Investigation of Fear of Covid-19 , Work Stress and Affecting Factors in Prehospital Emergency Healthcare Workers

Purpose: Since healthcare workers work in the same environment with infected patients, they have a higher risk in terms of COVID-19 transmission compared to other parts of society, and accordingly, they experience more stress. The aim of this study to investigate the fear of COVID-19, work stress, and affecting factors in prehospital healthcare workers. Material and Methods: The research has a descriptive and cross-sectional design. The research was completed with a total of 399 individuals. Data were collected online using an introductory information form, the Fear of COVID-19 Scale, and the General Work Stress Scale. Results: The level of fear of COVID-19 was higher in women compared to men (B=-1.451, p=0.012), in married individuals compared to singles (B=-1.667, p=0.011), in those with low income compared to those with moderate or high income (B=-2.259, p<0.001), and in those who were vaccinated compared to those who were not vaccinated (B=-1.722, p=0.005). Conclusion: In prehospital emergency healthcare workers, the fear of COVID-19 was higher among women, married individuals, those with low income, those who were COVID-19-vaccinated, and those with high levels of anxiety and depression. Those with low income, high education level, and high anxiety level had a higher level of work stress

ANTIVIRAL ACTIVITY OF BETAFERON FOR COVID-19

Objective: SARS-CoV-2 infection has been spread worldwide since 2019 and declared a pandemic infection. Unfortunately, humanity is still trying to deal with the infection. Under these circumstances, scientists head towards drug repurposing studies as the fastest solution for combatting SARS-CoV-2 viral infection. Betaferon (Interferon beta-1b) is a member of interferons, and its mechanism of action is the same as naturally produced interferon beta-1a in the immune system. Material and Method: In this study, the antiviral effect of Betaferon on SARS-CoV-2 infection in vitro and in silico was analyzed. The drug toxicity, gene expression, and docking calculations are evaluated. Result and Discussion: Betaferon showed significant antiviral activity against COVID-19. Furthermore, Betaferon decreased the expression of both viral entries mediating proteins such as ACE2 and TMRPSS2. Betaferon decreases not only the expression of TMPRSS2 but also the enzymatic activity of TMPRSS2. Furthermore, in silico analyses revealed that Betaferon interacts with viral Spike protein. Hence, a decrease in the expression of viral entry mediating proteins, inhibition of the activity of TMPRSS2, and interaction with viral Spike protein indicate that Betaferon has an antiviral activity for COVID-19 virus through inhibition of viral entry pathway. © 2022 Authors. All rights reserved.

The Impact of the COVID-19 Pandemic on Pregnant Women: A Qualitative Approach

BACKGROUND: Pregnant women are one of the special groups most affected by the COVID-19 pandemic. The aim of this study was to analyze how the COVID-19 pandemic influenced the feelings, thoughts, and behaviors of pregnant women. METHOD: A descriptive phenomenological approach was employed to explore the experiences of 15 pregnant women. Data were gathered by using semi-structured interviews focusing on pregnant women's feelings, thoughts and behaviors. Word cloud analysis and content analysis were performed. FINDINGS: Data analysis revealed three main themes: emotions, hardships, and coping. Emotions were grouped into five categories: fear, anxiety, disappointment, loneliness, and regret. Hardships were grouped into two categories: physical and financial. Coping was grouped into four categories: social support, normalization, religious practices, and positive thinking. According to word cloud analysis, the most frequently mentioned words were pregnant, COVID-19, anxiety, fear, positive thinking, hardships, regret, stress, affect, and alone. CONCLUSIONS: Women experienced feelings of fear, anxiety, disappointment, loneliness, and regret in the prenatal period. They also faced physical and financial hardships and benefited from social sup-port, normalization, religious practices, and positive thinking to cope with these hardships. © 2023 Springer Publishing Company, LLC.

Reasons for individuals' COVID-19 vaccine hesitations and changing decisions over time: A longitudinal qualitative study

Objective: COVID-19 is a serious public health problem. Therefore, it is important to vaccinate the community. This study was aimed at examining the reasons for individuals' COVID-19 vaccine hesitations, and decisions that have changed over time. Material and methods: This was a prospective longitudinal qualitative study. Results: Confidence, fear, conspiracy theories, belief, and social pressure play a role in vaccine hesitancy. The most important factor in the changing decisions of individuals who are hesitant about vaccination is pressure. Confidence and fear also lead to a change of decision. However, it was remarkable that most of the participants who were vaccinated due to pressure did not want to be revaccinated. Conclusions: Governments, media, vaccine companies, health professionals, and scientists should act together to increase the vaccination rates of individuals.

