Responsible Leadership and Innovation during COVID-19: Evidence from the Australian Tourism and Hospitality Sector

The COVID-19 crisis provides an opportunity for sustainable renewal and requires responsible leaders who are responsive to stakeholder needs and able to innovate in light of new challenges. This study draws on stakeholder theory and responsible leadership theory to examine (a) the challenges industry leaders face as a result of COVID-19 and (b) their innovative responses in light of their responsibilities to stakeholders and society. We conducted a corpus linguistics study based on high-volume media websites reporting tourism and hospitality news on leadership and innovation. We applied a stakeholder and social responsibility lens to the data analysis. We discovered that, despite the challenges that leaders faced, some transcended self-interest or integrated self-interest with consideration for the interest of others and formed partnerships with other stakeholders resulting in win-win solutions. In particular, we found evidence of leaders who (1) responded to the needs of owners, employees, customers, and community stakeholders and (2) developed not only incremental innovations but substantial ones benefitting stakeholders in business and society. We discuss responsible leadership as a pathway for transforming the tourism and hospitality industry towards a more sustainable and community-centred 'new normal'. Based on our findings, we present recommendations for future research and policymakers.

Bio-Psycho-Social Complaints and Stress in Social Work Students During the COVID-19 Pandemic

Shortly after the WHO declared the Corona outbreak a pandemic on March 12, 2020, universities around the world closed and teaching switched almost entirely to an online format, creating additional challenges and requiring students to quickly adjust their study habits. These changes and the uncertainty of when universities would reopen created additional potential sources of stress. The aim of this study is to investigate the bio-psycho-social impact of the COVID-19 pandemic among social work students at a faculty of applied social sciences in Germany in a multidimensional manner. Our central research question was therefore: how do students experience study-related stressors after the outbreak of the pandemic and what are the effects on physical and mental health? We analyzed data from 618 students (age: 28.73, SD = 8.20 years;gender: 84.4 % female, 13.1 % male, 2.1 % inter/diverse). The data collection was conducted through an online survey from 08/03/2020 to 11/01/2020. The results showed a significant increase in psychological complaints as well as social, economic and study-related stress during the COVID-19 pandemic. These correlated significantly, as expected, with psychological discomfort due to reduction in social contact (r = .647, p < .001), with somatic discomfort (r = .597, p < .001), area-specific concerns (r = .520, p < .001, living alone (r = .244, p < .001), and with fear of infection (r = .164, p < .001). In contrast, the number of semesters studied (r = .0119, p < .695) and the question about receiving a student loan (r = -.078, p < .107) were not significant. The reduction of social contacts shows multiple effects on different levels, in the area of emotions, cognitions and behavior. In order to reduce students' stress levels and strengthen coping resources, issues of self-efficacy, sense of coherence, and improvement of study conditions are discussed. © 2022 Duncker und Humblot GmbH. All rights reserved.

Rhino-Orbital Mucormycosis in the Elderly Population after Covid-19

Introduction: In this study, we aimed to retrospectively evaluate the characteristics of mucormycosis cases seen in our clinic during the COVID-19 pandemic, the management of their treatment and the SARS-CoV-2 variants that were dominant at that time. Method(s): The medical records of patients diagnosed with rhino-orbital mucormycosis between March 2020 and July 2022 were retrospectively evaluated. Result(s): Nine patients were diagnosed with rhino-orbital mucormycosis. Of these patients, six were male and three were female, and the patients were between the ages of 65-75 (mean 69.2). After the diagnosis of mucormycosis, antifungal treatment was initiated with liposomal amphotericin-B. Eight patients underwent surgery within 48 hours, only one patient refused to undergo surgery. Conclussions: Mucormycosis is a rapidly progressing opportunistic fungal infection. Therefore, the most basic criteria determining mortality is the early detection of about mucormycosis infection and to diagnose it as soon as possible, especially in patients with an underlying immunosuppressive condition. Once a diagnosis of mucormucosis has been established, risk factors, especially blood sugar regulation, should be corrected. Furthermore, systemic and local antifungal therapy shuold be initiated, and urgent debridement should be performed. Copyright © 2022, Geriatrics Society. All rights reserved.

