Levels and Trends of Maternal Mortality and Morbidity by Cause in North Africa and Middle East, 1990 to 2019: An Analysis for the Global Burden of Disease Study 2019

Background: Since 1990, the maternal mortality significantly decreased at global scale as well as the North Africa and Middle East. However, estimates for mortality and morbidity by cause and age at national scale in this region are not available. Method(s): This study is part of the Global Burden of Diseases, Injuries, and Risk Factors study (GBD) 2019. Here we report maternal mortality and morbidity by age and cause across 21 countries in the region from 1990 to 2019. Result(s): Between 1990 and 2019, maternal mortality ratio (MMR) dropped from 148.8 (129.6-171.2) to 94.3 (73.4-121.1) per 100 000 live births in North Africa and Middle East. In 1990, MMR ranged from 6.0 (5.3-6.8) in Kuwait to 502.9 (375.2-655.3) per 100 000 live births in Afghanistan. Respective figures for 2019 were 5.1 (4.0-6.4) in Kuwait to 269.9 (195.8-368.6) in Afghanistan. Percentages of deaths under 25 years was 26.0% in 1990 and 23.8% in 2019. Maternal hemorrhage, indirect maternal deaths, and other maternal disorders rank 1st to 3rd in the entire region. Ultimately, there was an evident decrease in MMR along with increase in socio-demographic index from 1990 to 2019 in all countries in the region and an evident convergence across nations. Conclusion(s): MMR has significantly declined in the region since 1990 and only five countries (Afghanistan, Sudan, Yemen, Morocco, and Algeria) out of 21 nations didn't achieve the Sustainable Development Goal (SDG) target of 70 deaths per 100 000 live births in 2019. Despite the convergence in trends, there are still disparities across countries.Copyright © 2022 Academy of Medical Sciences of I.R. Iran. All rights reserved.

Public Health Measures Enacted by the Norwegian Political Leadership to Protect the Elderly in Response to the SARS-CoV-2 Pandemic Crisis

The SARS-CoV-2 pandemic crisis is ongoing, and the elderly are still affected by the virus, sometimes with fatal consequences. The political leaders are, inter alia, focussed on protecting citizens, including this vulnerable group. This article aims to describe the response of the Norwegian political leadership, with a focus on the public health measures enacted to protect the elderly during the SARS-CoV-2 pandemic crisis in the years 2020 and 2021. This study has a descriptive qualitative research design using thematic-content analysis as a methodology to evaluate data collected from official documents, national statistics and public health documents from Norway. Statistics show that the elderly mortality rate per 100,000 person-weeks during the first wave of the SARS-CoV-2 pandemic was 2.69 in Norway;during the second wave of the pandemic, it was 1.43. The public health measures the Norwegian political leadership instigated were more effective in containing the crisis when compared to other European countries, and this paper investigates the reasons. The results of our study provide public health policy decision-makers with insights into analytical material showing the usefulness of different measures enacted by the Norwegian government. The Norwegian government's responses to the crisis, such as the public health measures, restrictions, social consequences for vulnerable groups such as the elderly, as well as cross-government and cross-community cooperation, will need further in-depth analysis. © 2023 Miroslava Tokovska et al., published by Sciendo 2023.

Association between COVID-19 stress, coping mechanisms and stress-related oral conditions among Egyptian adults: a cross-sectional study.

