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Background: Coronavirus pandemic in 2019 led India to implement a complete lockdown except for essential services. Cancer patients faced hindrances in seeking medical help. This caused stress and worry, leading to reduced quality of life (QoL). This study evaluated QoL and pain management in palliative care cancer patients during the lockdown. Patients and Methods: This was a cross-sectional observational study at a tertiary cancer hospital, over one month period with convenience sampling. Participants included all who were unable to visit the palliative outpatient department during the lockdown during the COVID-19 pandemic. They were contacted telephonically and a valid QoL questionnaire was filled out. Disease, demographic details and pain were assessed. Result(s): A total of 51 were interviewed, 45% (n = 23) patients reported difficult access to medication during the lockdown;18 (35.3%) required morphine to alleviate pain and 6 (33.33%) faced difficulty in acquiring morphine tablets. QoL scores did not differ based on access to morphine (p = 0.648). Mean QoL scores were 12.7 +/- 3.76 and 15.0 +/- 3.60 amongst patients who did not have access to other medications and those who did have access, respectively (p = 0.03). Overall QoL FACT G7 mean score was 14 +/- 3.8. The variables NRS (pain intensity) and QoL scores were found to be negatively correlated (Pearson's Correlation Coefficient: r (49) = -0.69, p < 0.00001). Conclusion(s): Evaluation of QoL of palliative care cancer patients during global crises plays an important role in the assessment of patients' overall condition as well as to maintain a continuum of care.Copyright © Via Medica.
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Drawing on the concept of sociomateriality, this paper investigates the digitalisation of Non-Governmental Organisations (NGOs) in developing countries during the COVID-19 pandemic. NGOs represent one sector in which the consequences of digitalisation have been particularly striking. Nationwide lockdowns, travel restrictions and strict government guidelines led to NGOs embarking on a transition towards digitalisation for their continuity and survival. Adhering to a qualitative approach, data for the study have been derived through semi-structured interviews with stakeholders, focus group discussions with beneficiaries and a review of documentary sources. Outlining both the benefits and consequences of digitalisation, the findings of the study illustrate the way how the NGOs' digitalisation has triggered changes in both their operations and modes of communication, altered their relationships with beneficiaries and other stakeholders, and transformed their identity. The key contribution made by the paper involves moving beyond the human-centred and techno-centric approaches to digitalisation, which dominate the existing accounting literature, and illustrating how the performance of technologies evolves in everyday life. In doing so, the paper delineates the role that the technology itself can play in shaping NGOs' day-to-day practices in developing countries. © 2023 The Author(s)
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Coronavirus disease-2019, a viral disease caused by the novel severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2), was identified by the Centre for Disease Control (CDC), China, on January 7, 2020. This mysterious respiratory epidemic occurred in Wuhan, China, in late December 2019. A month after its outbreak in China, the World Health Organization (WHO) de-clared it as a public health emergency of international concern (PHEIC) due to its severity and high transmission potential throughout the world, leading many nations to implement multiple lock-down sessions and strict social distancing measures. As of September 21, 2020, 30,675,675 active cases and 954,417 deaths had been reported worldwide. Intensive research is being carried out across the globe to identify precise diagnostic techniques and develop novel, effective vaccines against the virus. Herein, we elaborate on details of epidemiology, genetics, pathophysiology, diag-nosis, prevention, and vaccine trials related to this pandemic.Copyright © 2021 Bentham Science Publishers.
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Background The global health community has emphasized the importance of reporting epidemiological data by age and sex groups in the COVID-19 pandemic. However, age and sex disaggregated data of COVID-19 cases and deaths are rarely reported. Such data are very crucial for public to make truly informed choices about their own diseases risk and also for governments for public policy response. Objective To assess age and gender difference among COVID-19 cases and deaths in Nepal. Method This is a retrospective study which uses public data on COVID-19 cases and deaths released by Ministry of Health and Population, Government of Nepal from January to November, 2020. The data analysis was carried out using SPPS software version 26. Result Nepal reported 233,452 confirmed cases and 1,566 deaths of COVID-19 from 23 January 2020 to 30 November 2020. We found statistically significant differences on COVID-19 cases by age and gender in Nepal with higher number of cases among males of economically active age groups (20-60 years). Similarly, we found significant difference in COVID-19 mortality with more death occurred among male group compared to female group and with highest number of deaths among the people of above 60 years. Furthermore, we found differences in cases and deaths among provinces. Conclusion The age and gender differences in COVID cases and deaths in Nepal indicates needs of considering age and sex groups seriously while planning for testing, case management and vaccination against COVID-19 infections in Nepal. Copyright © 2020, Kathmandu University. All rights reserved.
