"Mexican Wave": Analysis of Cognitive Structures of University Students Related to Covid-19

In this study, it is aimed to examine the cognitive structures of health management students about Covid-19. The word association test was used to collect data in the study, which was designed according to the phenomenology design. In the test, covid-19 was determined as the key concept and the cognitive structures of the students were revealed through what Covid-19 evokes, what it is like, negative effects, positive effects and how it will shape the future. From the 80 students reached, a data set of 4000 words in total, 800 belonging to each category, was obtained and the data were themed by subjecting them to content analysis. In the analysis, "mask" and "distance" as connotations, "comprehension" and "plague" as analogy, "disruptions with education" and "disorder of psychology" as negative effects, "spending time with family" and "spending time for yourself" as positive effect and, as a future, the codes of "prudent life" and "increase in economic problems" have emerged. All codes were gathered in themes and top themes and interpreted. As a result, when it comes to Covid-19, university students have more connotations of precaution and protection;students likened Covid-19 to infectious or fatal diseases;restrictions and measures were considered at the beginning of the negative effects;as positive effects, the process was seen as an opportunity for development and learning, and there were thoughts that social life would transform in the future due to this epidemic.

Anxiety levels of healthcare personnel in different stages of COVID-19 pandemic: A nationwide study from Turkey Healthcare personnel and COVID 19

Aim: SARS CoV-2 transmission in healthcare personnel was first reported on January 20, 2020. The aim of this study was to evaluate the anxiety levels experienced by healthcare personnel in Turkey during the COVID-19 pandemic and the factors affecting these levels. Material(s) and Method(s): A survey investigating sociodemographic features and examining anxiety levels was conducted among approximately 1000 healthcare personnel who were expected to take active roles in the pandemic across Turkey. The survey was conducted in three stages: before the pandemic spread to Turkey, at the beginning of the pandemic and when the pandemic became prominent. A logistic regression analysis was performed to determine the factors affecting anxiety and predictors of anxiety levels. Result(s): In the first survey, always (odds ratio, 15.781;p<0.01) and often (odds ratio, 5.365;p<0.05) media use, in the second survey media use (p<0.05) and profession (odds ratio, 0.021;p<0.05) and in the third survey, marital status (odds ratio, 17.716;p<0.01) and gender (odds ratio, 4.431;p<0.05) were determined as the predictors of anxiety related to COVID-19. Discussion(s): As a result of this study, healthcare personnel groups were defined (women, nurses, married people) who need special intervention and support to provide spiritual comfort when working on the front line in the fight against COVID-19. Further comprehensive studies are needed of the extent of psychological support required by healthcare personnel and to whom and how this support should be provided.Copyright © 2022, Derman Medical Publishing. All rights reserved.

Effects of the Beach Chair Position on Respiratory Function in Covid-19 Patients

Introduction: Whether beach chair position can improve pulmonary compliance in mechanically ventilated subjects with Coronavirus disease 2019 (COVID-19) is unclear. This study aimed to investigate the impact of beach chair position on pulmonary compliance and oxygenation in mechanically ventilated patients with COVID-19. Material(s) and Method(s): Forty-four COVID-19 subjects admitted to intensive care unit (ICU) of our institute who receive invasive mechanical ventilation were enrolled in this observational study. Patients were initially placed in supine position. Following a couple of hours patients were then placed in beach-chair position (head of bed elevated to 30 degrees) at least 16 hours a day. Data from mechanical ventilator was recorded hourly in each position. Total compliance was defined as tidal volume (VT, milliliters) divided by the difference between plateau pressure (cm H2O) and positive end-expiratory pressure (PEEP, cm H2O) Blood gas analysis was performed bi-hourly. Mean values were taken for statistical analysis. The difference in lung compliance, airway resistance, and blood gas analysis between supine and beach chair position was the primary outcome measure of this study. Result(s): Positioning patients form supine to beach-chair led to a significant improvement in lung compliance (29.68+/-10.42 ml/cm H2O vs. 33.96+/-11.71 ml/cm H2O, p<0.001), reduction in airway resistance (17.51+/-8.44 H2O/L/sc vs. 16.73+/-8.06 H2O/L/sc, p<0.001) and led to a significant decline in plateau pressure (30.82+/-5.94 cm H2O vs. 29.98+/-5.68 cm H2O, p=0.001). Moreover a significant improvement in PaO2 was observed following positioning from supine to beach-chair (67.93+/-20.29 mm Hg vs. 87.83+/-27.33 mm Hg, p<0.001). Conclusion(s): Compared to supine position, beach chair positioning improves lung compliance and oxygenation in COVID-19 patients with acute respiratory distress syndrome (ARDS) who receive invasive mechanical ventilation. Copyright © 2022 A. CARBONE Editore. All rights reserved.

