Outbreak Of Coronavirus Disease Research Articles

Development and Validation of In-vitro Release Study of Molnupiravir Capsules by RP-HPLC

Introduction: The coronavirus disease-2019 (COVID-19) outbreak all over the world has led researchers to strive to develop treatment and preventive measures to control its progression. Methods: Molnupiravir, a prodrug of the synthetic nucleoside derivative N-4-hydroxycytidine was found to be a promising candidate against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Results: It could significantly reduce the risk of hospitalization and mortality among patients with positive SARS-CoV-2 reports. In this study, an RP-HPLC method with UV detection was developed to determine its dissolution and release in the capsule dosage form. The developed method was validated as per International Council for Harmonization (ICH) guidelines. Conclusion: The method was evaluated and validated for its applicability using various parameters. It was found to be a simple, rapid, selective, sensitive, accurate, precise, robust and rugged method.

Impact of COVID-19 mitigations on anxiety and depression amongst university students: A systematic review and meta-analysis.

While much research has addressed mental health concerns related to the coronavirus disease 2019 (COVID-19) pandemic, there remains a scarcity of studies specifically exploring the changes in anxiety and depression among university students before and after the implementation of COVID-19 mitigation measures. In this systematic review and meta-analysis, we searched databases including MEDLINE (Ovid), EMBASE (Ovid), PsycINFO (Ovid), CINAHL (EBSCO), ERIC (EBSCO), the WHO COVID-19 database, Scopus, and Science Citation Index (Web of Science) as of 15 February 2023. We included studies that used a validated tool to measure changes in anxiety or depression at two distinct time points - before (T1) and during (T2); during (T2) and after (T3); or before (T1) and after (T3) COVID-19 mitigation. The quality of studies was assessed using an adapted Joanna Briggs Institute Checklist for longitudinal studies. Utilising random-effects models, we synthesised changes in continuous outcomes as standardised mean difference (SMD) with 95% confidence interval (CI) and binary outcomes as risk difference (RD) with 95% CI. In total, 15 studies were included in this review, with eight of moderate and seven of high quality. In most of the included studies (n = 13), the majority of participants were women. Eleven studies analysed mental health outcomes between T1 and T2 of COVID-19 mitigations. Continuous symptom changes were a minimal or small improvement for anxiety (SMD = -0.03, 95% CI = -0.24 to 0.19, I2 = 90%); but worsened for depression (SMD = 0.26, 95% CI = -0.01 to 0.62). However, the proportions of students reporting moderate-to-severe symptoms, defined by specific cut-offs, increased during COVID-19 mitigation measures for both anxiety (RD = 0.17, 95% CI = -0.04 to 0.38, I2 = 95%) and depression (RD = 0.12, 95% CI = 0.03 to 0.22, I2 = 72%). Sensitivity analyses, which distinguished between baseline periods based on awareness of COVID-19, demonstrated an exacerbation of both symptoms when comparing the period before the global awareness of the COVID-19 outbreak (before December 2019) with the period during the implementation of mitigation measures. Mental health outcomes, especially depressive symptoms, were observed to worsen in university students during COVID-19 mitigations. Despite considerable heterogeneity requiring careful interpretation of results, the impact of COVID-19 mitigations on mental health in university students is evident. PROSPERO (CRD42021266889).

Effect of Quarantine on Body Weight Among Residents of Assisted Living Facilities During the COVID-19 Pandemic.

Assisted living facility (ALF) residents are at greater risk of declining health and death from coronavirus disease 2019 (COVID-19) due to advanced age, frailty, chronic conditions, and transmission prevention methods. One method, room quarantine, can lead to isolation and potential weight changes. Continuous room quarantine was mandated by the state for all nursing home and ALF residents. The objective of the current study was to determine the degree and significance of weight loss during quarantine through retrospective chart review and use these findings to guide a quality improvement project. Pre-and post-COVID-19 weights were compared for 53 house call program residents. Descriptive statistics and logistic regression were used. This small convenience sample demonstrated significant weight loss for 40% of ALF residents quarantined during the COVID-19 pandemic. Males showed a greater risk of significant weight loss. Weight loss of 5% in 1 month is considered problematic in older adults. As quarantine measures continue to be used for COVID-19 outbreaks, weight changes, particularly among males, need to be monitored and reported for intervention. [Journal of Gerontological Nursing, 49(9), 29-34.].