Resilience and life quality of health professionals in capital of Turkey during COVID-19 pandemic : Özge Tonbuloğlu Altıner

Background COVID-19 pandemic has had significant effects on physical and mental health of health professionals. It is thought that resilience protects individuals against mental illness and helps individuals cope with difficulties and stress more effectively. In this study, it was aimed to evaluate resilience, life quality and related factors of health professionals during COVID-19 pandemic. Methods A cross-sectional study was performed among health professionals working at a tertiary hospital in Turkey’s capital Ankara. An occupation based stratified sampling was done with taking alpha 0.05 and 1-beta 0.80. A questionnaire that consists of sociodemographic information, COVID-19 Impact on Quality of Life Scale and Connor Davidson Resilience Scale was used to collect data. The results of scales were divided into two parts by taking the median values as cut off points. Descriptive/inferential statistics and logistic regression were performed on IBM’s SPSS 27.0 program. Results A total of 987 participants were surveyed. 66% of them were female, and the average age was 36. Multivariate logistic regression analysis results that physicians (OR:1.48, 95% CI:1.05-2.07, p = 0.024) and nurses (OR:1.46, 95% CI:1.08-1.97, p = 0.013) have lower resilience. The impact of COVID-19 on quality of life was higher for the following groups;physicians (OR:2.07, 95% CI:1.43-3, p < 0.001), nurses (OR:1.61, 95% CI:1.10-2.36, p = 0.013), who have bachelor/higher degrees (OR: 1.54,95% CI: 1.02-2.31,p=0.038), infected with COVID-19 (OR:1.33, 95% CI:1.02-1.74, p = 0.034), have COVID-19 related relative lost (OR:1.42, 95% CI:1.06-1.89, p = 0.016), and live with risk groups (OR:1.31, 95% CI:1.01-1.71, p = 0.042). Conclusions Physicians and nurses who take care of patients one-on-one have lower resilience and higher decrease in life quality due to COVID-19 impacts. This result indicates a significant quality drop in health services is inevitable during pandemics and should be considered by the policy makers. Key messages • Policies should be developed to increase the resilience of healthcare professionals so that they can effectively combat public health emergencies such as COVID-19 and not affect their quality of life. • It is necessary to determine risk groups among health workers and plan training programs to increase resilience.

Dynamic allostery highlights the evolutionary differences between the CoV-1 and CoV-2 main proteases.

The SARS-CoV-2 coronavirus has become one of the most immediate and widely studied systems since its identification and subsequent global outbreak from 2019 to 2022. In an effort to understand the biophysical changes as a result of mutations, the mechanistic details of multiple different proteins within the SARS-CoV-2 virus have been studied and compared with SARS-CoV-1. Focusing on the main protease (mPro), we explored the long-range dynamics using the Dynamic Coupling Index (DCI) to investigate the dynamic coupling between the catalytic site residues and the rest of the protein, both inter- and intrachain, for the CoV-1 and CoV-2 mPro. We found that there is significant cross-chain coupling between these active sites and specific distal residues in the CoV-2 mPro not present in CoV-1. The enhanced long-distance interactions, particularly between the two chains, suggest subsequently enhanced cooperativity for CoV-2. A further comparative analysis of the dynamic flexibility using the dynamic flexibility index (DFI) between the CoV-1 and CoV-2 mPros shows that the inhibitor binding near active sites induces change in flexibility to a distal region of the protein, opposite in behavior between the two systems; this region becomes more flexible upon inhibitor binding in CoV-1, while it becomes less flexible in the CoV-2 mPro. Upon inspection, we show that, on average, the dynamic flexibility of the sites substituted from CoV-1 to CoV-2 changes significantly less than the average calculated across all residues within the structure, indicating that the differences in behaviors between the two systems is likely the result of allosteric influence, in which the new substitutions in CoV-2 induce flexibility and dynamic changes elsewhere in the structure.

Patient Communication and Consultation Experience with Tele-medicine in Patients with Movement Dısorders in COVID-19 Pandemic: Its Usability, Benefits and Problems

Objective: Access to health centers was restricted during the coronavirus disease-2019 pandemic, which hit our country in March 2020. Ensuring the medical control of patients who were followed up in the neurology outpatient clinic with the tele-medicine method was an important step to decrease the viral load of patients and physicians. This study aimed to share our tele-medicine experience with patients with movement disorders. Materials and Methods: The data of 71 patients with movement disorder who communicated with our unit between March 11, 2020 and June 20, 2020 were retrospectively analyzed. Results: A total of 117 verbal and written interviews with 71 patients were mostly conducted via WhatsApp®. The evaluation of reasons for physician consultation revealed that patients most frequently communicated for worsening rigidity and prescription-drug requests. Of these interviews, 25 (21.4%) resulted in setting patient appointments for a physical examination. The tele-medicine service in 92 (78.6%) interviews solved the problem without physical contact with patients. Conclusion: Movement disorder evaluations are suitable through teleconference. Therefore, our teleneurology application, which we actively use, is effective in reducing the risk of viral transmission to both patients and healthcare workers during the pandemic. Developing telemedical applications is necessary in terms of their legal aspects and implementation in the world, especially in our country. ©Copyright 2021 by Turkish Neurological Society.

