Behavioral Changes in the Community following COVID-19 Pandemics, A Conceptual Model Derived from a Grounded Theory Study in Iran

Background: COVID-19 epidemic in Iran has imposed a heavy social, economic, political, and psychosocial burden and caused devastating social problems. On the other hand, it has also led to promising social cohesion. This study aimed to explore the community-wide changes following the COVID-19 pandemic and to understand how these changes may affect the Iranian community. Methods: This qualitative study used the grounded theory approach and conducted from May 2020 to March 2021 at Shiraz University of Medical Sciences, Shiraz, Iran. Adopting a purposive sampling approach, 15 faculty members in different fields participated in this study, and 17 interviews were performed. Results: This study indicated that the core phenomenon in the social change process was "struggling for survival and livelihood”. Therefore, people tried to identify and choose strategies to deal with or repel COVID-19 disease as a life-threatening situation. A set of contextual factors influenced their choice. The media and the performance of organizations as intervening conditions also played an important role in this process. Finally, this complex process led to constructive and destructive outcomes in society. Conclusion: The COVID-19 epidemic caused various multifaceted social changes in the Iranian community. Some social consequences were constructive and contributed to community development, while others jeopardized community development goals. Therefore, the paradigm model developed in this study can help policymakers and social planners develop programs to promote community health. © 2023 Authors. All rights reserved.

Perceptions of family caregivers in the caring for COVID-19 patient: self-sacrificing management, fear, and loneliness to protect the patient - a qualitative content analysis

This study aimed to evaluate the perception of family caregivers in the care process of patients with COVID-19. This study was conducted on 19 family caregivers, who were selected using purposive sampling from 2021 to 2022. Unstructured interviews were used to collect data. The data were analyzed using the Kyngas conventional content analysis approach. The analysis of data led to three main themes, including unremitting efforts in physical care in the light of traditional medicine, accuracy, and intelligence in psychological attention and trying to maintain environmental health. According to the results, family caregivers provide high levels of self-sacrificing, continuous, and comprehensive, combined with fear and loneliness care in different dimensions with little or no support from the family, community, and health team.

Determination of the Efficacy of Daclatasvir Plus Sofosbuvir in Patients with Acute Respiratory Coronavirus Syndrome (SARS-COV-2): A Randomized Clinical Trial

Background: To tackle the 2019 coronavirus infection (COVID-19) disease pandemic, effective antiviral therapy is critical. We assessed the efficacy of sofosbuvir and daclatasvir for treating patients with COVID-19. Methods: This was a randomized controlled trial in adults with moderate-to-severe COVID-19 disease admitted to Razi Teaching Hospital in Ahvaz, Khuzestan Province, Iran. Patients were randomly assigned to the sofosbuvir and daclatasvir group (n=35, intervention group) and control group (n=35, standard care). The primary endpoint of this study was the length of hospital stay, clinical improvement, mechanical ventilation, mortality, and side effect. Results: We found that the combination of Daclatasvir and Sofosbuvir (DCV+SOF) did not make a statistically significant difference in terms of mortality. There was no significant difference in the duration of hospitalization between the two groups. The two groups did not differ significantly in terms of the frequency of side effects. There were 2 cases of intubation and death in both groups. Conclusion: The medications used in this study, i.e, the combination of daclatasvir and sofosbuvir, failed to show a significant effect in patients, and despite promising laboratory studies, there were no improvements observed in vital signs and the indicators studied, including clinical signs. Hospitalization days, ventilator requirements and mortality did not make a significant difference. To confirm the results of this study, conducting researches with a larger sample size are needed. © 2022 Seventh Sense Research Group®

Initial Considerations for Height Categories as a Replacement of Weight Categories in Senior Taekwondo Athletes

Background. Taekwondo (TKD) like many combat sports utilizes weight as a measure to categorize competitors. In an attempt to gain advantage over opponents, athletes practice rapid weight loss to qualify for the lowest weight class possible. This practice is routine despite being fundamentally dangerous to the health of athletes. Height is a measurement that cannot be exploited for competitive advantage and has the potential to be a healthier alternative for sport classifications. Purpose and aim. This study evaluated the relationship between weight and height categories in classifying competitive senior TKD athletes for the potential of using height as a healthier grouping method. Methods. The height and weight of 118 male (n=83) and female (n=35) athletes were measured by either physical measurement during weigh-in at the Canadian National Taekwondo Championships (n=31) or following Covid-19 restrictions, athletes (n=87) were given an online survey for height and weight. The athletes were categorized by sex and senior Olympic weight category. The athletes were then grouped by 4 proposed height categories based on CDC height weight growth charts. Results. We found that 80.72% of male athletes remained within ±1 category when categorized by height and 94.29% of female athletes remained within ±1 category when categorized by height. Conclusions. Height categorization does little to disrupt current competition cohorts while disincentivizing unhealthy rapid weight loss practices in TKD athletes and providing more equitable competition by matching athletes of similar height and reach. © Idōkan Poland Association

