جستجوی مقالات مرتبط با کلیدواژه « pandemics » در نشریات گروه « پزشکی »

Dear Editor, Coronavirus disease (COVID‑19), a terrifying pandemic that has plagued the world for more than 2 years and continues to infect and kill people, mutations in its spheres, especially the omicron sphere, has accelerated the incidence of infection and death. According to the World Health Organization on February 25, 2022, more than 5 million COVID‑19 deaths were reported worldwide.

Medical students’ specialty selection influences the composition of the physician workforce and the effectiveness of health systems. Therefore, the identification of factors that influence the choice of specialty is critical for an evidence-based health policy. This study aimed to investigate the effect of the Coronavirus Disease 2019 (COVID-19) pandemic on the determinants of specialty choice among Iranian medical residents. In early 2022, this qualitative study was conducted among Iranian medical residents in seven provinces, including Tehran, Isfahan, Fars, Khorasan Razavi, Kerman, Kermanshah, and Khuzestan. The participants were selected using a purposeful sampling method. Data were collected using 74 semi-structured in-depth face-to-face interviews. Finally, a thematic content analysis (conventional content analysis) method was applied for data synthesis. The participant’s mean age was 28.7±2.5 years, and more than 52% (N=39) were men. Following data synthesis, 10 sub-themes and four main themes were identified, including educational aspects affected by the pandemic, career-related hazards, personal and professional lifestyles affected by the disease, and experiences and beliefs regarding the pandemic. The COVID-19 pandemic has had a significant impact on medical students’ educational, professional, and personal aspects of specialty choices. This study demonstrated how the disease affected the choice of specialty. Therefore, the findings could be used for developing national health policy and planning.

The death and fear of the COVID-19 pandemic has been a major concern in all countries. Estimating the burden of the disease is one of the indicators that estimates the severity of the damage caused by the disease. This study was performed to estimate the burden of years of life lost due to COVID-19 infection and premature death in North Khorasan.

In this study, all cases of definitive infection (PCR test positive) with COVID-19 from the beginning of the epidemic to April 2021 were included in the study. Disability-Adjusted Life -Years index (DALYs) was used to estimate the burden of the disease.

Since the beginning of the epidemic, 63697 definite cases of the disease have been identified (prevalence equal to 7%) and the total number of years of life lost due to disability and premature death was estimated at 24769 years. This number represents 28.7 years per 100,000 populations, which in women and men, this number was equal to 26.6 and 30.8, respectively.

According to the results of the study, COVID-19 has caused significant loss of years of life, which due to age and concomitant diseases, deaths are more common in the elderly.

Context: 

The coronavirus disease 2019 (COVID-19) pandemic adversely affected the operation of health systems and services and dramatically increased the responsibilities of health professionals. Medical and nursing practitioners are an integral part of health care. They shouldered an important role in the fight against the novel coronavirus despite the potential risks.

Evidence Acquisition: 

The present article applied a narrative approach to examine the nature and scope of the medical and nursing professions, especially during a pandemic or epidemic, and to describe the societal impact of the recent public health emergency. This study also analyzed the experience gained from the pandemic and how this could be used to ethically guide health services and clinicians through similar crises in the future.

 The COVID-19 crisis revealed ethical dilemmas related to the retention of balance between the commitment to duty and the discretion to opt out. Health workers' obligation to treat derives from their professional role and is based on scientific, moral, and legal grounds. A pandemic mandates health staff to work at the limits of their competencies and entails the risk of infection with the pathogen, physical exhaustion, and emotional stress. The tremendous toll on society and health care due to the spread of a pathogen needs to be managed. The responsibility of clinicians to care for the sick is at the core of any successful response to a pandemic. Protective measures, safety training, sustainable working hours, and moral and fiscal compensation are essential prerequisites for the fulfillment of their tasks.

 Despite the reduced clinical severity associated with new variants, individual and collective fatigue among doctors and nurses continues to exist. The most recent epidemiological indicators show that the COVID-19 pandemic is still progressing but with a decelerating rhythm. In addition, preparation for a potentially catastrophic future pandemic is appropriate. Therefore, there is no time for complacency. All the involved parties need to ensure that health professionals uphold the mission of their profession.

 The COVID-19 pandemic led to significant concerns and public panic. Due to the ambiguous and deadly nature of this virus, it triggers anxiety related to COVID-19 and a fear of death. On the other hand, early maladaptive schemas (EMSs) can impact anxiety.

 The current research aimed to determine the relationship between EMSs, COVID-19 anxiety, and death anxiety during the COVID-19 pandemic among Zahedan University of Medical Sciences (ZAUMS) students in Iran.

 The present descriptive-analytical cross-sectional study was conducted on 120 ZAUMS students selected through a purposive and convenience sampling technique from May 2022 to December 2022. The data were collected using the COVID-19 Anxiety Scale, the short version of the Young Schema Questionnaire (YSQ), and the Templer Death Anxiety Scale (DAS). The data were analyzed in SPSS 22 using various statistical methods, including frequency analysis, mean calculation, standard deviation calculation, descriptive indices, and multiple regression analysis.

 The disconnection and rejection schema predicted COVID-19 anxiety without a moderator or with a history of contact with a COVID-19 patient as a moderator (B = 0.10, t = 2.69, P < 0.05, R2 = 0.09). Impaired autonomy and performance could predict death anxiety with the moderating role of a history of contact with a COVID-19 patient (B = 0.31 t = 2.14, P < 0.05), history of contracting COVID-19 (B = 0.24; t = 2.12, P < 0.05), discipline, and study period or without any moderator. Over-vigilance could predict death anxiety with the moderating role of discipline or without a moderator (B = 0.41, t = 2.93, P < 0.05).

 Disconnection and rejection with or without a moderator predict COVID-19 anxiety. Over-vigilance, impaired autonomy, and performance schema domain predict death anxiety. Effective moderators in predicting variables are contact with a COVID-19 patient, history of contracting COVID-19, discipline, and study period.

One of the high‑risk groups exposed to the coronavirus disease 2019 (COVID‑19) pandemic was pregnant women at risk of pregnancy complications due to a weakened immune system and inability to use various drugs to treat COVID‑19. Accordingly, this study was conducted to investigate the complications in pregnancy before and during the COVID‑19 pandemic.

This cross‑sectional study was performed on all pregnant women in Shahroud, Iran. The time interval from February 18, 2019, to February 17, 2020, was considered before the COVID‑19 pandemic and from February 18, 2020, to February 17, 2021, was considered the COVID‑19 pandemic. Sampling was conducted by census and included 6851 pregnant women. The required information was extracted from hospitals’ health deputy registration system and high‑risk pregnancy registration program.

Based on the findings, hypertension disorder, gestational diabetes, placental abruption, pre‑eclampsia, cesarean section, hospitalization in neonatal intensive care unit (NICU), preterm birth, and hospitalization in other hospital wards increased by 1.88%, 1.93%, 0.12%, 0.45%, 5.45%, 1.00%, 1.20%, and 1.40%, respectively, in 2020 compared to 2019. A statistically significant difference was also observed between them (p < 0.05). Also, the regression results showed that the chances of high blood pressure, Gestational Diabetes Mellitus (GDM), placental abruption, and cesarean section were increased by 10.91, 1.53, 5.51, and 2.83 times, respectively.

Pregnancy complications have increased during the COVID‑19 pandemic. As a result, there is a need to take appropriate health and medical measures to reduce the risks associated with the COVID‑19 epidemic for pregnant women and neonates.

Despite the passage of more than two years since the coronavirus disease 2019 (COVID-19) pandemic, the persistence of the coronavirus and its circulation at varying levels globally necessitates a deeper understanding of the factors influencing its transmission and impact. This study aimed to investigate the relationship between environmental factors, population density, and genetic variations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with a specific focus on elucidating their implications for public health measures and vaccine development.

This observational analysis was conducted utilizing daily reported SARS-CoV-2 cases in various countries. Additionally, monthly changes in ultraviolet (UV) radiation index, population density per km2, and viral genetic variations were assessed. Comparative analysis was performed to examine correlations between these variables. Data analysis was conducted using SAS 9.3 software with a generalized linear model (GLM) approach.

This study revealed significant correlations between UV index and key epidemiological parameters, including mortality rate, average case number, and transmission rate. Population density per square kilometer did not exhibit any substantial relationship with these variables. Analysis of viral clades suggests potential immunological insights, indicating varying degrees of immunity conferred by certain genetic variants.

