Den här studien har som syfte att undersöka hur universitetsstudenter har upplevt omställningen från campusbaserad undervisning till distansundervisning under Covid-19. Studien begränsar sig till universitetsstudenter och utforskar tre frågeställningar: Hur upplevde universitetsstudenterna interaktionen under distansundervisningen med lärare och studenterna i jämförelse till undervisningen som tidigare skedde på campus? På vilket sätt beskriver studenterna skillnaden i maktrelationerna mellan lärare och studenter i distansundervisningen under Covid-19 jämfört med campusundervisning? och Vilka är de sociala konsekvenser som dyker upp med distansundervisning under Covid-19? För att besvara dessa frågeställningar har vi valt den hermeneutiska metodansatsen för att skapa förståelse kring det studerade ämnet. För att besvara studiens frågor genomfördes kvalitativa individuella intervjuer fysiskt via Zoom med tio studenter från olika lärosäten runt om i Sverige. Intervjupersonernas upplevelser analyserades utifrån sociologiska begrepp, Goffmans dramaturgiska perspektiv samt Foucaults maktbegrepp. Resultaten av studien avslöjar likheter i studenternas upplevelser av distansundervisning under Covid-19. Interaktionen via Zoom skiljer sig från den som sker på campus och påvisar att olika aspekter av sociala interaktioner mellan studenter och lärare har förändrats. Naturlig interaktion med andra studenter, som var möjlig på campus, upplevdes som svår på Zoom. Studenterna uttrycker en osäkerhet i sitt rollutövande och märker förändringar i hur de framträder, inklusive en ökad synlighet av privata bakgrundsmiljöer. Det framkommer även förändringar i maktrelationen mellan lärare och studenter. Slutligen visar resultaten både fördelar och nackdelar med distansundervisning, såsom möjligheten att närvara på föreläsningar vid sjukdom. Samtliga studenter föredrar dock traditionell campusbaserad undervisning framför distansundervisning.

Denna studie syftar till att belysa gymnasielärares erfarenheter i omställningen från traditionellklassrumsundervisning till distansundervisning under coronapandemin. Med särskilt fokus på geografiämnetundersöks hur denna förändring påverkade lärares undervisningsmetoder samt lärarnas förmåga att nå målen iläroplanen och deras upplevelser av den nya undervisningsformen som de blev tvingade till. Genom intervjuermed geografilärare på olika gymnasieskolor har data samlats in och analyserats för att få en djupare förståelse förhur lärare anpassade sin undervisning till distansformatet. Frågeställningarna kretsar kring vilka delar avgeografiämnet som påverkats mest, lärarnas förmåga att säkerställa att eleverna når betygskriterierna ochlärarnas personliga uppfattningar om distansundervisning. Resultaten från studien visar på betydande utmaningarsåsom anpassningen av bedömningsmetoder, svårigheter att bibehålla interaktiv och praktisk undervisning samten ökad arbetsbelastning och stress bland lärarna. Dessa resultat bidrar till en ökad förståelse för de komplexakonsekvenserna av pandemin inom geografiundervisningen och kan användas som en grund för vidareutveckling av distansundervisningsmetoder.