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This qualitative study explored teachers' use of technology to manage teaching and learning activities during COVID-19 in Nepalese higher education institutions. To this end, 11 teachers from three universities located in five provinces of Nepal were purposefully selected. Their experiences of using technological tools were explored through semi-structured interviews and document analysis. The findings show that the implementations of online teaching and learning to manage students' learning loss during the COVID-19 were marred by paradoxical policy, insufficient resources, teachers' attitudes, socio-psychological issues, the lack of trained teachers and connection among technology, curriculum, pedagogy and assessment. Interestingly, the findings demonstrate that the teachers have taken the COVID-19 crisis as an opportunity for learning to use technologies in their teaching and learning activities. Based on these findings, we suggest that the government of Nepal needs to design an action plan to facilitate free mental health and wellbeing counseling programmes for students and teachers, provide sufficient devices with internet access to their students and train teachers and staff on how they can blend technologies, pedagogies and contents.
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Study Objectives: Lung point-of-care ultrasound (L-POCUS) is a novel, radiation-free diagnostic tool that could aid in COVID-19 prognosis in non-critically ill patients. Prognostication requires capturing presenting symptoms and outcomes that may change over time. Variations of environment, presenting symptomatology and follow up can introduce uncontrolled heterogeneity impacting outcome. The purpose of our study was to examine demographic, clinical, and 40-day follow up patterns between two national sites enrolling ambulatory COVID patients for the purpose of determining the association between hypoxia at day 40 and initial L-POCUS findings. Method(s): This was a cross sectional study design of patients at two tertiary care institutions in the Northeast (NE) and Midwest (MW) from January 1st, 2021-April 30th, 2022. We included subjects with respiratory complaints who tested positive for COVID-19 and maintained oxygen saturation >=92% for two hours after presentation to the emergency department as part of a larger project focused on describing L-POCUS prognostic characteristics in non-critically ill COVID patients. Initial vital signs and diagnostic data were collected. Blinded L-POCUS operators recorded seven lung windows (two anterior, two lateral and three posterior per lung field). We utilized a rubric that ranged from zero to six with zero being normal lung and six indicating severe lung pathology from COVID to score each image. Pleural findings included indentation, thickening (each one point), or discontinuity (two points). Parenchymal abnormalities included B lines (1-3 B lines =1 point, >3 B lines =2 points, coalescing or "waterfall" B lines=3 points). Subpleural consolidations scored an automatic six points out of a maximum of 42 per lung. Subjects received pulse oximetry use training and were followed by structured chart review or telephone interview 40-days following presentation. Telephone follow up included highest and lowest pulse oximetry at rest and on 60 second ambulatory test and a structured chart review at any health care visit documented evidence of hypoxia. Hypoxia was defined at <=92% 40 days from index visit. We present descriptive data and corresponding parametric or non-parametric statistic. Result(s): We enrolled 154 subjects (MW 122 (80%), NE 32 (21%). The NE population was more likely to be Hispanic (55% vs 18%, p=<.05) while the MW site was more likely to be African American (76% vs 42%, p<.05). There were no sex differences (NE, 63% female, MW 56% female). There were no significant differences between age (NE 40 years (IQR 31-54), MW 42 years (IQR, 30-56), or Body Mass Index (NE 29 (IQR 25-33), MW 29 (IQR, 24-35). CXR was ordered for 128 (83%) subjects and CT for 18 (12%) but there was no difference between sites (NE: CXR 27(93%), CT 5 (17%), MW: CXR 101 (83%), CT 13 (11%)). Median L-POCUS scores were 6 (IQR 5-12) and differed by site (NE 14, (IQR 13-27);MW 2 (IQR 2-10, p<.0001). Forty day telephone follow-up was 40% (59/154) and did not differ by site. We identifed 40 (26%) cases of subsequent hypoxia within 40 days of index visit. Outcome did not differ by site (NE 5/32 (16%): MW35/122 (29%), P=0.18). Conclusion(s): There were no meaningful clinical differences between cohorts at distinct geographical locations although NE subjects score higher on initial L-POCUS. Telephone follow up rates were low at both sites. Prognostication may need to account for L-POCUS scoring variability. No, authors do not have interests to disclose Copyright © 2022
