaktorer och lönsamheten för svenska bankaktiebolag under perioden 2015-2022. Vidare är studiens syfte att undersöka bankens lönsamhet påverkad av Covid-19-pandemin. Resultaten visar att de interna lönsamhetsfaktorerna hade förväntat samband med lönsamheten, förutom kreditrisken. Bankstorlekens effekt var positiv, kapitalstrukturen hade tvådelat resultat och likviditetsrisken var negativ. Kreditrisken hade däremot ett positivt samband. De externa visade dock inga betydande samband med lönsamheten. Dessutom tyder resultaten på att svenska banker har hanterat Covid-19-pandemins effekter relativt väl, med endast en måttlig minskning av ROAA och en ökning av ROAE under perioden 2020-2022.

The COVID-19 pandemic has had adverse effects on the well-being, health and behaviour of children and adolescents, probably due to social restrictions.1–3 A lot of studies were conducted during the particularly challenging first year of the pandemic, when there were lockdowns and day care, schools and leisure facilities were closed. Our online survey in February 2022 investigated parents' perceptions of the long-term consequences of the pandemic on child development. We also explored associations between these consequences and the children's age and sex, the family's socioeconomic status (SES) and the children's fear of COVID-19.