Progression of COVID-19 under the highly restrictive measures imposed in Argentina

The variety and extent of non-pharmaceutical measures implemented by the government to control COVID-19 in Argentina were exceptional, making this country the best example to analyze the evolution of COVID-19 under the most stringent and longer-lasting restrictive policies- which included 119 days of strict nation-wide lock-down, 304 days of less restrictive lock-downs, and 35 days of curfews. Two of the three peaks of infection correlated with the germicidal solar flux received in Argentina, suggesting a seasonal component and a role for the virus persisting in the environment. A massive public gathering crowding the presidential square in Buenos Aires, during which nearly half of those present were without face masks, did not alter the infection curve in that city. Comparative epidemiological data (standardized per million inhabitants) shows that COVID-19 in Uruguay, a neighboring country whose capital is at a similar latitude than Buenos Aires and who did not mandate lock-downs or curfews, progressed much slower (until vaccination started) than in Argentina. The number of yearly deaths caused by respiratory diseases and influenza in Argentina before the pandemic was similar to the total number of deaths attributed to COVID-19 cumulated on April 25, 2021, more than a year after the pandemic started. The failure to detect any benefit on ameliorating COVID-19 by the long and strict nation-wide lock-downs in Argentina should raise world-wide concerns about mandating costly and ineffective restrictive measures during ongoing or future pandemics

The first year of COVID-19 in Italy: incidence, lethality, and health policies

Background: The novel coronavirus disease is an ongoing pandemic that started in China in December 2019. This paper is aimed at estimating the first two infections waves in Italy in relation to adopted health policies.Design and methods: We moved deaths of the Italian COVID-19 registry from recorded to infection date by the weighted moving average. We considered two infection fatality ratios related to the effective or saturated health system, we estimated the likely incidence curve from the resulting deaths and evaluated the curve shape before and after the national health policies.Results. From the 24th of February 2020 to the 7th of February 2021, we estimated 6,664,655 (4,639,221-9,325,138) cases distributed on two waves. Suitable daily infection fatality rates were 2.53% within the first wave and 1.15% within the second one. The first wave (February-July 2020) had its peak on the 14th of March 2020 (26,575). The second wave (August 2020-February 2021) was fatter with the peak on the 12th of November (60,425) and a hump in December before decreasing to 26,288 at the end. Adopted health policies were followed by changes in the curve rate.Conclusion: Tracing infection contacts and quarantining asymptomatic people reduced virus lethality in the second wave.  Restriction on population mobility is effective within a suppression strategy, distance learning reduces contacts among families. Removal of restrictions should be implemented by sequential steps for avoiding a quick rising of incident cases. A reasonable public health daily goal to control both virus spread and lethality could be to find at least 87 cases for each death

Self-efficacy impact of the Mini-CEX among nursing students in North Sumatera, Indonesia

Background: Mini-CEX is a popular workplace exam that includes direct observation and a feedback conversation. This evaluation occurs in a workplace setting as part of the daily work. Self-efficacy is a mandatory soft skill for nursing students during an internship. Therefore, this study aims to identify the effect of Mini-CEX on self-efficacy among these students.Design and Methods: A quasi-experiment design was conducted with a control group. All the nursing student intents of the Sari Mutiara Indonesia University were considered as the study population. This population was then divided into one control and one intervention group of 24 and 25 students, respectively. Subsequently, data collection was carried out using general self-efficacy.Results: The results showed the self-efficacy was low in the control group (66.7%), and Mini-CEX was discovered to have a significant effect on self-efficacy among nursing students undergoing internships (p=0.000). Conclusions: The Mini-CEX was concluded to effectively increase self-efficacy among nursing students and is suggested as a mandatory method for evaluating these students

Effectiveness of self-management on adherence to self-care and on health status among elderly people with hypertension

