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Post COVID-19 pandemic, tourists remain eager to sample local food when visiting new destinations. However, being in a strange island environment and eating unfamiliar food, may enhance the feeling of uncertainty, thus increase Western tourists' perceived risk particularly with unfamiliar food and culture. International tourists may perceive unfamiliar foods as strange or even dangerous, which could affect the overall tourism experience. Western tourists' risk perception towards local island food in Malaysia remains unexplored despite the popularity of island destinations. The present study aims to explore Western tourists' perceived risk factors regarding local island food and their impact on willingness-to-try. Adopting a qualitative stance, semi-structured interviews were conducted between July and August 2020 involving nine Western tourists (two male, seven female) at various food outlets in Perhentian and Redang Island. The data were analyzed using thematic analysis and aided with Atlas.ti software. Results indicated the presence of perceived health risk, environmental and safety risk. Hedonism and the emotional connection remain a key attraction to the island-style dining experience.
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Background: Regarding the growing burden of non-communicable diseases (NCDs) and exposure to their risk factors, and the continuous need for nationwide data, we aimed to develop the latest round of the STEPwise Approach to NCD Risk Factor Surveillance (STEPS) survey in 2021 in Iran, while the COVID-19 pandemic was still present.Methods: In addition to the three main steps of this survey, including questionnaires, physical measurements, and laboratory assessments, we adapted the survey with the situation caused by the COVID-19 pandemic, by adding to various aspects of study phases and changing some scientific and executive procedures in this round of STEPS survey in Iran. These changes were beyond the initial novelties embedded within the survey before the pandemic, by refining the study protocol benefiting from the previous experiences of the STEPS survey.Results: By amending the required changes, we could include a total of 27 874 individuals in the first step of the survey. This number was 27 745 and 18119 for the second and third steps. Comparing the preliminary results with the previous nationwide surveys, this study was highly representative on both national and provincial levels. Also, implementing the COVID-19 prevention and control strategies in all stages of survey led to the least infection transmission between the study investigators and participants.Conclusion: The novel initiatives and developed strategies in this round of Iran STEPS survey provide a state-of-the-art protocol for national surveys in the presence of an overwhelming catastrophe like the COVID-19 pandemic and the triggered limitations and shortages of resources.
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Background: The coronavirus disease 2019 (COVID-19) epidemic is a great challenge among healthcare workers, especially nurses, due to their more frequent and closer contact with patients. Objectives: This study aimed to evaluate anxiety, depression, and their causes among nurses with COVID-19 infection in different wards of a hospital. Methods: This cross-sectional study was carried out between February 1st to October 30th, 2020, among all nurses with COVID-19 infection in different wards of Imam Khomeini Hospital (university hospital), Tehran, Iran. The nurses were contacted by phone, and data were collected using a self-administered, valid, structured questionnaire consisting of sociodemographic characteristics and clinical symptoms. Psychological complications, including anxiety and depression levels, were assessed and their association with other sociodemographic variables was also evaluated. Results: A total of 158 nurses were entered into the study, out of which 112 (70.2%) cases were females. Among all participants, 72.8% and 42.4% of the subjects reported anxiety and depression, respectively. The frequency of moderate to severe anxiety was significantly greater in women than in men (P<0.001). The infected nurses who worked in low-risk departments experienced a greater proportion of moderate to severe depression (P=0.004). In addition, the most prevalent reason for anxiety and depression was found to be the fear of infecting family members. Conclusion: Nurses bear a significant psychological burden during the COVID-19 pandemic, markedly when they get infected and experience clinical symptoms. Therefore, the government and other staff should provide some facilities and supportive administrative work for reducing anxiety and depression and improving nurses' psychological health.
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Objectives: The coronavirus (COVID-19) pandemic is a global public health challenge. It is the source of great stress and anxiety for individuals and communities around the world and has had serious effects in individuals with diagnosed mental disorders. This study compares the all-cause mortality of COVID-19 patients with and without diagnosed mental health disorder (MHD) treated at Los Angeles County Department of Health Science (LAC-DHS). Methods: We collected ICD-10 and demographic clinical modification diagnoses in COVID-19 patients in LAC-DHS from March to May 21, 2020 using coded data. Diagnosis codes identified as with and without MHD (F00-99). The relative risk of mortality in COVID-19 patients with and without standardized mean difference (SMD) was calculated. Furthermore, the mortality rate in COVID-19 patients in African American vs other ethnicities was examined. The study protocol was approved by the IRB Committee Board of Olive View-UCLA Education and Research Institute in Sylmar, California. Results: Among 9304 COVID-19 patients treated at LAC-DHS, 37.3% (3475) had an MHD. The mortality rates in COVID-19 patients were 0.36% in patients aged 0 to 17 years, 1.72% in patients 18 to 34, 3.9% in patients 35 to 44, 5.47% in patients 45 to 54, 7.05% in patients 55 to 64, 10.2% in patients 65 to 74, 15.1% in patients 75 to 84, and 19.1% in patients 85+. The total mortality rate of COVID-19 patients without and with an MHD was 5.36% vs 6.82% (p < 0.05). After adjustment for age, regression analysis showed that the relative risk of mortality was 29% (relative risk [RR] = 1.29;95% CI, 1.1-1.6;p = 0.001) in COVID-19 patients with an MHD compared to those without. Finally, the mortality rate in African American COVID-19 patients was significantly higher (6.72% and 7.6% without and with an MHD, respectively) as compared to other ethnicities. The age-adjusted regression analysis showed that the RR of mortality was 35% (RR = 1.35;95% CI, 1.25-2.67;p = 0.01) in African American COVID-19 patients with and without MHD, compared to the corresponding groups with other ethnicities. Conclusions: The findings of this study reveal an increased risk of mortality in COVID-19 patients across all ages, which is significantly higher in those with an MHD. Furthermore, the mortality rate was disproportionately higher in African Americans compared to the other ethnicities. In children and adolescents, COVID-19 and its related mortality, while uncommon, are still present. BRV, CM, RF
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In late 2019, SARS-CoV-2 started to spread throughout the world causing the COVID-19 that has taken a considerable number of lives. Results obtained from several investigations have explained the virus origin, pathogenicity, and transmission. Similar to SARS coronavirus, the pulmonary angiotensin converting enzyme (ACE) 2 was introduced as the virus receptor for entering the cell. An increased body of epidemiological and clinical evidences has shown modulating effects of vitamin D in lung injuries through several mechanisms. Several clinical symptoms as well as molecular factors have shown to be related to the disease transmission and severity. In this study, vitamin D, ACE concentrations, and neutrophil to lymphocyte ratio (NLR) were measured in patients with confirmed COVID-19 in comparison with control group. Results demonstrated significant alterations in vitamin D and ACE levels as well as NLR in the patients' group. Contribution of those factors with the prognosis and severity of the disease has been shown.