The results show that personal initiative can strengthen enterprise emergency management ability. The mediating effect of executive power between personal initiative and emergency management ability of enterprise has also been proved. In addition, the two adjustment variables of political skills and perceived organizational support both have a positive impact on the improvement of personal initiative and execution. Therefore, in order to improve the enterprise emergency management ability, it is suggested that enterprises should give full play to the personal initiative and improve the individual and overall executive power. The conclusion of this paper can provide new methodological support for improving emergency management ability.This study aims to explore the influence mechanism of personal initiative on the overall emergency management ability of enterprises so as to put forward effective measures to improve the emergency management ability. Based on social interaction theory and feature activation theory, the concepts of organizational support theory, executive power, and political skills were introduced to construct a corresponding theoretical model. We collected data through an online questionnaire to test this model  Emergency management has been attracting attention from all walks of life in recent years . At the Some scholars pointed out that, in the face of a complex and changeable environment, corporate employees are not always passively restricted by them but tend to make breakthroughs and changes, make a series of active behaviors to understand and obtain the information as well as other resources needed for survival and development so as to effectively improve their adaptability to the work and organizational environment . At the Although many scholars have carried out in-depth research on the improvement measures and evaluation of personal initiative or enterprise emergency management capability, few scholars have combined these two variables for systematic analysis, nor have they explored the relationship between them and the implicit influence mechanism . But, inAs an individual characteristic, initiative will be affected by external factors. Friction and conflict are not conducive to the full play of initiative , which rIn summary, this article introduces the concept of executive power and takes the concepts of organizational support theory and political skills as moderating variables, thereby constructing a model of the relationship between personal initiative and corporate emergency management capabilities at the organizational level. Then, SPSS and AMOS software are used for regression analysis and structural equation model analysis to test that model. The aim of this paper is to explore the influence mechanism of individual initiative on the emergency management ability of the enterprise, clarify the influence relationship between internal research variables, and provide some innovative ideas for future emergency work execution and the cultivation and improvement of enterprise emergency management ability.Starting from individual initiative, this article uses empirical methods to study its impact on the emergency management capabilities of enterprises. We can prove from the data level that personal initiative and emergency management capabilities are, indeed, related so as to provide ideas for talent selection and quality training in organizational management. And through the study of internal mechanisms, we can understand which factors have caused the impact and the actual impact of the impact during the entire process of personal initiative affecting emergency management capabilities. Therefore, we can take corresponding measures to ensure that individual initiative can play its value, thereby promoting the improvement of the emergency management capabilities of the organization.The concept of personal initiative was first put forward by In order to effectively prevent and predict the occurrence of public emergencies to minimize the possible losses or negative impacts caused by public emergencies, the government, departments, units, and other organizations have carried out a series of work, such as the formulation of emergency laws and regulations, emergency plans, and the establishment and improvement of emergency response, namely emergency management . SpecifiConceptually, it is obvious that people with initiative, due to their characteristics of “spontaneity,” “taking the lead in action,” and “overcoming difficulties,” may be more likely to adapt to the complex and changeable working environment , make apIn addition, according to the social interaction theory, there are behavioral and psychological interactions between individuals, individuals and groups, and between groups. Personal initiative can affect not only oneself but also affect others and even organizations through exchange and cooperation. On the one hand, highly motivated individuals are more willing to share knowledge and conduct organizational learning . Thus, tThere are also traces to follow in academic research. According to the above discussion, we speculate that there may be a positive correlation between personal initiative and corporate emergency management ability. Therefore, the first hypothesis of this paper was put forward:Hypothesis 1: personal initiative is positively related to emergency management ability of enterprise.The definition of executive power differs on different levels. At the individual level, it is the ability of individuals to perform their own roles and responsibilities and complete the corresponding tasks, while it refers to the ability of an organization or group to implement and achieve the strategic objectives of the plan at the group level . The strSome scholars have studied the interaction between executive ability and enterprise-related capabilities, which provides a certain basis for the hypothesis of this paper. Hypothesis 2: Executive power is positively related to the emergency management ability of enterprises.Hypothesis 3: Personal initiative is positively related to executive power.Combining Hypotheses 2 and 3, the hypothesis that executive power plays a mediating role in the influence model can be formed:Hypothesis 4: executive power mediates the relationship between personal initiative and emergency management ability of enterprise.Hypothesis 5: Political skills will positively moderate the relationship between personal initiative and executive ability, and individuals with higher political skills can better play the positive role of their initiative on execution.Organizational support theory points out that the benefits employees received from their employers will directly affect the achievement of organizational goals. For example, once employees got more support, they will respond to organizational support through high attendance and punctuality, thus forming more emotional commitments to the organization and responding flexibly to the possible problems in organizational activities . AccordiOn the other hand, in the process of continuous social communication with organizations, the perception of organizational support plays an important role in determining the psychological cognition of employees, and is an important driving force for individuals to make positive work behaviors. In order to change the work cognition and attitude of the individuals, the most important thing is to make them feel that the pay and return are equal . Fay andBased on the above analysis of the relationship among perceived organizational support, executive power and personal initiative, we speculate that perceived organizational support may be able to moderate the relationship between personal initiative and executive power. When individuals gain a high level of perceived organizational support, it can promote their initiative and enhance executive power. Therefore, the following assumptions are put forward:Hypothesis 6: Perceived organizational support will positively moderate the relationship between personal initiative and executive power. Compared with low perception individuals, high perceived individuals can exert the positive influence of their initiative on executive power better.Based on the above discussion, the theoretical model of this study is formed, as shown in The participants are full-time employees of companies in high-risk industries, such as chemical industry, construction, and transportation. These companies are located in Jiangsu, Zhejiang, Shanghai, and other places in China with rapid economic development.Of the entire sample, 40% of the participants were male and 60% were female. The ages of participants were divided into different age groups as follows: under age 25 (67.79%), 26–35 years old (21.63%), 36–45 years old (5.77%), and 46 years old and above (4.81%). Regarding the education level of the participants, 2.29% of them have junior high school education and below, 1.83% of them have high school education, 7.8% of them have junior college degree, 79.36% of them have bachelor degree, 8.72% of them have master’s degree or above. In terms of enterprise type, which the sample personnel engaged in, state-owned enterprises account for 18.35%, private/private enterprises account for 46.79%, foreign-funded enterprises  account for 6.42%, social organizations account for 5.5%, and others account for 22.94%. In terms of the position of the sample personnel in the enterprise, the grassroots employees account for 75.63%, while the managers account for 24.37%. With regard to job tenure, 56.42% have worked for their organizations for less than 1 year, 28.44% for 1–3 years, 5% for 3–5 years, 6.42% for 5–10 years, and 3.22% for more than 10 years. Overall, the distribution of samples is diverse.via Wechat and QQ. The participants in this study voluntarily participated by filling out online questionnaires, so the data obtained are random. Moreover, in order to ensure the effectiveness of the questionnaire, the filling time of the questionnaire is controlled within 20 min. The entire questionnaire process lasted approximately 1 month, from April to May 2020. A total of 270 questionnaires were returned. After removing the questionnaires with obvious regularity and consistency, 208 valid samples were finally collected (the recovery rate was 77%).Due to the impact of COVID-19 virus, data collection depends on an online questionnaire survey. First of all, we contacted classmates, friends, and relatives working in chemical, construction, transportation, and other industries in different cities. After their consent, we posted the online