Psychological factors responsible for low adherence to mask-wearing measures during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic has led to >6 million deaths. Anti-mask movements may decrease the effects of preventive measures. Psychological factors that may be related to anti-mask behaviour are not well researched. AIMS: This study aims to determine the psychological correlates of anti-mask attitudes and behaviour in an online general population sample, focusing on the possible role of claustrophobia. METHOD: Data on attitudes and behaviour toward mask-wearing were collected from an online sample of 3709 people. Predictors of both anti-mask attitudes and behaviour were assessed with linear and logistic regression analyses. RESULTS: Few people (3.3%) were overtly opposed to mask-wearing; mask opposition was more common in men than women. Predictors of negative attitude toward mask-wearing and low adherence to mask-related measures were similar and included male gender, lower education, lower income, being employed, having had COVID-19 and lower COVID-19-related anxiety. Psychopathology measures did not show a prediction, whereas claustrophobia had a significant prediction that was over and above those of other predictors. Avoidance behaviour had similar predictors, except for higher COVID-19-related anxiety. CONCLUSIONS: Although low adherence to mask-wearing during the pandemic was not related to having a mental disorder, it may partly be caused by psychological factors. Those who had a negative attitude also reported lower adherence behaviour, and were characterised by being male, having lower education, being employed and having lower COVID-19-related anxiety; claustrophobia was a strong predictor of attitude. Understanding psychological factors responsible for low adherence may help to decrease morbidity and mortality in future pandemics.

COVID-19 vaccination practice of children with rheumatic disease: a survey-based study

Objective: This cross-sectional study was carried out to investigate the vaccination status of children with rheumatic disease and the reasons why children were not vaccinated.

Evaluation of nasal function in patients with COVID-19: nasal secretion, nasal clearance, and SNOT-22 score

Objective: This study aimed to investigate the nasal findings in patients who tested positive for the coronavirus disease 2019 (COVID-19) and objectively evaluate the amount of nasal secretion and nasal clearance. Methods: The study included 40 patients who tested positive and 40 volunteers who tested negative for COVID-19 infection. The self-administered Turkish version of the sinonasal outcome test -22 (SNOT-22) questionnaire was used to evaluate the sinonasal findings, the nasal Schirmer test was used to evaluate the amount of nasal secretion, and the saccharin test was used to evaluate nasal clearance. The results of both groups were compared. Results: The SNOT-22 score averages were 23.3±14.5 and 11.2±11.7 for the COVID-19-positive group and COVID-19-negative controls, respectively. In the COVID-19 positive group, SNOT-22 results were statistically significantly higher than those of the controls (p≤0.001). The nasal Schirmer and nasal saccharin test results in the COVID-19-positive group were statistically significantly higher than those of the controls (p≤0.002 and p≤0.001). Conclusion: In patients who tested positive for COVID-19 infection, increased amounts of nasal secretion and prolonged nasal clearance time were observed. They also had higher SNOT-22 scores than those of the negative controls. Although these findings demonstrate that there may be changes in nasal functions in patients positive for COVID-19 infection, new studies are needed to elucidate the nasal effects in detail.

Clinical course of COVID-19 in children with rheumatic disease under biologic therapy from Turkey

Introduction: What a biological disease-modifying antirheumatic drugs (bDMARDs)? and/or underlying rheumatological diseases, which we frequently use in our pediatric rheumatology practice, affect the clinical course of COVID-19 has not been fully demonstrated. Objectives: Here, we aimed to reveal the course of COVID-19 infection in patients with rheumatic disease and receiving bDMARD treatment. Methods: This was a retrospective, multicenter study in patients with a biological treatment had been initiated. This real-life study is based on secondary data collection from medical records of patients evaluated at the 14 Pediatric Rheumatology Clinics in Turkey from April 2020 to April 2021. The diagnosis of COVID-19 was confirmed in 101 patients by nasal PCR and in 10 patients by antibody test. Results: The study population of 112 patients consisted of 70 females (63.6%). The mean age of patients was 12.87 ± 4.69 years. The primary diagnosis of patients was as follows;59 juvenile idiopathic arthritis, 33 systemic autoinflammatory diseases, 10 vasculitis, 8 connective tissue diseases. The mean duration of primary disease was 4.62±3.65 years. Nineteen patients had also additional comorbid diseases (hypertension, Chron's disease, hereditary spherocytosis, and chronic renal failure, astma, cardiomyopathy, adrenal insufficiency in individual patients). Prior to COVID-19 infection, 35 patients (31.8%) were using canakinumab, 10 were infliximab (9.1%), 25 were adalimumab (21.8%), 18 were etanercept (16.4%), 9 were tocilizumab (8.2%), 4 were anakinra (3.6%), 6 were rituximab (5.5%), 1 was abatacept (0.9%), and 3 was tofacitinib (2.7%). The median exposure time of a biologic drug was 13.5 months. Additionally, 66 patients were using DMARD, and 27 patients were also receiving corticosteroid. 70 (63.6%) patients had at least one COVID-19-related symptom (fever, cough, diarrhea, myalgia, anosmia and/or rash), while 40 (36.4%) patients were asymptomatic. Respiratory findings were seen in 26% of all patients, 7 patients also had pathology in computed tomography. Hospitalization was required in 25 patients (22.7%) at median of 6 days (IQR: 4-10). Five patients developed MIS-C and 2 of these patients were followed up in the pediatric intensive care unit. Laboratory tests revealed that fourteen patients had elevated acute phase reactants, ten had elevated D-dimer levels, 5 had lymphopenia (< 1000/mm3), and five had hyperferritinemia. Conclusion: In patients with underlying comorbidities, COVID-19 can have a severe course regardless of the use of bDMARD. In the light of these findings, it would not be correct to say that the currently used bDMARDs worsen the course of COVID-19 infection or to say whether they affect the severity of the disease, but still, the disease findings-modifying effects of these drugs, especially high fever and myalgia, have been observed.

Asymptomatic SARS-COV-2 seropositivity: patients with childhood onset rheumatic diseases versus healthy children

Introduction: Although 10-20% of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infected individuals experience life-threatening events, children are most likely to have a significantly milder COVID-19 disease course. However, they might have a pivotal role in the transmission. Raised concerns regarding the vulnerability of those with several comorbidities led to studies evaluating the patients with rheumatic diseases, but they were not found to be significant risk factors for a severe disease course, neither in childhood nor in adulthood. Objectives: We aimed to find out the asymptomatic SARS-CoV-2 seroprevalence among pediatric patients with rheumatic diseases and healthy children and to compare them with each other. Methods: Patients with familial Mediterranean fever (FMF), juvenile idiopathic arthritis (JIA), juvenile systemic lupus erythematosus (jSLE) and healthy children (HC) who remained asymptomatic during the pandemic are examined by ELISA Immunoglobulin (Ig) A and IgG tests in this cross-sectional study. Results: Overall, 149 subjects (90 females) were included in the study. While IgA was positive in 15 subjects (10%) (HC: 8, jSLE: 3, FMF: 2, JIA: 2;p=0.196), IgG was positive in 14 subjects (9.4%) (HC: 7, JIA: 5, FMF: 1, jSLE: 1;p=0.156). Nineteen subjects (12.75%) were IgA or IgG positive (HC: 8, JIA: 5, jSLE: 3, FMF: 3;p=0.644). Although not significant, seropositivity was more often in HC group. The mean age of the IgA and IgG positive subjects was 11.62 ± 5.11 (p=0.391) and 11.18 ± 5.95 (p=0.433) years, respectively. Ten (66.7%) of the IgA positive subjects (p=0.807), and 9 (64.3%) of the IgG positive subjects (p=0.980) were females. Two of the seropositive subjects had a contact history with a confirmed COVID-19 case (FMF:1, IgA: negative, IgG: positive;HC:1, both IgA and IgG positive). During the pandemic, 3 (20%, p=1) of the IgA positive subjects were receiving hydroxychloroquine (HCQ), 2 (13.3%, p=0.738) were receiving colchicine, one was receiving steroids (6.7%, p=0.694), one was receiving conventional disease modifying anti-rheumatic drugs (cDMARDs) (azathioprine: 1) (6.7%, p=0.116), and one was receiving biologic DMARDs (bDMARDs) (adalimumab: 1) (6.7%, p=0.699). On the other hand, 3 (21.4%, p=0.404) of the IgG positive subjects were receiving steroids, 2 (14.3%, p=1) were receiving bDMARDs (adalimumab: 2), 2 (14.3%, p=0.520) were receiving cDMARDs (azathioprine:1, methotrexate: 1), one was receiving colchicine (7.1%, p=0.302), and one was receiving HCQ (7.1%, p=0.467). Both IgA and IgG positivity were not found to be related to age, sex, underlying rheumatic diseases and received treatments of the patients. Conclusion: We revealed that patients with childhood-onset rheumatic diseases, even if they receive immunosuppressive medication such as bDMARDs or cDMARDs, might have an asymptomatic SARSCoV- 2 infection, similarly to their healthy peers.