Greenspace exposure is conducive to the resilience of public sentiment during the COVID-19 pandemic.

The coronavirus disease 2019 (COVID-19) pandemic significantly impacts people's sentiment and mental health, threatening their health and lives. We gathered 4.17 million geotagged social media posts from Weibo and scrutinized the nuances of the collective sentiments of netizens in four megacities in China during the first pandemic wave (from 1 December 2019 to 30 April 2020). Our findings suggest that the COVID-19 outbreak significantly reduced the Sentiment Index (SI) in China's cities, and the collective sentiments expressed in Wuhan were even more negative than those in the other three megacities. We explored the uncharted impacts of exposure to three geographical environment factors (GEFs) on SIs. Public exposure to greenspaces increased, while exposure to indoor built spaces decreased during the lockdown period. The exposure to sidewalks increased in rural areas but decreased in the main urban areas. The contributions of various GEFs to the SIs were the lowest during the lockdown period, and SIs were strongly affected by the pandemic. However, greenspace had the most potent effect on SIs, improving public sentiment resilience and mitigating mental health risks.

The clinical and immunological characteristics of COVID-19 patients with delayed SARS-CoV-2 virus clearance.

The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has posed a great threat to human health. Some severe COVID-19 patients still carried detectable levels of SARS-CoV-2 even after prolonged intensive care unit treatment. However, the immunological features of these COVID-19 patients with delayed virus clearance (CDVC) are still unclear. We retrospectively reviewed the clinical and immunological data of 13 CDVC cases, who were admitted into one hospital in Wuhan from February to April 2020. These data were also compared to those of perished (n = 9) and recovered (n = 52) cases. The expression of the exhaustion marker PD-1 on circulating T cells of these patients was measured by flow cytometry. High levels of serum interleukin-6 (IL-6), IL-1β, IL-8, as well as other inflammatory mediators, were seen in CDVC cases. Severe lymphopenia was observed in CDVC patients with the counts of total lymphocytes (0.9 × 109 /L), CD4+ T cells (0.35 × 109 /L), and CD8+ T cells (0.28 × 109 /L) below their corresponding lower limits of normal range. Similar to the perished group, CDVC cases have higher percentages of CD25+ Foxp3+ regulatory T cells (Treg) in circulation. Moreover, enhanced expression of the exhaustion marker PD-1 on CCR7- CD45RA+ effector, CCR7+ CD45RA- central memory, and CCR7- CD45RA- effector memory CD4+ and CD8+ T cells were also observed in CDVC cases. CDVC patients still have SARS-CoV-2 and these cases manifest with severe clinical symptoms due to persistent inflammation. Augmentation of the frequency of circulating Treg, severe lymphopenia, and functional exhaustion of T cells might lead to inefficient clearance of SARS-CoV-2. Therefore, enhancing lymphocyte counts and reversing T-cell exhaustion might be key methods to boost immune responses and eliminate SARS-CoV-2 in CDVC patients.

Geographic Information Database of Herbs against COVID-19 in Thailand: The Medicinal Plants those Folk Healers Commonly Used for Treatment and Boosting People's Immunity

The rapid outbreak of coronavirus disease 2019 (COVID-19) has demonstrated the need for the development of new vaccine candidates and therapeutic drugs to fight against the underlying virus, severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Currently, no antiviral treatment is available to treat COVID-19, as treatment is mostly directed at relieving the symptoms, and retrospectively, herbal medicinal plants have been used for thousands of years as a medicinal alternative, including for the treatment of various viral illnesses. The aim of this study is to conduct a survey in terms of identifying the area where the population commonly uses the medicinal plant in comparison to the cumulative number of COVID-19 reports in each area, including the classification of medicinal plants by type and a stepwise approach shown in the form of geographic information maps in those areas. An observational study on the cultivation of medicinal plants those folk healers commonly used for healing. beneficial for treatment and strengthening the immunity of the people in 9 provinces of Thailand. According to the situation of the spread of COVID-19, there are people infected in Thailand. In each area where medicinal plants were used, there was a significant positive result when compared to the cumulative COVID-19 incidence; the majority was with the lowest cumulative COVID-19 incidence and the most commonly used medicinal plants, such as Artemisia annua, Harrisonia perforate (Blanco) Merr, Capparis micracantha, Tacca leontopetaloides, Andrographis paniculata, Phyllanthus emblica, Ficus carica, Tiliacora triandra, Terminalia bilaria, and Cannabis indica. This study exercise may lend enough credence to the potential value of Thai medicinal plants (herbs) as possible leads in anti-COVID-19 drug discovery through research and development.