questionnaire in their company groups For the measurement of variables, this paper refers to the validated scales in the existing Chinese and English literature to collect relevant data. So all scales have good reliability and validity. In order to ensure the accuracy of wording, English scales were translated into Chinese by professionals. During data collection, items of all variables were measured on a five-point Likert scale .Personal initiative was measured with a five-item scale, which was modified according to Chinese cultural background based on the scale developed and verified by According to the measurement scale of individual political skills proposed by We used the five-item scale proposed by As for the executive power measurement scale, we selected the five-item scale of enterprise-level executive power improved by As for the measurement of emergency management ability, there is no recognized and unified scale that can be directly used in this study. We referred to the questionnaire used by In order to exclude the potential impact of demographics and some variables related to work background in this study, we controlled for six variables: gender, age, education level, nature of enterprise, position, and work tenure. Each of these variables is frequently included in relevant studies . First, In the part of data analysis and hypothesis testing, we firstly used SPSS 22.0 software to test the reliability and common method deviation of the collected data. And the mean value, standard deviation, and correlation coefficient of all variables were measured. Secondly, we conducted a confirmatory factor analysis (CFA) using AMOS software to examine the validity of structure, convergence, and distinction . Lastly,2/df (Chi square degree of freedom ratio), root mean square error of approximation (RMSEA), goodness-of-fit index (GFI), comparative fit index (CFI), and normed fit index (NFI) to test the fit of the model. It is acceptable for χ2/df to be between 1 and 5 . In addition, in the later confirmatory factor analysis, it can be seen that the fitting effect of the single factor model is significantly worse than that of the model established in this paper, so there is no serious common method deviation in this study.In this part, AMOS software was used for confirmatory factor analysis to analyze the convergent validity of the whole theoretical model. The factor loads of all constructs are mainly considered in the evaluation of convergence validity. The following table see shows thep = 0.001, indicating that there is good internal consistency between the items of the scale and the latent variables described. In addition, according to the established formula, the average extraction variance (AVE) of each latent variable is greater than 0.5, and the combined reliability (CR) is greater than 0.7, so the whole model has good convergence validity.It can be seen from 2/df is 1.02 and is in the range of 1–5. Furthermore, RMSEA is 0.01, less than 0.05. GFI is 0.901, NFI is 0.917, and CFI is 0.998, greater than 0.9, indicating that the model has good fitting effect and structural validity. In addition, through comparing the data of fitting index with those of the other nested models, it can be seen that the theoretical model used in this study is significantly better, indicating that the theoretical model has good discriminant validity.In this paper, confirmatory factor analysis was used to test the discriminant validity. From the model fitting results in According to the above analysis of the reliability and validity of the model, each part has passed the test, indicating that the measurement model meets the requirements.p < 0.01). To some extent, the Hypothesis 1–3 proposed in this paper is also confirmed. In addition, the correlation between the control variables and the five research variables can be observed. Age is positively correlated with personal initiative and perceived organizational support (p < 0.05). Positions show significant positive correlation with personal initiative, political skills, executive ability, and emergency management ability at different levels. Job tenure is also positively correlated with the five research variables in this paper. There is no correlation between the two control variables of gender as well as the education level and the research variables in this study.This part lists the basic statistical information and correlation coefficient of control variables and research variables. From In this paper, we used the structural equation model analysis method to test the hypotheses. The mediating effect model used in the verification process is shown in p < 0.001), showing that Hypothesis 1 is tenable. Executive power has a positive impact on the emergency management level and the standardized path coefficient is 0.5961 (p < 0.001), so Hypothesis 2 is supported. What is more, personal initiative positively affects the emergency management level, and the standardized path coefficient is 0.1401 (p < 0.05); thus, Hypothesis 3 is also tenable.It can be seen from the path inspection statistical table  that theN = 208). The test results are shown in P value is 0.0007, and the 95% partial correction confidence interval is , excluding 0, so the mediating effect is significant, indicating that Hypothesis 4 holds. In addition, the standardized effect value can be obtained according to the output of AMOS, in which the direct effect of personal initiative on the execution power is 0.4317, and the direct effect value of execution power on emergency management ability is 0.5961. The total effect of personal initiative on emergency management ability is 0.3974, of which the direct effect is 0.1401, accounting for 35.3% of the overall effect. Accordingly, the indirect effect is 0.2573, accounting for 64.7% of all. In contrast, the indirect effect formed by mediating variables can better constitute a positive correlation between personal initiative and enterprise emergency management ability, which confirms the importance of the mediating effect of execution power in the model.In addition, the deviation correction percentile bootstrap method was used to test the mediating effect through AMOS software. In this study, 2,000 repeated samples are selected , indicating that political skill has significant moderating effect on the relationship between personal initiative and executive power, but it weakens the influence of personal initiative on executive power to some extent. The specific regulation effect can be seen vividly in the following decomposition diagram.This study used the point selection method and drew the moderating effect decomposition diagram according to the output result of bootstrap of process proceedings, which directly shows the difference of the regulation effect between the relationship among personal initiative and emergency management ability under the level of high political skills (one standard deviation above the average) and a low level of political skills (one standard deviation below the average). From T test of the interaction item after decentralization of the two variables of personal initiative and perceived organizational support is not significant (P = 0.201 > 0.05). Therefore, the moderating effect of perceived organizational support between personal initiative and executive power is not significant. Hypothesis 6 set in this study is not tenable.The Hypotheses 1–4 in this study were verified to be true, which confirms the positive effect of personal initiative on executive power as well as enterprise emergency management ability, and the intermediary effect of executive power in this model is also proved. It is clear that enhancing the personal initiative can effectively improve the executive power and enhance the emergency management ability of enterprises through direct and indirect methods.Through hypothesis testing, Hypothesis 5 in this paper was proved to be not tenable. Although political skills have a significant moderating effect between personal initiative and executive power, it presents a weakening effect contrary to the assumption, that is, individuals with high political skills will weaken the positive impact of their initiative on executive power. There may be several reasons for this:(1)Individuals with high political skills will have a sense of fatigue when they constantly adjust their behavior, thereby weakening the positive impact of personal initiative on executive power . In orga(2)The influence of personal initiative on executive power may be more reflected in individual professional ability and technology. Political skills, as a kind of social skills, cannot fully exert their positive influence, support, and recognition on others in the long term and complex organizational political life. Instead, individuals are committed to acquiring certain organizational rights in the process of obtaining resources and achieving goals, which, in turn, poses a status threat and tensions to leadership . In addi(3)About 84.86% of the subjects in this study have worked for 3 years or less, and the proportion of grassroots employees is large. Maybe, the political skills of these individuals are not perfect, or the role of political skills in communication and interaction among groups is not fully played due to the short working years, job restrictions, and the influence of the organizational environment and others.In addition, the moderating effect of perceived organizational support between personal initiative and executive power in Hypothesis 6 was also proved to be insignificant in hypothesis testing. The following three reasons may explain for it.