Influenza vaccine uptake among JIA patients in COVID-19 era: A multi-centre cross-sectional study

Introduction: JIA patients are targeted for vaccination as a population at risk of severe influenza disease. Recent COVID-19 pandemic is an additional challenge;nonetheless, their influenza vaccine coverage remains uncertain. Objectives: To assess the flu vaccination rate in JIA patients & investigate family's attitudes towards it;to identify how COVID-19 pandemic has affected caregiver's decision on flu vaccine administration. Methods: A multi-center cross-sectional study was conducted across 9 countries. Participants completed a questionnaire about the flu vaccination uptake history including the year of 2020-21, sociodemographics and data regarding the disease. Analysis was conducted using SPSSv.20. Results: 655 JIA caregivers were surveyed across 9 countries (Table). The majority was employed (61.2%), married (78.5%) & held a tertiary education (43.1%). Patient's median age was 11y (IQR: 7-15). Principal diagnosis was oligoJIA (34%) & most patients were treated systemically (81%). 21.7% had received influenza vaccine in the past & 18.6% in 2019-20 season;85% were fully vaccinated. 152 children (23.2%) were vaccinated against flu the current season. The majority was informed by their ped rheumatologist (33.5%). Highest uptake was recorded in Greece (79.3%) while lowest in Turkey (1.1%) (p<0.01) (Table). Employed & self-employed and those with tertiary education were more likely to vaccinate their children compared to unemployed & those with elementary education (28.2% & 29.9% vs 13.6%, 28% vs 9.7% respectively, p<0.01). Children with psoriatic & polyJIA had the highest uptake (both 30%) while patients with undifferentiated reported the lowest (7.4%, p<0.01). Among vaccinators, 92.4% were fully vaccinated, 64.6% had been vaccinated in the past & 57.6% in 2019-20 season (p<0.05). An increase was reported in uptake between 2019-20 & 2020-21 seasons (18.6% vs 23.2%, p<0.01). Among non-vaccinators, 52% did not have the chance to discuss their concerns. Major reason for non-vaccination was unawareness of the need (36%);13% reported it was a doctor's advice. Caregivers suggested that informing in advance (67%) may improve uptake. Most of caregivers expressed their concerns regarding their children's vulnerability to SARS-COV-2 due to JIA (51.3%) & their risk of COVID-19 (85.3%);51.3% of them were pro COVID-19 vaccine administration to their children (Table). Those who vaccinated their children against flu in the 2019-20 & 2020-21 seasons were more likely to vaccinate them against SARS-COV-2 (79.5% & 73.4% respectively, p<0.01). Conclusion: Despite variations among countries, flu vaccine uptake remains low in JIA patients. Higher education, thorough informative discussion and notifying families in advance may lead to universal vaccine coverage in children with RDs.

