Digital Commons Network^™

Academic Loss-Related Anxiety Among College Students During Covid-19 Pandemic, Sagar Rai, Zareen Akhtar, Kaushal Kishor Singh, Madan Lal Brahma Bhatt, Sudhir Kumar Verma, Sujita Kumar Kar

Indian Journal of Health Sciences and Biomedical Research KLEU

BACKGROUND:

The global outbreak of SARS-CoV2, initially affecting few individuals in Wuhan city of China, is now devastating millions of lives. Among all, students face substantial challenges, mainly in academic losses due to the imposed lockdown that may be detrimental to their mental well-being. Our study aimed to identify the anxiety levels among university students undergoing training in various disciplines.

METHODS:

It was a cross-sectional study. General Anxiety Disorder-7 scale within a semi-structured questionnaire was used to assess students' anxiety levels about their academic loss.

RESULTS:

A total of 507 students from India participated in the survey. Eventually, the prevalence …

The Other Corona Warriors A Kap Study On Covid-19 Among Janitors And Housekeeping Staff From A Tertiary Care Hospital In Eastern India, Vineeta Shukla, Ripan Saha, Ankita Mishra, Meghna Mukherjee, Mausumi Basu, Raghunath Misra

Indian Journal of Health Sciences and Biomedical Research KLEU

BACKGROUND:

Janitors and housekeeping staff are an integral part of our health-care system and are also in the frontline to fight this pandemic. COVID-19 infection is a new disease which currently has no specific treatment and vaccine, but this disease is preventable if there is a high level of awareness. This is especially important for housekeepers as they are unable to get adequate protection unlike doctors and nurses. They also receive less importance and appreciation than other frontline workers.

OBJECTIVES:

To assess the knowledge, attitude, and practice (KAP) of janitors and housekeeping staff of a tertiary care hospital on COVID-19 …

Cross-Sectional Study Of Awareness Toward Covid-19 Among Medical Students Of Kumaun Region Of Uttarakhand, Thakkar Hemaben, Sujan Singh, Poonam Kumari, Mohd. Maroof, Maneesh Bhatt

Indian Journal of Health Sciences and Biomedical Research KLEU

Background:

COVID-19 pandemic has been declared as a public health emergency of international concern by the World Health Organization. Being highly contagious in nature, it has become a major concern for healthcare profession.

Aims and Objectives:

The aim of the study is to assess the medical students' awareness regarding risk perception, disease transmission, and prevention of COVID-19 and to study their source of information and activities affected by lockdown.

Materials and Methods:

We conducted an online, descriptive cross-sectional study in April–May 2020, using WhatsApp Messenger. Medical students of 1

st

-year and 3

rd

-year (posted in community medicine department) …

Infection Control Measures During Covid-19 Pandemic – An Otorhinolaryngological And Head-And-Neck Perspective, Santosh Kumar Swain, Sanjay Kumar

Indian Journal of Health Sciences and Biomedical Research KLEU

Otorhinolaryngologists and head-and-neck surgeons are considered as high-risk group of health-care workers due to their nature of work for exposure to the respiratory tract. During routine assessment and treatment of patients, otorhinolaryngologists and head-and-neck surgeons with their assisting staffs inevitably come in contact with secretions of the respiratory tract which may become aerosolized at time of the sneeze or cough. All otorhinolaryngology patients must be considered as potential carriers of COVID-19. A great emphasis must be given on the history such as flu-like symptoms, travel history, and contact history with potential carriers which will help triage patients into high risk. …

Perspective Of Medical Students On Online Teaching-Learning Process During Covid-19 Pandemic, Pradnya Shree Dhotre, Abdul Kayyum Shaikh, Shree Vinayak Dhotre

Indian Journal of Health Sciences and Biomedical Research KLEU

Context:

In India, responses to the COVID-19 pandemic in medical education resulted in closures of medical colleges and adoption of online teaching-learning methods, which is challenging for both faculty and students.

Aim and Objectives:

The aim of this study is to know the perspectives of medical students on online teaching-learning method and to evaluate the efficacy of online teaching-learning process.

Subjects and Methods:

One hundred students of the first MBBS course were included in the study. The present study was conducted in a form of online survey using Google forms.