The influence of benefit finding on academic engagement among Chinese college students: A moderating effect model

ObjectiveTo explore how college students’ academic engagement has changed in the outbreak of coronavirus disease 2019 (COVID-19) (hereinafter referred to as “in the outbreak”), this research will encompass more than just looking into the relationship among anxiety, benefit finding (BF) and academic engagement, but also involve evaluating how anxiety moderates the positive impact of BF on academic engagement. MethodAmong college students, this study comprised an online-based cross-sectional survey in cities where COVID-19 broke out. Convenience sampling method was used. The survey took place between November 10 and November 19, 2021, during which all the cities surveyed were in the outbreak. With language revision, scales include Student Version of the Utrecht Work Engagement Scale (UWES-S), recompiled Benefit Finding Scale (BFS) and 7-item Generalized Anxiety Disorder Scale (GAD-7), as methods for gauging the academic engagement, BF and anxiety experienced by college students, respectively. ResultsAcademic engagement in the outbreak is higher than that before the outbreak stage of COVID-19 (hereinafter referred to as “before the outbreak”) (Z = −18.201, P < 0.001). Between anxiety and BF, a negative correlation can be observed in the outbreak (P = 0.001), whereas BF and anxiety have an adverse correlation with academic engagement (P < 0.001). The positive effect of BF on academic engagement will be debilitated by anxiety. Further analysis shows that college students who are close to medium-and high-risk areas, worried about the infection, unvaccinated and concerned about the epidemic, are more likely to be anxious (P < 0.001). Those with confidence in government's ability to prevent and control the epidemic, as well as increased trust in medical workers, have a higher BF (P < 0.001). ConclusionsWhile COVID-19 could still exert adverse effects on psychology of college students, but it can also stimulate college students to perceive the meaning of life. In the outbreak, an increase in academic engagement seems to be a manifestation of growth in adversity. Compared with short-term negative emotional intervention, life meaning and gratitude in education may stimulate their potential ability for a longer time.

Is Environmental, Social and Governance (ESG) Disclosure Value Enhancing? Evidence from Top 100 Companies

Embracing environmental, social, and governance (ESG) megatrend among Malaysian firms is becoming crucial as ESG compliance and disclosure are still in the infancy stage, especially after the coronavirus disease (COVID-19) outbreak. Aligned with the government’s initiatives, this study examined the effects of ESG disclosure on firm performance. Using 180 firm-year observations from the top 100 firms listed on Bursa Malaysia from 2018 to 2021, we found that the ESG score boosted firm performance, as its disclosure attracted investor confidence and indirectly increased investment and firm performance. However, it was discovered that controversies provide a positive signal to investors in emerging countries as it improved their firm performance; further analysis was conducted to investigate which ESG pillars had a positive effect on the firm performance. The social pillar was associated with higher firm performance as it can influence workplace culture and indirectly increase firm performance. Contrasting findings were also found on the governance pillar on firm performance which indicated that governance did not improve firm performance directly, but good governance may contribute to better ESG investment and disclosure. Indirectly, it can improve firm performance. This study adds important evidence on the effects of ESG pillars and ESG controversies on firm performance. Keywords: Environmental Social Governance (ESG), firm performance, sustainability

Efficient and Robust Driver Fatigue Detection Framework Based on the Visual Analysis of Eye States

