Exploring the linkage between workplace precaution measures, covid-19 fear and job performance: The moderating effect of academic competence

The coronavirus disease 2019 (Covid-19) has created emerging mental health challenges around the world. