Questionnaire-Based Investigation of COVID-19 Vaccine Hesitancy among Omani Parents in the Outpatient Pediatric Departments of Sultan Qaboos University Hospital: A Cross-Sectional Study (preprint)

Background: Vaccinating children against COVID-19 is an essential public health approach for preventing infection in children and adults. This study aimed to explore parents' attitudes toward and the rate of COVID-19 vaccine hesitancy among children in Oman. Methods: This cross-sectional study used an online, self-administered questionnaire. The 9-item questionnaire was validated earlier and administered between June 2021 and May 2022. Multiple logistic regression was used to determine the factors associated with vaccine hesitancy. The parents received a pre-validated Google questionnaire. Responses from the parents of children younger than 11 years of age were accepted. Results: 384 participants completed the questionnaire, including 207 males (54%). The response rate was 86% (384/447). Of the 384 participants, 69% of the parents hesitated to vaccinate their children aged 1-11-year-old children). In parents of children aged 1–4 years, parental vaccination status was significantly associated with vaccine hesitancy (odds ratio [OR]: 0.116, 95% confidence interval [CI]: 0.044–0.306; p < 0.001). Additionally, vaccine hesitancy was significantly more common in mothers than in fathers (OR: 0.451, 95% CI: 0.240–0.848; p = 0.013). . Mothers of children were 77% more likely to be hesitant than fathers (.78, 95% confidence intervals (CI) = 0.50–0.1.23; p = 0.283). Conclusion: Many parents hesitated to vaccinate their children against COVID-19. Consequently, future awareness campaigns and strategies should target new vaccines. The results of our study show that the Arabic version of the 5-point Likert Scale for Vaccination Hesitancy is a valid and reliable tool.

mRNA Vaccines: from a weak tool to a leading technology to fight COVID-19 by Yahya Fahad Jamous (preprint)

In recent years, mRNA-vaccine technology has seen significant advances in the prophylaxis against many diseases. Today, after the emergence of COVID-19 and the use of mRNA vaccines as prophylactic vaccines to prevent the spread of the disease and control the pandemic, data collected over the last 2 years has shown that the mRNA vaccine will become a leading technology as it is potent, inexpensive, rapidly developed and safe. This review will present an overview of mRNA vaccines and give an update related to their safety and efficacy against COVID-19.

Analisis Hukum terhadap Limitasi Pelaksanaan Solat di Masjid Era COVID-19

Islam has taught and emphasised greatly on unity and solidarity among Muslims. This matter has become part of the agenda in various activities of Muslims;including in the matters of worship or ritual practices. The ultimate reason for performing prayers in the mosque, whether for Friday prayers or obligatory prayers, is to develop the unity of the ummah and revealing Islamic teachings. However, the COVID-19 pandemic phenomenon that has hit the world today requires that the implementation of prayers in mosques be studied and refined by putting in appropriate procedures and limitations to curb the spread of this epidemic. The inconsistency in terms of procedures between states in the implementation of Friday prayers and congregational prayers in mosques also invites disputes among the community. Thus, this paper will examine and analyse the procedures and limitations of the implementation from the aspect of Islamic law, based on current situation. This study uses a qualitative method through a content analysis approach and the primary source used is fatwa documents which related to the issues studied both at the national and state levels. In fact, these primary sources were analysed with a comparative approach. As a result, the findings of the study found that the differences in the setting of procedures and limitations issued by the state authorities regarding Friday prayers and congregational prayers in mosques are common and have specific justifications based on Islamic law. The only difference is in the matter of furu 'which is allowed in Islam. It is hoped that the analysis and details made through this paper will improve the negative perceptions of the public towards religious institutions in the country. In fact, hopefully this paper will be a benchmark for scholars in the field of Islamic studies to support and enhance the knowledge in the contemporary fiqh as well as to give a clear opinion for the questions and problems faced by Muslims nowadays. Ajaran Islam amat menitikberatkan soal kesatuan dan perpaduan dalam kalangan umat Islam. Perkara ini menjadi sebahagian agenda dalam pelbagai aktiviti umat Islam termasuklah dalam urusan ibadah atau amalan ritual. Tuntutan kepada pelaksanaan solat di masjid sama ada bagi solat Jumaat mahupun solat fardu adalah bertujuan untuk membina kesatuan umat dan menzahirkan syiar Islam. Namun, fenomena pandemik COVID-19 yang melanda dunia hari ini menuntut agar pelaksanaan solat di masjid dikaji dan diperhalusi dengan meletakkan prosedur dan limitasi sewajarnya bagi membendung penularan wabak ini. Ketidakseragaman dari sudut prosedur antara negeri dalam pelaksanaan solat Jumaat dan solat berjemaah di masjid juga mengundang pertikaian dalam kalangan masyarakat. Justeru, kertas kerja ini akan meneliti dan menganalisis terhadap prosedur dan limitasi pelaksanaannya dari aspek syarak berasaskan realiti semasa. Kajian ini menggunakan kaedah kualitatif melalui pendekatan analisis kandungan. Sumber primer yang digunakan adalah dokumen fatwa yang dikeluarkan berkaitan isu dikaji sama di peringkat kebangsaan mahupun negeri. Sumber primer ini dianalisis dengan pendekatan komparatif. Hasilnya, dapatan kajian mendapati perbezaan dalam penetapan prosedur dan limitasi yang dikeluarkan oleh pihak berkuasa negeri berhubung solat Jumaat dan solat berjemaah di masjid adalah berasas dan mempunyai sandaran serta justifikasi kukuh berpandukan hukum syarak. Perbezaan hanyalah dalam perkara furu' yang dibenarkan dalam Islam. Diharapkan, kupasan dan perincian yang dibuat melalui kertas kerja ini akan memperbaiki persepsi negatif masyarakat awam terhadap institusi keagamaan di negera ini. Malah, kertas kerja ini diharap menjadi batu asas untuk sarjana dalam bidang pengajian Islam memperkayakan khazanah fiqh kontemporari bagi merungkai persoalan dan permasalahan semasa yang dihadapi oleh umat Islam.

The Era of Coronavirus: Assess the Impact of Distance Learning Course on the Levels of Hand Hygiene Knowledge, Attitude and Practice of Students in Low Resources Country

Introduction: Hand Hygiene is an essential method to preclude infections in all healthcare environments. Education is essential to advance hand hygiene performance amongst nurses and nursing students. The aim is to find out the usefulness of a self-paced online hand hygiene course on the knowledge, attitude and practice of nursing students by evaluating student performance in post-tests. Methods: The study employed a quasi-experimental design in which data were collected using two questionnaires from undergraduate nursing students and they were exposed to interactive lectures and online activities related to risks, benefits, and key recommendations for hand hygiene. The following two surveys were used, Hand Hygiene Knowledge Questionnaire for Health-Care Workers;and Handwashing Assessment Inventory. Data were collected through pre-post tests. Results: Nurses reported a significant change for the better in hand hygiene comprehension, attitude, and performance of hand hygiene behaviours. The present study revealed a significant increase in hand hygiene knowledge belief, attitude, and outcomes among university students after participating in the training intervention. The majority of participants in the pretest rated their knowledge level as poor. Conclusion: Interactive training and online learning courses on hand hygiene could be used to influence the beliefs, attitudes and behaviours of students to bring about the desired change in hand hygiene practice. [ FROM AUTHOR] Copyright of Malaysian Journal of Medicine & Health Sciences is the property of Universiti Putra Malaysia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Long-acting vaccine delivery systems.

Bolus vaccines are often administered multiple times due to rapid clearance and reduced transportation to draining lymph nodes resulting in inadequate activation of T and B lymphocytes. In order to achieve adaptive immunity, prolonged exposure of antigens to these immune cells is crucial. Recent research has been focusing on developing long-acting biomaterial-based vaccine delivery systems, which can modulate the release of encapsulated antigens or epitopes to facilitate enhanced antigen presentation in lymph nodes and subsequently achieve robust T and B cell responses. Over the past few years, various polymers and lipids have been extensively explored to develop effective biomaterial-based vaccine strategies. The article reviews relevant polymer and lipid-based strategies used to prepare long-acting vaccine carriers and discusses their results concerning immune responses.

Prognostic Value of Non-HDL Cholesterol in COVID-19 Pneumonia. / Valor Prognóstico do Colesterol não HDL na Pneumonia por COVID-19.

BACKGROUND: In addition to coronary artery disease, non-high-density lipoprotein(non-HDL-C) provides short and long-term predictive information for many chronic inflammatory diseases such as stroke, hemodialysis, post-renal transplant, non-alcoholic hepatosteatosis, and human immunodeficiency virus. OBJECTIVES: This study examined the predictive value of non-HDL-C measured before SARS-CoV-2 for mortality in COVID-19 infection. METHODS: This study retrospectively included 1435 patients diagnosed with COVID-19 and treated in the thoracic diseases ward in a single center between January 2020 and June 2022. All patients included in the study had clinical and radiological features and signs of COVID-19 pneumonia. The COVID-19 diagnosis of all patients was confirmed by a polymerase chain reaction studied from an oropharyngeal swab. Statistical significance was set at p < 0.05. RESULTS: The study patients, including 1435 subjects, were divided into 712 patients in the non-surviving group and 723 in the surviving group. While there was no difference between the groups regarding gender, there was a statistically significant age difference. The non-surviving group was older. Age, lactate dehydrogenase(LDH), C reactive protein(CRP), triglycerides, D-dimer, and non-HDL-C were independent risk factors for mortality in regression analyses. In correlation analysis, age, CRP, and LDH were positively correlated with non-HDL-C. In the ROC analysis, sensitivity for non-HDL-C was 61.6%, and specificity was 89.2%. CONCLUSION: We believe that the non-HDL-C level studied before COVID-19 infection can be used as a prognostic biomarker for the disease.

FUNDAMENTO: Além da doença arterial coronariana, a lipoproteína de não alta densidade (não-HDL-C) fornece informações preditivas de curto e longo prazo para muitas doenças inflamatórias crônicas, como acidente vascular cerebral, hemodiálise, pós-transplante renal, hepatoesteatose não alcoólica e vírus da imunodeficiência humana. OBJETIVOS: Este estudo examinou o valor preditivo do não-HDL-C medido antes do SARS-CoV-2 para mortalidade na infecção por COVID-19. MÉTODOS: Este estudo incluiu retrospectivamente 1.435 pacientes diagnosticados com COVID-19 e tratados na enfermaria de doenças torácicas em um único centro entre janeiro de 2020 e junho de 2022. Todos os pacientes incluídos no estudo apresentavam características clínicas e radiológicas e sinais de pneumonia por COVID-19. O diagnóstico de COVID-19 de todos os pacientes foi confirmado por uma reação em cadeia da polimerase estudada a partir de um swab orofaríngeo. A significância estatística foi estabelecida em p < 0,05. RESULTADOS: Os pacientes do estudo, incluindo 1.435 indivíduos, foram divididos em 712 pacientes no grupo de não sobreviventes e 723 no grupo de sobreviventes. Embora não tenha havido diferença entre os grupos em relação ao sexo, houve uma diferença de idade estatisticamente significativa. O grupo que não sobreviveu era mais velho. Idade, lactato desidrogenase (LDH), proteína C reativa (PCR), triglicerídeos, D-dímero e não-HDL-C foram fatores de risco independentes para mortalidade em análises de regressão. Na análise de correlação, idade, PCR e LDH foram positivamente correlacionados com não-HDL-C. Na análise ROC, a sensibilidade para não-HDL-C foi de 61,6% e a especificidade foi de 89,2%. CONCLUSÃO: Acreditamos que o nível de não HDL-C estudado antes da infecção por COVID-19 pode ser usado como um biomarcador prognóstico para a doença.

Comparison of Noninvasive Mechanical Ventilation With High-Flow Nasal Cannula, Face-Mask, and Helmet in Hypoxemic Respiratory Failure in Patients With COVID-19: A Randomized Controlled Trial.

OBJECTIVES: For COVID-19-related respiratory failure, noninvasive respiratory assistance via a high-flow nasal cannula (HFNC), helmet, and face-mask noninvasive ventilation is used. However, which of these options is most effective is yet to be determined. This study aimed to compare the three techniques of noninvasive respiratory support and to determine the superior technique. DESIGN: A randomized control trial with permuted block randomization of nine cases per block for each parallel, open-labeled arm. SETTING AND PATIENTS: Adult patients with COVID-19 with a Pao2/Fio2 ratio of less than 300, admitted between February 4, 2021, and August 9, 2021, to three tertiary centers in Oman, were studied. INTERVENTIONS: This study included three interventions: HFNC (n = 47), helmet continuous positive airway pressure (CPAP; n = 52), and face-mask CPAP (n = 52). MEASUREMENTS AND MAIN RESULTS: The endotracheal intubation rate and mortality at 28 and 90 days were measured as the primary and secondary outcomes, respectively. Of the 159 randomized patients, 151 were analyzed. The median age was 52 years, and 74% were men. The endotracheal intubation rates were 44%, 45%, and 46% (p = 0.99), and the median intubation times were 7.0, 5.5, and 4.5 days (p = 0.11) in the HFNC, face-mask CPAP, and helmet CPAP, respectively. In comparison to face-mask CPAP, the relative risk of intubation was 0.97 (95% CI, 0.63-1.49) for HFNC and 1.0 (95% CI 0.66-1.51) for helmet CPAP. The mortality rates were 23%, 32%, and 38% at 28 days (p = 0.24) and 43%, 38%, and 40% (p = 0.89) at 90 days for HFNC, face-mask CPAP, and helmet CPAP, respectively. The trial was stopped prematurely because of a decline in cases. CONCLUSIONS: This exploratory trial found no difference in intubation rate and mortality among the three intervention groups for the COVID-19 patients with hypoxemic respiratory failure; however, more evidence is needed to confirm these findings as the trial was aborted prematurely.

Opportunities and challenges of leveraging COVID-19 vaccine innovation and technologies for developing sustainable vaccine manufacturing capabilities in Africa.

The COVID-19 pandemic heralded unprecedented resource mobilisation and global scientific collaboration to rapidly develop effective vaccines. Regrettably, vaccine distribution has been inequitable, particularly in Africa where manufacturing capacity remains nominal. To address this, several initiatives are underway to develop and manufacture COVID-19 vaccines in Africa. Nevertheless, diminishing demand for COVID-19 vaccines, the cost competitiveness of producing goods locally, intellectual property rights issues, and complex regulatory environments among other challenges can undermine these ventures. We outline how extending COVID-19 vaccine manufacturing in Africa to include diverse products, multiple vaccine platforms, and advanced delivery systems will ensure sustainability. Possible models, including leveraging public-academic-private partnerships to enhance success of vaccine manufacturing capacity in Africa are also discussed. Intensifying research in vaccine discovery on the continent could yield vaccines that further bolster sustainability of local production, ensuring greater pandemic preparedness in resource-constrained environments, and long-term health systems security.

Prognostic value of R wave peak time in COVID-19 pneumonia.

BACKGROUND: R wave peak time (RWPT) is also known as intrinsicoid deflection time or ventricular activation time. It shows the conduction time from the endocardium in the ventricle to the epicardium. It provides diagnostic and prognostic information for many cardiovascular diseases, such as RWPT prolongation, left ventricular hypertrophy, volume overload, conduction system abnormalities, and myocardial ischemia. Objectives The aim of this study is to investigate the relationship between COVID-19 mortality and RWPT in superficial ECG. METHODS: This study retrospectively examined 640 patients diagnosed with COVID-19 and treated in an intensive care unit at a single center between January 2021 and June 2022. All patients included in the study had clinical and radiological characteristics and signs of COVID-19 pneumonia. RESULTS: 640 patients included in the study were divided into 2 groups: surviving and deceased. There were 510 patients in the surviving group and 130 patients in the deceased group. The deceased group was found to be significantly older. The number of patients with COPD was higher in the deceased group. Troponin, lactate dehydrogenase (LDH), C-reactive protein (CRP), D-dimer and T-peak to T-end interval(Tpe) and RWPT were found to be significantly increased in the deceased group. In binary logistic regression analysis; age, COPD, LDH, CRP, troponin, D-dimer, Tpe interval, RWPT were determined as independent risk factors for mortality. CONCLUSIONS: Prolonged RWPT is useful in risk stratification for COVID-19 pneumonia mortality.

Places Nigerians visited during COVID-19 government stay-home policy: evidence from secondary analysis of data collected during the lockdown.

Introduction: Compliance with the Government's lockdown policy is required to curtail community transmission of Covid-19 infection. The objective of this research was to identify places Nigerians visited during the lockdown to help prepare for a response towards future infectious diseases of public health importance similar to Covid-19. Methods: This was a secondary analysis of unconventional data collected using Google Forms and online social media platforms during the COVID-19 lockdown between April and June 2020 in Nigeria. Two datasets from: i) partnership for evidencebased response to COVID-19 (PERC) wave-1 and ii) College of Medicine, University of Lagos perception of and compliance with physical distancing survey (PCSH) were used. Data on places that people visited during the lockdown were extracted and compared with the sociodemographic characteristics of the respondents. Descriptive statistics were calculated for all independent variables and focused on frequencies and percentages. Chi-squared test was used to determine the significance between sociodemographic variables and places visited during the lockdown. Statistical significance was determined by P<0.05. All statistical analyses were carried out using SPSS version 22. Results: There were 1304 and 879 participants in the PERC wave-1 and PCSH datasets, respectively. The mean age of PERC wave-1 and PCSH survey respondents was 31.8 [standard deviation (SD)=8.5] and 33.1 (SD=8.3) years, respectively.In the PCSH survey, 55.9% and 44.1% of respondents lived in locations with partial and complete covid-19 lockdowns, respectively. Irrespective of the type of lockdown, the most common place visited during the lockdown was the market (shopping); reported by 73% of respondents in states with partial lockdown and by 68% of respondents in states with the complete lockdown. Visits to families and friends happened more in states with complete (16.1%) than in states with partial (8.4%) lockdowns. Conclusions: Markets (shopping) were the main places visited during the lockdown compared to visiting friends/family, places of worship, gyms, and workplaces. It is important in the future for the Government to plan how citizens can safely access markets and get other household items during lockdowns for better adherence to stay-at-home directives for future infectious disease epidemics.

The Relationship between Social Media Exposure and Social Comparison Level: Instagram as a Model

This research designed to discover the relationship between the exposure of social media and social comparison level, taking Instagram as a model based on age, social status, educational level, job, frequency of opening Instagram daily and numbers of hours spend on the app per day as study variables to discover if there are relationships between these variables and social comparison level among Palestinian females Instagram users. This research is a descriptive study used the survey methodology that depended on pre- prepared questionnaire was developed by Sharmaa, et al. (2022). The internal consistency was checked by Cronbach's Alpha Coefficient. The values of the test were above 0.9, point out excellent (1.0–0.90) reliability for all the constructs (Sharma, et al., 2022). The sample included 140 Palestinian females who have an effective Instagram application and use it periodically. Frequencies tables and One Way ANOVA test were used by SPSS program to examine the hypothesis of the study. Six statistical hypotheses were tested. Results from data analyzing found that there is no significant statistical relationship between the exposure to Instagram and social comparison level based on age, educational level, social status, job, frequency of opening the app per day and number of hours spend on the app per day. The research found that the sample's majority expressed that Others' Instagram posts inspire and motivate them. Also,half of the sample care about the way the others interact with their posts and think that people present themselves on Instagram in a different way compared to reality and that they don't make positive or negative judgments on others based on their number of likes and followers.