Fatigue detection based on vision is widely employed in vehicles due to its real-time and reliable detection results. With the coronavirus disease (COVID-19) outbreak, many proposed detection systems based on facial characteristics would be unreliable due to the face covering with the mask. In this paper, we propose a robust visual-based fatigue detection system for monitoring drivers, which is robust regarding the coverings of masks, changing illumination and head movement of drivers. Our system has three main modules: face key point alignment, fatigue feature extraction and fatigue measurement based on fused features. The innovative core techniques are described as follows: (1) a robust key point alignment algorithm by fusing global face information and regional eye information, (2) dynamic threshold methods to extract fatigue characteristics and (3) a stable fatigue measurement based on fusing percentage of eyelid closure (PERCLOS) and proportion of long closure duration blink (PLCDB). The excellent performance of our proposed algorithm and methods are verified in experiments. The experimental results show that our key point alignment algorithm is robust to different scenes, and the performance of our proposed fatigue measurement is more reliable due to the fusion of PERCLOS and PLCDB.

The Trend of Change in Oral and Maxillofacial Injuries of Pediatric Patients in the COVID-19 Pandemic: a Regional Emergency Medical Center and Dental Hospital Study

The purpose of this study is to analyze changes in dental trauma in children under the age of 12 during the period of Coronavirus Disease 2019 (COVID-19). March 2020, when COVID-19 was officially declared a pandemic by the World Health Organization, was set as the starting point for COVID-19. From March 2018 to February 2020, subjects in the pre-COVID-19 period were classified as the Pre-COVID-19 group, and from March 2020 to March 2022, subjects in the post-COVID-19 period were classified as the COVID-19 group. Information related to trauma was collected through electronic medical records. The number of trauma patients before and after the outbreak of COVID-19 decreased significantly. During the COVID-19 period, there was no significant difference in the male-female ratio or the distribution order of age groups. In the COVID-19 group of permanent teeth, the ratio of trauma caused by personal mobility was higher than trauma caused by sports. In the COVID-19 group of permanent teeth, the ratio of crown fracture with pulp involvement was significantly higher than the ratio of crown fracture without pulp involvement. Changes in trauma patterns caused by COVID-19 were observed more clearly in school-aged children than in preschool children. In a pandemic situation such as COVID-19, it is expected to be used as a good educational basis for knowing that frequent diagnoses can change due to changes in the environment.

COVID-19 Pandemisi Sırasında Sağlık Çalışanlarında Maskeyle İlişkili Baş Ağrısı: Somali'den Çalışma

Aim: After the outbreak of Coronavirus Disease 2019 (COVID-19), new headaches have been reported to develop or worsen among healthcare workers who regularly wear personal protective equipments. In this study, we investigated the possible relationship between de-novo (new-onset) headache features associated with the mask used and pre-existing and exacerbated headaches. It is the first study on this subject on behalf of Somalia. Methods: This is a cross-sectional study conducted at the Mogadishu COVID-19 pandemic hospital, Somalia, with volunteer healthcare workers. Data were collected through a questionnaire. Participants were asked 15 questions in the survey and Pearson-chi-square test was used as statistics. Results: This study was conducted with 200 healthcare workers working in the hospital, 114 (57%) were male, 86 (43%) were female, and the mean age was 28. Participants 90 (45%) used surgical masks, 32 (16%) filtered masks (N95), 78 (39%) both; majority of 109 (54.5%) wore masks for more than 6 hours a day. Pre-existing headache was reported by78(39%) of the subjects. 55(70%) of those with pre-existing headache reported aggravation of their headache. Statistically significant relationship was found between duration of mask use and aggravation of pre-existing headache. De-novo headache characteristics were throbbing 21(20%), pressing 31(29%), unilateral 19(18%), and 35(33%) bilateral. A statistically significant relationship was also found between the duration of use of face mask and the development of de-novo headache, regardless of mask type. Conclusion: As per our study, prolonged use of face masks during COVID-19 pandemics was associated with de-novo headaches and exacerbation of pre-existing headache. This situation, which has caused complaints as healthcare professionals and some patients continue to wear masks, will continue to be investigated.