Results:

A total of 97 students participated willingly in the …

Covid-19 And The Increased Risk Of Ischemic Stroke In Young Adults, Sarah Webster

Lynchburg Journal of Medical Science

The COVID-19 virus and sequelae are responsible for causing significant hospitalizations, long term complications, and mortality. While some recover without incident from COVID-19, there are those that suffer complications and lingering side effects, one in particular is coagulopathy leading to ischemic stroke. Although the incidence of ischemic stroke in young adults under 55 has generally been increasing over the past few decades due to the increase in modifiable risk factors, the overall stroke risk in young adults is still substantially lower than that of older adults. There is evidence to suggest that during and after infection with COVID-19, adults are …

Indoor Airborne Pathogen Transmission And Control: A Role Of Environmental Factors And Material Properties, Eloise Eyo Parry-Nweye

Dissertations - ALL

The transmission of infectious airborne pathogens has severe implications on human health and economic stability. This is evidenced by the re-emergence of global pandemics with high mortality rates, various respiratory diseases, crop damage, incurred nationwide financial costs, etc. These causative pathogens, encompassing viruses, fungal spores, etc., attach to aerosol and droplet particles, enabling their aerial dispersal and leading to a cascade of detrimental events. Developing interventions to control pathogenic transmission requires an in-depth understanding of the various modes of disease transmission. However, existential gaps within the respective disease transmission modalities remained. For instance, while viruses are predominantly transmitted via aerosols, …

Editorial: The Gendered Impact Of Covid-19: Communicating Risks, Hope, Opportunities, And Challenges, Satarupa Dasgupta, Sudeshna Roy, Marissa Joanna Doshi, Ruma Sen

College of Communication Faculty Research and Publications

No abstract provided.

The Use Of Health And Herbal Products For Covid-19 Self-Prevention And Its Affecting Factors According To Theory Of Planned Behavior, Suppachai Insuk, Supanida Kittirattanasak, Mullika Sirithongkaset, Daranee Chiewchantanakit

The Thai Journal of Pharmaceutical Sciences

Introduction: Despite the World Health Organization’s recent declaration of the end of the COVID-19 pandemic, the lessons learned from the outbreak remain crucial for future public health responses. In Thailand, the pandemic’s impact led individuals to explore self-protection methods, including potentially ineffective health products. This study examined the prevalence of health and herbal products used for COVID-19 self-prevention, to identify the types of these products in use and to identify factors influencing their utilization.

Methods: A cross-sectional study surveyed 400 Thai participants aged 25–60 who had never contracted COVID-19. The study employed convenience sampling and self-administered online questionnaires based on …

Fda-Approved Drugs As Potential Covalent Inhibitors Of Key Sars-Cov-2 Proteins: An In Silico Approach, Murat Seri̇lmez, Anwar Abuelrub, İsmai̇l Erol, Serdar Durdaği

Turkish Journal of Biology

Background/aim: The COVID-19 pandemic caused by SARS-CoV-2 necessitated rapid development of effective therapeutics, prompting this study to identify potential inhibitors targeting key viral and host proteins: RNA-dependent RNA polymerase (RdRp), main protease (Mpro), transmembrane serine protease 2 (TMPRSS2), and angiotensin-converting enzyme 2 (ACE2). Methods: We used covalent docking and molecular dynamics (MD) simulations to screen FDA-approved compounds against these targets using diverse covalent reaction mechanisms. Top-ranking compounds underwent further evaluation through MD simulations to assess binding stability and conformational dynamics. Results: Several promising drug repurposing candidates were identified: bremelanotide, lanreotide, histrelin, and leuprolide as potential RdRp inhibitors; azlocillin, cefiderocol, and …

Pneumococcal Colonization Dynamics Among Young Children With And Without Respiratory Symptoms During The First Year Of The Sars-Cov-2 Pandemic., Liset Olarte, Brian R. Lee, Dithi Banerjee, Douglas Swanson, Christopher J. Harrison, Rangaraj Selvarangan

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Non-pharmaceutical interventions to mitigate the spread of SARS-CoV-2 were implemented across the United States in 2020. These public health measures might influence pneumococcal colonization in younger children and their subsequent risk of invasive pneumococcal disease. Our objective was to evaluate pneumococcal colonization rates in children ≤ 5 years of age with and without respiratory symptoms during the first 12 months of SARS-CoV-2 pandemic (April 2020 - March 2021).