These findings underscore the importance of environmental and genetic factors in shaping the trajectory of the COVID-19 pandemic. By elucidating the role of UV radiation and viral genetic diversity, this study informs public health strategies and underscores the necessity of ongoing surveillance and vaccine development efforts tailored to the evolving SARS-CoV-2 landscape.

The recent public health crisis of the COVID-19 pandemic has influenced the professional identity of nurses as well as nursing students globally. Gender and its intersections are critical moderators of professional identities. The study aimed to elaborate on the reflections of male nursing students in India, about nursing and gendering in nursing, in the context of the COVID-19 pandemic. A qualitative phenomenological exploration was conducted using semi-structured interviews during the March 2021 among seven male nursing students who were purposively selected from a nursing college, Bangalore, South India. Thematic manual analysis as described by Braune and Clarke were used to transcribe the interviews and derive themes and subthemes. The major themes that emerged were; enhanced visibility and professional identity, resisting gender norms in nursing, and reaffirming the decision of choosing nursing. Based on the interviews, we conclude that the COVID-19 pandemic has catalyzed negotiations in the perceived gender positions of male nursing students. We contribute to the existing literature by illuminating how critical situations like the COVID-19 pandemic are contributing to resisting gender norms in professional nursing.

Given the changes caused by COVID-19, modern information technology has gained a higher position, fostering the realistic comprehension of technology, developing an interdisciplinary program, and endorsing scientific and technological activities within the educational environment. Considering the advancement of information technologies after COVID-19, this study was conducted to explore the role of new information technology in shaping education during the pandemic.

In this systematic review, all relevant studies were searched in Medline/PubMed, Scopus, Web of Science, ProQuest, Iran Medex, Magiran, and Scientific Information Database (SID) databases from 2019 to 2022. The analysis was conducted using a thematic analysis approach.

Of the 1966 search results, 15 articles were included in this systematic review. These comprised 9 journal articles, 5 conference studies, and 1 thesis study. Data were extracted under two main categories—education and knowledge management—and four subcategories: Learning, performance quality, infrastructure, and planning.

Developing positive and creative skills in using new technologies is a complex process, which, through joint planning in multidisciplinary teams, can enhance technology-driven education. However, using new information technologies requires more support for educational leadership.

Both coronavirus disease-2019 (COVID-19) and cancer place a heavy burden on the society and mental health of patients. Spiritual health may play a prominent role in coping with stressful conditions. Considering the existing controversy regarding the correlation between spiritual health and stress related to the COVID-19 pandemic in cancer patients, this study aimed to assess the correlation between spiritual health and COVID-19 stress in cancer patients.  

This cross-sectional study was conducted on cancer patients presenting to Rasoul and Firouzgar Hospitals, affiliated with Iran University of Medical Sciences, in 2022. After obtaining written informed consent, eligible patients filled out the spiritual health questionnaire and COVID Stress Scale (CSS). Data were analyzed by the Pearson and Spearman correlation coefficients and one-way ANOVA.  

The mean (SD) levels of COVID-19 stress and spiritual health were equal to 106.5 (44.5) and 26.2 (10.9), respectively, which are regarded as moderate levels. An inverse correlation of -0.48 was found between spiritual health and COVID-19 stress (P < 0.001). Spiritual health decreased by an increase in the stage of cancer (P < 0.001). The mean COVID-19 total stress score and its domain scores [except for the post-traumatic stress syndrome (PTSD) domain] were significantly higher in patients with poor spiritual health compared with those with good spiritual health. However, the difference in this regard was not significant between patients with poor and moderate spiritual health (P > 0.05).   

This study confirmed the prominent role of spiritual health in the reduction of COVID-19 stress. Promotion of spiritual health in cancer patients should be considered as an inseparable part of patient care to prevent disease aggravation and decrease the stress level of cancer patients, particularly during the COVID-19 pandemic.

Emergency Medical Technicians (EMTs) face many challenges and problems as the front line of dealing with epidemics including COVID-19. Therefore, the present study was aimed at exploring the challenges of EMTs in providing pre-hospital care during the COVID-19 pandemic. This qualitative research was conventional content analysis conducted between November and December 2021. The participants were 15 emergency medical technicians working in the emergency center 115 in Shahroud selected by purposeful sampling method. Data were collected through semi-structured in-depth interviews at the location of the participants. Then, the codes, subcategories and categories were extracted by inductive process.  Challenges among EMTs in providing pre-hospital care during the COVID-19 pandemic were categorized under four themes including (1) work factors (high work pressure, non-cooperation of patients, difficulty working with protective equipment) (2) unprepared organization (lack of coordination between medical centers, (3) threatened health (psychological disorders, physical problems) and (4) restless social (challenges with family members, social isolation). Health care managers, authorities and policy makers should use effective strategies to prevent and reduce the challenges of EMS workers in order to minimize their negative effects on EMTs and improve the quality of services provided.