(1)Although individuals with high perception of organizational support can reduce their concerns about risks and make them more motivated to play their own initiative, there are always some people in the entire organization who are afraid of risks and choose to give up at different times, such as early or midterm. The process may involve individual trait differences similar to risk-taking traits, that is, personal risk-taking or risk-avoiding tendencies . If the (2)Individuals in the organization are not faced with a simple personal situation but a group context in which individuals, other individuals, and the organization interact with one other. Therefore, whether the motivating effect of organizational support can be played effectively depends not only on one’s own perception but also on social communication . Individ(3)The average value of perceived organizational support in this sample is lower than the average of other research variables. This may be due to the fact that most of the sample objects have been employed for less than 3 years or the exploitative nature of enterprises; thus, the individuals do not get enough support they need, resulting in the negative regulatory effect of perceived organizational support personal initiative on executive power.Although political skills and perceived organizational support have not been proved to play a moderating role in the hypothesis between personal initiative and executive power, there is no doubt that these two variables are positively correlated with personal initiative and executive power. By cultivating political skills and enhancing the perception of organizational support, the interaction and cooperation between individuals and other members of the organization can be strengthened. On the other hand, it will encourage individuals to exert their initiative when they realize that they have received spiritual and practical material support. Generally speaking, the analysis of these two elements has certain research significance for improving the emergency management ability of enterprises.This study mainly has three theoretical contributions. Firstly, the existing studies either focus on the cultivation of personal initiative and consequence analysis, or the analysis of influencing factors and the construction of the evaluation model for emergency management ability. Few studies connect the two variables, let alone combine them into a theoretical model for empirical analysis. This paper combines personal initiative with emergency management ability, and then to research and analysis the influence mechanism between them. It fills in the application and research of the concept of personal initiative in emergency work. On the other hand, it enriches the research on the consequences of personal initiative in the aspect of enterprise capability. Secondly, the concept of executive power is introduced into the model as an intermediary variable, which expands the influence of personal initiative on the emergency management capability of the enterprise in the indirect path. This further deepens the correlation between personal initiative and emergency management ability. Finally, we believe that, in the process of the transition from personal initiative at the individual level to executive power at the organizational level, there is interaction, communication, and cooperation among organizational members. Therefore, we explore whether the two potential variables of political skills and organizational support play the role of regulatory variables in the model and their actual role. It is helpful to systematically analyze how personal initiative plays a positive role in emergency work scenarios.Our results also have several important practical implications. First, they confirm that improving personal initiative can effectively improve the emergency management ability of enterprises. Due to the difference between innate and acquired in the acquisition of this ability , the effSecond, we find that the impact of personal initiative on enterprise emergency management ability is also reflected in the indirect path of execution, so the improvement of execution power is also very important. In addition to the introduction of information resources and advanced technology by enterprises, organizations should pay attention to the gradual progress when setting goals, adhere to the process of accumulating small goals to achieve large goals, pay attention to the differences among different people when setting goals and not assign complicated tasks to careless people. On the other hand, it is for individual cultivation and training. In addition to training in professional skills and safety skills guidance, regular safety drills and emergency evacuation should also be used to cultivate and enhance individual response capabilities and team cohesion .Finally, through the research, although the positive relationship between personal initiative and executive power is not changed, we find that the positive impact of the initiative of individuals with high-level political skills on executive power is reduced. Therefore, enterprises should be cautious in the work arrangement of relevant personnel in order to maximize the positive role of personal initiative. It cannot be ignored that political skills and perceived organizational support have a positive effect on the improvement of individual initiative and execution. So enterprises should adopt effective methods, such as systematic practice, alternative learning, and communication skills training, to cultivate individual political skills . It is aThe original hypotheses of this study have not been fully verified, so there must be deficiencies and limitations. The shortcomings of this research and the prospects for future research are summarized as follows:(1)Some scales used in this study refer to the foreign scales, but there are still differences between these scales and the local scales in China. Therefore, we should further explore and develop local scales.(2)In terms of sample collection, although a variety of options are set up on the basis of the six control variables, most of them are still concentrated on individual options, such as the age of 25 and below, and the education level of undergraduate, which may have a certain adverse impact on the verification of research hypotheses. In the future, methods should be selected to investigate the sample population of other options to enrich the diversity of samples.(3)This study adopted the method of horizontal research. So longitudinal data should be collected to further demonstrate the relationship between variables after time.(4)There is a transition from the individual level to the organization level between personal initiative and emergency management ability of enterprises. It may not be comprehensive to describe the influence mechanism of these two variables simply based only on the executive power, political skills, and perceived organizational support proposed in this study. Future research should open up new ideas, carefully study the complex relationships between individuals in the organization, clarify the influence relationships between various elements in the organization, and enrich the model by adding different variables and theories so as to deeply study the influence mechanism of personal initiative on emergency management ability of enterprise.Starting from personal initiative, this paper analyzes the influence mechanism between personal initiative and emergency management ability. According to our research results, the improvement of personal initiative helps to improve the enterprise emergency management ability, and it can further positively affect the emergency management ability by indirectly improving the execution ability. Therefore, in high-risk industries, we should pay attention to the cultivation and promotion of personal initiative in emergency management. In addition, political skills have a negative regulatory effect on the relationship between personal initiative and executive power (without changing the positive correlation between them). Moreover, both political skills and perceived organizational support have a positive relationship with personal initiative and execution, so their positive role should also be carefully and appropriately used. This study combines personal initiative and emergency management ability to carry out empirical analysis. Thus, it enriches the research on emergency theme and provides enlightenment and suggestions for the construction of enterprise emergency management ability.The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author/s.The studies involving human participants were reviewed and approved by the Ethics Committee of China University of Mining and Technology. The patients/participants provided their written informed consent to participate in this study in accordance with the Declaration of Helsinki.SL conducted the overall control and guidance for this study. FX designed and drafted the manuscript, and then collected and analyzed the data. ZX provided guidance in the process. YK and QY participated in the distribution of the questionnaires and the modification and improvement of the manuscript. All authors contributed to the article and approved the submitted version.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


In view of their profound involvement in human health and disease, the ~800 G-protein coupled receptors (GPCRs) and the ~520 protein kinases encoded in the human genome are the focus of intense research into their biology in normal cells, and into their potential as drug targets. Indeed, collectively, GPCRs and PKs account for a significant proportion of current global drug discovery targets    invasion by malaria parasites  the targeting of interactions between PKA and A kinase anchoring proteins (AKAPs) and (ii) the interruption of the dynamic signaling complex between PKA and the calcium-dependent kinase CDPK1 that is essential for RBC invasion. Targeting of the interaction between PKA and AKAPs has been intensively studied in the human host with STAD-2, a stapled peptide inhibitor that mimicks a conserved docking helix shared by AKAPs . The first gatekeeper inhibitors were from a series of imidazopyridines, which unfortunately had secondary targets. Another drawback for some of these compounds was the moderate/slow killing rate in the blood stages. A novel chemical scaffold, a thiazole lead structure, was identified in a screen of the GlaxoSmithKline Full Diversity collection of 1.7 million compounds with desired ADME  properties. Preclinical testing will determine whether these compounds can be considered as leads for novel antimalarials. Interestingly, Rotella et al. report in the present Topic Issue that they were not able to select resistance to PKG inhibitors in Plasmodium species; low propensity for resistance may suggest polypharmacology, which would be an advantage in the context of combination therapy.Despite the advent of peptoidomimetics, small molecules remain essential. In a review article Zilberstein reported in this Topical Issue identify Leishmania PKA as key to a checkpoint during promastigote to amastigote transformation. Binding of cAMP to the catalytic sites of PKA causes a dissociation of the PKAr subunit and in consequence activation of PKAc, a central part of the promastigote to amastigote differentiation signaling pathway. A unique feature of Trypanosomatid PKAr is the occurrence of 12 phosphorylation sites. Interestingly, serine 262 (S262) is preferentially phosphorylated under exposure to acidic pH, suggesting that phosphorylation is controlled by a pH sensor. Elucidation of the underlying molecular mechanism might constitute a basis to develop strategies to prevent differentiation into amastigotes in the human host.Recent results obtained by Plamodium. The advent of genetic manipulation of erythroid progenitors (Egan et al., cAMP/cGMP-regulated signaling pathways are essential for stage conversion in the complex life cycles of Apicomplexa and Kinetoplastids, and hence offer a rich resource of unique targets for treatment of the diseases caused by these parasites. However, only a few components of these pathways, notably the PKA and PKG ortholog, have thus far been demonstrated to be druggable. The non-canonical GPCRs of parasites represent potential targets, and so do the cyclases and phosphodiesterases that regulate cyclic nucleotide levels. Finally, it must be kept in mind that host cell signaling plays an important part in the life cycle of All authors listed have made a substantial, direct and intellectual contribution to the work, and approved it for publication.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