Background: Adherence to self-care is the goal of nursing care for elderly people with hypertension to give them optimal functional health status. The purpose of this paper is to determine the effectiveness of self-management on adherence to self-care and management of health status elderly people living with hypertension in Pekanbaru City. Design and methods: This study design was quasi-experimental with a pre-post test with a control group. The self-management intervention was provided through four home visits to elderly people living with hypertension with a caregiver. Samples were taken by the consecutive sampling technique, and a total number 134 elderly people were participants. The instruments used were the adherence to self-care questionnaire and the Short Form 12 Health Survey (SF12) for elderly people.Results: The results showed that most of the respondents with hypertension were 60-74 years of age (84.3%), were female (67.9%), of Minang ethnicity (48.5%), had completed primary school (44%), were unemployed (81.3) %), had a family history of hypertension (50%), were non-smokers (52.2%), and had never drunk alcohol (95.5%). The effects of self-management were positive on adherence to caring for themselves (p<0.001) and on health status (p<0.001). The most influencing factor on self-care compliance and health status after being controlled by confounding variables was self-management (p<0.001).Conclusions: This study recommends that nursing interventions on self-management for elderly people with hypertension in the community and should be integrated into the Community Health Nurses’ (Perkesmas) program in Indonesia.&nbsp

A pre/post analysis of the impact of the COVID-19 pandemic on the psychosocial work environment and recovery among healthcare workers in a large university hospital in Sweden

Background. The impact of the COVID-19 pandemic on workload, mental health, and well-being of healthcare workers, and particularly those on the front-line, has received considerable attention.Design and methods. We surveyed hospital employees about their working environment during the pandemic and identified departments which were negatively affected in comparison to the pre-pandemic situation, as well as factors contributing to this.Setting and participants We surveyed all hospital employees at Sahlgrenska University Hospital, Sweden in September 2020 and compared results across departments and to the results of a large employee survey from October 2019.Results. The overall impact of the pandemic on perceived working conditions and possibility for recovery differed among departments. During the pandemic, healthcare workers working with COVID-19 patients reported poorer working environments than other employees. Factors significantly related to perception of work environment and recovery during the pandemic included worries of being infected, departmental transfer, and having insufficient access to personal protective equipment. Men reported better working conditions than women in all, but one item and higher age was related to better perceived working environment.Conclusions. Our results indicate that the pandemic differentially affects hospital departments and underscores the multifactorial nature of this topic. Contributing factors to poor perceived working environment could be addressed at times of high workload, such as during the pandemic, including providing appropriate support to managers, ensuring possibility for recovery during working hours, and acknowledging worries about infection. Young healthcare workers and staff who are relocated due to the pandemic warrant special attention

Autism screening tests: A narrative review

As screening tests are tools to quantify communication-interactive abilities of speech and language; therefore, to evaluate, screen, diagnose and treat various aspects of one’s abilities, they are necessary. The purpose of this study is to review the existing autism screening tools, their subtests, administration, scoring, and application in clinical and research contexts in children and adults. This study was a review of autism screening tools; hence, an electronic search through databases such as PubMed, Scopus, Medline, SID, and Magiran was performed from 2000 to 2021. The tests were examined in terms of year of publication, duration, age range, assessment method, subtests, and psychometric properties and furthermore, they were reviewed in details. In this study, 19 autism screening tests were evaluated and The Autism Spectrum Quotient was found to have the shortest administration time while The Gilliam Autism Rating Scale had the longest, and the only test that varied in duration was the Autism Screening Instrument for educational planning. Autism screening is a complex issue. Reviewing these articles reveals that some tests have been used more in recent years due to their specialized subtests or easy and fast administration. Prompt testing is extremely crucial especially in emergency situations like the current COVID-19 pandemic the world is struggling with today. A review of speech tone tests shows that the CARS-2 is one of the most widely validated autism assessments

COVID-19 and the excess of mortality in Italy from January to April 2020: what are the risks for oldest old?

In February 2020, Italy has been the first country in Europe fighting against COVID-19. In March 2020, Italian government declared national lockdown. Until May 4th, people stayed in home confinement and only the so-called “essential works and activities” were continued. Like in other countries, both for the disease severity and for the risk of death, the higher the age of people the higher the risk. In the first months of 2020, Italy saw a very high number of deaths related to COVID-19, with a huge age effect, and there is an agreement on the view that there had been also an excess of mortality and on the role of mortality as a correct way to reflect the dynamics of the virus’s spread. In this paper we briefly discuss the trends of mortality during the first 4 months of 2020 according to the data by the Italian National Institute of Statistics

Appraisal survey of the knowledge, attitudes, and behaviors of Jordanian society toward diet and nutrition during COVID-19 era