The analysis of real-world data and the development of mathematical models played a fundamental role in understanding the epidemiology of COVID-19 and informing public policies throughout the recent pandemic. This thesis presents a collection of modeling approaches and results addressing key questions that arose during the COVID-19 crisis, with a specific focus on the emergence and epidemiological features of SARS-CoV-2 variants of concern (VOC) in Italy and related public health implications. In the first chapter, conducted analyses suggest that the Alpha variant was approximately 50% more transmissible than historical lineages of SARS-CoV-2, and that this transmissibility advantage was enough to outcompete a variant associated with immune escape phenomena and circulating in central Italy in February 2021 (i.e., the Gamma variant). In the second chapter, by investigating the potential impact of new hypothetical VOCs in Italy in late 2021, modeling results highlighted that the emergence of variants associated with significant immune escape (i.e., with a rate at which vaccinated or recovered individuals from infection with pre-circulating lineages become infected being at least one-fifth that of unvaccinated individuals who never experienced SARS-CoV-2 infection) would have been able to replace pre-circulating lineages in a couple of weeks. Strict restrictions would have been required to prevent a new large epidemic wave. In the third chapter, the analysis of genomic and epidemiological data associated with the expansion of the Omicron variant over the Italian territory revealed that this variant was able to become dominant at the national level in less than a month, increasing the net reproduction number from 1.15 to 1.83. Despite the marked growth advantage of Omicron compared to the previously circulating Delta variant, a moderate impact on the number of severe cases was observed, likely due to the high proportion of vaccinated individuals in the country by the end of 2021. In the fourth chapter, the estimation of the intrinsic generation time of the Omicron variant (mean: 6.84 days) was found to be similar to that of previous lineages. Such estimates have been key to define adequate isolation, quarantine, surveillance, and contact tracing protocols in 2022. The prevention of SARS-CoV-2 transmission in educational settings represented a key challenge during the pandemic, due to the large proportion of asymptomatic carriers in young individuals. The last chapter presented in this thesis shows that, when the Alpha variant was circulating in Italy, almost half of positive students and school personnel ascertained during in-person education were likely infected by school contacts. The mean number of secondary cases caused at schools was found to be 0.33, with high heterogeneity in the chance of onward transmission. Provided estimates suggest that the timely identification of cases combined with reactive quarantine policies had the potential of reducing SARS-CoV-2 transmission in schools by at least 30%.

Bakgrund: Covid-19 var en pandemi som orsakades av coronaviruset SARS-CoV-2 som sedan i slutet av 2019 spridit sig snabbt över stora delar av världen. Studier från utbrott av tidigare coronavirus har visat att sjuksköterskors upplevelse av att vårda patienter med liknande infektionssjukdomar har varit utmanande. Att beskriva sjuksköterskors erfarenheter av att vårda patienter under Covid-19-pandemin kan användas till eventuella framtida infektionsutbrott.  Syfte: Syftet med studien var att undersöka sjuksköterskors upplevelse av att vårda patienter med misstänkt eller bekräftad Covid-19 inom slutenvården.  Metod: En allmän litteraturstudie med systematisk ansats som är baserad på elva kvalitativa artiklar. Datainsamlingen gjordes i databaserna CINAHL och PubMed.  Resultat: Analysen resulterade i två huvudteman och åtta subteman. Huvudtemat fysiska och psykiska utmaningar inkluderar subtemana utmanande arbetsmiljö, rädsla för smittspridning, utmaningar gällande personlig skyddsutrustning, brist på kunskap och kompetens samt utmaningar vid omvårdnad. Huvudtemat upplevelser av ledning och medarbetare inkluderar subtemana ledning och organisationens roll, sjuksköterskornas behov av stöd samt teamarbete.  Slutsats: Studien visade att sjuksköterskor som arbetar i en pandemi behöver få tillgång till stöd av både kollegor och ledning samt få tydliga riktlinjer och utbildning för att kunna erbjuda en god och säker vård.

Den här studien är ämnad att kartlägga vilka faktorer som associeras med att en skolahanterade distansundervisningen bättre eller sämre baserat på den andel elever somklarade av skolan på utsatt tid. Studien gjordes genom att undersöka vilka faktorer somskulle kunna tänkas associeras med ett bättre eller sämre studieresultat och utifråndessa göra hypoteser om vad som kommer göra att en skolla associeras med ett bättreeller sämre studieresultat. Dessa hypoteser testas sedan genom att samla in relevantdata i ett dataset, som sedan används för olika typer av regressioner, för att på så sättkunna se vad som korrelerar med ett bättre eller sämre resultat. Resultatet gav ingetsjälvklart svar, men det indikerar att skolor med hög andel elever med utländskbakgrund korrelerar med ett sämre resultat och att friskolor korrelerar med ett bättreresultat.