STUDY DESIGN: This is a retrospective cross-sectional study evaluating pneumococcal colonization rates, density and serotype distribution across three study periods (April-July [Period 1], August-November [Period 2] and December-March [Period 3]) after …

Adjunctive Homoeopathic Treatment Of Covid-19-Positive Cases Of Geriatric Age Group – A Case Series, Vinitha Edavattath Ramanan, Suhana P. Azis, K.C. Muraleedharan, Divya Babu

Indian Journal of Research in Homoeopathy

Introduction: The second wave of COVID-19 peaked during May 2021 and had a higher mortality and morbidity rates than the first wave. About 53% of people over 60 years of age died in India due to the pandemic by the end of July 2021. Cases Summary: Twenty reverse transcription-polymerase chain reaction-confirmed COVID-19-positive patients belonging to the geriatric age group were successfully treated with Homoeopathy. Seventeen of these consulted through in-person visits at a long-term care facility (LTCF) for the elderly, and three cases belonged to the home-isolated category. Out of those treated, 14 had comorbidities, such as type II …

A Rubric For Assessing Conformance To The Ten Rules For Credible Practice Of Modeling And Simulation In Healthcare, Alexandra Manchel, Ahmet Erdemir, Lealem Mulugeta, Joy Ku, Bruno Rego, Marc Horner, William Lytton, Jerry Myers, Rajanikanth Vadigepalli

Computational Medicine Center Faculty Papers

The power of computational modeling and simulation (M&S) is realized when the results are credible, and the workflow generates evidence that supports credibility for the context of use. The Committee on Credible Practice of Modeling & Simulation in Healthcare was established to help address the need for processes and procedures to support the credible use of M&S in healthcare and biomedical research. Our community efforts have led to the Ten Rules (TR) for Credible Practice of M&S in life sciences and healthcare. This framework is an outcome of a multidisciplinary investigation from a wide range of stakeholders beginning in 2012. …

Low Frequency, High Complexity: Assessing Skill Decay In Transesophageal Echocardiography Post-Simulation Training, Enyo Ablordeppey, Emily Terian, Collyn T Murray, Laura Wallace, Wendy Huang, Erica Blustein, Alexander Croft, Ernesto Romo, Mansi Agarwal, Daniel Theodoro

2020-Current year OA Pubs

INTRODUCTION: Resuscitative transesophageal echo (rTEE) is a promising adjunct to cardiac arrest resuscitation. However, it is a high-acuity diagnostic tool that is rarely used in this setting and its safety establishment is limited because of low occurrence. High-acuity, low occurrence skills such as rTEE during cardiac arrest inevitably decay. In this study we examined the content and percentage of rTEE skill decay following simulation-based education (SBE).

METHODS: Resuscitative TEE-naïve emergency physicians (EP) were trained using a combination of clinical exposure, web-based didactics, and monthly hands-on sessions with a high-fidelity rTEE simulator for four months. The COVID-19 pandemic created a natural …

Who's At Home?: Individual-And Family-Level Sociodemographic Characteristics Associated With Stay-At-Home Motherhood, Deegan Minchey

Theses and Dissertations

In this study, I assess the relationship between various types of demographic variables, including individual, partner, and family-level information, and the likelihood of mothers staying at home. Using nationally representative data from the 2019,2021, and 2023 waves of the Annual Social and Economic Supplement (ASEC) to the Current Population Survey to account for differences across the COVID-19 pandemic, this analysis examines the likelihood of becoming a stay-at-home mother (SAHM) across three separate regression models. From the variables analyzed, I find that various individual, family, and partner demographic characteristics are significantly associated with the likelihood of becoming a SAHM. These results …

The Effect Of Sars-Cov-2 Reinfection On Long-Term Symptoms In The Innovative Support For Patients With Sars-Cov-2 Infections Registry (Inspire), John J. Openshaw, Ji Chen, Robert Rodriguez, Michael Gottlieb, Kalyani Mccullough, Michelle Santangelo, Mandy J. Hill, Kristyn Gatling, Ahamed H. Idris, Samuel Mcdonald, Lauren E. Wisk, Jonathan Dyal, Ralph C. Wang, Kristin L. Rising, Efrat Kean, Kelli N. O'Laughlin, Kari A. Stephens, Caitlin Malicki, Zhenqiu Lin, Erica S. Spatz, Huihui Yu, Robert A. Weinstein, Joann Elmore

Department of Emergency Medicine Faculty Papers

BACKGROUND: The clinical consequences of repeated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are not clear, especially as they relate to long-term symptoms after infection. We analyzed data collected for the Innovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE) to determine whether reinfection changes the likelihood of symptoms 3-6 months after reinfection compared with the likelihood in individuals experiencing a single infection.

METHODS: Individuals reporting a single SARS-CoV-2 infection or a single reinfection were included in this analysis. A positive SARS-CoV-2 test occurring ≥90 days after a first infection was considered a reinfection. Outcomes included severe fatigue (fatigue …

Sars-Cov-2 Nsp15 Enhances Viral Virulence By Subverting Host Antiviral Defenses, Allen Caobi, Tamarand L Darling, Adrianus C M Boon, Et Al.

2020-Current year OA Pubs

SARS-CoV-2 encodes numerous virulence factors, yet their precise mechanisms of action remain unknown. We provide evidence that the SARS-CoV-2 nonstructural protein 15 (nsp15) enhances viral virulence by suppressing the production of viral double-stranded (dsRNA), a potent inducer of antiviral signaling. The viral variants lacking nsp15 endoribonuclease activity elicited higher innate immune responses and exhibited reduced replication in human stem cell-derived lung alveolar type II epithelial cells, as well as in the lungs of infected hamsters. Consistently, these variants caused significantly less weight loss and mortality compared to wild-type (WT) virus in K18-hACE2 mice. Mechanistically, the cells infected with nsp15 mutants …

Exploring Age And Employee Experience Among Healthcare Workers Post-Covid-19 Pandemic, Sheila-Celestine Bonner

Doctoral Dissertations and Projects

This study focused on the well-being of healthcare employees and their experience following COVID-19. The pandemic has negatively affected adults over the age of 50 in the United States and limited their ability to return to work. Older adults who have returned to work have faced challenges with discrimination, lack of work, stress, and other factors. A survey of 59 adult healthcare workers, 21 years and older, was conducted to determine whether there is a relation between age and perceptions of organizational support during the pandemic including work factors such as stress, job satisfaction, and age discrimination. A non-experimental research …

How Executive Leaders Build Trust: Navigating Organizational Disruption During The Covid-19 Mega-Crisis, Marji Karish

Electronic Theses and Dissertations

The COVID-19 pandemic, declared a global health crisis by the World Health Organization (WHO) on March 11, 2020, created a “mega-crisis” characterized by intersecting physiological, economic, political, social, and cultural disruptions. This study examines how senior organizational executives narrate their response to the crisis, focusing on their engagement with organizational stakeholders. Using a constructivist grounded theory methodology, I conducted in-depth interviews with 12 organizational leaders to construct the Theory of Social Crisis Leadership Communication (SCLC).

Findings highlight the centrality of trust as an interdependent relationship in which executive leaders and organizational stakeholders rely on each other to navigate crises successfully. …

The ‘Un-Doing’ And ‘Re-Doing’ Of Nurses’ Derealisation: Exploring The Effects Of The Heroic Keyworker Discourses During The Covid-19 Pandemic, Anna Conolly, Emma Rowland, Ruth Abrams, Ruth Harris, Daniel Kelly, Bridie Kent, Keith Couper, Jill Maben

School of Nursing and Midwifery

Using, and extending, Butler’s theory of recognition and censorship, this article examines the way in which nurses’ subject positions were regulated in the transformative liminality of the COVID-19 pandemic, where normal matrices of power were ‘undone’ and new ones formed. During the pandemic, societal discourses regarding nurses shifted from treating them as less-than-human and their care-work invisible and unrecognised (derealised), to an elevated position where they became appreciated and treated as heroes, then reverting to a derealised state. As part of the building of subjectivities in this liminal period, nurses constructed boundaries against ‘unmoral’ others, either members of the public, …

Importance Of Outbreak Response Research In Bridging Knowledge Gaps On Emerging Infectious Diseases, Robert F Breiman, David Wang, Michael Diamond, Adrianus C M Boon, Et Al.