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Background COVID-19 is an infectious disease caused by a newly discovered coronavirus. The number of cases and dramatic loss of human life worldwide created psychological problems among general public, including health care workers. Objective To determine the burden of anxiety, depression, and functional impairment among health care workers in the early days of lockdown during the first wave of COVID-19 outbreak in Nepal. Method A hospital-based cross-sectional study was carried out among all the employees of Hospital for Children Eye ENT and Rehabilitation Services, Bhaktapur during the COVID-19 pandemic lockdown from April 3, 2020 to May 2, 2020 using an online questionnaire. The tools used were adopted from Nepali version of Hospital Anxiety and Depression scale (HADS) and Nepali version of WHO Disability Assessment Schedule (WHODAS 2.0). Result The mean age (SD) of the participants (n=86) was 32.53 (7.92) years. Male and female participants were equal in number. The point prevalence of anxiety and depression was 25.6% and 14.0%, respectively. Females had a higher prevalence of both anxiety (39.5% vs 11.6%, p < 0.01) and depression (18.6% vs 9.3%, p=0.351). Clinical and nonclinical staff both had a higher prevalence of both anxiety (31.0% and 20.5%, p=0.265) and depression (16.7% and 11.4%, p=0.478). The mean functional impairment score (WHODAS 2.0) among all participants and participants with anxiety and depression was 19.47 (95% CI: 18.13-20.80), 21.27 (95% CI: 18.08-24.46), and 19.92 (95% CI: 15.28- 24.56), respectively. Conclusion Anxiety and depression during the first lockdown due to COVID-19 pandemic were highly prevalent in clinical and non-clinical employees. Besides controlling the outbreak, special consideration should be given to mental health.
Subject(s)
COVID-19 , Adult , Anxiety/epidemiology , COVID-19/epidemiology , Child , Communicable Disease Control , Cross-Sectional Studies , Depression/epidemiology , Female , Health Personnel/psychology , Humans , Male , Pandemics , SARS-CoV-2ABSTRACT
With the structural shift in education due to the pandemic, worldwide educators adapted by a variety of methods, including a change to the course delivery method. Many universities closed and/or moved to wholly online delivery. With the online video formats, either synchronous or asynchronous, faculty were able to create a library of videos which could be later used as a tool. This new collection of videos could be used for asynchronous delivery or online courses, or as supplemental instructional videos. A survey was conducted to determine student perceptions of supplemental instructional videos. Supplemental instructional videos were available pre-pandemic by individual instructors and publishers. Instructors may have offered videos through a Learning Management System (LMS) or a streaming platform. These types of videos vary from general topic overviews to course specific content. Certain types of courses and content have long been identified as appropriate for online delivery, like software-based courses. However, instructors have been slow to adopt online delivery for hands-on laboratory exercises or architectural studios. Because of this post-pandemic paradigm shift, there is an opportunity to identify the associated shift in student perceptions. A survey instrument was developed to assess student perceptions about supplemental instructional videos. All of the students surveyed are enrolled in courses which provide supplemental instructional videos through their LMS. The survey was not limited to perceptions about current courses. Students across engineering, engineering technology, and architecture disciplines were asked about their perceptions of supplemental instructional videos made available through LMS. The LMS collects analytical data about usage, and depending on the LMS, precisely how much and which portions of a video were viewed by students. The survey included demographic questions in addition to questions about experience with online learning and supplemental instructional videos. Students surveyed included all levels of undergraduate students and graduate students from two universities in different states. Students are generally split in their preference for online or face-to-face delivery methods. About two-thirds of the respondents had been exposed to supplemental instructional videos. Similar to completely online courses, respondents identified reasons that supplemental instructional videos were a good resource, which included the lack of time constraints and the ability to watch and re-watch the videos. © American Society for Engineering Education, 2022.