Bilateral Acute Macular Neuroretinopathy (AMN) after COVID-19 and its Clinical Course. / Bilaterale akute makuläre Neuroretinopathie (AMN) nach COVID-19 und Verlauf.

Acute macular neuroretinopathy (AMN) is a rare disease entity. It is mainly observed in young women with a history of influenza-like infection or who have been taking oral contraceptives for several years. Patients typically describe subjective visual deterioration and mono- or bilateral paracentral relative scotomas. In some cases, funduscopic ophthalmic examination may reveal subtle sharply demarcated flat lesions of reddish-brown or orange colour in the macular region. Diagnosis is usually made by near-infrared fundus imaging which shows hyporeflective areas, and SD-OCT imaging which manifests changes in the outer retinal layers. In the following, three patient cases with bilateral AMN are described which occurred in direct temporal relationship to a recent SARS-CoV-2 infection.

The Association of Eating Behaviour with Physical Activity and Screen Time among Adolescents in the Klang Valley, Malaysia: A Cross-Sectional Study.

Over the last few decades, the time adolescents spend using electronic devices has increased significantly. The aim of this study was to evaluate the impact of screen time and physical activity on eating behaviour in adolescents. This study used the Physical Activity Questionnaire for Adolescents (PAQ-A) Malay version and the Dutch Eating Behaviour Questionnaire (DEBQ) Malay version methods with secondary students around the Klang Valley. The sampling technique used was purposive sampling. With parents' consent, an online survey was conducted among adolescent school children aged between 13 and 17 years during the COVID-19 pandemic in the Klang Valley, Malaysia. There were 372 respondents participating in this study. The results showed that 99.4% of them had more than 4 h screen time a day, and that 38.5% have more than three devices at home. Moreover, there was a significant mean difference in screen time for console games without a handheld device between male and female adolescents (p < 0.05). There was also a significant mean difference in the emotional, restricted and external eating behaviour scores between male and female adolescents (p < 0.001). There was a significant relationship between physical activity and the time duration spent on a television, telephone and laptop during weekends (p < 0.05). There was a significant relationship between eating behaviour and time spent watching television and using laptops during weekends (p < 0.05). Based on the moderation model, gender as a moderator variable indicated that there was a significant relationship between screen time and interaction screen time and gender with emotional eating (p < 0.001). Female adolescents had a stronger relationship between screen time and emotional eating compared to male adolescents (p < 0.05). Meanwhile, for physical activity level as a moderator variable, the results showed that there was a significant interaction between screen time and physical activity for emotional eating behaviour (p < 0.05). In conclusion, this study indicates that screen time was higher among female adolescents and significantly related to emotional eating behaviour. Therefore, the educational sector should emphasise the motivation of adolescents to engage in physical activity, reduce their screen time and eat healthy foods such as fruits and vegetables.

Anxiety, coping style and hopelessness during COVID-19 pandemic: An Iranian population-based study.