The present study investigated the association between COVID-19 stresses and oral conditions including gingivitis, oral hygiene, oral ulcers, and dry mouth. This was a cross-sectional study that collected data from adults in community settings in Alexandria, Egypt, between October 2021, and February 2022. Gingival condition and oral hygiene were assessed using the gingival and plaque indices. Participants were asked if they experienced oral ulcers during the past week and dry mouth during the past year. COVID-19 fears and coping were assessed using the COVID Stress Scale (CSS), and the Brief Resilience Coping Scale (BRCS), respectively. Oral health behaviors were assessed using the World Health Organization questionnaire. Regression analyses were used to assess the association between the dependent variables (clinically assessed gingival and plaque indices, reported presence of oral ulcers, and dry mouth) and explanatory variables (CSS and BRCS) after adjusting for confounders (COVID-19 status, oral health behaviors, smoking, age in years, sex, and highest educational level). The response rate was 88.8% (373/420). The mean (SD) age = 39.26 (11.45) with 74.3% females and 49.3% reporting completing high school or higher education. The mean (SD) plaque and gingival indices were 1.59 (0.66) and 1.39 (0.59), respectively. Only 20.1% reported the presence of oral ulcers and 41.6% reported xerostomia. Lower plaque score was associated with higher COVID-19 contamination fears (B = - 0.03, 95% CI - 0.05, - 0.02) and higher compulsive checking and reassurance-seeking (B = - 0.02, 95% CI - 0.03, - 0.009). Lower gingival score was associated with higher COVID-19 contamination fears (B = - 0.02, 95% CI - 0.03, - 0.002). Higher odds of reporting dry mouth were associated with greater fear of COVID-19 socioeconomic consequences (AOR = 1.05, 95% CI 1.001, 1.09), and lower coping scores (AOR = 0.93, 95% CI 0.88, 0.99). The findings suggest an association between COVID-19 specific stresses and stress-related oral conditions and shed light on the possible link between mental and oral health, emphasizing the importance of integrated planning of care services.

Avoiding Food Neophobia and Increasing Consumer Acceptance of New Food Trends—A Decade of Research

The increasingly fierce competition in food trends requires producers to innovate and develop new foods to be accepted and to avoid neophobia by consumers at the same time. Food neophobia’s motivational adoption barriers include the consumption of novel foods, social norms and conflicting eating goals. Therefore, appropriate strategies are needed to avoid neophobia amid the presence of new food trends in the market. Efforts to avoid food neophobia can also be accepted as part of the sustainability concept, in which the consumer has new foods to choose from in order to reduce scarcity in one particular type of food. The food industry is also challenged to produce healthy food by producing food from natural ingredients. In this article, new food trends and advances in food processing are described, and through them, strategies to avoid neophobia and increase consumer acceptance of new food trends are referenced. Neophobia meets marketing food products delivered to consumers facing motivational adoption barriers, such as the consumption of novel foods, social norms and conflicting eating goals, which are indicated to be challenges to purchase drivers in new food trends. Tasting foods is indicated as one of the most efficient means to ensure neophobia reduction in new foods and new food trends. Other factors identified to reduce food neophobia are education, income, taste and exposure to novel foods. Some preconditions for novel foods to be accepted by consumers are related to the very nature of food innovation, the manufacturer’s features and market circumstances. Food processed with advanced technologies may differ depending on the brand of the food production company and the knowledge of consumers about the novel foods. Moreover, food technology is seen as more acceptable for plant food products based or natural ingredients for consumers. In addition to the focus on health benefits, it is supports the sustainability of food systems. Another accidental element is the transparent traceability system providing accurate and adequate information about such novel foods.

Use of Evolutionary Algorithms in a Fractional Framework to Prevent the Spread of Coronavirus

Mathematical modeling can be utilized to find out how the coronavirus spreads within a population. Hence, considering models that can precisely describe natural phenomena is of crucial necessity. Besides, although one of the most significant benefits of mathematical modeling is designing optimal policies for battling the disease, there are a few studies that employ this beneficial aspect. To this end, this study aims to design optimal management policies for the novel coronavirus disease 2019 (COVID-19). This is a pioneering research that designs optimal policies based on multi-objective evolutionary algorithms for control of the fractional-order model of the COVID-19 outbreak. First, a fractional-order model of the disease dynamic is presented. The impacts of the fractional derivative's value on the modeling and forecasting of the disease spread are considered. After that, a multi-objective optimization problem is proposed by considering the rate of communication, the transition of symptomatic infected class to the quarantined one, and the release of quarantined uninfected individuals. Numerical results clearly corroborate that by solving the proposed multi-objective problem, governments can control the massive disease outbreak while economic factors have reasonable values that prevent economic collapse.