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The majority of the academic institutions across the globe transitioned education delivery to alternate methods, irrespective of specializations, in response to the pandemic. However, very little is explored regarding how architecture educators perceive the Online Learning Environment (OLE) transition impacts based on gender differences. The need for such a study emerges as the literature indicates that women are more impacted than males during natural disasters, which might include a pandemic. The unit of analysis for the study was architecture educators in India. India was purposely selected as it is one of the top three countries globally from the perspective of enrolled university students. The study explored the impacts of the OLE transition among architecture educators as per gender in India. An online survey method was used to allow adequate data collection during a pandemic. The developed online instrument was hosted on Qualtrics. The developed online instrument was pilot tested by education experts in India. The instrument was emailed to the deans of more than 450 architecture colleges in India for dissemination among the educators affiliated with the institutions. In addition, the research team used interpersonal channels such as Whatsapp for instrument distribution. Two follow-up emails were sent to increase the response rate. The survey instrument was disseminated in March and April 2021, one year after the pandemic had impacted globally, also the timeframe when the pandemic started to severely impact India. The study used 165 complete responses from architecture educators. Approximately 59% of the respondents identified themselves as females. Further, most of the respondents had a Master's degree as a terminal degree. The study identified perception differences of COVID-19 impact on architecture educators. The study found that female educators had less experience with OLE and were less aware of the resources available at the University and institute levels before the impact of COVID-19. At the same time, a higher number of male educators indicated a negative productivity impact than their female counterparts. Finally, agreement among genders could be observed in the areas of administration monitoring online teaching, factors impacting the productivity of the architecture educators, and concerns about working from home. © American Society for Engineering Education, 2022.
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Technology has revolutionized our world and everyday life over the years. In all these revolutions, technology our lives easier faster, better fun made. To withdraw or transfer money to someone you no longer have to enter the bank. Many banks have already made online transactions possible, everywhere. With your cell phone and banking application, you can manage all your bills online. Moreover, it is clear that COVID-19 million workers have been forced to stay home for the past eight months. There is a need to quickly transform digital technology into a 2020 vision. This adaptation came into effect almost immediately with the lockout, especially for India digital payments. The Government of been actively promoting online payments since 2016, starting with monetization. 'Digital India' was the driving force behind many digital and Indian economic decisions. There are different methods of digital payments in India, bank cards, Unstructured Support (AEPS) Data (USSD), Aadhaar Enabled Payment System, Integrated Payment (UPI), Bank Prepaid Cards etc. Therefore, overall Govt-19 has provided incentives for digital payment in India. © 2022 Author(s).
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Background: Neutralizing antibodies cocktail (Casirivimab and Imdevimab) has received conditional recommendation by FDA and WHO for mild to moderate COVID infection in specific high-risk groups. Persons with underlying chronic illnesses are at high risk of developing severe disease. The effectiveness of various repurposed drugs approved for the management is variable. Antibodies cocktail has shown promising results in preventing progression to severe disease. But the data about its use and safety from India is scarce. Herein, we present a retrospective analysis of 10 patients who were administered with the antibodies cocktail between Aug 2021 and Oct 2021. Methodology: We conducted an observational retrospective analysis of clinico-radiological, inflammatory parameters, progression of the disease, and outcome amongst ten mild and moderate COVID 19 patients treated with antibodies cocktail. Results: Ten patients were administered the antibodies cocktail (casirivimab 600 mg and Imdevimab 600 mg). The median age was 63.5 years, and four patients were partially vaccinated, and the rest were unvaccinated. Diabetes and hypertension were the commonest comorbidities;hematological and solid organ malignancies were other comorbidities. The median CRP level on admission was 91.5 mg/dL. Other inflammatory markers like neutrophil: lymphocytes ratio, ferritin, and LDH were higher than normal limits. None of our patients required supplemental oxygen or progressed to severe ARDS nor has any adverse reactions. All patients were discharged in a stable condition within six days of the therapy. Four patients had radiological opacities consistent with COVID 19 pneumonia and had shown regression after the therapy. The observation indicates that this therapy may also be effective in the early pulmonary phase of the disease. Conclusions: The neutralizing antibodies cocktail has shown encouraging results in our analysis in preventing progression to severe disease and is not associated with severe adverse reaction.