The impact of COVID-19 on clinical course and treatment among patients with juvenile systemic sclerosis

Introduction: The Corona virus disease -2019 (COVID-19) caused by the novel Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) made a sustainable impact on health care worldwide. Till know, there are limited data regarding the impact of SARS-CoV-2 pandemic on patients with juvenile systemic sclerosis (JSS). Objectives: We aimed to explore the influence of SARS-CoV-2 pandemic among patients with JSS. In this context, we performed a web-based survey by focusing on patients' complaints, accessibility to health care and compliance of routine treatment. Methods: The questionnaire including 28 questions was send by the telephone or by the e-mail to patients diagnosed with JSS. The first part of the form included questions regarding the demographic characteristics of patients. The second part included multi-choice of questions regarding the clinical characteristics of patients, treatment they used for the JSS and the continuation and/or discontinuation of regular follow up during the pandemic. Results: Of the 27 responders, 22 (81.5%) were females. The mean age at the time of the study was 17.3 ±3.5 years. Five patients (18.5%) responded that they had deterioration of the disease during the last 6 months. Six patients (22.2%) reported the irregular usage of their routine scleroderma treatment during pandemics. Nine patients (33.3%) missed their routine clinic control since the proclamation of the SARS-CoV-2 pandemics: 2 patients due to a lockdown, 4 patients were afraid to be infected by the SARS-CoV-2 if they go to hospital, 1 patient was feeling well so she decided to postpone the visit and 1 patient took the advantage of telemedicine. Seven patients (25.9%) had a contact with family member diagnose as COVID-19. A total of 4 patients (14.8%) were diagnosed as COVID- 19 and only 1 (3.7%) of them was hospitalized. All of those 4 patients had symptoms of fever, fatigue, myalgia and headache but they completely recovered. Nine patients were under biological treatment (tocilizumab) but only one of them was diagnosed as COVID-19. Conclusion: This is the first study evaluating the impact of COVID-19 on patients with JSS. The COVID-19 hasn't significantly disrupted the medical care in JSS patients. The telemedicine could be an acceptable option for patients disenabled to come to hospital due to different reasons.

Evaluation of the Frequency of Side Effects after Coronovirus Inactive Vero Cell Vaccine in Healthcare Workers of Gazi University Hospital

Objective: COVID-19 (Coronavirus disease 2019) is a global pandemic that affected more than 125 million people all over the world. Vaccines will play a key role in the control of this pandemic. Although inactive vaccine technologies are reliable and being used for a long time, Coronavac is a newly developed vaccine and studies on the side effects of this vaccine are limited. The aims of this study is to evaluate the frequency of possible side effects of Coronovac vaccine and to investigate whether there is a difference between the 1st and 2nd dose vaccines in terms of the frequency of side effects. Methods: This single-center, retrospective descriptive study was carried out in health care workers (HCWs) of Gazi University Hospital who received 2 doses of Coronavac vaccine between January and March 2021. At least 14 days after 2 dose of vaccination, serious advers events, non-serious advers events and possible side effects are collected by the questionnaire forms prepared for the study by the researchers. All data were analyzed by IBM SPSS Statistics version 20.0 (IBM Corp., Armonk, N.Y., USA). The questionnaire forms, prepared for the study, were delivered to volunteer HCWs manually or online by the researchers at least 14 days after 2 dose of vaccination. The data obtained through the questionnaires were transferred to the computing environment and analyzed. Results: 1102 HCWs were enrolled in the study and 392 (35.6 %) had at least one adverse event after the 1st or 2 nd dose Coronavac vaccine. The most common adverse events were: Headache 230 (20.9%), fatigue 225 (20.4 %) and local reactions 193 (17.5%). Serious adverse events occurred in 3 (0.3 %) patients (1 Anaphylaxis,2 Angioedema) after vaccination. The majority of adverse events associated with Coronavac vaccine occured within the first 48 hours. The incidence of adverse events after vaccination is higher in healthcare workers with a known history of vaccine and non-vaccine allergies (42.7% vs. 34.3%, p<0.05, Chi-square test). More frequent side effects were observed after second doses in healthcare workers who developed side effects after the 1st dose of vaccine (70.5% vs. 5.3, p<0.01, Chi-square test) Conclusion: In our study, we found that short-term adverse events of Coronovac vaccine were found to be consistent with phase 1/2 studies and it was observed to be safe for clinical use. However, there is still a need for long-term follow-up in terms of monitoring side effects after administration for the safety of vaccine use.