Epidemics are threats to communities and their health. The preparedness of makeshift hospitals in epidemics in management, planning, implementation, and structure to provide appropriate and timely services is essential. Studies show that the incidence command system and the operational fact sheet based on task descriptions and instructions in makeshift hospitals are not considered. This study is designed to develop an appropriate organizational structure for makeshift hospitals.

This was a descriptive-analytical cross-sectional study in two stages, including review and expert panel studies, to develop a national fact sheet guide and the structure of makeshift hospitals.

Based on the nature of disasters, makeshift hospitals should have specific structures. In the structure designed for a makeshift hospital, according to the center’s services and time of activation, it is necessary to have a manager, management, and executive staff. A medical specialist, such as an infectious or pulmonary specialist, is essential, depending on the situation. Considering the limited resources in developing countries and the importance of managing resources (financial, human, and equipment) and improving the quality of health services, it will be helpful to formulate a management structure and implement operational worksheets in the least possible time.

The use of command and management structure will improve decision-making in critical situations, especially in cases of epidemics, the need for quarantine, and the provision of services to injured patients.

Many studies have investigated the rate of suicide attempts and their risk factors during the coronavirus disease 2019 (COVID-19) pandemic; however, the results are still challenging.

This study investigated and compared the risk factors effective in suicide attempts during the pandemic period and one year before.

This case-control study was conducted at Loghman Hakim hospital, Tehran, Iran. Random sampling included all patients in the inpatient ward who were over 12 years of age and committed suicide during the pandemic within October 1, 2021, to August 30, 2022 (case group; n = 160) or one year before within March 11, 2019, to March 11, 2020 (control group; n = 160). Demographic information, mental-psychological status, and socioeconomic status (SES) of the patients in the case group, before and after the COVID-19 pandemic, were recorded during face-to-face interviews using a predesigned semi-structured questionnaire by study staff trained and supervised by a clinical psychiatrist. Additionally, the data of the patients in the control group were retrospectively recorded during the review of medical records and telephone interviews. The Wilcoxon signed-rank test was used to compare the variables in the case group before and after the COVID-19 pandemic. The Student’s t-test and chi-square test were used to compare the variables between the case and control groups. Additionally, to determine the risk factors predicting suicide attempts during the pandemic, a multivariable logistic regression test was used. The data were analyzed using PASW18 software.

The results showed that the patients in the case and control groups had significant differences in terms of age (P = 0.01), underlying mental disorders (P = 0.032), and parental relationship (P = 0.001). Moreover, the variables of suicidal ideation (P = 0.002), feeling lonely (P = 0.023), sleep disorder (P = 0.32), and domestic violence (P = 0.004) in the case group were significantly higher than the control group. In addition, the comparison of these variables in the patients of the case group, before and after the COVID-19 pandemic, showed that the start of the pandemic triggered these factors and led to an increase in suicide attempts in this population. Finally, the logistic regression analysis showed that the variables of SES, having a close friend, parental relationship, previous planning for suicide, domestic violence, andjob loss could be considered predictive risk factors for suicide attempts during the pandemic period.

According to the present study’s findings, the psychological and socioeconomic conditions triggered by the COVID-19 pandemic led to an increased likelihood of suicidal ideation or attempts in vulnerable individuals.

The objective of this mini review is to highlight the critical deficiencies in employing consistent and accurate data collection methods during the Covid-19 pandemic. These shortcomings resulted in confusion, misinterpretations, stigmatization, and disparate predictions, ultimately hindering the global response to this potentially devastating pandemic. This article emphasizes the importance of uniform sampling and precise data reporting to overcome these challenges.