Effect of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers on Clinical Outcome in COVID-19 Patients with Hypertension

Background: Hypertension is the main factor to predict the severity and mortality of COVID-19. The use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) is challenging. This study aimed to investigate the effect of ACEIs and ARBs on clinical outcomes in COVID-19 patients with hypertension. Materials and Methods: This cross-sectional study was carried out on 498 patients who were referred to Razi hospital following COVID-19 development and also had hypertension. Patients were divided into two groups receiving drugs in the ACEIs and ARB's groups and those not receiving these drugs. The primary outcome was death up to one month after the onset of symptoms. Results: Cardiovascular disease in patients taking ACEIs/ARBs was higher (p<0.001). One hundred eleven deaths (22.3%) were seen in the studied patients in whom 66 deaths (59.5%) belonged to the group not taking ACEIs and ARBs (p>0.05). Seventy-nine patients (15.86%) were admitted to ICU in which 62.03% of these patients died while the non-ICU mortality rate was 14.8% (Odds Ratio = 9.40;95% CI: 5.54 to 15.95, p <0.001). A subgroup analysis found that among patients with diabetes who had hypertension, the incidence of death was 43.55% in the group taking ARBs/ACEi lower than in another group significant (p = 0.021). Conclusion: The mortality rate in the patients taking ACEIs/ARBs is not different from other groups. It was found that among COVID-19 patients with diabetes who had hypertension, the incidence of death in the patients taking ARBs/ACEi was lower than in another group. © 2021 Universitas Gadjah Mada - Faculty of Pharmacy. All rights reserved.

Is a Brain Stroke Caused by COVID-19 Seen Under Two Years of Age? A Case Report

Brain ischemic stroke in children, especially in infancy, is a rare condition. Stroke presents a variety of symptoms and usually is an underestimated diagnosis in infants. The current coronavirus disease-2019 (COVID-19) pandemic involves different organs in the human body, such as the central nervous system. Researchers believe a probable association between this RNA virus and stroke but with a few cases of strokes in the pediatrics field with positive reverse transcription-polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome coronavirus 2 (SARS CoV-2). Herein, reported a 17-month-old girl with hemiparesis and focal status epilepticus that was admitted to Firoozabadi Hospital. The onset of symptoms was approximately 4 days before the admission with a non-bloody and watery diarrhea, nausea, vomiting, and a low-grade fever. The brain magnetic resonance imaging with diffusion-weighted imaging sequence confirmed acute ischemic stroke (AIS). COVID-19 RT-PCR test was requested due to the multisystemic involvement, which revealed a positive result. Thus, according to the positive RT-PCR and other negative results along with fever and gastrointestinal involvement, which is a common form of COVID-19 infection in pediatric patients, her neurological symptoms were confirmed with COVID-19 infection. Based on our knowledge, this is the first case of AIS due to SARS CoV-2 infection that was reported under 2 years of age worldwide. COVID-19 infection in pediatric patients has different presentations. In a significant number of these patients, the involvement of more than two body organs could be seen, known as “multisystem inflammatory syndrome in children” that is associated with COVID-19. Some strokes due to COVID-19 infection were reported with its association to hypercoagulability state, thus we introduce a related case of one infant. According to the new emerging coronavirus and its probability of nervous system involvement, checking the COVID-19 RT-PCR test in the nasopharynx and cerebrospinal fluid of all children who present with neurological symptoms is recommended, even in the post-COVID-19 era. © 2021 by Turkish Neurological Society.