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Globally, billions of people and their livelihood are threatened by the onset of COVID-19. In Nepal, resource-poor people who lost their job were the hardest hit among millions of impacted populations. Further, the associated effects of pandemics are food supply chain interruption and people's inferior physical and mental wellbeing. The COVID-19 pandemic and associated impacts have questioned Nepal's ability to achieve the 17 United Nations sustainable development goals (SDGs) in the post-pandemic era. Yet no scientific studies available to see COVID-19 and SDGs relationships in Nepal, government reports, and macroeconomic updates indicated that COVID-19 is likely to deter significantly in achieving SDGs targets. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to quantify the impacts of the COVID-19 pandemic in Nepal's macro-economy from March 2020 to December 2021. Our study indicated that the COVID-19 exerted inevitable challenges in achieving SDGs targets in terms of food security and household poverty. Therefore, this paper recommended creating more employment opportunities in the domestic economy and establishing a resilient food system. Copyright © 2022 Joshi, Poudel, Kafle, Bhattarai, Prasai and Adhikari.
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The rapid and seemingly endless expansion of COVID-19 can be traced back to the inefficiency and shortage of testing kits that offer accurate results in a timely manner. An emerging popular technique, which adopts improvements made in mobile ultrasound technology, allows for healthcare professionals to conduct rapid screenings on a large scale. We present an image-based solution that aims at automating the testing process which allows for rapid mass testing to be conducted with or without a trained medical professional that can be applied to rural environment and third world countries. Our contributions towards rapid large-scale testing includes a novel deep learning architecture capable of analyzing ultrasound data that can run in real time and significantly improve the current state-of-the-art detection accuracies using image based COVID-19 detection. © 2021 IEEE.
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This paper presents a novel ultrasound imaging point-of-care (PoC) COVID-19 diagnostic system. The adaptive visual diagnostics utilize few-shot learning (FSL) to generate encoded disease state models that are stored and classified using a dictionary of knowns. The novel vocabulary based feature processing of the pipeline adapts the knowledge of a pretrained deep neural network to compress the ultrasound images into discrimative descriptions. The computational efficiency of the FSL approach enables high diagnostic deep learning performance in PoC settings, where training data is limited and the annotation process is not strictly controlled. The algorithm performance is evaluated on the open source COVID-19 POCUS Dataset to validate the system's ability to distinguish COVID-19, pneumonia, and healthy disease states. The results of the empirical analyses demonstrate the appropriate efficiency and accuracy for scalable PoC use. The code for this work will be made publicly available on GitHub upon acceptance. © 2021 IEEE.
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The paper examines students' perspectives that impact the student learning activities' transition due to COVID-19. The study seeks to determine how face-to-face or in-person teaching to nontraditional or online methods has affected the student, particularly in the construction program. Additionally, as construction courses typically include labs and capstone projects, it is essential to determine how these courses were delivered as the programs transitioned to the online mediums. The research study compares content delivery before and during COVID-19. The survey questions are used to determine the challenges students face in accessing the course management system, familiarizing themselves, and being satisfied with the course management system, and student's satisfaction with the instructors' delivery of the course content. Online survey instruments were created to circulate among construction students to a) evaluate the student learning experience during COVID-19 and b) identify student adaptation of content delivery during COVID-19. The students' perspectives are analyzed with the challenges faced by the students. The survey results will be used to assist faculty in identifying construction curriculum requirements based on the student's perceived ability to learn for any future move to online learning, either due to weather or illness. © American Society for Engineering Education, 2021
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This research project is to determine how the student internships have been affected by the COVID-19. The paper examines student internships in the construction industry experiences from Georgia and Oklahoma. This research evaluates internship requirements, the challenge of getting internships, safety measures in the work environment, and identifies construction experience perceptions during the COVID-19 pandemic. Students were surveyed to provide information about how internships have been affected during this time. The results of the survey are used to predict how future economic changes would affect internships. An online survey instrument was created to circulate among construction students to a) evaluate internships experience during COVID-19, b) identify adaptation of working environment in the office and field, c) use of additional safety measures, d) identify any project changes due to COVID-19, and e) describe their role of the COVID-19 response team. The results of the student internships activity are analyzed to examine the changes associated with their previous internships before COVID-19 versus their internship during the COVID-19 pandemic. The two states, Georgia and Oklahoma, are compared with students' respondent perspectives. Additionally, insights into external views of the media or political background are identified in the students' responses. © American Society for Engineering Education, 2021
