ABSTRACT
Background. Theoretical models of behavior change focus on psychological constructs, including intention and self-efficacy, but they do not consider the role of stressors. In this study, the impact of home confinement was explored as an external stressor on mental health, sleep, loneliness, tiredness, and behavior of children during the coronavirus disease of the 2019 (COVID-19) pandemic. Material and methods. Ten children aged 7-17 years who were restricted at home for at least one month during the COVID-19 outbreak were included. Semi-structured interviews with children were conducted to elicit their feelings, reflections, and responses to home confinement during the COVID-19 pandemic. The children expressed that they felt lonely and tired at home "sometimes" to "most of the time". Results. The children had no sleep status quality as before the COVID-19 outbreak, including difficulty in falling asleep, insomnia, and hypersomnia. Most children had depression and anxiety symptoms with different severities. The children were irritable, aggressive, or nervous at home. Only one child reported that she was more active and had positive changes compared with before. Most children experienced some degree of conflict with their parents or siblings. Conclusions. This study found that some children were affected by different kinds of emotional issues at home during the COVID-19 pandemic.
ABSTRACT
OBJECTIVE: Poor dietary habits are considered to be the second-leading risk factors for mortality and disability-adjusted life-years (DALYs) in the world. Dietary patterns are different based on cultural, environmental, technological, and economic factors. Nutritional deficiencies of energy, protein, and specific micronutrients have been shown to contribute to depressed immune function and increased susceptibility to infections. We aimed to explore the relation of dietary factors with global infection and mortality rates of COVID-19 in this study. DESIGN: In the current ecological study, the countries that had national dietary data from the Global Dietary Databases of the United Nations and coronavirus disease statistics from the World Health Organization (WHO) were included. The countries that had coronavirus disease statistics from the WHO were consecutively checked for the recent data of the dietary factors. SETTING: World. PARTICIPANTS: 158 countries across the world. MEASUREMENTS: infection and mortality rates of COVID-19; dietary factors. RESULTS: The median crude infection and mortality rates by COVID-19 were 87.78 (IQR: 468.03) and 0.0015 (IQR: 0.0059), respectively. The two highest percentage of the crude infection rate were between 0 and 500 (75.9%) and 500-1000 (8.9%) per one million persons. The regression analysis showed that the crude infection rate has been increased by raising consuming fruits (Beta: 0.237; P=0.006) and calcium (Beta: 0.286; P=0.007) and was decreased with rising consuming beans and legumes (Beta: -0.145; P=0.038). The analysis showed that the crude mortality rate was increased by raising consuming sugar-sweetened beverages (Beta: 0.340; P<0.001). Whereas, the crude mortality rate by COVID-19 has been decreased by increasing fruits consuming (Beta: -0.226; P=0.047) and beans and legumes (Beta: -0.176; P=0.046). CONCLUSION: The present study showed the higher intake of fruits and sugar-sweetened beverages had a positive effect on infection and mortally rates by COVID-19, respectively. In contrast, the higher intake of beans and legumes had a negative effect on both increasing infection and mortality rates.