The prognostic significance of vitamin D deficiency in patients with COVID-19 pneumonia.

BACKGROUND: Vitamin D has anti-inflammatory and immunomodulatory effects via the downregulation of pro-inflammatory cytokines. We aimed to demonstrate the effect of vitamin D levels on survival in COVID-19 patients. MATERIALS AND METHODS: 207 COVID-19 patients were included in the study. Serum vitamin D levels were measured, and patients with levels <20 ng/ml or 21 to 30 ng received a single 300.000 IU dose of vitamin D. RESULTS: Of 207 patients, 37 received vitamin D, while 170 did not. Demographic, radiologic and mean laboratory values were similar between the groups. The mean plasma vitamin D level without vitamin D support (n=170) was 50.82±16.12 ng/ml (30.28-81.35) vs. 16.98±6.2 ng/ml (4.20-28.30) in vitamin D group. The most remarkable finding were the mortality rates; while only 1 patient (2.7 %) died in the vitamin D group, 24 patients (14.1 %) died in no vitamin D supplementation group (p=0.038). CONCLUSION: Although a few retrospective studies put forth a relation between vitamin D deficiency and COVID-19 course severity there is still paucity of data about the efficacy of vitamin supplementations in COVID-19 patients. A single 300.000 IU dose of vitamin D seems to represent a useful, practical, and safe adjunctive approach for the treatment or prevention of COVID-19 (Tab. 1, Fig. 1, Ref. 30).

Severity and serum 25(OH)D levels

Introduction: This study aimed to evaluate the relationship between serum 25-hydroxyvitamin D [25(OH)D] levels and clinical course and outcome of Coronavirus disease-2019 (COVID-19). Materials and Methods: In this single-center, prospective study, patients with COVID-19 were divided into three groups with uncomplicated disease, mild pneumonia, and severe pneumonia. Cases were compared in terms of clinical and laboratory findings as well as serum 25(OH)D levels on hospital admission. Patients were also grouped according to their COVID-19-related outcomes and then compared in terms of 25(OH)D levels.

Relationship between COVID-19 clinical severity and serum 25(OH)D levels

Introduction: This study aimed to evaluate the relationship between serum 25-hydroxyvitamin D [25(OH)D] levels and clinical course and outcome of Coronavirus disease-2019 (COVID-19). Materials and Methods: In this single-center, prospective study, patients with COVID-19 were divided into three groups with uncomplicated disease, mild pneumonia, and severe pneumonia. Cases were compared in terms of clinical and laboratory findings as well as serum 25(OH)D levels on hospital admission. Patients were also grouped according to their COVID-19-related outcomes and then compared in terms of 25(OH)D levels. Results: The median serum 25(OH)D levels of the COVID-19 and control groups were 16 (11-23) ng/ml and 21.5 (18-25) ng/ml, respectively (p<0.001). No significant differences were found in the serum 25(OH)D levels between noncomplicated, mild pneumonia, and severe pneumonia groups 16.5 (16-25.2), 15 (11-21), and 16 (11.5-26.5) ng/ml, respectively, p=0.521. When compared in terms of COVID-19-related outcomes, no significant difference was found in vitamin D levels. Conclusion: Patients with vitamin D deficiency may have higher risk for COVID-19 infections. However, no relationship was found between serum vitamin D levels and clinical severity and outcomes of COVID-19.