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With the current pandemic, a potential recession is also occurring. Considering the “Great Recession” of 2007-2010, student enrollments went up while taxpayer support to public universities fell. Also associated with these changes was the increase in unemployment which correlates with the increase in enrollment. Non-traditional students (not typical recent high school graduates) return to college as jobs become more difficult to find. In a thorough review of the American Society of Engineering Education archives, there is little about any correlation between job placement and the Great Recession. Internships are a part of many construction, engineering, and architecture degree programs. These might be mandatory for course credit or strongly encouraged, yet voluntary, during college. Internships could also be mandatory for professional credentials after graduation. Little research is available to identify any correlation between internship placement and recessions. Anecdotal relationships between recessions and internships have been reported. With the current economic situation associated with the Covid pandemic, there is an opportunity to identify changes that occur in the construction industry. A thorough review of existing literature is performed. To determine the change in internship employment, a survey instrument was created. Respondents shared their perspective about gaining a summer internship this summer as compared to previous years. A comparison of recent salary data and career fair data was used to identify any economic changes which have occurred. This research seeks to define the relationship between the university, industry, and student and how it was affected by Covid. © American Society for Engineering Education, 2021
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Background: There is more than twofold rise in prevalence of mucormycosis cases in India during the COVID-19 pandemic which needs to be evaluated. Aims: The study aimed to document the spectrum of cases of mucormycosis seen at our Institute during COVID-19 times. Methods: The study is a retrospective observational study carried out at our Institute from May 2021 to mid-June 2021. All patients with biopsy-proven mucormycosis were enrolled in the study. The patients were subjected to complete history taking, ophthalmological examination, and imaging studies. The patients were treated with a multidisciplinary approach with antifungal therapy as well as surgical intervention when needed. Results: Ten patients (n=10) were seen, with a mean age of 50.3 years. The major risk factors included recent use of steroids, uncontrolled diabetes, and CKD. The most common presentation was swelling of unilateral eye and ptosis, followed by loss of vision. Inflammatory marker (CRP) and d-dimer were raised at presentation in all cases. Imaging showed the spread of infection from paranasal sinus to orbit and brain via cavernous sinus, which was a poor prognostic factor. Intravenous Amphotericin-B was given to all patients for at least 4 weeks. Two patients were discharged after completion of treatment and mortality was seen in three patients. Conclusion: We present an array of COVID-associated-mucormycosis (CAM) cases from Eastern India. CAM is presenting with rhino-orbito-cerebral involvement. There is poor outcome with cerebral involvement and high incidence of adverse effects with deoxycholate formulation of amphotericin-B. The causal association of COVID-19 with mucormycosis needs to be unearthed but possible preventive role of anticoagulation should be evaluated. © 2021 Journal of Association of Physicians of India. All rights reserved.
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The relation between attachment to places and human mobility are not straightforward or linear, but is frequently indirect and mediated by social, cultural and economic drivers. Migration affects people positively, but most migratory movement are due to economic issue, financial problem, unemployment, vulnerability, stress or shocks. This migratory movement has a place attachment angle that is now becoming increasingly noticed for several times. Place attachments are based on interpersonal interaction and can alter a person's perception of risk and coping techniques in areas prone to natural disasters. The COVID-19 pandemic had a significant impact on migrants. The interplay of COVID-19 and the decline in economic activity have led to both domestic and international instability. Due to environmental change, migration explains complex interactions, hazards and unpredictability. This study examines the problems and opportunities in terms of place for the immobile population that undergo environmental degradation and clarifies its significance in the pandemic situation in Indian context. © 2021 by SPC (Sami Publishing Company).