This thesis analyzes Sweden's unique and puzzling approach to the COVID-19 pandemic by using the securitization framework, exploring if Sweden's strategy during the pandemic's first year reflects securitization, (de)securitization, or non-securitization. It employs content analysis to evaluate Sweden's response, analyzing primary sources and academic literature, and uses a discourse table based on existing theoretical studies by Barry Buzan, Ole Waever, and Jaap de Wilde (1998) and Lene Hansen (2012) to assess indicators of securitization, (de)securitization or non-securitization. The study finds that initially, Sweden combined (de)securitization and non-securitization, led by the state epidemiologist Anders Tegnell and the Public Health Agency of Sweden (PHAS), treating the virus as a manageable health issue within existing healthcare systems. However, as the pandemic progressed, the Swedish government, led by Prime Minister Stefan Löfven, adopted a securitization strategy, framing COVID-19 as a significant national health threat. This shift illustrates the dynamic roles of various actors in pandemic discourse. The thesis argues against a binary view of securitization and (de)securitization, showing their fluid application in real-world crises. It highlights the interaction between scientific and political decision-making in crisis management, suggesting a spectrum of responses involving (de)securitization and non-securitization.

Background: Short-term medical missions (STMMs) involve the temporary provision of medical services by foreign healthcare providers or students to a recipient community. This thesis seeks to explore the impacts of the COVID-19 pandemic on these projects. Methods: A scoping review was conducted identifying articles published from 2015-2022 relevant to medical missions and COVID-19. Additionally, semi-structured interviews were conducted with key informants to describe experiences and explore perspectives from STMM stakeholders. Results: The scoping review resulted in 37 included articles. These findings were supported by semi-structured interviews with six stakeholders. Both the review and interview results described cancellation of in-person activities by STMM organizations during the shutdown and subsequent consequences experienced by the organizations and partners. Alternative initiatives were implemented supporting pandemic response and incorporating virtual platforms for patient care. Remote educational programs for patients and healthcare providers were also developed and employed. Safety protocols were developed and implemented when lockdown measures were lifted. Changes in mission models and a shift towards sustainability and long-term initiatives were also discussed. Conclusions: STMMs have received significant criticism in recent years. Travel restrictions forced an inevitable pause on these projects, creating an opportune time to explore these changes and identify implications for the future. The impact of COVID-19 resulted in countless adaptations within STMM organizations. Further research is needed to identify which changes have been sustained. / Thesis / Master of Science (MSc) / This thesis seeks to explore the impact of the COVID-19 pandemic on short-term medical missions (STMMs). International travel restrictions and safety concerns brought STMMs to a forced pause. Through a scoping review and semi-structured interviews with stakeholders, this thesis aims to describe experiences, responses, and adaptations of STMM organizations consequent to the pandemic. The review and interviews confirmed the substantial number of STMM cancellations during the lockdown. The forced withdrawal of care compounded on existing demands for overwhelmed healthcare systems in low- and middle-income countries. STMM organizations pivoted to assisting with pandemic response and disaster relief. Virtual initiatives were also developed to provide support remotely. Safety protocols were developed and implemented. At the time of the review and interviews, several STMM organizations had resumed in-person care. The review and stakeholders revealed a shift from the classic STMM model to prioritizing long-term, sustainable initiatives with local community involvement.

Taking GDP growth and inflation as endogenous variables, this paper employs a Structural VAR from Baumeister and Hamilton (2015, 2019) to identify aggregate demand and aggregate supply shocks for Bhutan, focusing on the COVID-19 pandemic. The results suggest that 94 percent of the GDP growth plunge in 2020 is attributable to a fall in aggregate supply. The higher inflation during the COVID-19 pandemic in 2020 also implies a negative supply shock. Although the magnitudes differ, characterizing the COVID-19 pandemic in Bhutan as a supply shock coincides with preceding episodes that were also primarily driven by supply shocks.