Analisis kesalahan diksi dan gaya bahasa pidato pejabat pemerintahan berkaitan dengan pandemi COVID-19

The emergence of the COVID-19 pandemic caused many officials to make speeches regarding the COVID-19 outbreak. The speech was in the form of reports appeals and support for health protocol policies during the COVID-19 pandemic. The analysis of errors in the use of diction and the use of governmental language styles is interesting to analyze and can be used as online teaching materials in the language error analysis course. The purpose of this study is to describe the patterns of diction errors and to describe the style of speech of government officials regarding COVID-19. This study uses a qualitative descriptive method that describes language data in speeches of government officials regarding COVID-19. The data analysis technique used the language error analysis approach (diction) and the language style analysis approach. Collecting data in research using observation techniques and note-taking techniques. The data source comes from speeches by government officials regarding COVID-19. The results of the study show that there are still many uses of wrong and inaccurate diction, the use of conjunctions from but the use of prepositions in and in the wrong form/pronunciation of the day and the date and there are still many jumbo word uses. Meanwhile the language styles found included parallelism climax anticlimax association pleonasm and repetition. Keywords: Diction error analysis, Analysis of language style, Official Speech, COVID-19 Munculnya pandemi Covid-19 menimbulkan banyak pejabat yang melakukan pidato menyoal wabah Covid-19. Pidato tersebut berupa laporan, himbauan, ataupun dukungan terhadap kebijakan protokol kesehatan selama pandemi Covid-19. Analisis kesalahan penggunaan diksi dan penggunaan gaya bahasa pidato pejabat pemerintahan tersebut menarik untuk dianalisis dan dapat dijadikan sebagai bahan ajar daring pada mata kuliah analisis kesalahan berbahasa. Tujuan penelitian ini mendeskripsikan pola kesalahan-kesalahan diksi dan mendeskripsikan gaya bahasa pidato pejabat pemerintahan berkait Covid-19. Penelitian ini menggunakan metode deskriptif kualitatif yang menggambarkan data bahasa dalam pidato para pejabat pemerintahan berkait Covid-19. Teknik analisis data menggunakan pendekatan analisis kesalahan berbahasa (diksi) dan pendekatan analisis gaya bahasa. Pengumpulan data dalam penelitian ini menggunakan teknik simak dan teknik catat. Sumber data berasal dari lima pidato pejabat pemerintahan berkait Covid-19. Hasil penelitian menunjukkan bahwa masih banyak penggunaan diksi yang salah dan kurang tepat, yakni penggunaan kata hubung dari, tapi, penggunaan kata depan di dan pada yang tidak tepat, bentuk penulisan/pengucapan hari dan tanggal, serta masih banyak penggunaan kata yang berlewah. Sementara itu, gaya bahasa yang ditemukan meliputi gaya bahasa paralelisme, klimaks, antiklimaks, asosiasi, pleonasme dan repetisi. Kata Kunci: Analisis Diksi, Analisis gaya bahasa, Pidato Pejabat, Covid-19

