Bakgrund: I slutet av 2019 fick sjukdomen Covid-19 en snabb spridning världen över och resulterade i en global pandemi. Tillgängliga vacciner som framställdes mot Covid-19 sågs som den främsta åtgärden för att stoppa pandemins utveckling liksom ger vaccinet ett personligt skydd varpå detta förhindrar allvarlig sjukdom och död. En del av sjuksköterskans profession är att skydda sig själv och skydda vårdtagare som är i behov av omvårdnad. Trots att vaccinet anses effektivt och säkert uttrycker vissa sjuksköterskor och sjuksköterskestudenter som utbildar sig inom professionen vaccinationstveksamheter. Syfte: Syftet var att beskriva faktorer som påverkar sjuksköterskor och sjuksköterskestudenters vaccinationstveksamhet kopplat till Covid-19. Metod: Arbetet är en icke-systematisk litteraturstudie med utgångspunkt i en strukturerad litteratursökning i databaserna Cinahl och PubMed som resulterat i en sammanställning av resultaten från kvantitativa vetenskapliga artiklar mellan år 2020–2022.  Resultat: I resultatet identifierades fyra övergripande kategorier som beskrev vaccinationstveksamheter bland sjuksköterskor och sjuksköterskestudenter; upplevda rädslor, insamlad information och befintlig kunskap, tvivel på vaccinets effekt och effektivitet samt vaccinet anses inte nödvändigt. Slutsats: Trots den professionella roll som följer yrket som sjuksköterska påvisar resultatet vaccinationstveksamhet bland sjuksköterskor och sjuksköterskestudenter, som utbildar sig inom yrket. Fynden i litteraturstudien kan användas som grund för att skapa interventioner. Genom att rikta interventionerna mot faktorer som leder fram till vaccinationstveksamhet bland sjuksköterskor och sjuksköterskestudenter kan vaccinationsintresset öka, både kopplat till Covid-19 och framtidens eventuella virusutbrott.

This qualitative phenomenological study explored the experiences of students working as resident assistants (RAs) in college or university housing departments during the March 2020 COVID-19 shutdown. Twelve current and former RAs participated in qualitative interviews exploring their experience as their institutions shut down because of COVID-19. Three broad categories of experience were found: RAs who were considered essential employees and required to work during the pandemic, RAs who were given the option of working during the pandemic, and RAs who were laid off at the beginning of their pandemic. The central research question was regarding the perceived experience of RAs during the pandemic. RA job duties were detailed from before the pandemic and after the shutdown had taken place. Subquestions regarding RAs’ experiences with their supervisors, their experiences with their peers, their experiences with support systems at their university, and their academic experiences were also detailed. Coding and subsequent analysis yielded the following themes: role of communication, motivation, confusion, disappointment, negative stress, residential life, and unexpected positives. The research includes a discussion about the differing outcomes based on whether or not RAs had choice in their decision to continue to work during the COVID-19 shutdown. The project concludes with recommendations for practice for staff and administrators in housing and residence life, student affairs, academic affairs, and human resource services. These recommendations included implications for RAs and their relationships, RAs as college students, the mental health of RAs, and RAs as essential personnel. Implications for further research included exploring the role of college student supervisor as advocate and caretaker, the services offered by universities during times of crisis, and the exploration of being essential personnel and student employees.

TITLE: Intent to Vaccinate Children Against COVID-19 by Caregiver Vaccination Status in Northeast Tennessee AUTHOR INFO Yordanos Tafesse MD1 tafesse@etsu.edu Olivia A. Sullivan, EMT, MPH1 sullivano@etsu.edu Samuel Pettyjohn, DrPH, MPH1 pettyjohns@etsu.edu 1 Center for Rural Health Research, East Tennessee State University, Johnson City, TN. Addressing vaccine hesitancy is crucial in mitigating the spread of the ongoing COVID-19 pandemic. Children are mostly asymptomatic or have milder symptoms of COVID-19 than adults, and thus may remain undiagnosed, allowing the disease to spread to a large number of people; they are also at a high risk of long-term morbidity from as-of-yet undetermined effects of “long COVID.” Therefore, this analysis sought to examine caregivers’ intent to have their children vaccinated against COVID-19 based on the caregivers’ vaccination status and the age of the children. Using a secondary dataset from a survey in Northeast Tennessee, researchers found a significant difference between vaccinated and unvaccinated caregivers in intent to vaccinate their children in all age groups. Among caregivers with vaccine-eligible (12+ years children), unvaccinated caregivers (n=16) were significantly more likely than vaccinated caregivers (n=71) to not have had their child vaccinated (X2=24, df=1, p=7.8x10-7). Among caregivers who had not yet had their children vaccinated, unvaccinated caregivers (n=23) were significantly more likely to indicate they would “definitely not” get their children vaccinated than vaccinated caregivers (n=76) among all age groups of children: 0-4 years (X2=7.8, df=1, p=5.1x10-3), 5-9 years (X2=28, df=1, p=1.4x10-7), 10-13 years (X2=30, df=1, p=3.6x10-8), and 14+ years (X2=16, df=1, p=6.1x10-5) (Figure 2). The percentage of caregivers indicating they would “definitely not” get their child vaccinated differed by age of children among vaccinated caregivers (X2=11, df=3, p=0.011) but not unvaccinated caregivers (X2=5.1, df=3, p=0.16). Limitations include a small number of unvaccinated caregivers in the sample and the inability to account for correlation in the data. These results corroborate other findings nationwide, and demonstrate the need to provide high-quality education to address vaccine hesitancy in Northeast Tennessee.