Die COVID-19 Pandemie ist die bisher verheerendste Pandemie des 21. Jahrhunderts. Durch die Einführung neuer mRNA-basierter Impfstoffe sowie der hohen Rate natürlicher Infektionen konnte die weltweite SARS-CoV-2-Immunität gesteigert werden. Trotz aller Erfolge zur Eindämmung der Pandemie kann eine Infektion auch heute noch zu schweren Verläufen und Tod führen. Eine adäquate COVID-19-Therapie ist folglich auf potente Virostatika angewiesen. Eine durch Umgehung zeitaufwändiger klinischer Studien schnell verfügbare Alternative zu neu entwickelten Arzneimitteln ist die Anwendung etablierter Medikamente. Wir isolierten und charakterisierten ein von einem Patienten stammendes SARS-CoV-2-Virus. Dieses Virusisolat wurde bisher in elf Publikationen verwendet. Mittels quantitativer Echtzeit-Polymerasekettenreaktion untersuchten wir eine Substanzbibliothek mit mehr als 300 neuen und bereits zugelassenen Wirkstoffen auf ihre Wirksamkeit gegen SARS-CoV-2. Dabei konnten wir zeigen, dass der selektive Serotonin-Wiederaufnahmehemmer Fluoxetin die SARS-CoV-2-Replikation ab einer Dosis von 0,8 μg/ml signifikant inhibiert, einer bei der Behandlung von Depressionen häufig angewandten Dosierung. Der EC50-Wert lag bei 387 ng/ml. Die Behandlung mit Fluoxetin resultierte in einer reduzierten Zahl an Virusprotein-produzierenden Zellen, was darauf hindeutet, dass es die virale Reinfektion und/oder Proteinexpression inhibiert. Fluoxetin ist ein racemisches Gemisch, wobei das (S)-Enantiomer der potentere Serotonin-Wiederaufnahmehemmer ist. Wir konnten zeigen, dass beide Enantiomere einen vergleichbaren antiviralen Effekt gegen SARS-CoV-2 aufweisen, wodurch das (R)-Enantiomer bei virologischer Indikation gegebenenfalls präferiert werden sollte. Fluoxetin hat keinen Einfluss auf die Replikation des Tollwut-Virus und des Humanen Respiratorischen Synzytial-Virus, was auf eine Virusspezifität hindeutet. Weitere aus der Bibliothek stammende signifikante Inhibitoren der SARS-CoV-2-Replikation sind die am Institut für Organische Chemie Würzburg entwickelten Substanzen AKS 232 und AKS 128. Neben der medikamentösen Therapie ist die akkurate Bestimmung neutralisierender Antikörper gegen SARS-CoV-2 zur Quantifizierung des bestehenden (Re-) Infektionsschutzes sowie zur Planung zukünftiger Impfstrategien von großer Bedeutung. Im Rahmen dieser Arbeit entwickelten wir unter Verwendung der quantitativen Echtzeit-Polymerasekettenreaktion erfolgreich ein zuverlässiges Testverfahren zur Detektion neutralisierender anti-SARS-CoV-2 Antikörper. / The COVID-19 pandemic is the most fatal pandemic of the 21st century. The introduction of new mRNA-based vaccines and the high rate of natural infections have increased global SARS-CoV-2 immunity. Despite the successes in containing the pandemic, infection can still lead to severe courses and death. COVID-19 treatment is therefore dependent on potent antivirals. The development of new antivirals is a prolonged process. By bypassing time-consuming clinical trials, repurposing established medication offers a quickly available alternative to newly developed drugs. We isolated and characterized a patient-derived SARS-CoV-2 virus. This virus isolate has been used in 11 publications so far. Using quantitative real-time polymerase chain reaction, we investigated a compound library with more than 300 new and already approved substances against SARS-CoV-2. We showed that the selective serotonin reuptake inhibitor Fluoxetine significantly inhibits SARS-CoV-2 replication at a concentration of 0.8 µg/ml, a dosage frequently used in the treatment of depression. The EC50 was determined with 387 ng/ml. Treatment with Fluoxetine resulted in a decrease in viral protein-expressing cells, indicating that it inhibits viral reinfection and/or protein expression. Fluoxetine is a racemate with the (S)-enantiomer being the dominant serotonin reuptake inhibitor. We have shown that both stereoisomers have a comparable antiviral effect against SARS-CoV-2, suggesting the (R)-enantiomer might be the preferred option for virological indications. Fluoxetine suppressed neither Rabies virus nor human Respiratory Syncytial Virus replication, indicating it is virus specific. Other significant inhibitors of SARS-CoV-2 replication originating in the compound library are AKS 232 and AKS 128, developed with the Institute of Organic Chemistry Würzburg. In addition to drug therapy, the accurate determination of neutralising antibodies against SARS-CoV-2 is of great importance for quantifying the existing (re)infection protection and for planning future vaccination strategies. In this work, we successfully developed a reliable test procedure for the detection of neutralising anti-SARS-CoV-2 antibodies using the quantitative real-time polymerase chain reaction.