There is an increasing global concern of financing poor people who live in low- and middle-income countries. The burden of non-communicable diseases of these people is, by in large, connected to a lack of access to effective and affordable medical care, weak financing, and delivery of health services. Policymakers have assumed, until recently, that poor people in developing countries would not pay health insurance premiums for the cost of future hospitalization. The emergence of community-based health financing (CBHF) has brought forth a renewed and empowered alternative. CBHF schemes are designed to be sustainable, varying in size, and well organized. Developing countries, such as Nigeria, have been testing and finetuning such schemes in the hope that they may 1 day reciprocate high-income countries.A sample size of 372 respondents was used to assess the slums of Awka, the capital city of Anambra State, Nigeria, and empirically evaluate the socio-demographic characteristics of those who uptake CBHF using the provider Jamii Bora Trust (JBT). Cross-sectional research used a quantitative research approach with the instrumentality of structured questionnaires. Descriptive analysis was adopted to determine the socio-demographic characteristics of those who have CBHF uptake in Awka and evaluate the presence and benefits of CBHF in the city’s slums.The results show that more youth and middle-aged persons from 18 to 50 years are more insured  than those who are over 50 years of age. Gender distribution confirm more females  to be health-insured than their male counterpart . This perhaps reflected the reproductive roles by women and the fact that women have better health-seeking behavioral attitude. Moreover, the results correlate with previous studies that confirm women are more involved in local sustainable associations in low-income settings, of this nature, in sub-Saharan Africa. Corroborating this further, married people are more insured  than those who are not married  and insured members report higher use of hospitalization care than the non-insured.CBHF uptake favored members in the lower income quintiles who are more likely to use healthcare services covered by the JBT scheme. This confirmed that prepayment schemes and the pooling of risk could reduce financial barriers to healthcare among the urban poor. Recommendations are suggested to improve enrollment levels in the CBHF programs. One of the increasing concerns of promoting global universal health has been financing for more than 1.5 billion poor people who live in middle- and low-income countries . The burCommunity-based health promotion models target the whole community instead of disease-based models in which only the patient is targeted for treatment –20. AlthCBHF schemes can be used to assist the health status of many developing countries and have been found to be cost effective and replicable. In the case of Nigeria, the principal healthcare financing agents are the households which belong to CBHF schemes through out-of-pocket payments. Given the social, physical, and demographic infrastructure in the country, such schemes become an integral part of informal settlements. The socio-economic status—characterized by poverty, poor housing, and inaccessibility to basic healthcare—underpin the essence of assessing the performance of any scheme. The purpose of the study is to undertake an empirical evaluation of the socio-demographic characteristics of those who participate in CBHF schemes uptake in Awka, Anambra State, Nigeria. This will help to provide national and state government with knowledgeable insight into the core features of developing robust policy guidelines in terms of management and scheme development. The finding will also enrich existing knowledge and, hence, will be of interest to academicians, health practitioners, insurance companies, and the broader community who seek to explore and carry out further investigations in this field of study.Although the CBHF schemes have been considered as an innovative financing mechanism for the poor, they are not a new concept. Today’s social health insurance systems in many developed countries  as well as tax-based financing schemes  date back to small-scale community-based schemes that would meet the definition of CBHF . In someFor example, the Abota village insurance scheme in Guinea-Bissau was initiated in 1980 in the face of the breakdown of government funding for healthcare . In contIn Nigeria and Kenya, several CBHF schemes have emerged to meet the healthcare financing needs of low-income earners who have traditionally been largely left out of the private insurance system. CBHF schemes vary greatly in type and scope and range from small funds run by community welfare groups to large non-governmental organization-based schemes. In Kenya, CBHF schemes have formed an umbrella association known as the Kenyan Community Based Health Financing Association (KCBHFA) in which organizations are registered under the Ministry of Gender and Youth. In Nigeria, nine primary organizations similarly based on the KCBHFA system intercorrelate throughout the country, namely: Western Region Community Services, Christian Organizations Research and Advisory Trust for Africa, Tropical Institute of Community Health, Christian Health Association of Nigeria, International Center for Development and Research, Eldoret Christian Community Services, Inter-Diocesan Christian Community Services, Support for Tropical Initiatives in Poverty Alleviation, and Jamii Bora Trust (JBT). Remarkably, JBT, a microfinance institute, was founded by Ingrid Munrowith’s initial small loans to fifty beggars in Nairobi in 1999 and, to date, has grown into one of the largest microfinance institutions in Africa . JBT hasMany sub-Saharan countries began the post-colonial period with the intention of providing free or heavily subsidized healthcare to their citizens. Difficult economic periods, during the 1970s and 1980s, resulted in the abandonment of a universal health goal by virtually all sub-Saharan African countries. In the late 1980s, African health ministries, guided in part by the United Nations International Children’s Emergency Fund (UNICEF), the World Bank, and WHO, shifted their healthcare strategies to a subsidized, fee-for-service model that involved active community participation . LauncheMali was the first West African country with a legislative framework to govern micro health organizations, passed in 1997 , 42, 43.In 1999, the Rwandan Ministry of Health instituted a CBHF pilot test in three districts. In order to collect policy development improvements, the Ministry collaborated with the partnership healthcare providers. The initiative was started in order to protect the communities most vulnerable and at risk. To date, CBHF schemes in Rwanda have grown into one of the “largest experiments in community-based risk-sharing mechanisms in sub-Saharan Africa for health-related problems” . SimilarWhile the growth rate of these schemes has been impressive, it is rather unfortunate that it can only insure a small proportion of every administrative population. For example, the estimated number of beneficiaries in Mali, Burkina Faso, and Benin in 2006 was a little over half a million people out of a combined population of about 36 million in the three countries . AlthougAnother main challenge of CBHF in Africa is the issue of equity. The Tanzanian bill that established national health financing for civil servants was mandatory and designed to cover employees, spouses, and children as legal dependents . PrelimiHaving examined the benefits and the challenges of CBHF, it is important to take proactive steps to ensure sustainability. One way to do this, is to integrate CBHF within the larger health system of a given country . Care muIt is apparent that CBHF schemes are viewed by many as a promising new tool for health system improvement for rural populations in low-income countries, particularly in sub-Saharan Africa . It is aFurthermore, the prevailing concept of illness and risk make it very relevant to whether a household decides to purchase health financing or not. Cultural habits in dealing with the risk of illness can influence the demand for CBHF, e.g., in rural Benin, people commonly put money aside for unpredictable events like marriages and funerals but believe that saving money for eventual healthcare costs is equivalent to wishing oneself will become disease-stricken . FortunaWidespread poverty among potential members can be a serious obstacle. If people are struggling daily to survive, they are less willing to pay financing premiums in advance in order to use services at a later point in time. A positive impact of health financing on equity and access must be questioned if a large proportion of the population cannot even afford CBHF membership. Social exclusion may persist even if barriers to health access is reduced for part of the population, and exemption mechanisms for the poorest—e.g., sliding scales for premiums—are enacted as a possible remedy . After on = 372 was calculated.A cross-sectional research design is adopted through a descriptive analysis to evaluate the presence and benefits of CBHF in Awka, Anambra State, Nigeria. The study adopted a quantitative method to gather needed descriptive data on the socio-demographic characteristics of the selected residents in the city of Awka who partake in CBHF schemes or otherwise. The data was collected