The use of prone positioning in severe COVID-19 outside the intensive care unit.

OBJECTIVES: It was aimed to demonstrate the applicability of the prone position with high-flow oxygen to COVID-19 patients with severe respiratory failure in the service in September when the number of cases and the need for intensive care were increased. MATERIAL AND METHODS: The prone position was applied for a minimum of 30-minute periods for at least four hours a day. The patients' oxygen saturation levels and respiration rates were monitored before and 30 minutes after prone positioning. RESULTS: Ten patients, nine males (9/1, M/F), were included in the study. Mean oxygen saturation at baseline was 75.8±12.14 (min: 50 %; max: 90 %) and all patients had high oxygen demand. The oxygen saturation of the patients differed significantly before and after (83.4±6.38 %; 90±5.31 %, p <0.001) prone positioning. Similarly, respiration rates differed significantly before and after (23.9±6; 21.4±4.97, p <0.001) prone positioning. Two patients died during treatment. CONCLUSION: This study highlights the promise of prone positioning performed in ward conditions for improving oxygenation in COVID-19. While the study contains a small group, it may provide guidance for the clinical management of COVID-19 patients to prevent the need for intensive care in the challenging course of therapy (Tab. 2, Fig. 2, Ref. 15).

The mediation relationship between life satisfaction and subjective vitality fear of COVID-19 and problematic internet use

Objective: This aim is to examine the mediating role of life satisfaction and rotating vitality in the relationship between fear of COVID-19 and problematic internet use in adolescents. Method: The participants in Turkey to 532 adolescents (304 females, 228 males) are formed. In the study COVID-19 Fear Scale, Life Satisfaction Scale, Subjective Vitality Scale, and Problematic Internet Use Scale were used. Due to the COVID-19 outbreak, education was not held in schools, so data were collected online. For this, scales were sent to the participants through online data collection prepared via Google Forms. Results: Relationships between adolescents' fear of experiencing coronavirus and their life satisfaction, fitness, and problematic internet use were determined by Pearson correlation analysis. It is seen that the problematic internet use has a positive relationship with the fear of COVID-19, a negative relationship with life satisfaction and other vitality, and low follow-up. It is observed that there is a low level, negatively significant relationship between COVID-19 and life satisfaction and vitality. Regression analysis examined the mediating relationship between life satisfaction and age's fear of COVID-19 and internet use. The research was performed by Hayes (2009) to test the mediating effect. The process was carried out in the macro mirror. In this method, 5000 resampling method was chosen. Discussion: Their results mediate the relationship between life satisfaction and health fear of COVID-19 and problematic internet use.

The Impact of The Coronavirus Disease 2019 Outbreak on The Quality of Life of Patients with Epilepsy

Objectives: We aimed to investigate the effects of the coronavirus disease 2019 (COVID-19) outbreak on the quality of life (QOL) of patients with epilepsy. Methods: A total of 104 epilepsy patients admitted to our hospital during October and November of 2019 were evaluated for their QOL using the QOL in Epilepsy-31 questionnaire. These assessments were repeated in July 2020 and August 2020 to evaluate the impact of the epidemic on the QOL of epilepsy patients in the same group. The data of the patients were analyzed in SPSS. Results: During the pandemic period, overall score values decreased significantly compared to the pre-pandemic period (p=0.049). Although most of the subscores worsened with the pandemic, the most significant deterioration was observed in emotional well-being (p=0.021). There were six patients (5.8%) whose seizure frequency increased during the pandemic period. In the multivariate analysis, the only parameter that predicted an increase in seizure frequency during COVID-19 was the overall score. Overall score had a positive correlation with educational level. Disease duration, age, marital status, and number of drugs used were found to be negatively correlated with the overall score of the patients. Conclusion: The COVID-19 epidemic causes a significant deterioration in QOL in patients with epilepsy. During epidemics such as COVID-19, clinicians should consider psychosocial factors. In patients with epilepsy, measures should be taken not only to control seizures but also to prevent deterioration in mental health and QOL.