Objetivo: Describir las características clínico-epidemiológicas de gestantes con COVID-19 y sus recién nacidos, atendidos en un hospital de EsSalud - Chiclayo. Marzo 2020 – junio 2021. Materiales y Métodos: Se realizó un estudio descriptivo, retrospectivo y transversal. Se revisó las historias clínicas virtuales de las gestantes con COVID-19 y sus recién nacidos atendidos en el servicio de Gineco-Obstetricia del Hospital II Luis Heysen Inchaustegui. Resultados: La población fue de 152 gestantes, de las cuales el 34.2% tuvieron igual o mayor a 35 años. Los meses de marzo y abril del 2021 fueron los de mayor incidencia con 24 y 21 casos reportados, respectivamente. Tos (68.4%), malestar general (63.1%) y disnea (47.3%) fueron los síntomas más comunes. La prueba diagnóstica más utilizada fue la serológica IGM/G (48.7%). El 98% presentó infección a partir de las 29 semanas de gestación, las complicaciones obstétricas más frecuente fueron RPM con un 14.5%, seguida de preeclampsia con 8.6% y el 46.7% tuvo anemia. Respecto a los recién nacidos, el 55.3% fueron del sexo masculino, con un peso entre 2500-4000 gramos (91.4%). Se evidenció que el 18.4% presentó dificultad respiratoria, el 6.6% fiebre y el 59.2% tuvo una estancia hospitalaria mayor a las 36 horas. Conclusiones: El rango de edad de las mujeres gestantes con COVID- 19 estuvo entre los 28 y 36 años. Tos y malestar general fueron los síntomas más frecuentes; y las complicaciones obstétricas fueron RPM y Preeclampsia. En relación a los recién nacidos, el 99.3% tuvo un Apgar mayor a 7 puntos a los 5 minutos de vida, con un peso normal en el 91.4%. Los síntomas que presentaron fueron dificultad respiratoria y fiebre. / Aim: To describe epidemiological and clinical characteristics of pregnant women with COVID19 and their newborns, treated at a Hospital in Chiclayo from March 2020 through June 2021. Methods: This is a descriptive, retrospective and cross-sectional study that reviewed the medical records of pregnant women with COVID-19 and their newborns treated in the Gynecology and Obstetrics department of II Luis Heysen Inchaustegui Hospital. Results: The population was 152 pregnant women, of which 34.2% were 35 years old or older. The months of March and April 2021 were the months with the highest incidence with 24 and 21 cases reported, respectively. Cough (68.4%), general malaise (63.1%) and dyspnea (47.3%) were the most common symptoms. The most used diagnostic test was the IGM/G serological test (48.7%). 98% presented infection after 29 weeks of gestation, the most frequent obstetric complications were PPROM with 14.5%, followed by preeclampsia with 8.6% and 46.7% had hemoglobin less than 11g/dl. Regarding the newborns, 55.3% were male, weighing between 2500-4000 grams (91.4%). It was evident that 18.4% had respiratory difficulty, 6.6% had fever and 59.2% had a hospital stay of more than 36 hours. Conclusions: The age range of pregnant women with COVID-19 was between 28 and 36 years. Cough and general malaise were the most frequent symptoms; and obstetric complications were PPROM and Preeclampsia. In relation to newborns, 99.3% had an Apgar score greater than 7 points at 5 minutes of life, with a normal weight in 91.4%. The symptoms they presented were respiratory distress and fever.