COVID-19 vaccines, perceptions and trust amongst vaccine refusers: A qualitative thematic analysis study

BackgroundThe outbreak of coronavirus disease 2019 (COVID-19) has resulted in huge morbidity and mortality since its onset in 2019. By June 24, 2023, only 32.2% of people in low-income countries have received at least one dose. This paper explores the perceptions and trust of vaccine refusers based on the thematic analysis. MethodsIn this study, we used a descriptive qualitative research design to explore the perceptions of the persons who did not believe in receiving the COVID-19 vaccine in Iraqi Kurdistan. This approach allowed us to explore the COVID-19 vaccine issue in-depth. Individual interviews were conducted with 14 participants in Kurdistan, Iraq. ResultsResults showed that the participants had a great fear of the serious side effects of COVID-19 vaccines. Some believed that the virus was not natural and had been made by humans for different reasons including making profits from vaccines. Some believed that there was a silver material inside the vaccine that would force people to receive more doses in the future. Few believed that receiving COVID-19 vaccines was crossing the borders of God. Reinfection was a factor in selling more doses of vaccines. The participants were affected by the advice of the community and social media and not receiving the COVID-19 vaccines from healthcare workers, lack of responsibility from the government and companies, and not having trust in vaccines in this region. ConclusionsConspiracy thinking, perceived negative effects, fear, reinfection, side effects of COVID-19 vaccines could be related to perceived vulnerability and seriousness among vaccine refusers.

Spatial clustering analysis of COVID-19 using LISA: A case study of the 2022 winter Day in Hanoi, Vietnam

Background:A novel coronavirus disease outbreak in 2019 (COVID-19) caused by he emergence of severe acute respiratory syndrome coronavirus 2 (SARS CoV 2) in China quickly spreads throughout the world. This study aimed to analyze the spatial clustering of COVID-19. Methods:The global and local Moran's I statistic (LISA) was used to investigate the spatial clusters of COVID-19 including spatial clusters (high-high and low-low) and spatial outliers (low-high and high-low). Results: A case study of COVID-19 locally transmitted cases reported in a 2022 winter day in Hanoi city has indicated that high-high spatial clusters were totally concentrated in 6 urban districts in the Hanoi metropolitan including such as districts of Dong Da, Gia Lam, Thanh Tri, Hai Ba Trung, Cau Giay, and Long Bien. Whereas, low-low spatial clusters were mainly in sub-urban districts such as Ba Vi, Thach That, Phuc Tho, and Son Tay town (0 cases) in the northwest and Ung Hoa district in the south of Hanoi. Conclusions:The study results indicated the effectiveness of LISA in analysis of spatial clustering of COVID-19. Findings in this study make great contributions to the fight of the COVID-19 pandemic.

Interface-Based Design of High-Affinity Affibody Ligands for the Purification of RBD from Spike Proteins.

The outbreak of coronavirus disease 2019 (COVID-19) has sparked an urgent demand for advanced diagnosis and vaccination worldwide. The discovery of high-affinity ligands is of great significance for vaccine and diagnostic reagent manufacturing. Targeting the receptor binding domain (RBD) from the spike protein of severe acute respiratory syndrome-coronavirus 2, an interface at the outer surface of helices on the Z domain from protein A was introduced to construct a virtual library for the screening of ZRBD affibody ligands. Molecular docking was performed using HADDOCK software, and three potential ZRBD affibodies, ZRBD-02, ZRBD-04, and ZRBD-07, were obtained. Molecular dynamics (MD) simulation verified that the binding of ZRBD affibodies to RBD was driven by electrostatic interactions. Per-residue free energy decomposition analysis further substantiated that four residues with negative-charge characteristics on helix α1 of the Z domain participated in this process. Binding affinity analysis by microscale thermophoresis showed that ZRBD affibodies had high affinity for RBD binding, and the lowest dissociation constant was 36.3 nmol/L for ZRBD-07 among the three potential ZRBD affibodies. Herein, ZRBD-02 and ZRBD-07 affibodies were selected for chromatographic verifications after being coupled to thiol-activated Sepharose 6 Fast Flow (SepFF) gel. Chromatographic experiments showed that RBD could bind on both ZRBD SepFF gels and was eluted by 0.1 mol/L NaOH. Moreover, the ZRBD-07 SepFF gel had a higher affinity for RBD. This research provided a new idea for the design of affibody ligands and validated the potential of affibody ligands in the application of RBD purification from complex feedstock.