Purpose: The purpose of the study was to explore the impact of COVID-19 on undergraduate students’ well-being and the inter-relationships of emotional resilience, physical health, perceived stress, anxiety, quality of life, and perceived social support of undergraduate college students in the Appalachian region during COVID. Aim: The inter-relatedness of the six well-being variables was assessed in a convenience sample (N = 1203) of undergraduate students at an academic institution in the Appalachian region to answer the research question: what is the inter-relationship of undergraduate students’ levels of emotional resilience, physical health, perceived stress, anxiety, quality of life, and perceived social support during the COVID-19 pandemic. Methods: A cross-sectional descriptive design was used to delineate the inter-relationship of areas of well-being. The researcher received approval from the university’s IRB. Participants completed demographic questions, five measurement instruments related to five of the variables, and three physical-health-related items from the Infectious Disease Measurement tool. The survey was published using the online survey platform Qualtrics. SPSS version 28 was used to perform descriptive statistics on the six well-being variable and the correlations between them. A one-way ANOVA test was used to determine the variance between levels of study and between age groups. Results: There were significant statistical differences between participants’ levels of study in the 4-year programs and the following four areas: emotional resilience, perceived stress, quality of life, and perceived social support. Conclusions: This study reveals that students’ emotional resilience and perceived social support are instrumental in promoting students’ mental and physical health.

Medical students are more susceptible to experiencing stress, anxiety, depression, and subsequent burnout relative to their peers in other professional fields. The Medical Student Well-Being Index (MSWBI) is a standardized and validated survey that represents the percentage of medical students “at risk” for adverse psychological outcomes, including but not limited to depression, anxiety, suicidal thoughts. At Quillen College of Medicine (QCOM), the MSWBI data has been collected annually in an attempt to better understand the factors that contribute to and mitigate medical student burnout. Through the use of the Medical Student Well-Being Index (MSWBI), we compared the changes in the percentage “at risk for adverse psychological outcomes” of first-year medical student responses at Quillen College of Medicine over several years. MSWBI is composed of a seven-item survey. Student responses were summed to total scores then categorized as “at risk” or not “at risk”. We used a two-sided Chi-square Fisher’s exact test analysis. Results demonstrated a statistically significant increase in “at risk” students of MS1s for the Classes of 2024 and 2025 relative to the prior Class of 2021 (MS1 ’21 vs ’24: p-value = 0.0191; MS1 ’21 vs ’25: p-value = 0.0103). The data demonstrate that during the COVID-19 pandemic, there has been an increasing percentage of M1 students found to be “at risk for adverse psychological outcomes” such as burnout, depression, and suicide. By finding those at risk, we can then start to determine the modifiable factors contributing to burnout to mitigate downstream consequences. With increasing rates of burnout among medical students and physicians during the COVID-19 pandemic, albeit for varying reasons, there is an urgency and demand for medical schools to foster competent, compassionate doctors to enter the workforce.