from different parts of slums in the city which allowed for the generation of descriptive data. A descriptive survey generated statistical information on the socio-demographic features of participants of CBHF schemes among the residents of Awka. The study focused on the 12,246 JBT members with Jamii Bora Health Insurance (JBHI) located in the Awka branch . The stun = sample size, z = z-score associated with a 95% level of confidence, p = sample proportion, e = margin of error, and N = population size .Where: The study then adopted a stratified sampling method, which is commonly used to produce a precise estimate of characteristics of a whole population . It is aA three-week pilot questionnaire was conducted with 30 sampled members to test for questionnaire issues  and validity of the questions. Questionnaires were then officially administered to sampled members for the purpose of gathering study data. Questionnaires with guiding instructions, i.e., for the purposes of understanding the task, were distributed to the identified population by the authors and a number of research assistants. The respondents who received the questionnaires were made up of slum dwellers in the city of Awka who had previous knowledge about the CBHF scheme and whether they have an uptake or not in it.To further strengthen the research, a pilot study was also undertaken in the slums of Kibera, Nairobi, Kenya, which has a similar JBHI scheme. This assisted the researchers by testing both the research instruments and the ability of the research assistants to administer the instruments. Moreover, members of the JBHI scheme in Kibera were sampled and interviewed which helped identify gaps in the instruments. A total of 50 respondents were included in the pilot study, validating the data collection method and the comparison of data with existing information in relevant offices and studies. This was done through cross-checking the information gathered with the already existing data in relevant institutions and through observation—ensuring data consistency and accurateness. In testing for reliability, piloting of the instrument was necessary. The instrument was tested using the split half method before the study was fully approved. In this case, the instrument was found to be resulting in inconsistencies which required necessary adjustments to ensure that they measured up to the required standards. This was done through simplifying some of the language in the questionnaires, reframing the questions, and restructuring the questionnaire. Guiding instructions were also rephrased, as necessary, to ensure that the instruments gave reliable information and what was desired in the study.Descriptive statistics was applied to analyze the gathered data. After the data was collected and before the analysis was done; the data was first refined to eliminate any undesired or unwanted information that could have made the analysis problematic. This was done through organizing and editing the data to remove any repetitions, inconsistencies, errors, and anything not well understood as presented by the respondents. This was followed by coding the data to establish how possible answers would be treated by assigning them with numerical values. The final dataset was then stored in both soft and hard copies for reference during the analysis process. The data was tabulated and classified as per the characteristics observed and then analyzed in its own class using frequency tables. The data were analyzed using SPSS Statistics Version 27 and Microsoft Excel 2019 software packages. Similar studies of this nature in Africa , 16, AsiPrior to the commencement of the study, verbal authorization was obtained from all the relevant authorities for conformity and to ensure that the study would not be discontinued. First, the authority from the University of Nairobi, Nairobi, Kenya, was given to commence the study as well as assistance from the University to seek the proper permissions within Kenya. Permission to commence the study was also sought from JBT which is the institution in charge of the CBHF scheme in the study area. The research further acquired authorization from the community health project’s Mathare Clinic which is the JBHI accredited hospital in Awka. Moreover, verbal consent from all respondents through talking and explaining to them the purpose of the study was received. Confidentiality was guaranteed and respondents are not identified in any way. The study was approved by the National Open University of Nigeria (NOUN) Ethical Committee and complied with the ethics of scientific research described in the NOUN Charter of Ethics and Ethical Principles in-line with the Declaration of Helsinki and other applicable ethical principles and legislation in Nigeria. Ethical approval was granted by the NOUN Research Administration and Advancement, Research Ethics Sector, Ethical Committee.The study aims to examine the extent of changes in the socio-demographic characteristics of residents who are involved in the uptake of CBHF schemes in the city of Awka. A total of 372 questionnaires were distributed to selected respondents in the city which were all filled and returned with a 100% response rate. This was (clearly) an acceptable rate and was attributed to the fact that the questionnaires were administered mostly during the weekend and were physically dropped off to the respondents and collected on an agreed date. During the interaction with the respondents, fieldwork notetaking was performed in which observation and additional face-to-face dialogue was reported on. Additional questioning included the average number of times respondents were hospitalization annually and their general perspective  to the JBHI scheme, its service availability and reliability, and why they were happy (or not) with the scheme and how it could be improved. Table In addition, the study examines the relationship between specific socio-demographic factors and the level of resident participation within the CBHF schemes. For example, how marital status relates to the level of insurance status of the respondents. The results reveal the proportion of those insured was higher among the married  than the unmarried . This confirmed the assertions of previous studies which suggested that marital status had a statistically significant positive effect on health insurance ownership , 36. MarThe study examines also the scope of social health insurance within the informal sector. Thus, it found that within the city of Awka’s slums, informal savings groups were common, and slum dwellers made monthly contributions—communally. The slum dwellers shared their contributions on a revolving basis as a member-based group to help cater for various needs, including funeral and healthcare expenses. This is necessary since urban slum dwellers in Nigeria are often being confronted with inadequate waste disposal methods that festers disease, which can easily turn into a local outbreak . This reSimilarly, the study sought to examine the religion of the respondents and their insurance status. The results show 62.8% of the insured respondents were Protestant and 22.4% were Catholic, while 14.8% of the respondents were from the Islamic faith. Likewise, 53.8% of the non-insured respondents were Protestant and the percentages for Catholic and Muslim were 32.9 and 13.3%, respectively. Participation in the JBHI scheme was significantly higher among respondents who have secondary school and higher education level . Those who had primary school education and are insured constituted 33.8%. There was a significantly low enrolment of the insurance among the respondents who had no formal education . The research underscored those with secondary school education level and above as more likely to use JBHI benefits than those with less education. With the exception of a few results, particularly the place of residence, most other results obtained in from this study validate or corroborate with findings from other similar studies , 14, 16.The data disclosed that more youth are non-insured compared to those in other age groups. It can also be observed that more women were insured. This could be attributed to the fact that more women are involved in organizing and being a part of community-based organizations throughout Nigeria –61 whereThe data disclosed that individuals in the lowest and low-income group are more likely to be enrolled in the JBHI scheme in comparison to others. This is supported by previous studies, suggesting that inclusion of the poorest was dependent on the design and implementation features of the scheme –78. JBHIThe study demonstrates the key socio-demographic characteristics of the people who have uptake of CBHF in Awka, Anambra State, Nigeria. It was found that uptake of JBHI benefits was higher than in most other CBHF studies –71, 73. On the basis of these findings, the following three recommendations are suggested. First, since the majority of youth respondents have the lowest enrollment in CBHF, it would be recommended that a review of the insurance package made by CBHF be more attractive and suitable to younger people. This is a good idea, since it creates a strong generational commitment to sound healthcare and cyclic financial support of the system as a whole. Second, since 74% of the respondents said that service delivery at JBT could be improved by simply increasing the amount of hospitals covered under the scheme, it would be recommended that the national JBHI network expand their 90 approved hospitals so that their services can be more accessible to the community. This would, potentially, enlarge their cliental and, indirectly, improve hospitals and clinics requiring the JBHI standard. Third, the need for community sanitization should be prioritized in order to initiate a change of cultural beliefs and any misconception that inhibits enrollment of cliental into CBHF-based schemes. Disease and illness should be seen as somewhat of a random event that can hit anyone and, hence, preparedness via insurance should be highlighted at all levels of government. This study, through a detailed literature review, managed to piece together key CBHF historical components specific to sub-Saharan countries. It is therefore expected that it will aid, especially the bottom end of the economic ladder and the safety net necessary to meet healthcare requirements. Future study into socio-demographic factors is needed and should focalize on developing further support mechanisms such as employer-based health insurance, family health risk, and educative social and community planning.