The outcome of oxygen therapy on desaturated patient with moderate to severe symptoms in Kogabwilhan II Indrapura Field Hospital

Background: Since the first outbreak of Coronavirus Disease 2019 (COVID-19) in late 2019 in Wuhan, the SARS-CoV virus has grown rapidly and spread around the globe. The virus invades respiratory epithelium, causing inflammation and damage to lung cells, which causes impaired gas exchange and leads to a desaturated state. Kogabwilhan II Indrapura Field Hospital in Surabaya was an initial emergency hospital for asymptomatic and mild-symptomatic COVID-19 patients. Due to the massive surge of COVID-19 cases in East Java, it had to treat moderate and severe symptomatic patients. Aim: The study aims to report clinical prognosis post-COVID-19 infection. Method: This is a retrospective descriptive study in Kogabwilhan II Indrapura Field Hospital with desaturated COVID-19 patients from March 2020 to October 2021 as samples. Results: Of 471 admitted COVID-19 patients with desaturation, 36.9% were moderate-symptomatic, and 63.9% had severe ones. All patients received oxygen therapy and multivitamins. Then, 29.7% of patients were cured, while 70.3% were referred. 48.4% of referred patients were bonam, 10.2% were pronounced deceased, and 11.7% were unknown. Conclusion: Most patients declared cured after being referred to another center.

Body mass index and prevalence of metabolic syndrome among Korean adults before and after the COVID-19 outbreak: a retrospective longitudinal study.

Studies evaluating weight changes during the coronavirus disease 2019 (COVID-19) pandemic have yielded inconsistent results, and most of those studies were based on self-reported anthropometric measures. We investigated changes in body mass index (BMI), professionally measured waist circumference (WC), and metabolic syndrome components from before to during the pandemic in a sample of the adult population in Korea. This retrospective study included 1,118 male and female (age≥18 years) who underwent health checkups at a university medical center between January 1, 2016 and March 31, 2022. Changes in BMI, lifestyles, and metabolic syndrome components during the pandemic were analyzed using the paired t-test, McNemar test, generalized estimating equations, and repeated-measures analysis of variance. Changes in body weight, BMI, and body fat percentage during the pandemic were not clinically significant. However, statistically significant results were found for decreased physical activity (p<0.001) and WC (p<0.001), and exacerbation of all metabolic syndrome components (except serum triglyceride levels). Moreover, the metabolic syndrome prevalence increased significantly from 20.2% to 31.2% during the pandemic (p<0.001). The prevalence of abdominal obesity and high fasting blood glucose levels also significantly increased from 2019 to 2021. Metabolic syndrome, its components, and fat distribution worsened significantly after the implementation of social distancing and lockdowns, despite no clinically significant changes in body weight and BMI. Further studies on the post- pandemic period should investigate the long-term impact of social lockdowns on BMI and the prevalence of metabolic syndrome.

The association of COVID-19 with diffuse large B-cell lymphoma: a Mendelian randomization study

ABSTRACT With the outbreak of coronavirus disease 2019 (COVID-19), there has been an increasing focus on exploring the relationship between SARS-CoV-2 infection and tumors. However, there is no consensus on the association between COVID-19 and lymphoma. In this study, genome-wide association study (GWAS) summary data sets for COVID-19 and lymphoma were obtained from the OPEN GWAS website. Single nucleotide polymorphisms (SNPs) were selected as genetic instrument variants for fulling P < 5 × 10−8 and linkage disequilibrium [LD] r2 < 0.001. Both palindromic and outlier SNPs were removed. Cochran’s Q test, the MR‒Egger intercept test, and leave-one-out analysis were employed to assess the sensitivity of the effect of COVID-19 on lymphoma. The results showed that COVID-19 patients with very severe respiratory symptoms have an increased risk of developing diffuse large B-cell lymphoma (IVW, OR = 1.765, 95% CI 1.174–2.651, P = 0.006). There was no association between COVID-19 with very severe respiratory symptoms and Hodgkin’s lymphoma or other types of non-Hodgkin’s lymphoma. No horizontal or directional pleiotropy was observed in the Mendelian randomization analysis. In conclusion, SARS-CoV-2 infection with very severe respiratory symptoms may be a potential risk factor for diffuse large B-cell lymphoma (DLBCL), and follow-up studies with larger samples are needed.