Update on the First Year of COVID-19

The current outbreak of the Coronavirus, severe acute respiratory syndrome Coronavirus-2, which originated in the Wuhan province of the People's Republic of China became a pandemic. Although the clinical findings of the infection vary in adults, the most common symptoms are fever, dry cough, and shortness of breath. The diagnosis of the Coronavirus disease-2019 (COVID-19) is made by clinical symptoms, laboratory tests, and radiological methods. Many drugs such as antivirals, antibiotics, and corticosteroids are used in the treatment of COVID-19. For the successful control of the pandemic, prevention strategies are the key. There is strong consensus that, in addition to wearing masks, hand hygiene, and social distancing, an effective COVID-19 vaccine is probably the most effective approach to sustainably control the pandemic. In this article, current information about the pathogenesis, epidemiology, risk groups, diagnosis, treatment, prevention strategies, and vaccination of the disease in the first year of the COVID-19 pandemic are discussed.

The Effectiveness of Using Telemedicine to Follow-up Breast Cancer During the Covid-19 Pandemic: A Scoping Review

The coronavirus disease (COVID)-19 outbreak has brought to the agenda that telemedicine (TM) services, which are rapidly spreading in the world, can be effective in reducing face-to-face medical appointments for cancer follow-up and breast cancer screening. The aim of this study is to evaluate the effectiveness of TM use in the follow-up of women diagnosed with breast cancer during the COVID-19 epidemic. The literature search was carried out in four electronic databases (PubMed, CINAHL, Science Direct, and PsycInfo) until April 14, 2020. Electronic searches started on March 22, 2020, and ended on April 14, 2020. Search terms included were tele-health or telephone and pandemic or SARS-COV-2 outbreak. Search was limited to English language and full-text articles. A total of 334 articles matching the search criteria were identified by the researchers. Five articles with no restrictions in research design met the inclusion criteria and were included in the review. In these studies, it was determined that TM services are an effective method for relieving outpatient services in breast cancer follow-up, breast imaging, screening, routine follow-up, and examinations. In addition, these studies concluded that TM services save time, increase access to care, provide improvement, and increase satisfaction levels. It was observed that the demand of women with breast cancer to benefit from TM services was affected by sociodemographic factors (advanced age and low education level, etc.). It is recommended that TM services be taken into account in the realization of individual care and follow-up services for women with breast cancer.

Impact of the first six months of the covid-19 pandemic on orthopedic and hand trauma surgery

Reduced mobility due to COVID-19 prevention measures caused major changes in the number and types of orthopedic trauma cases. This study aimed to compare the profile of trauma-related general orthopedic surgery and hand surgery cases between the first six months of the COVID-19 pandemic and the corresponding periods of previous years in order to determine strategies for managing orthopedic traumas in unusual circumstances such as pandemics. Patients over 18 years old who underwent orthopedic surgery due to trauma were grouped according to sur gery date as pre-pandemic group 1 (G1, March 16–September 18, 2018), pre-pandemic group 2 (G2, March 18–September 20, 2019), and the pandemic group (G3, March 19–September 21, 2020). Between-group differences with p<0.05 were considered significant. The study included a total of 3522 patients: 1351 in G1, 1427 in G2, and 744 in G3. There was a significant decrease in the number of patients in G3 compared to the other groups (p=0.001), while the number of hand surgeries did not differ significantly between the groups. As a result, the ratio of hand trauma surgeries to general orthopedic traumas was significantly higher in G3 (p <0.05). During the COVID-19 pandemic, there was a decrease in orthopedic trauma surgeries and an increase in hand trauma surgeries. In this period of increased hand traumas, hand surgeons should be encouraged to intervene remotely using technology (telemedicine).

The new normal transition process in the Covıd-19 pandemic: World and Turkey

The Covid-19 outbreak that emerged in the world at the end of 2019 turned into a pandemic by affecting the whole world at the beginning of 2020. Measures such as domestic / international travel restrictions, curfew, quarantine implementation, closure of schools / universities, and closure of some workplaces against the Covid-19 pandemic have changed the daily life routines of many people in the world. The mitigation of these measures has been considered due to their social and economic adverse effects. Maintaining the basic principles such as the use of masks, compliance with the social distance rules, paying attention to personal hygiene, and continuing with limited life is almost a new normal. Therefore, normalization processes have started in the countries. © Copyright 2021 by Gazi University Medical Faculty - Available on-line at web site http://medicaljournal.gazi.edu.tr/

The New Normal Transition Process in the Covid-19 Pandemic: World and Turkey

The Covid-19 outbreak that emerged in the world at the end of 2019 turned into a pandemic by affecting the whole world at the beginning of 2020. Measures such as domestic / international travel restrictions, curfew, quarantine implementation, closure of schools / universities, and closure of some workplaces against the Covid-19 pandemic have changed the daily life routines of many people in the world. The mitigation of these measures has been considered due to their social and economic adverse effects. Maintaining the basic principles such as the use of masks, compliance with the social distance rules, paying attention to personal hygiene, and continuing with limited life is almost a new normal. Therefore, normalization processes have started in the countries.