Truths and myths about superfoods in the era of the COVID-19 pandemic.

Nowadays, during the current COVID-19 pandemic, consumers increasingly seek foods that not only fulfill the basic need (i.e., satisfying hunger) but also enhance human health and well-being. As a result, more attention has been given to some kinds of foods, termed "superfoods," making big claims about their richness in valuable nutrients and bioactive compounds as well as their capability to prevent illness, reinforcing the human immune system, and improve overall health.This review is an attempt to uncover truths and myths about superfoods by giving examples of the most popular foods (e.g., berries, pomegranates, watermelon, olive, green tea, several seeds and nuts, honey, salmon, and camel milk, among many others) that are commonly reported as having unique nutritional, nutraceutical, and functional characteristics.While superfoods have become a popular buzzword in blog articles and social media posts, scientific publications are still relatively marginal. The reviewed findings show that COVID-19 has become a significant driver for superfoods consumption. Food Industry 4.0 innovations have revolutionized many sectors of food technologies, including the manufacturing of functional foods, offering new opportunities to improve the sensory and nutritional quality of such foods. Although many food products have been considered superfoods and intensively sought by consumers, scientific evidence for their beneficial effectiveness and their "superpower" are yet to be provided. Therefore, more research and collaboration between researchers, industry, consumers, and policymakers are still needed to differentiate facts from marketing gimmicks and promote human health and nutrition.

From Digital Divide to Technostress during the COVID-19 Pandemic: A Scoping Review

Background and purpose: This paper relates challenges faced by older adult employees during the COVID-19 crisis in order to describe strategies to reduce the digital divide and technostress, thereby supporting inclusion and retention in the marketplace. Older adults are particularly at risk of Internet-related social exclusion, especially during the COVID-19 pandemic. The main research question of the current scoping review were: What kind of strategies can reduce the digital divide and technostress of older adult employees and contribute to their inclusion and retention in the working market during the COVID-19 pandemic? Methodology: This review is based on the Arksey and O'Malley framework for scoping reviews. The six-stage framework includes: identifying research questions, identifying relevant studies, study selection, charting the data, summarizing and reporting the results, and a consultation exercise. A scoping review was conducted using five humanistic and social electronic databases - CINAHL with full text, EBSCO, Medline, Soclndex, Web of Science - and additionally hand-searches performed on Google Scholar. The search was limited to studies published from January 2020 to March 2021. After applying inclusion and exclusion criteria, 10 articles were included. Results: This review shows that the most important strategies are: 1) ICT educational training courses;2) social dialog;3) building inclusive workplaces;4) implementation of successful 'aging in public' policies. Our results are beneficial for individuals, organizations, industries and different societies by showing how concrete strategies can be implemented at multiple levels. Conclusion: The study has found that one of the most effective strategies to reduce the digital divide faced by older adult employees during the COVID-19 crisis and technostress is social dialog between employers and employees, which can be a source of innovative and creative solutions (e.g. partnership programs or tailored support). Social dialog should include active cooperation with older adult workers - asking what they need and want - to enable skills development through training.

Impact of Social Media Infodemics on Mental Health among Health Colleges’ Students at Saudi Universities during COVID-19 Pandemic

Background: Saudi Arabia has been severely affected by COVID-19 since March 2020. The COVID-19 “infodemic” has spread a plethora of misinformation on social media leading to public panic and serious public health consequences. We aimed to investigate the impact of social media infodemics on mental health status among health colleges’ students, as future healthcare workers, at Saudi universities during the COVID-19 pandemic. Methods: We used a cross-sectional web-based survey to collect data from 400 health colleges’ students. We assessed average time spent on social media and used the shortened Pittsburgh sleep quality index, generalized anxiety disorder scale, and Center for Epidemiology scale for depression to measure sleep quality, generalized anxiety disorder, and depressive symptoms. Generalized linear regression was used to determine associations with mental health burdens. Results: About 21.5% reported more than 3 hours/day of exposure to social media. Prevalence of poor sleep quality, anxiety, and depression disorders was 16%, 31%, and 24%, respectively. No significant difference was determined between males and females (P>0.05);however, a significant association was detected with time spent on social media (P<0.001). Conclusion: We found a significant mental health burden among health colleges’ students during the COVID-19 pandemic. Spending too much time on social media is a potential risk factor. Controlling social media infodemics, early mental health interventions, and continuous monitoring of consequences should become routine as part of preparedness efforts. © 2022 Nour et al.