Immune response against SARS-CoV-2 vaccines in treatment-naive multiple sclerosis patients

Introduciton: Multiple Sclerosis (MS) is an autoimmune disease with B-cell dysregulation playing an essential role in pathogenesis. As B-cells are also responsible for antibody production, their disfunction could also affect the humoral immune response against SARS-CoV-2 vaccines. Aim(s): To compare the immune response after messenger RNA (mRNA) BNT162b2 (Pfizer/BioNTech) and inactivated Coronavac vaccines in newly diagnosed treatment-naive MS (tnMS) patients and healthy controls (HC). Method(s): A single-center cross-sectional study evaluating antibody response against SARS-CoV-2 vaccines (inactivated vs mRNA) in HC and newly diagnosed and treatment-naive MS patients. Serum samples were collected at least two weeks after the second dose of the vaccine. The cutoff level of seropositivity is >= 50 antibody unit (AU)/ml. Result(s): 46 participants had two doses of inactivated Coronavac (35 HC and 11 tnMS), and 103 (57 HC and 46 tnMS) had two doses of mRNA. There was no significant difference in antibody response between HC and tnMS in the inactivated vaccine group. In the mRNA group, the antibody titers were significantly higher in HC (p=0.009), though no difference in the seropositivity rates was observed. Conclusion(s): Although MS is an autoimmune inflammatory disease, it does not affect immunity against the SARS-CoV-2 vaccine in treatment-naive patients.

COVID-19 antibody response after two doses of SARSCoV- 2 vaccines in multiple sclerosis patients' an update to the previous study

Introduction: Disease-modifying therapy (DMT) may decrease the immune response to COVID-19 vaccines, and the antibody response against SARS- CoV-2 is still not fully explored in people with multiple sclerosis(pwMS). Aim(s): To evaluate the immune response after messenger RNA (mRNA) BNT162b2 (Pfizer/BioNTech) and inactivated Coronavac vaccines in pwMS treated with a DMT compared to healthy controls(HC). Method(s): Patients who came to our MS unit for treatment or routine control were included in the study. Serum samples were collected at least two weeks after the second dose of the vaccine. The cutoff level or seropositivity is >= 50 antibody units (AU)/ml. The antibody titers were compared between HC and each treatment group. Result(s): 815 pwMS treated with DMT, 90 untreated MS patients and 92 healthy controls were enrolled in this single-center crosssectional study. In total, 500 (50.2%) participants received two doses of inactivated Coronavac, and 497(49.8%) received two doses of BNT162b2. In HC group, only one patient who had mRNA vaccine was seronegative. All patients on cladribine (n =14, 100%)and azathioprine (n=5) treatment have seropositive results in both vaccine types. Among treatment groups, fingolimod and ocrelizumab were associated with lower antibody titers (p<0.005). Only in fingolimod group, seropositivity rate was higher for mRNA vaccine compared to inactivated vaccine. The SARS CoV-2 antibody titer was significantly associated with mRNA vaccine [beta= 0.739 (0.067) 95%CI= 0.607;-0.870 p<0.001], EDSS [beta= -0.061 (0.024) 95%CI= -0.108;-0.013 p<0.012], time between second vaccine dose and sample collection dates [beta=-0.002 (0.001) 95%CI= -0.003;-0.001 p<0.001] and relapsing MS type [beta= -0.395 (0.136) 95%CI= -0.662;-0.127 p<0.004] Conclusion(s): Fingolimod and ocrelizumab therapy are associated with decreased immunity after SARS CoV2 vaccines. mRNA type of vaccine is the preferable choice in pwMS.