During the first year of the COVID-19 pandemic, dental faculties had to rethink their way of teaching and interacting with students and of delivering solid theoretical knowledge and practical skills to students. Background: The purpose of the study was to assess dentistry students’ opinions about the online activity, together with a self-evaluation of their mental and physical health, during the first wave of the pandemic. Methods: A cross-sectional study was conducted using an online survey. Three hundred and three students, enrolled across all six years of study, were included in the research. Socio-demographic and academic data were collected, along with a self-evaluation of physical and mental status. Some items investigated students’ opinions about distance learning and the impact of that online activity on their achievement. The answers were rated using a five-item Likert-like scale. Data were analyzed using SPSS (v.24). Results: statistical analyses showed that more than 20% of the students strongly agreed with the statement that they felt more anxious and depressed during the first months of the pandemic, and more than 30% were totally satisfied with their relationships with their family members. One-fifth of the respondents declared that they were totally dissatisfied with the relationships with their colleagues and friends. Overall, 50.60% of the students attended the courses/labs in their entirety when they were connected online. Two-thirds of the respondents considered that their practical training was affected due to the online activity, and that not all of the subjects could be taught online. More than half of the respondents agreed that the most objective evaluation method is that of the multiple-choice exams administered at school, and considered that exclusively utilizing online assessments of students encourages unethical behaviors. Age, involvement in online activity, and active participation using video cameras were strongly correlated with satisfaction with academic results. Conclusions: The results of the present study showed that online activity was a good alternative for dentistry students during the pandemic restrictions. The positive aspects, together with the negative consequences, of distance learning should also be taken into consideration by university teachers and academic institutions to improve teaching experiences and to ensure a solid professional formation for dentistry students. After the outbreak of the pandemic, universities were forced to align with the restrictions imposed by the governments of each country. The rate of spread of the virus in each country has led to various measures, from the total closure of courses to partial closures, depending on the epidemiological data identified at the regional level.In the academic environment, the preventive measures taken were, in general, to completely stop all activity in the classroom, to move the didactic activity to an online environment, and to avoid coexistence on university campuses.According to the American Dental Education Association (ADEA), on 15 May 2020, some key changes were implemented in United States (USA) dental training institutions specifically due to the COVID-19 crisis. Students were sent home for a period, and institutions planned to evaluate their return strategies .Many studies conducted in the USA one year after the outbreak of the COVID-19 pandemic also pointed out several positive changes among dental faculties, including curricular changes; students’ involvement in frontline healthcare services; and the adoption of new strategies and methods of learning, teaching, and evaluating students. In order to continue the educational process, policy makers, institutions, teachers, and students worked together to cope with the pandemic crisis. A swift implementation of creative methods was adopted to avoid disruptions in practical training relating to patients and clinical competencies . In manyDental treatments were considered to be of very high risk due to aerosol generation, so the greatest challenge for the teaching staff was to decrease the risk of COVID-19 infection while ensuring the continuity and quality of the dental education system. In light of national COVID-19 infection-control recommendations, dental faculties had to suspend in-person instruction, and teaching activity was conducted online. Some researchers who focused on online dental education pointed out the rapid change adopted by dental faculties in many countries, such as the USA ,7,8,9, GThe nature of teacher–student interactions changed, and the new type of virtual communication had to use more rich visual content, interactive video tools, graphs, or web-based interaction to meet students’ need for interaction but also to help students create their own learning styles. Individual tasks or online working group sessions were implemented. The need for developing practical skills proved that online learning was an efficient tool in the medical sciences, including dental education, during these special pandemic times.Distance learning has facilitated the ability for students to continue their studies in dentistry, thus creating the opportunity to access information and simulate practical skills. The online development of the didactic activities also required students’ access to audio—video connection means and to a stable connection to the internet. Various studies  showed tIn the field of dentistry education, the evaluation of TB teaching and learning in non-prepared situations, such as those imposed by the COVID-19 pandemic, has not been fully investigated in Romania.In Romania, between March and October 2020, the faculties of dentistry decided to suspend face-to-face courses. Regarding the next academic year, various methods of carrying out teaching activities were proposed (online or on-site), and practical stages with patients were considered a high-risk activity. This study aimed to evaluate dentistry students’ opinions about academic activity after the first wave of the pandemic and to identify different aspects related to online activity among undergraduate dental students.The present study was conducted for two weeks, between 18 November and 2 December 2020. The study period represents the middle of the first academic semester that usually starts in Romania on 1 October and lasts until 10 February. During the period that this study was developed, due to the epidemiological conditions and restrictions imposed among all universities in Romania and Europe, the main parts of the academic activities in the medical sciences were conducted online. The dentistry faculty organized only online activity during this first semester, so students were located at home .The questionnaire was created and distributed using the Google Forms application  to all students of the dentistry faculty across all academic years. The participants were informed about the purpose of the study. Filling in the questionnaire was assumed as informed consent to participate in the study. No incentives were offered to students, and they had the ability to withdraw from the research with no consequences. The inclusion criteria were that participants had to be students enrolled in dentistry studies (in years 1 to 6 of study), and the questionnaire had to be submitted before the deadline. Exclusion criteria were students being enrolled in master’s degree or doctoral research programs and/or questionnaires being submitted after the deadline.The survey form was sent to 527 students who were registered across all years of study. A total of 314 participants answered the questionnaire before the deadline; after eliminating 11 respondents who declared that they were postgraduate or Ph.D. students, a total of 303 participants were finally included in the research See .-The first part collected socio-demographic-, academic-, and health status-related data .-The second part collected information about students’ physical and mental health status and their fear of infection with COVID-19. Self-rated items were constructed, and answers were rated using a five-item Likert-like scale.-The third part of the survey inquired about students’ satisfaction with their academic results and relationships with friends, colleagues, and family members, as related to the restrictions imposed by the COVID-19 pandemic.-The fourth part collected data regarding students’ opinions about their online activities; their practices and habits during lectures; practical stages that were developed online; the teaching and evaluation process; and the impact of online classes on their academic achievement and results, together with ethical concerns about evaluation.