During the 2019-nCoV pandemic, many health institutions stopped providing services, thus causing disruptions in  the health system. This study aimed to examine the decayed, missing, and filled teeth (DMFT) index of individuals during the  post-pandemic normalization period.   This cross-sectional study included 640 adult patients aged more than 18 years, who applied to Health Science  University Gulhane Faculty of Dentistry for dental treatment between July 20, 2021, and December 31, 2021. The information  forms were filled by the dentist of the patients during their first examination, which included the demographic data of the patients  (age, sex, educational status, occupation, and income status), oral hygiene habits of the patients (patients’ frequency of tooth  brushing, floss use, and mouthwash use) and frequency of going to the dentist. In addition, the patients were examined by the  same dentist using only mirrors and probes, and their DMFT index data (number of decayed, missing and filled teeth) were  recorded. The data obtained from the study were analyzed using one-way analysis of variance (P<0.05).   The mean age of the individuals participating in this study was 40.94±22.89 years, and the DMFT index was 10.38±5.47.  When the DMFT index was examined according to age ranges, the lowest DMFT index was in the 18–30 years (6.15±3.5)  (P<0.05). The group that used daily brushing, flossing, and mouthwash showed the lowest DMFT ratio of 6.56±3.75.   This study showed that the group that used tooth brushing, flossing, and mouthwash had the lowest DMFT index  when health services were disrupted, such as during the pandemic period.

The aim of this study is to examine the general behavioral status of individuals who apply to the Periodontology clinic during the COVID-19 pandemic, to evaluate their health anxiety levels and to compare their anxiety score averages in terms of various factors. Our study was carried out using the face-to-face survey method. Participants were asked to fill out a demographic data form, a survey form questioning pandemic-related behaviors, and the Short Health Anxiety Inventory (SHAI). The effects of factors such as age, gender, marital status, educational status, working in a health institution and having had COVID-19 disease on health anxiety levels were investigated. Kolmogorov-Smirnow test, Shapiro-Wilk test, Indepedent Samples T-Test, ANOVA, and Tukey HSD tests were used for statistical analysis (p<0.05.). A total of 400 volunteer participants were included (252 females, 148 males). Anxiety score averages showed a statistically significant difference in terms of gender and education groups (p=0.023; p=0.001, respectively). Accordingly, female's mean SHAI score (17.45±7.053) was found to be higher than male's (15.69±8.161). The SHAI mean scores of primary school graduates (20.86±6.105) were higher than those of high school (15.95±8.197) and university graduates (16.11±6.367). There was no significant difference in terms of marital status, working in a health institution and being diagnosed with COVID-19. In addition, 48.2% of the participants only used surgical masks. Most participants declared that their confidence in healthcare workers (HWs) increased during the epidemic. Females and individuals with low educational status had higher health anxiety in this study. Moreover, it can be emphasized with this study that the pandemic has increased the confidence in HWs.

Reinfection and hospital readmission due to COVID-19 were significant and costly during the pandemic. This study aimed to assess the rate and risk factors of SARS-Cov-2 reinfection, recurrence, and hospital readmission, by analyzing the national data registry in Iran.

This study was a retrospective cohort conducted from March 2020 to May 2021. A census method was used to consider all of the possible information in the national Medical Care Monitoring Center (MCMC) database obtained from the Ministry of Health and Medical Education; the data included information from all confirmed COVID-19 patients who were hospitalized and diagnosed using at least one positive Polymerase Chain Reaction (PCR) test by nasopharyngeal swab specimens. Univariate and multivariable Cox regression analyses were performed to assess the factors related to each studied outcome.

After analyzing data from 1,445,441 patients who had been hospitalized due to COVID-19 in Iran, the rates of overall reinfection, reinfection occurring at least 90 days after the initial infection, recurrence, and hospital readmission among hospitalized patients were 67.79, 26.8, 41.61, and 30.53 per 1000 person-years, respectively. Among all cases of hospitalized reinfection (48292 cases), 38.61% occurred more than 90 days from the initial SARS-Cov-2 infection. Getting infected with COVID-19 in the fifth wave of the disease compared to getting infected in the first wave (P<0.001), having cancer (P<0.001), chronic kidney disease (P<0.001), and age over 80 years (P<0.001) were respectively the most important risk factors for overall reinfection. In contrast, age 19-44 years (P<0.001), intubation (P<0.001), fever (P<0.001), and cough (P<0.001) in the initial admission were the most important protective factors of overall reinfection, respectively.

Reinfection and recurrence of COVID-19 after recovery and the rate of hospital readmission after discharge were remarkable. Advanced or young age, as well as having underlying conditions like cancer and chronic kidney disease, increase the risk of infection and readmission.