Vitamin D deficiency prevention policies in Iran: a retrospective policy analysis.

Iran has a higher prevalence of vitamin D deficiency (VDD) than the global level. This study aimed to assess VDD prevention policies in Iran through a policy analysis of agenda setting using the multiple streams framework (MSF). Using Kingdon's MSF model, this qualitative analytical study performed a policy analysis on vitamin D-related policies in Iran. The policy documents were reviewed, and in-depth interviews were conducted with stakeholders (n = 27) using the framework analysis method. To categorize data and extract the related themes, MAXQDA version 10 was used. According to Kingdon's MSF theory, the problem stream included the high prevalence of VDD among Iranian infants (23.3%), adolescents (76%), and adults (59.1%). The policy stream was identified to focus on preventing programs for non-communicable diseases in the health sector. The political stream indicated that national and international support could provide a political climate for this issue. According to our results, a window of opportunity for policymaking on VDD prevention has opened. However, there are some challenges related to the implementation of these policies. These include the dominance of a treatment-based view rather than a prevention-based approach in the health sector, economic problems, and restricted access to health services due to the outbreak of coronavirus disease 2019 (COVID-19). To strengthen and implement VDD prevention policies, the stakeholders need support from high-level policymakers.

Feeling Lonely, Engaging Online During the Outbreak of COVID-19: A Longitudinal Study of Chinese Older Adults.

There is growing concern that the coronavirus disease 2019 (COVID-19) pandemic and associated social distancing policies may exacerbate mental health problems in older adults. Most studies primarily have focused on developed countries, whereas the mental consequences of the pandemic in developing countries are less well known. This study evaluates the influences of the global pandemic in relation to loneliness and family contact among older Chinese adults and examines the roles of internet adoption in alleviating the emotional experience of loneliness. We run individual fixed effects regression models using the 2018 and 2020 waves of the Chinese Family Panel Studies survey with 4,944 respondents aged 60 and above to capture the average within-person changes before and after the first outbreak of COVID-19 in China. We further examine the mediating effects of internet adoption on loneliness using structural equation modeling (SEM). Simultaneous SEM tested the effects of internet literacy and social network site use, and heterogeneous effects analyses were also conducted across subgroups. Fixed effects estimates indicated increased loneliness and decreased family contact during the pandemic. Moreover, more older adults were found to use the internet in 2020. The fixed-effect estimations and structural equation models consistently found that older adults' use of the internet contributed to more social contacts and virtual meetings with their children, which have alleviated the emotional experience of loneliness. Digital inclusion of older adults to adopt the internet can be beneficial to improve mental well-being and alleviate loneliness during times of pandemic crisis. The targeted acceleration of digitalization to reduce the digital divide needs to be considered.

Sources of meaning in life among older adults during the COVID-19 pandemic: A qualitative study.

This study aims to explore the sources of meaning in life (MIL) and its impact on South Korean older adults during the coronavirus disease 2019 (COVID-19) pandemic. This study had a qualitative descriptive study design. The study participants included 18 older adults. Six focus group interviews were conducted. Data were analysed using content analysis. The subcategories 'Continued learning and growth', 'Self-transcending practices' and 'Efforts to maintain good health' were extracted under the category 'Sources of MIL for older adults'. Similarly, the subcategories 'Tremendous changes brought about by the virus' and 'Varying patterns of adjustment to the pandemic' were extracted under the category 'Changes in the sources of MIL since the COVID-19 outbreak'. Our study provides an in-depth understanding of the changed sources of MIL for older adults during the COVID-19 pandemic. The findings serve as useful guidance for planning interventions for older adults to lead meaningful lives during the COVID-19 pandemic and post-pandemic crises.