-Self-rated items were constructed, and answers were rated using a five-item Likert-like scale.After researching the literature about e-learning and online activity during the COVID-19 pandemic, a survey was constructed in order to assess students’ opinions about the educational process during restrictions. The questionnaire contained four parts:p < 0.05.All analyses for this research were performed using the IBM Statistical Package for Social Sciences (SPSS) Statistics for Windows, version 24 . The descriptive statistics of the socio-demographic- and academic-related data were expressed as means (M) and standard deviations (SD), frequencies, and percentages (%). In order to assess comparative results considering gender, marital status, and academic activity, a Mann–Whitney test was performed. The relationship between variables was assessed using Spearman correlations. The level of statistical significance was set at The present study was conducted in accordance with the Declaration of Helsinki, and the protocol was approved by the Ethical Committee of Faculty of Medicine at the University of Oradea, Romania, with the registration No. 12/20.11.2020.Socio-demographic-, academic-, and health-related data were collected from all of the participants enrolled in the undergraduate dental program within the University of Oradea at the time of the research. The majority of the respondents were females, which is in congruency with the worldwide gender distribution in medical studies. For descriptive analyses, subjects were presented by year of study; however, this variable was restructured for comparative results as preclinical  and clinical  academic years. The descriptive analysis of data is presented in Social distancing requirements, restrictions against visiting family members and friends, and the interruption of academic activity at the university or in dental clinics were all reported to have had a great impact on the psychological health status of students. Students were also asked about the activities that they engaged in during the first months of the pandemic in order to cope with stress related to the various restrictions and to keep them healthy. More than one-third of the respondents declared that they had watched documentaries, films, and show series ; more than one-fifth indicated that they had read books or journals ; a minority of the group declared that they had cooked ; and some of the respondents said that they had spent their time doing physical activities .Students were asked to self-rate their mental health status regarding the following different problems: sleep, eating, depression, anxiety, and getting bored. The respondents had to indicate their level of agreement with the statements using a five-item Likert-type scale. Answer options included 1—strongly disagree, 2—disagree, 3—neither agree nor disagree, 4—agree, and 5—strongly agree. The students’ scores are detailed in Six items investigated students’ satisfaction regarding their physical and mental health; their relationships with friends, family members, and colleagues; and their academic results during the first months of COVID-19 restrictions. The answers were rated using a five-item Likert-type scale with response options ranging from 1—totally unsatisfied to 5—totally satisfied.We identified that more than half of the students surveyed were satisfied with their physical health, but that almost 30% were unsatisfied with their mental health. Furthermore, more than 50% were unsatisfied with their relationships with friends and colleagues, while 57% were satisfied with their relationships with family members. The responses are presented in During the present research, the academic activities of dentistry students were developed online. The majority of the students connected to the online platforms from their homes , and a low percentage of students indicated that they participated in online activities from other places, where the internet connection was better than that at their homes .The need to move teaching activities to an online environment resulted in determination on the part of the universities to find platforms quickly in order to carry out courses and practical activities in the best possible conditions. Students were asked what platforms they used most often to conduct various school activities, such as those used for online connections for theoretical or practical meetings, the completion of assignments and their submission to teachers, and online courses.A total of 63 students (20.70%) declared that they used the Microsoft Teams University Platform for their academic activity; more than half of the respondents indicated that they used Zoom, Google Meetings, and Skype  more often for their online activity, and a small number of them  reported that they usually preferred using other ways of communicating with colleagues and teachers . Moreover, when communicating with their colleagues regarding their academic tasks, dentistry students preferred to use social platforms  or Microsoft Teams .Where communication with their teachers was concerned, students declared that they predominantly used Microsoft Teams , social networks , email , or communicated through faculty administration staff .Most students preferred to use laptops for online activities . A lower percentage said they used their smartphones to connect , and an even smaller percentage said they participated in online classes using a desktop computer .A series of sixteen items were constructed in order to identify dental students’ opinions about online education. The results showed that over two-thirds of the respondents (79.90%) believed that their practical training had been affected due to the use of online activity and that not all subjects could be taught online (73.90%). We also identified that more than half of the students disagreed with the following statements: that the didactic activity was more interactive online than within the institution ; that they had preference for online activity over the type carried out within the institution , and that lectures and practical stages were more interesting online.Regarding the involvement of teachers, students appreciated that the academic staff made the courses available to students in the digital format, but they considered that the teachers were not well-trained in using the online platforms and audio–video tools.The analysis of the responses proved that online participation did not encourage students to be active; we found that only 8.80% of students connected with a video-camera. However, 22.40% of students agreed that they could focus better on new information than when they attended the course/laboratory in person.Two items were used to evaluate students’ opinions about the amount of time available for study and hobbies during the restrictions imposed by the COVID-19 pandemic. The results showed that more students indicated that they invested time in hobbies and recreational activities than in studying or academic tasks. The detailed results are presented in The e-learning processes and online evaluations were two of the most challenging aspects during the first months of the pandemic, because the teaching staff had to develop and use different types of instruments. Therefore, the students had to adjust to the new academic methods and tools. A number of items aimed to investigate students’ opinions regarding online evaluation as compared to the classic one, as well as the ethical aspects of online evaluation methods.The results proved that 46.20% of students totally disagreed with the statement that online oral evaluation is the most objective method, and that 40% of the respondents totally agreed with the statement that an online multiple-choice exam is the most objective method available for the evaluation of the students.More than 60% of the respondents agreed that the most objective evaluation method was that of the multiple-choice question exam (MCQ) administered at school, with 37.30% of the total students surveyed totally agreeing with that. It is also noteworthy that almost half of the questioned students indicated that they agreed with the opinion that exclusive online assessment of students encouraged unethical behaviors. The detailed results are presented in Three items investigated students’ fear regarding the risk of COVID-19 infection. This survey was conducted before their return to school. The respondents had to indicate their level of agreement with the statements using a five-item Likert-type scale rated as follows: 1—strongly disagree, 2—disagree, 3—neither agree nor disagree, 4—agree, and 5—strongly agree. The responses showed that students were more afraid of being infected by patients during their internship than of contracting the virus during classes or from classmates. The frequency of answers is presented in p < 0.001).There were significant differences between women and men in terms of e-learning teaching activity. Men (Mdn = 4.00) had more positive opinions than women (Mdn = 3.00) about the internet connection quality that influenced the quality of the teaching activity . At the same time, men (Mdn = 2.00) were more involved in the online activity, keeping their video camera connected during the courses , as opposed to women.The results of the present research showed that, unlike women (Mdn = 2.00), men (Mdn = 3.00) considered that the teaching activity was more interesting in the online environment  than healthy students (Mdn = 4.00). Moreover, the results of the Mann-Whitney test  showed that students suffering from chronic diseases noticed that during the pandemic they had more sleep disorders (Mdn = 4.00), unlike the rest of the students (Mdn = 3.00). At the same time, chronically ill students considered that the amount of information taught in the online activity was higher (Mdn = 4.00), unlike healthy students (Mdn = 3.00), .Comparative analyses showed that dental students suffering from chronic diseases (Mdn = 3.00) were less satisfied with the relationships with their family members during the restrictions related to the COVID-19 pandemic . Significant differences were also registered regarding the occupancy of the room where the students live; thus, unlike the students who shared a room with someone (Mdn = 3.00), students who lived alone (Mdn = 2.00) considered that online courses were not so interesting .The comparative analyses also showed