Background and Aims: The COVID-19 pandemic has caused new conditions such as nationwide quarantine, a dramatic decrease in-person interaction and an increase in death anxiety for governments and people. The pandemic of an unpredictable disease with no definite treatment can pose physical and psychological risks to individuals. The present study aimed to investigate the state of anxiety, coping styles, and hopelessness of people in the lockdown period and reopening in Iran. Methods: In this national population-based cross-sectional study, a total of 1191 people who had access to social networks from all over Iran completed the anxiety, hopelessness, and coping style questionnaires online using the snowball sampling method. Analysis was conducted using Stata software version 12 (Stat Corp). The significance level was set at 0.05. Results: The results of the study suggested that women experienced higher levels of anxiety than men, and, in stressful situations, women were more likely to use emotion-focused coping styles, while men frequently used problem-focused coping styles. The majority of participants reported moderate levels of anxiety and low levels of hopelessness (64.04%). The results of multiple linear regression show any level of anxiety mild (ß = 0.59, 95% confidence interval [CI]: 0.32-0.85), moderate (ß = 0.72, 95% CI: 1.36-1.08), and severe (ß = 2, 95% CI: 1.36-2.56) relative to the none anxiety significantly increase the hopelessness, Furthermore, showing a negative significant adjusted association with the problem-focused coping style (ß = -0.06, 95% CI: -0.07 to -0.04), and a significant positive association with the emotion-focused coping style (ß = 0.04, 95% CI: 0.02-0.06). Conclusion: Our findings could be used to prevent psychological damage in societies and suggested addressing problem-focused coping style, especially during a crisis, and providing people with preprepared mental health protocols at this pandemic.

Clinical Characteristics of COVID-19 from the Otorhinolaryngologist's Perspective: First Report from Oman, Middle East.

To study the otorhinolaryngological clinical characteristics of COVID-19 positive patients. A prospective cross sectional study on sixty five patients who were SARS-CoV-2 PCR positive, and completed 14 days of isolation period were surveyed with a questionnaire. The responses were evaluated and assessed. Sixty five SARS-Cov-2 PCR positive cases were included in the study. There were 57 (87.6%) males and 8 (12.3%) females. Thirty five (53.8%) were in home isolation, whereas, 30 (46.2%) were under institutional care. Forty five patients (72.6%) presented with mild symptoms, and 4 (6.4%) developed moderate symptoms. Thirteen (21%) were asymptomatic. Overall, 46 patients (70.7%) presented with upper airway symptoms with or without general symptoms. More than half of the patients experienced pharyngodynia or sorethroat, smell and taste dysfunction as common symptoms (66.7%, 61.4% and 50.7% respectively). Severe headache was noticed by eighteen (27.7%) patients. Other respiratory symptoms such as nasal congestion, rhinorrhoea, sneezing, facial pain, etc. were present with less frequency. In more than half of the patients (61.5%), all the symptoms recovered within 5 days, in 12 (18.5%) between 5 and 8 days, and in 9 (13.8%), between 9 and14 days. However, in four patients, symptoms lasted for 28-30 days. In seven patients (10.7%), symptoms recurred after the period of isolation, however, the retest was negative. Fever, cough and or shortness of breath are the commonly reported prominent symptoms of COVID-19, however, there is a changing trend of clinical presentation towards variable otorhinolaryngologic manifestations. Pharyngodynia, taste and smell dysfunctions are common in patients with COVID-19, and could represent potential characters.

Challenges Experienced by Mothers of Children with Cerebral Palsy during the Movement Control Order (Lockdown) in Malaysia: A Qualitative Study

Background and Purpose: Following the global coronavirus (COVID-19) outbreak and the recent spike in COVID-19 cases in Malaysia, the Malaysian government had imposed a Movement Control Order (MCO) on 16 March 2020 as a measure to curb the outbreak. Consequently, all non-essential affairs were suspended and operated fully on a work-from-home basis, when schools were temporarily closed, and citizens were urged to stay at home. Despite a high number of studies on the negative impacts of MCO to various sectors, there is a little concern noted for the potential impacts on vulnerable populations, including parents with special kids such as cerebral palsy (CP). The purpose of this qualitative study was to investigate the burdens and difficulties associated with the experience of caring for children with CP during the MCO Methodology: This study was designed as qualitative research. Twenty-six participants were selected using a purposive sampling method to involve in in-depth interviews. They were the parents who joined the Cerebral Palsy Support Group in Terengganu, Malaysia. The interview responses were thematically analyzed using a content analysis method. Findings: Four main themes were revealed from the thematic analysis, namely emotional distress, worry over postponement of therapy and medical consultation, burn out due to work from home, and conditions of the CP children themselves. The findings indicated that both mothers, either working or housewife, experienced depression and deterioration in physical health and psychosocial emotions. Contributions: Interventions in the forms of financial aids, guidance for CP children self-therapy at home, and emotional supports are urgently needed to ensure mothers and their CP children maintain their quality of life despite the MCO.