Antibody response after a booster dose of SARS-CoV2 vaccines in multiple sclerosis

Introduction/Objectives: Immunity after two doses of inactivated and messenger RNA(mRNA) SARS-CoV 2 vaccines in Multiple Sclerosis (MS) is influenced by the Disease-Modifying Therapy (DMT) and vaccine type used. Being lower in fingolimod, ocrelizumab, and inactivated vaccine groups. A booster dose could change this discrepancy. Aim(s): To compare the immunogenicity of a booster dose of mRNA BNT162b2 (Pfizer/BioNTech) versus inactivated vaccine, performed after completing two doses of inactivated Coronavac in people with MS (pwMS). Method(s): pwMS and Healthy Controls (HC) who received a booster dose of SARS-CoV 2 mRNA or inactivated vaccine after completing two doses of inactivated Coronovac were enrolled in this single-center cross-sectional study. Serum samples were collected at least two weeks after the third dose of the vaccine. The antibody titers were compared between HC, MS, and each treatment group. Result(s): Each of 339 pwMS and 52 HC received three doses of SARS-CoV-2 vaccines. 283 (72,3%) participants received a booster dose of mRNA, and 108 (27,7%) participants received a booster dose of inactivated Coronavac. In all comparisons, patients treated with ocrelizumab had the lowest antibody titer (p<0.005). In the fingolimod group, booster mRNA caused a higher antibody titer than the inactivated vaccine. In total, pwMS had a lower antibody titer than HC regardless of the vaccine type. In regression analyses having a booster mRNA [beta= -0.671 (0.133) 95%CI= -0.933 - -0.409, p<0.001] and lower disease duration [beta-0.019 (0.010)95%CI= -0.038 - 0.000, p=0.44] were two markers which significantly associated with higher antibody titer in pwMS. Conclusion(s): The study shows that a third dose vaccine is an effective strategy to boost antibody response in the MS population, and the mRNA SARS CoV-2 vaccine's booster is preferable to inactivated ones.

Mindfulness, Perceived Stress and Coping Strategies during Covid-19 Pandemic in Turkish Dentistry Students

Purpose: The aim of the present study was to evaluate the association between perceived stress, mindfulness and coping strategies of undergraduate dental students during the COVID-19. Material and Methods: A cross-sectional study was conducted among 128 undergraduate dental students in 3rd, 4th and 5th grade. Students completed surveys including the Perceived Stress Scale (PSS), the Mindful Attention and Awareness Scale (MAAS) and the Coping Orientation to Problems Experienced inventory (COPE). Data were analyzed using the Mann-Whitney U-test, Analysis of Variance, Student's t-test, Kruskal Wallis test and Spearman correlation. Results: A negative association was found between the MAAS and PSS according to the Spearman's correlation coefficient (rs =-0.823, p<0.001). There were positive relationships between MAAS and COPE inventory subscales of positive reinterpretation and growth (rs = 0.385, p < 0.001);use of instrumental social support (rs = 0.233, p = 0.008);active coping (rs = 0.384, p < 0.001);use of emotional social support (rs = 0.208, p = 0.018);planning (rs = 0.244, p = 0.005). There were negative relationships between MAAS and COPE inventory subscales of behavioral disengagement (rs =-0.245, p = 0.005);alcohol-drug use (rs =-0.233, p = 0.008). Conclusion: Dental students with a high level of mindfulness had a low level of perceived stress. The findings may guide the mindfulness-based stress reduction programs or stress awareness lectures development and implementation within the academic curriculum.

Anxiety levels of healthcare personnel in different stages of COVID-19 pandemic: A nationwide study from Turkey

Aim: SARS CoV-2 transmission in healthcare personnel was first reported on January 20, 2020. The aim of this study was to evaluate the anxiety levels experienced by healthcare personnel in Turkey during the COVID-19 pandemic and the factors affecting these levels.Material and Methods: A survey investigating sociodemographic features and examining anxiety levels was conducted among approximately 1000 healthcare personnel who were expected to take active roles in the pandemic across Turkey. The survey was conducted in three stages: before the pandemic spread to Turkey, at the beginning of the pandemic and when the pandemic became prominent. A logistic regression analysis was performed to determine the factors affecting anxiety and predictors of anxiety levels.Results: In the first survey, always (odds ratio, 15.781;p<0.01) and often (odds ratio, 5.365;p<0.05) media use, in the second survey media use (p<0.05) and profession (odds ratio, 0.021;p<0.05) and in the third survey, marital status (odds ratio, 17.716;p<0.01) and gender (odds ratio, 4.431;p<0.05) were determined as the predictors of anxiety related to COVID-19.Discussion: As a result of this study, healthcare personnel groups were defined (women, nurses, married people) who need special intervention and support to provide spiritual comfort when working on the front line in the fight against COVID-19. Further comprehensive studies are needed of the extent of psychological support required by healthcare personnel and to whom and how this support should be provided.

Another Epidemic in the Shadow of Covid 19 Pandemic: A Review of Monkeypox

While humanity has not been able to end the fight against the COVID-19 pandemic, newly reported cases of monkey-pox have caused unease.The current review sheds light on the transmission routes, pathogenesis, clinical presentation, treatment, and prevention of the disease in this early stage of the ongoing monkeypox epidemic.