The last few years have prompted empirical research about the COVID-19 pandemic. Undoubtedly, the pandemic has influenced a multitude of psychological constructs, including religiosity and substance use (Harper et al., 2020). Research about the effects of COVID-19 on religiosity and substance has been repeatedly demonstrated in the literature (Buchtova et al., 2022; Mosaval et al., 2022; Baillargeon et al., 2020). Although previous research has found relationships between these variables, no research exists about the potential connection between religiosity, substance use, and the COVID-19 pandemic. One of the purposes of this research study is to fill this existing gap in the literature. The COVID-19 pandemic has certainly exacerbated substance use and its complex facets. Additionally, the pandemic has negatively impacted several dimensions of substance use worldwide, including recovery meetings and communities, treatment services, and the cognitive and emotional functions of those with SUD and those who provide services to people with SUD (Palacio-Gonzalez et al., 2022; Mellis et al., 2021; Radfar et al., 2021; DeJong et al., 2022). Mellis et al. (2021) found that after the COVID-19 pandemic, individuals with a history of multiple SUDs reported more issues with telehealth and complications with accessing needed services. DeJong et al. (2021) highlighted the emotional aspects that people in recovery from SUD have faced since the COVID-19 pandemic. Substantial research regarding the negative relationship between religiosity and substance use exists. Religiosity is associated with a significant reduction in the rates of marijuana use, binge drinking, tobacco use, illicit drug use, and prescription drug use (Burdette et al., 2018; Edlund et al., 2010; Ford & Hill, 2012; Rivera et al., 2018). Johnson et al. (2008) found that negative beliefs about alcohol mediated the relationship between religious involvement and substance use. Additionally, the relationship between external religiosity and alcohol and tobacco use was moderated by internal religiosity, according to Marsiglia et al. (2011). These associations suggest that religiosity serves as a protective factor against substance use. Indeed, these findings are signified by Hai (2012) and Sartor et al. (2019), as they found that religiosity is a protective factor against marijuana and nicotine use. In the current study, we aim to investigate the moderating effects of COVID-19 on the relationship between intrinsic religious commitment and substance use using a simple moderation model conducted in PROCESS Macro by Hayes (2018). The model of religious commitment negatively predicting substance use, moderated by whether or not COVID-19 was occurring, was statistically significant, F(3, 436) = 9.71, p >.001, ∆R2 = .0625. This indicates that religiosity negatively predicts substance use, and COVID-19 significantly moderated the relationship. With these findings in mind, we propose that during COVID-19, when substance use increased, religious commitment served as a protective factor against increased use during COVID-19.

Huvuduppdraget för akutmottagningar är att ta hand om och stabilisera akut sjuka patienter. Överbeläggning och högt söktryck är inte ovanligt. Akutsjuksköterskor träffar under ett arbetspass åtskilliga patienter under korta, snabba möten och ska tillgodose en avancerad omvårdnad. När vårdandet sker i en smittsam vårdmiljö förändras förutsättningarna. Syftet med studien är att utforska tillgänglig vetenskaplig litteratur gällande vilka utmaningar akutsjuksköterskor möter när vårdandet sker i en smittsam vårdmiljö (covid-19) på akutmottagning. En systematisk och integrativ litteraturöversikt har valts som metod där nio artiklar inkluderats, fyra kvalitativa, fyra kvantitativa samt en med mixad metod. En tematisk analys har använts. I resultatet framkommer två teman ”förändringar i organisationen” samt ”ett utmanande arbete” som belyser akutsjuksköterskors förändrade arbetssätt under covid-19 pandemin. Utmaningarna var att det fanns en konstant rädsla för egen smitta eller att sprida smittan vidare, en ökad arbetsbelastning, förändrade rutiner och bristande möjligheter till adekvat omvårdnad. En ökad vårdtyngd upplevdes av akutsjuksköterskor då patienter var sjukare under pandemin även om söktrycket var lägre.

SARS-CoV-2 som startade en pandemi kallad Covid-19. Covid-19 visade sig kunna orsaka livshotande luftvägssymtom. Det skapade en rädsla för att bli smittad och restriktioner i samhället uppkom för att försöka förhindra och minska smittspridningen. Att arbeta inom ambulanssjukvård som ambulanssjuksköterska ställer krav på att bedöma och utföra behovet av omvårdnad samt utföra vård i olika situationer. Upplevelserna för ambulanssjuksköterskorna är att Covid-19 har medfört utmaningar i att arbeta inom ambulanssjukvården. Det blev svårigheter i att kommunicera med patienter och svårigheter att arbeta iförd skyddsutrustning. Svårigheterna medförde att arbetet med att bedöma behovet av omvårdnad och ge vård försvårades. De upplevde rädsla och oro för Covid-19 och dess framkomst. Det var både psykiskt och fysiskt påfrestande att arbeta inom ambulansverksamheten under Covid-19 och det stämde överens med forskningen kring ämnet. Vaccineringen gjorde att ambulanssjuksköterskor blev tryggare i vårdmötet. Arbetsmiljön blev succesivt bättre och upplevelsen av att möta och behandla patienter med Covid-19 blev mer som en vardag. Studien är en kvalitativ intervjustudie med 13 intervjuer av ambulanssjuksköterskor med öppna semistrukturerade frågor.