Introduction: This study aimed to evaluate the knowledge, attitudes, and behavior (KAB) of the Jordanian society toward nutrition and diet during the COVID-19 era.Design and methods: This study is an observational, cross-sectional study using a structured, validated, reproducible, self-administered online Arabic questionnaire. KAB of the study participants was assessed via a web-based, structured, validated, reproducible Arabic questionnaire. The tool for the assessment of the KAB was composed of 33-closed-ended multi-answer questions.Results: A total of 672 people were surveyed, 70.2% were between 18 and 34, and 69.5% were females. Participants have paid little attention to the healthfulness of their diet in the last year. The majority of participant’s attitudes towards using different approaches to manage weight in the next year were: eating smaller portions for weight management, tracking to maximize the amount of time of physical activity, and substituting lower-calorie foods for full-calorie alternatives. Only tenth of participants utilize the time to perform physical activity. The majority made changes to their diet and exercise, and strictly follow commitment in connection with planning for the following year.Conclusions: Educators, legislative, food manufacturers, household heads, and policymakers are called upon to improve Jordanians’ KAB on nutrition and diet. Furthermore, Jordanian nutrition and diet behavior can be invested to improve the dietary interventions designed by nutrition and dietetics professionals

Internship preparedness among students in healthcare-related fields in the COVID-19 era: Exploring the attitude and knowledge in Saudi Arabia

Background: In the COVID-19 era, efforts are being made to increase awareness among students and enhance best practices to mitigate the outbreak. To that end, the overarching aims of this study were to understand students’ attitude toward and knowledge of COVID-19 and examine the predictors of their attitude toward hand hygiene.Design and Methods: This cross-sectional survey study, conducted in Saudi Arabia, enrolled interns from diverse healthcare-related fields. The questionnaire was divided into three sections: sociodemographic data, knowledge of COVID-19, and attitude toward hand hygiene. The data was expressed as median and interquartile range (IQR).Results: In all, 371 responses were analyzed. The median knowledge score was 20, which was considered good. There were no statistically significant differences across age, hospital setting, or gender. Of the 254 respondents who had attended an educational session, 167 (65%) had a good knowledge score and 83 (33%) had a moderate score, compared with only four (2%) who had a poor score. The cumulative median score of the respondents’ attitudes was 6 (IQR [2]), which reflects a suboptimal attitude—only 38 (22%) reported a good attitude. The predicted effect of knowledge on attitude (good/suboptimal) was statistically significant (p = 0.02) using univariate logistic regression.Conclusions: The results suggest a strong need to encourage the current training program that targets hand hygiene practices among students in healthcare-related fields, especially prior to the internship year

An updated systematic review and network meta-analysis of 25 randomized trials assessing the efficacy and safety of treatments in COVID-19 disease

To date, there is no definite effective treatment for the COVID-19 pandemic. We performed an update network meta-analysis to compare and rank COVID-19 treatments according to their efficacy and safety. Literature search was performed from MEDLINE and CENTRAL databases from inception to September 5, 2020. Randomized clinical trials (RCTs) which compared the effect of any pharmacological drugs versus standard care or placebo 28-day after hospitalization in adult patients with COVID-19 disease were included. Risk ratio (RR) and 95% CI were calculated for 28-day all-cause mortality, clinical improvement, any adverse event (AEs), and viral clearance. A total of 25 RCTs, evaluating 17 different treatments, and 11,597 participants were analyzed. Remdesivir for 10-day compared to standard care (RR 0.69, 95% CI [0.48–0.99]), and a low dose compared to a high dose of HCQ (0.38, [0.17–0.89]) were associated with a lower risk of death. A total of 2,766 patients experienced clinical improvement, a 5-day course of remdesivir was associated with a higher frequency of clinical improvement compared to standard care (RR 1.21, 95% CI [1.00–1.47]). Compared to standard care, remdesivir for both 5 and 10 days, lopinavir/ritonavir, and dexamethasone reduced the risk of any severe AEs by 52% (0.48, 0.34–0.67), 24% (0.77, 0.63–0.92), 40% (0.60, 0.37–0.98), and 50% (0.50, 0.25–0.98) respectively. In this study of hospitalized patients with COVID-19, administration of remdesivir for 10-day compared to standard care was associated with lower 28-day all-cause mortality and serious AEs, and higher clinical improvement rate.&nbsp