Workplace Violence among Healthcare Providers during the COVID-19 Health Emergency: A Cross-Sectional Study.

(1) Background: Workplace violence among healthcare providers (HCPs) is a tangible barrier to patient care. The purpose of this study was to gain insight into physicians' and nurses' perceptions of workplace violence and their perceptions of communication skills during the COVID-19 health emergency. We also sought to assess and compare the association between types of workplace violence, communication skills, and several sociodemographic factors of physicians and nurses including gender, marital status, site of work, age, and educational level during this era. (2) Methods: We performed a cross-sectional study of a selected hospital in Jordan using the Arabic version of the workplace violence and communication skills scales for September to November 2020. We included a total of 102 physicians and 190 nurses via a self-reported questionnaire. (3) Results: During the COVID-19 health emergency, physicians (48%) experienced workplace violence more than nurses (31.6%). More than two-thirds of the participants did not formally report any type of violence. Multinomial logistic regression analysis showed that marital status, gender, age, site of work, educational levels, and communication skills were associated with different types of violence among the two samples. (4) Conclusions: A high prevalence of workplace violence is noted among HCPs in Jordan compared with before the pandemic, which highlights the importance of promoting public awareness during crises.

Communicating the risk of COVID-19 during sporting events in Qatar: Challenges and opportunities

Background: After a long, unprecedented pause, sporting events were cautiously resumed in Qatar in September 2020. With the persisting COVID-19 uncertainties, characterizing the COVID-19 risks related to sports activities remains to be examined, making it difficult to give clear messages 1. This report describes some of the key challenges and opportunities for communicating COVID-19 risks associated with sporting events. Methods: The outbreak investigation report for COVID-19 cases related to the Asian Federation Cup (AFC) Champions League-West hosted in Qatar Sep 14th to Oct 3rd, 2020 was interpreted and taken as a case study. Results: The outbreak investigation reports, which involved approximately 74 COVID-19 cases is shown in Figure 1 and constituted the main subject to communicate the risks of the infection. The investigation teams were engaged in person-to-person communication, reviewing the history of the possible risk exposure and explaining the recommended measures. Clubs' physicians and delegations besides the local organizing committee seem to have played a pivotal role as a credible source of information to the players and media about the possible case scenarios and the control measures2,3. The yet unclear mode of transmission may have contributed to the poor risk perception and the compliance with the unfamiliar preventive recommendations2,3. Conclusion: The profound evolution of the pandemic has already offered a unique opportunity to overcome the 'lack of attention' in the communication of communicable diseases. Using the epidemiological findings to communicate COVID-19 risks during sporting events seemed to be beneficial to explain the virus characteristics, emphasizing the role of the epidemiological approaches to improve the risk perception and the compliance with the public health advice.

Identification of potential inhibitors of SARS-CoV-2 from Artemisia annua compounds by in silico evaluation and their density functional theory (DFT)

The genus Artemisia has recognized medicinal value and its use by humans Dates back to centuries ago. With the appearance of the new coronavirus, end of 2019, several countries have recommended the use of herbal teas consisting mainly of Artemisia. The individual analysis of the constituents of this species is crucial to characterize and optimize its antiSARS-Cov-2 action. We evaluated by molecular docking the inhibitory action of major compounds of the Artemisia genus (Artemisinin, Arteannuin B, Alpha Thujone, P-Hydroxyacetophenone, Fisetin, Cirsimaritin, Capillin, beta-Sitosterol, and Quercetin) against three targets namely SARS-CoV-2 main protease (Mp), SARS-CoV-2 receptor binding domain (RBD) and human furin protease (HF protease). The two flavonols, quercetin and fisetin, have the best binding energies with the three targets. Quercetin/Fisetin possesses binding energy of -7.17/-6.9, -6.3/-6.15 and - 5.98/- 5.49 kcal/mol with MP, RBD and HF protease respectively. Their physicochemical properties meet the requirements of an oral active principle and are not toxic according to predictive simulations. Thereby DFT calculation has been used to analyze the electronic and geometric characteristics of these two compounds. The gap energies were also deduced for the stable structure and their reactivity. The abundance of Quercetin in different plants may be another advantage in the use of this bio-compound in the treatment of coronavirus.