Die COVID-19-Pandemie stellte die Gesundheitssysteme weltweit vor große Herausforderungen. Um die weitere Verbreitung von SARS-CoV-2 zu verhindern, verhängten zahlreiche Staatsregierungen einen Lockdown mit Kontakt- und Ausgangsbeschränkungen. Auch in Bayern wurde das öffentliche Leben zwischen 16. März und 26. April 2020 reguliert. Krankenhäuser und Kliniken sollten sich auf eine Notfallversorgung beschränken, um ihre Kapazitäten für SARS-CoV-2-Infizierten freizuhalten. Das ZMK reduzierte im Zuge dessen ebenfalls seinen Klinikbetrieb und setzte für sechs Wochen alle planbaren Behandlungen aus. Ziel dieser retrospektiven Studie war es, den Einfluss der COVID-19-Pandemie auf die Inanspruchnahme des Notdienstes des ZMK zu untersuchen. Hierzu wurden die Behandlungsdokumente der 1299 NotfallpatientInnen, die sich zwischen 3. Februar und 7. Juni 2020 vorstellten, analysiert. Besonderes Augenmerk lag auf PatientInnen höheren Alters und/oder mit Grunderkrankung, die anfällig für einen schweren COVID-19-Verlauf sind. Während des Lockdowns halbierte sich die Anzahl der NotfallpatientInnen des ZMK. Der Anteil der COVID-19-RisikopatientInnen änderte sich jedoch nicht signifikant. Auch hinsichtlich des Geschlechtes und der Vorerkrankungen konnten keine signifikanten Änderungen festgestellt werden. Die häufigste Diagnose im Notdienst waren unkontrollierbare Schmerzen, meist endodontischen oder parodontologischen Ursprungs, gefolgt vom Abszess und vom dentalen Trauma. Zudem stieg während des Lockdowns der Anteil der NotfallpatientInnen, die stationär aufgenommen werden mussten, um 4% an. Das pandemiebedingt ohnehin stark ausgelastete Gesundheitssystem sollte nicht zusätzlich belastet werden, insbesondere wenn im Pandemieverlauf mit einem Anstieg des zahnmedizinischen Behandlungsbedarfes zu rechnen ist. Notfälle sind frühzeitig zu behandeln, Routineuntersuchungen aufrecht zu erhalten und PatientInnen über die etablierten Hygiene- und Infektionsschutzmaßnahmen und das geringe Infektionsrisiko in zahnmedizinischen Einrichtungen aufzuklären. Ziel ist, die Mundgesundheit der PatientInnen während der Pandemie aufrecht zu erhalten und einer Verschlimmerung bestehender Erkrankungen vorzubeugen. Die frühe Phase der Pandemie und der ersten Lockdown bedeuteten keine übermäßige Mehrbelastung für das ZMK. Nach meiner Einschätzung kann eine Notfallversorgung aller PatientInnen im Pandemieverlauf oder während einer zukünftigen Pandemie mit konsequentem Hygienekonzept neben dem regulären Klinikbetrieb ermöglicht werden. / The COVID-19 pandemic poses a major challenge to health care worldwide. In order to decelerate the further spread of SARS-CoV-2, numerous state governments imposed a lockdown with contact restrictions. In Bavaria, public life was restricted between 16 March and 26 April 2020. Hospitals were required to suspend all scheduled treatments and focus on an emergency care in order to increase their capacity for treatment of SARS-CoV-2 infected people. The Dental school of the University Hospital Wuerzburg (ZMK) suspended elective dental health care for the six weeks of the lockdown in Bavaria and limited their service to only urgent emergency care. The aim of this study was to evaluate the influence of the COVID-19 pandemic on patients’ utilization of the dental emergency service. Therefore, files of 1299 patients of the ZMK between 3 February and 7 June 2020 were retrospectively analysed focusing on patients of older age and/or with underlying diseases vulnerable to a severe course of COVID-19. During lockdown, the number of dental emergency patients decreased by approximately 50%. However, the proportion of COVID-19 risk patients did not change significantly. Regarding sex and underlying diseases, no significant changes were found as well. The most frequent diagnosis was uncontrollable pain, usually of endodontic or periodontal origin, followed by abscess and dental trauma. Stationary admissions increased during lockdown by approximately 4%. The due to the pandemic already heavily utilized health care should not be stressed additionally, especially if expecting an increase in the demand of dental treatment in the course of the pandemic. Dental emergencies should be treated early to avoid stationary admissions to preserve hospital bed capacities. Routine check-ups should be maintained and patients should be informed about the established anti-infective hygienic measures and the low risk of infection in dental facilities in order to preserve patients’ oral health during the pandemic and prevent the exacerbation of existing, chronic diseases. The early phase of the COVID-19 pandemic and the first lockdown in Bavaria did not pose an additional burden on the ZMK. In my opinion, it is possible to preserve emergency dental care with strict anti-infective hygienic measures during this and possible further pandemics.

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