Return to Work in COVID-19: Review of Current Guidelines

Background and aims: Coronavirus Disease 2019 (COVID-19) is mainly a respiratory disease which is caused by the SARS-CoV-2 Virus. The outbreak first began in Wuhan, China, in December2019 and then expanded globally. COVID-19 can result in illness ranging from mild to severe. However, some of the affected individuals might be asymptomatic. Symptoms of the disease may appear in as few as 2 days or as long as 14 days after exposure. The main rout of disease transmission is person to person contacts. Nevertheless, touching contaminated surfaces is also asserted to be the alternative way of transmitting the virus. Since the emergence of COVID-19pandemic, due to the high rate of person to person transmission of SARS-CoV-2, widespread restrictions have been introduced all over the world to prevent the disease expansion. Apparently, work settings have not been exempted from these restrictions as well. The precise socioeconomic burden of the pandemic has not been estimated so far. However, it apparently contributes to many adverse health- related issues in either the individuals who have to be present in their workplaces in this circumstance or the ones who must stay at home. A considerable proportion of the affected individuals are working people who have to return to their workplace after the end of the quarantine period. Considering the direct and indirect impacts of this situation on economic activities, it is crucial to decide on employees’ returning to work in a way that cutting the chains of transmission is maintained. In other words, while evaluating an individual’s return to work the duration of the disease transmission ought to be taken into consideration. Furthermore, this should assess the individual in terms of the disease complications which may have an impact on his performance or might make him more vulnerable to hazardous occupational exposures. The objective of this article is to carry out a review of the current guidelines about deciding on the end of the isolation and return to work of employees recovered from COVID-19. Methods: The Google Scholar, PubMed, and Scopus databases were reviewed from 2019 to 2020. Furthermore, other relevant websites were also scrutinized including Centers for Disease Control and Prevention (CDC), Occupational Safety and Health Administration (OSHA), National Health Service (NHS) and Iran Ministry of Health and Medical Education guidelines. Results: Based on this review different strategies may be pursued regarding work resumption. In many countries making decision is mainly based on CDC guidelines. However, national health policy has been the major contributing factor in defining the return to work strategies in other parts of the world. Generally, determining the timing of return to work in employees recovered from COVID-19 is mainly based on clinical symptoms (symptom-based strategy) and or Reverse Transcription Polymerase Chain Reaction) RT-PCR (test (test-based strategy). In the light of the potential limitations, deciding on choosing either symptom-based or test-based strategy should be made on a case-by-case basis. For instance, considering that RT-PCR test may remain positive for even three months after the onset of the symptoms, it is likely that test-based strategy unnecessarily prolongs the period of isolation and work absence. In other words, prolonged virus shedding might not necessarily be an indicator of contagiousness or transmissibility. On the other hand, relatively high price of this molecular test alongside its inconclusive sensitivity are other factors limiting RT-PCR test. Recently, serology tests investigating antibodies (immunoglobulin G and M) have also been addressed in addition to the aforementioned assessments. Immunoglobulin G and immunoglobulin M (IgG and IgM) are usually detectable in serum after the second week of the disease but the exact duration in which these antibodies can be found following infection is not known. Notably, due to the fact that some individuals do not develop detectable IgG or IgM at all, negative serology test result oes not necessarily rule out that they have previously been infected. It is noteworthy to mention that some cross reactions have been determined between SARS-CoV-2 and other types of coroviruses which might contribute to false positive serology test results. On account of current limitations of such tests, their results should be interpreted alongside RT-PCR test, otherwise they would be challenging and misleading. In the light of the fact that the risk of Covid-19 transmission is not similar for all job categories, as well as different tasks in one work setting, another factor which should be taken into account is occupational exposures. Hence, performing detailed risk assessment by experts has a vital role in deciding on work resumption. This process should be meticulously carried out on an individual basis for all specific work places and also for each job or group of jobs within a work setting. Each risk assessment should consider the environment, the task, the threat, and the available resources, as well as ongoing preventive measures such as risk elimination strategies, engineering controls (such as physical barriers or proper ventilation) and personal protective equipment. On top of that, employers should be informed about the significance of the employees’ participation in this process which can apparently guarantee the success of implementing preventive measures in the workplace. It is noteworthy that while deciding on an individual’s return to work, the severity of the disease should also be taken into consideration since a severe illness can have a considerable impact on the person’s work ability and performance. This is specially the case for those who were admitted to intensive care units (ICU) due to their critical illness. Therefore, gradual return to the previous tasks and activities, in terms of work intensity and duration, should be encouraged in such cases. Conclusion: There is a general consensus on ending isolation and return to work of the recovered individuals in a 10 to14-day period after the onset ofsymptoms and clinical improvement in the non-test-based strategy. Regarding test-based strategy, current guidelines require two consecutive negative RT-PCR tests with at least 24-hour interval. Presently, serologic tests are not recommended for making decision about returning persons to the workplace in the guidelines. Other important factors that ought not to be overlooked include detailed risk assessment and the disease severity. © 2020 Iran University of Medical Sciences. All rights reserved.

Return to work in COVID-19: review of current guidelines. (Special Issue: COVID-19.)

The objective of this article is to carry out a review of the current guidelines about deciding on the end of the isolation and return to work of employees recovered from COVID-19.

A review on recent guidelines and articles about prevention of COVID-19 infection in dental settings

Introduction: Dental services are high-risk centers to spread the new coronavirus disease 2019 (COVID-19) due to the type of treatment and closeness of the staff to patients. For this reason, several guidelines have been developed by international organizations regarding the necessity for complying with health standards in these centers. The present study aimed to review the guidelines and studies conducted on the prevention and control of COVID-19 in dental settings. Materials and Methods: The current study was carried out to investigate COVID-19 prevention and control strategies in dental settings. Several databases, including Google Scholar, PubMed, and Scopus, since 2019 to 2020 in addition to the guidelines of the Centers for Disease Control and Prevention, Occupational Safety and Health Administration, National Health Service, and American Dental Association were reviewed through subject searching and used in the present study.