Community approach towards COVID-19 in Turkey: one month after the first confirmed case

INTRODUCTION: During this time when the COVID-19 is rising in Turkey, assessing the knowledge, attitude and practices of the public about the COVID-19 will be useful in finding out whether the interventions to control the outbreak are effective and viable. Furthermore, such studies are needed to properly manage the outbreak process and cast light on future interventions. This study aims to assess the knowledge, attitude and practices of people in Turkey about the COVID-19. METHODS: A cross-sectional survey was implemented between 11 and 21 April 2020 using an online questionnaire. The survey was applied online, and social media platforms were used to reach out to the highest number of people who met the inclusion criteria (i.n., people aged 18 or older). The questionnaire consists of three parts (socio-demographic 40 questions, medical history, and knowledge, attitude, and practice section). Descriptive statistics and a comparison of participants' knowledge degrees about COVID-19 is tested using the Chi square test. RESULTS: A total number of 8505 participant were accepted for the study. 59.3% (5045) of respondents were women and 77.7% (6808) had a university degree or higher. 85.6% (7277) of the participants had a good level of knowledge about COVID-19. Over 90% of participants have answered the questions about the mode of transmission of the COVID-19, symptoms, risk groups, isolation, and treatment correctly. 55.2% (4696) of respondents thought that the disease would be successfully taken under control in Turkey and 38.6% (3282) in the world eventually. 55.6% (4731) believed that the COVID-19 will not go away when the weather gets warmer. 35.1% (2983) believed that getting the disease is preordained by fate. The most frequently practiced protective behaviors included hand hygiene, staying at home and wearing mask outside. 98.8% reported that they use their hands in order to protect theirselves from COVID-19. DISCUSSION AND CONCLUSION: Though, the knowledge attitude and practice of participants in our study was evaluated high, there were some knowledge and practice gaps in study population that should be considered in further community interventions. The future interventions for the epidemic control need to consider social determinants such as the level of education, employment status and religious beliefs of people.

COVID-19 epidemiology and intervention strategies in Turkey

Turkey is one of the countries which have taken precautions against the COVID-19. The precautions taken brought the first case in our country to be seen later than many countries and to spread the epidemic less. After the first COVID-19 case was detected in our country on March 11, 2020, the four periods of 14 days have been examined separately about the course of the epidemic and the public health interventions implemented in these periods. And the results it has generated between the periods have been evaluated. The steady decline in case of increase shows we have controlled the epidemic.

The clinical and computed tomography findings of patients with COVID-19

Objective: To evaluate the demographic, clinical data and, computed tomography findings of patients diagnosed COVID-19. Methods: Patients who had COVID 19 suspicion in the emergency department of the university hospital in Istanbul, Turkey, between March 20, 2020, and April 1, 2020, were scanned. Demographic, characteristics, and computed tomography findings of patients with positive RT-PCR test results were analyzed. Results: The mean age of patients was 51.27 (6.45) years, and 72.5% were male. The median admission period of patients was 4 (1-10) days, and the mean length of hospital stay was 10.49 (6.6) days. The mean CT result time was 33.24 (11.56) minutes, and RT-PCR was 35.53 (14.36) hours. The most common complaint was a fever. Furthermore, shortness of breath and dry cough was other evident complaints. Only 7.8% of patients were asymptomatic. In 84.3% and 80.5% of patients had increased C-reactive protein levels and increased ferritin levels, while in 41.2% of patients had decreased lymphocyte count. Bilateral lung involvement, multifocal localized lung lesions, peripheral and central distribution of lesions were detected in most patients. Lesions were located at the posterior lung in more than half of the patients. The rate of involvement of the lower lobes was higher. Some 84.5% of the patients had two or more lobe involvements. Ground glass density (94.1%), consolidation (80.4%), pleural thickening (64.7%), crazy paving pattern (52.9%), vascular enlargement (47.1%), halo sign (43.1%), and air bronchogram (33.3%) were the most seen lesions. Conclusion: Computed tomography could be helpful in coordination with the clinical and laboratory parameters for early decision and isolation of patients with suspected COVID19 until RT-PCR test results obtained.