significant differences between students from urban areas (Mdn = 3.00) and those from rural areas (Mdn = 4.00), in the sense that students from rural areas lived in a room with more people . Age correlated positively with their degree of satisfaction regarding their academic results during the pandemic, in the sense that the advanced year of study students were in, the more satisfied they were with the results they obtained .The correlation analyses showed that there were positive correlations between students’ age and certain behaviors. We identified that as they got older, students consumed more energy drinks  and the more efficiently they could organize their daily schedule . At the same time, the more advanced year of study students were in, the more they believed that, during the pandemic, the time they spent on studying increased .Regarding the online development of teaching activities, the results showed that the older the students, the better they could focus on the new information received  or from patients with whom they came into contact during practical internships . We identified negative correlations between the age and physical and mental health of students, in the sense that the older the students, the more they noticed that during the pandemic they had fewer appetite disorders , felt less depressed , and felt less anxious .Additionally, age correlated positively with students’ feelings of fear, in the sense that as they got older, they were more frightened that they might become infected with COVID-19 during practical college activities  and the number of people in the household , in the sense that—in the case of smoking students—the more the students smoked, the more alcohol they consumed, and the more people that were in the house, the more students tended to smoke. A negative correlation was identified between cigarette consumption and the amount of time spent on recreational activities during the pandemic , in the sense that the more students smoked, the less time they spent on hobbies.We identified that cigarette consumption correlated positively with alcohol consumption , in the sense that alcohol consumption might increase in direct proportion to energy drink consumption. Moreover, alcohol consumption correlated positively with the degree of satisfaction regarding mental health  and the degree of satisfaction regarding relationships with family members during the pandemic , meaning that students with higher alcohol consumption had better relationships with family members and were more satisfied with their mental health. A strong negative correlation was identified between alcohol and drug use .Our results also proved a positive correlation between alcohol consumption and energy drink consumption , eating disorders , depression , anxiety  and boredom . These results proved that the more satisfied the students were with their physical condition, the less depressed, anxious, or bored they were, and the fewer sleep disorders or appetite disorders they had. The degree of satisfaction with their mental health correlated positively with the degree of satisfaction regarding their relationships with friends , colleagues , and family members  during the COVID-19 pandemic, in the sense that the better the relationships with colleagues, friends, or family members, the more satisfied students were with their mental health. Furthermore, the degree of satisfaction with their mental health correlated positively with the degree of satisfaction regarding the academic results students obtained during the pandemic , as well as their degree of concentration on the new information received in online activities , in the sense that the higher students’ satisfaction with their mental health, the better they could concentrate on online activities and the more satisfied they were with their obtained academic results.Strong negative correlations were revealed between the degree of satisfaction with their physical health and several items related to the physical and mental state students felt during the pandemic, such as sleep disorders  and the students’ preference to stay connected with video cameras during the online activity , in the sense that the more satisfied they were with the results they obtained, the more they tended to stay connected through video during the online activity and to participate fully in the courses. We identified a positive correlation between the degree of satisfaction regarding the academic results obtained and the students’ preference for online activity to the detriment of the traditional instruction carried out within the institution , in the sense that the more satisfied the students were with their results, the more they preferred to stay at home and attend online courses. At the same time, significant correlations were revealed between the degree of satisfaction with the academic results obtained by the students during the pandemic and the opinion that practical activities  and courses  were more interesting in the online format.Regarding the online academic activity, the correlation analyses showed that the degree of satisfaction regarding the academic results of the students obtained during the pandemic correlated positively with students’ full attendance of their courses or laboratory instruction in the online environment  or from colleagues , in the sense that the more that students were scared of contracting the virus at their college, the more they feared that they could become infected from patients or colleagues with whom they came in contact during their teaching activities at the faculty. Moreover, a positive correlation was identified between the fear of infection with the new virus during practical activities at college and the preference for online classes , in the sense that the more scared students were of COVID-19 infection, the more they preferred to participate in online teaching activities from home.The results also proved a positive correlation between the fear of COVID-19 infection during practical activities carried out in the college setting and the fear of infection from patients  declared that they were concerned about their practical skills.The correlation analyses proved that the more satisfied the students were with their physical condition, the less depressed, anxious, or bored they were, and the fewer sleep disorders or appetite disorders they had. The degree of satisfaction with their mental health correlated positively with the degree of satisfaction regarding their relationships with friends, colleagues, and family members during the COVID-19 pandemic. We also found that living in an apartment was correlated with a higher consumption of alcohol and cigarettes and less time spent on hobbies and relaxing activities. Similar findings were identified by Prieto et al. . The autWe found that the higher satisfaction with their mental health was, the better students could concentrate on online activities and the more satisfied they were with the academic results they obtained. We can conclude that during the COVID-19 pandemic, the strong relationship between mental health, academic results, and the level of satisfaction with academic activity was very well highlighted. Thus, during the lockdown, students who found satisfaction in studying considered themselves physically and mentally healthier and found strategies to better cope with stress.The present research presents a broad description of the student reality in a pandemic context, which could be relevant for detecting problems and making methodological and curricular decisions within the context of the training of future dentists. The present results are useful for students to understand the particular context in which they had to struggle, and also for university teachers in order to adapt their curricula and methods to meet students’ expectations as well as their own standards of teaching.There are some strengths of the present research. The number of participants was beneficial for cross-sectional study, and important conclusions by gender, environment, year of study, and level of satisfaction with physical and mental health were able to be generated. Additionally, the results are important for both students and teachers working in dental institutions for across various issues related to online activity: academic tasks, evaluation methods, learning, relationships, mental and physical status, ethical concerns, and social aspects. Therefore, from this point of view, the present study presents important results for all actors in the academic field .The limitation of this research is due to the regional context, meaning that the results could be influenced by the number of infections in the area and the severity of the lockdown restrictions. So, when results are considered in comparative analyses, researchers must also take into consideration the type of activity  when they proceed in drawing conclusions.The COVID-19 pandemic can be seen as a kickoff point for the motivation to invest in the technological innovation necessary to deliver the best possible education to our future dentists—even during the post-pandemic period—to ensure a higher level of satisfaction and stronger confidence in the preparedness of dental students for their future profession. The psychological impact of the online activity must not be neglected; teachers and psychologists must be aware of the strategies that have to be applied during online relationships in order to stimulate communication and increase the active participation of students.