Mesenchymal stem cell therapy in COVID-19 pneumonia: a prospective, randomized clinical research

Objective: Deficiencies in immune-regulatory mechanisms such as immune activation and T-regulatory cells are classically referred to as cytokine storms. Mesenchymal stem cells (MSCs) act as living anti-inflammatory cells that can rebalance cytokine/immune responses to restore balance in patients with coronavirus disease-2019 (COVID-19) acute respiratory distress syndrome by reducing the activation of T and B cells, and dendritic and natural killer cells. The aim of this study is to provide immune modulation with stem cell transplantation by reducing the damage caused and COVID-19 infection to tissues and organs. Material and Methods: In this prospective randomized single-center clinical trial, patients were divided into 3 groups: intubated without comorbidity (n = 7);intubated with comorbidity (n = 7);not intubated (n = 7). Dosage of MSCs transplantation for each group was 1 million cell/kg intravenous at days 0, 2, and 4. age, gender, APACHE II scores, procalcitonin, C-reactive protein (CRP) and leukocyte values, and cluster of difference 4 (CD4), CD8, interleukin 2 (IL-2), and IL-6 levels, morbidities, number of days in intensive care unit, mortality were recorded. Clinical results, changes in inflammatory and immune function levels, and side effects were evaluated. Each patient's improvement in oxygenation and symptoms were recorded in the days after MSC transplantation. After treatment, lymphocyte, CRP, tumor necrosis factor-a level, and IL-6 levels were recorded.

Nationwide strategies employed to provide and integrate palliative care to patients with covid-19

Background: Little is known on what palliative care (PC) has been provided to patients with COVID-19. Aims: To understand what PC was provided nationwide to patients with COVID-19 and strategies implemented to overcome barriers during the pandemic. Methods: Semi-structured interviews were conducted with physicians across Canada about their experiences providing PC to patients with COVID-19. Thematic analysis was used to describe and interpret overarching themes. Results: Twelve specialized PC (SPC) and 11 primary PC (PPC) were interviewed. Interim analysis of 16 coded interviews demonstrated SPC and PPC physicians used traditional strategies (such as opioids, oxygen and serious illness conversations) to manage symptoms, support end of life, and engage patients and families in goals of care conversations (GOC). Neither SPC nor PPC indicated strong adoption of GOC and symptom management tools circulated early in the pandemic. Both SPC and PPC indicated a shift to virtual communication due to restrictive visitor policies, highlighting the need for distanced support and planned communication. Care coordination for PC patients was challenged by a lack of community resources, family infected with COVID-19, prolonged hospital stays, and increased number of PC patients discharged to rehabilitation services. New PC structures included;GOC teams that functioned in the emergency department and medicine floors, integrated clinical rounding by non-PC clinicians with PC teams, and hospital-based PC outreach to long term care. Strategies to improve PC implementation included: virtual technologies, team collaboration, patient and family engagement tools, and symptom management and GOC conversations tools. Conclusions: While PC management approaches to support patients with COVID-19 were mostly unchanged, new structures and strategies were developed to ensure patients and their families were provided with support.

Online university teaching at the time of COVID-19 (2020): An Australian perspective

The impacts of COVID-19 have been widespread, and the education sector has not been immune to its effects. In March 2020 Australian universities were forced into a shutdown, which prompted an unanticipated, sudden shift in education, from on-campus and face-to-face to an off-campus and online mode of teaching and learning. This paper describes the experiences of two Sydney-based university unit coordinators, from two different institutions, who rapidly shifted their units online as a result of COVID-19. In particular, it applies reflection as a research method, to share what the authors’ encountered as successful, and what was challenging about teaching online. Motivating and retaining students was a key challenge identified by the authors. Therefore, the paper discusses the authors’ application of various digital programs and tools in their response to this challenge of motivation and engagement. It is hoped that our experiences might benefit those looking to integrate programs and tools in the online teaching and learning space. Although Australia is currently one of the most successful countries in their handling of COVID-19, there is still great uncertainty about the future. Globally the pandemic shows no signs of abating, as many countries struggle to manage high levels of transmission and infection rates, which in turn have an impact on the education sector more broadly. Consequently, online learning may be the ‘new normal’ for many institutions in the near future. Therefore, it is important for educators to share their online teaching experiences that can contribute to greater understandings of this space. © 2021, The International Academic Forum (IAFOR). All rights reserved.