2020-Current year OA Pubs

An important outcome of the devastating 2014 West African Ebola virus disease outbreak and the 2020 COVID-19 pandemic has been the growing promotion of conducting research during outbreaks of emerging infectious diseases (EIDs) as a valuable and acceptable process of acquiring knowledge to enhance our ability to better prevent and control these diseases in the future. Recognising the unique opportunity during outbreaks to leverage increases in cases over a short time interval and in a circumscribed area, we articulate a systematic process of conducting EID outbreak response research, highlighting knowledge gaps that should be prioritised, and measures that can be …

Analyzing The Trends Of Government Share Of Health Before, During, And After The Covid-19 Pandemic, Sara Parkhurst, Matthew Bitterman, John Drager, Dominic Gentile

Working Papers Series

This paper investigates whether the COVID-19 pandemic functioned as a critical juncture that led to lasting institutional change in government health investment. Using an original comparative framework, the analysis explores changes in health financing across ten OECD countries classified by Reibling et al.'s five-type typology of healthcare systems. We assess shifts in public, private, and government health expenditure before, during, and after the pandemic, using both descriptive and visual data. Our findings suggest that while nearly all countries increased government and public shares of health spending during the pandemic, the persistence of these changes varied by system type, GDP level, …

The Effect Of Ex-Ante Government Responsibility For Health On Public Health Financing In Post Pandemic Budgets, Denis Granados, Rylee Roman, Hallie Sidman

Working Papers Series

This paper investigates how pre-pandemic levels of government responsibility for public health financing influenced post-pandemic health spending across selected OECD countries. Using a combination of descriptive analysis and regression modeling, the study examines changes in public health expenditure per capita between 2019 and 2022, focusing on key variables such as the government’s share of health financing, the Total Pandemic Policy Intensity (PPI) index, and GDP per capita. Findings suggest that while all countries increased health spending post-COVID-19, the scale of change varied significantly based on economic capacity, institutional readiness, and political will. Notably, countries with higher pre-pandemic public health investment …

Functional Resilience Of Healthcare In The Critical Juncture Of The Covid-19 Pandemic, Avner Kronisch, Christian Bongiorno, Kerane Smith, John Baker

Working Papers Series

This paper offers a comparative analysis of eight national healthcare systems—spanning democracies, autocracies, and various institutional models—to evaluate resilience during the COVID-19 pandemic. Drawing on Shvetsova et al.’s framework of informational and authority redundancies, and Parker & Klein’s “choke point” theory of healthcare rationing, we examine how institutional structure shaped pandemic response, system adaptability, and continuity of non-COVID services. Using indicators like life expectancy, under-five mortality, hospital capacity, cancer survival, and excess mortality, we explore how systems absorbed shock and maintained essential care. We find that decentralized and polycentric governance structures, when paired with coordination and resource adequacy, enhanced resilience—exemplified …

Covid-19 & Healthcare (Re)Privatization? A Comparative Analysis Of High And Medium Per Capita Gdp Countries, Kristina Donders, Kaitlyn Matthews, Brittany Reyes, Frank. H. Rizzo

Working Papers Series

This paper examines whether the COVID-19 pandemic accelerated healthcare privatization in high- and medium-GDP countries. Drawing on political economy theories of path dependence and privatization, we analyze changes in public and private healthcare expenditures in eight countries: Canada, Chile, Denmark, Georgia, Luxembourg, Norway, the Philippines, and South Korea—comparing data from 2019 and 2022. Using World Bank indicators on healthcare financing, GDP, aging populations, and food insecurity, we find that although healthcare expenditures generally increased during the pandemic, this increase was primarily in public, not private, spending. Case studies of Georgia and South Korea reveal that local economic and demographic pressures, …

Institutional Change In Healthcare As Brought About By The Critical Juncture Of The Covid-19 Pandemic, Olga Shvetsova

Working Papers Series

This introduction to the 2025 capstone symposium lays the conceptual groundwork for a new approach to analyzing institutional change in healthcare systems triggered by the COVID-19 pandemic. Departing from conventional legal-institutional perspectives, it extends the decision space framework developed by Bossert (1998) to capture both formal authority and the de-facto responsibilities exercised by public and non-public actors. By disaggregating health responsibilities across levels of government and sectors—public, private, and hybrid—and operationalizing these as quantifiable indicators over time, the framework allows for real-time and comparative assessment of institutional transformation. The pandemic is treated as a critical juncture that exposed and reconfigured …

Longitudinal Outcomes Of The Covid-19 Pandemic On Youth Physical Fitness, Andjelka Pavlovic, David Leonard, Timothy J Walker, Derek W Craig, Jizyah Injil, Laura F Defina

Faculty, Staff and Student Publications

Importance: The COVID-19 pandemic led to a decline in physical activity levels among youths, which could have a negative impact on their fitness.