Learning from an Experience, Challenges and Approaches in the Workplace during COVID-19 Pandemic: A Content Analysis of International Documents (preprint)

Background The present study aims to investigate international measures of pandemic control at the workplace based on the guidelines of international organizations and learn from them and their experiences.Methods We conducted the qualitative study through the content analysis method. The search method included the guidelines published regarding the prevention and response in dealing with the COVID-19 pandemic in workplaces.Results We extracted eleven categories, consisting of legal requirements and duties of employees and employers, structure and program changes, risk assessment, risk communication, information and training, internal and external consultation and cooperation, provision of facilities and tools and workplace hygiene, special conditions, special groups, closing and reopening workplaces, reducing contact and exposure and mental health.Conclusions Protecting employees during a pandemic requires a multifaceted approach and strong advocacy. The operational plan of pandemic control should be developed according to the level of risk, and the support should be appropriate to the conditions of the employees and adapted to their needs.

Asymmetric effects and volatility transmission from metals markets to solar energy stocks: Evidence from DCC, ADCC, and quantile regression approach

Detrimental environmental repercussions have recently given rise to an interest in green investments. Although solar energy stocks are appealing assets for ethical investors, little is known about their dynamic correlations and linkages with metal (silicon, lithium, and rare earth) markets, particularly during economic events which is essential for hedging effectiveness and asset allocation. This study investigates the nexus between metal markets, oil price volatility (OVX), market sentiments (VIX), and solar energy markets using DCC, ADCC models, and the quantile regression approach. The results show both symmetric and asymmetric shock spillover between metals markets, VIX, OVX, and solar energy markets which are more prominent during COVID-19 pandemic, US-China trade frictions, and Russian invasion of Ukraine. For portfolio management, the hedging effectiveness of lithium stocks is highest, followed by silicon and rare earth metals. However, the hedge ratios are time-varying, and the variability is highest during US-China trade frictions. The quantile regression estimates reveal that lithium market is the most persistent determinant of solar energy stocks followed by silicon market even after segregating the periods into Paris Agreement and COVID-19 pandemic. Thus, lithium and silicon are driving markets of solar energy markets and can be a cause of omitted variable bias if stay unobserved. Nonetheless, there is little influence of VIX, rare earth metals, and OVX on solar energy stocks. Lastly, the estimations of threshold regression suggest that market sentiments change the association between metal markets and solar energy markets after the VIX reaches a certain threshold level. © 2023

Exploration roles and responsibilities of trade unions in preventing and responding to emergencies against epidemics: The case of COVID-19.

BACKGROUND AND AIM: The coronavirus disease 209 (COVID-19) pandemic has been affecting various strata of society including different guilds. Each of these segments has its role to play in controlling epidemics. Accordingly, this study aimed to explore trade unions' roles and responsibilities in the prevention and emergency response to epidemic, including the COVID-19 pandemic. MATERIALS AND METHODS: The present qualitative research was conducted using directed content analysis. Participants were selected by a purposeful sampling method. Data were collected through semistructured interviews and field notes and validated through Lincoln and Guba's (1985) evaluative criteria. Data were analyzed by MAXQDA software. RESULTS: Data analysis, constant comparison, and class integration provided a total of seven main themes, which were extracted into four domains of Plan, Implementation, Review, and Action. The main themes were categorized into the dimensions of each domain, so that the Plan domain included three dimensions of union/guild contexts, leadership and staff participation, and planning. The Implementation domain included two dimensions of support and operations. The Assessment domain had a performance evaluation dimension, and the Action domain was made up of an improvement dimension. CONCLUSION: Relying on their organizational and social capacities, trade unions can facilitate the leadership and participation of employees and communities for appropriate policies and making resilient decisions to control epidemics and other roles and responsibilities related to health.