Polymyositis and covid-19: A morbide association (a case report).

The COVID-19 pandemic and its impact on health systems had a significant effect on the management of inflammatory diseases in the long term and myopathies could be signs of COVID-19, making it difficult to diagnose the cause and effect relationship. An unvaccinated 62-year-old female patient followed for polymyositis was tested positive for COVID-19 on polymerase chain reaction (PCR) of nasopharyngeal swab revealed by dyspnea and rhinorrhea with fever and pulmonary involvement of 75%. She had an enlarged left ventricle with complete left branch block, inaugural diabetes mellitus with ketosis, kidney dysfunction, and inflammatory syndrome. Despite the early initiation of invasive ventilation in combination with the national protocol against covid-19, the patient died on day 4 of care. The best management should anticipate comorbidities and the evolutionary profile would guide the continuation of the treatment. Polymyositis like other rheumatic diseases was associated with a very high risk of developing a severe form of COVID-19. The combination of elder age and comorbidities led to a severe form of COVID-19 and therefore to a poor prognosis. The article aimed to show the severity of the association of covid-19 with polymyositis at the comorbid stage.

Covid-19 decompensating epilepsy in the elderly: A case report.

The COVID-19 pandemic has had a great impact on chronic diseases, including epilepsy. The imbalance of antiepileptic drugs in case of intercurrent infection with COVID-19 leads to worsening seizures. A 71-year-old man, followed for post-traumatic epilepsy for 30 years, was stabilized with phenobarbital and topiramate. He presented generalized tonic-clonic epileptic seizures without meningitis. He improved well on midazolam combined with the usual treatment before the diagnosis and worsening of the covid-19. The severity of the lung damage led to hypoxia, recurrence of seizures, and poor prognosis. The association between covid-19 and epilepsy remains pejorative despite management. An epileptic seizure should always be considered as a possible manifestation of COVID-19. The article aimed to establish the relationship between covid-19 and the risk of worsening seizures and to demonstrate the severity of the association between covid-19 and epilepsy in elderly patients.

One-health approach to MERS-COV, 2012-2017: Experience from Qatar

Objectives: The emergence of Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012 was accompanied by uncertainty about its epidemiological and clinical characteristics. Once camelus dromedarius was found to be the natural reservoir of the virus public health systems across the Arabian Peninsula came under unprecedented pressure to control its transmission. This study describes how a One Health approach was used in Qatar to manage the MERS-CoV outbreak between 2012 and 2017. Method(s): The One Health approach adopted brought together professionals working in the health, animal welfare, and environmental sectors. To manage the MERS outbreak the Qatar National Outbreak Control Taskforce (OCT) was reactivated in November 2012 and experts from the animal health sector were invited to join. Later, technical expertise was requested from the WHO, FAO, CDC, Erasmus University (EMC), and Public Health England (PHE). A One Health roadmap was subsequently delivered addressing surveillance and investigation, epidemiological studies and increased local diagnostic capacity. Result(s): The joint OCT, once trained, was allocated resources and had access to high risk areas to gather evidence on the potential source of the virus and investigate all cases within 24-48 hours of reporting. Lack of sufficient technical guidance on veterinary surveillance and poor risk perception among vulnerable populations constituted major obstacles to maintaining systematic One Health performance. Conclusion(s): A One Health approach is essential for generating evidence and implementing control measures to restrain MERS-CoV and other zoonotic diseases.