Objective: To examine longitudinal changes in cardiorespiratory fitness (CRF) and musculoskeletal fitness (MSF) among students at schools participating in a school-based physical activity program during fall 2019 through spring 2023.

Design, setting, and participants: This longitudinal cohort study included US schools reporting CRF and MSF data at least once during the pandemic (fall 2020 to fall 2021) and at least 1 additional time before or after. In a subset of schools for which learning modality data was …

Covid-19 Pandemic And Recovery Experiences: A Case Study With Montana Family And Consumer Science Cooperative Extension Agents, Hayley M. Somerfeld, J. Mitchell Vaterlaus, Nicole C. Wanago, Brianna Routh, Alison Brennan

Journal of Human Sciences and Extension

The present study examined the impact of COVID-19 and recovery experiences among Family Consumer Science (FCS) Extension Agents in Montana. All participants (n = 10) completed a survey with fixed-item and open-ended responses, and six also participated in in-depth interviews. A deductive qualitative case study approach was used. Agent experiences were analyzed using The Sendai Framework for Disaster Risk Reduction (SFDRR) four action priorities: (1) understanding risk, (2) strengthening disaster risk governance, (3) investing in disaster risk reduction for resilience, and (4) enhancing disaster preparedness for effective response and to “build back better” in recovery, rehabilitation, and reconstruction. Pandemic risks …

Comparison Of The Association Between Covid-19 And New Onset Diabetes In A Regional And National Dataset, Mary E. Lacy, Aaron P. Smith, Lindsey R. Hammerslag, Kory R. Heier, James Aaron, Alicia Fields, John L. Fowlkes, Simon J. Fisher, Jeffery Talbert, Philip A. Kern

Epidemiology and Environmental Health Faculty Publications

Aims: This study examined new onset diabetes following COVID-19 infection in large datasets. Methods: A retrospective cohort study design was used in three distinct databases: data from a large academic medical center (University of Kentucky Healthcare, UKHC), claims data from privately insured patients in the Merative MarketScan (MarketScan) database, and a subset of the MarketScan database with lab tests. Control groups included patients from the prepandemic timeframe (prepandemic cohort), as well as COVID-era patients without documented COVID infection (COVID − cohort). Results: Incident diabetes in COVID infected patients was higher in all datasets. In the UKHC and MarketScan datasets, the …

Association Of Sars-Cov-2 With Health-Related Quality Of Life 1 Year After Illness Using Latent Transition Analysis, Lauren Wisk, Michael Gottlieb, Peizheng Chen, Huihui Yu, Kelli O'Laughlin, Kari Stephens, Graham Nichol, Juan Carlos Montoy, Robert Rodriguez, Michelle Santangelo, Kristyn Gatling, Erica Spatz, Arjun Venkatesh, Kristin Rising, Mandy Hill, Ryan Huebinger, Ahamed Idris, Michael Willis, Efrat Kean, Samuel Mcdonald, Joann Elmore, Robert Weinstein

Department of Emergency Medicine Faculty Papers

BACKGROUND: Long-term sequelae after SARS-CoV-2 infection may impact health-related quality-of-life (HRQoL), yet it is unknown how HRQoL changes during recovery. We compared patient-reported HRQoL among adults with COVID-19-like illness who tested SARS-CoV-2 positive (COVID+) with those who tested negative (COVID-).

METHODS: Participants in this prospective, multicenter, longitudinal registry study were enrolled from December 2020 through August 2022 and completed 3-month follow-up assessments until 12 months after enrollment. Participants were adults (≥18 years) with acute symptoms suggestive of COVID-19 who received a Food and Drug Administration-approved SARS-CoV-2 test. Participants received questions from PROMIS-29 (subscales: physical function, anxiety, depression, fatigue, social participation, …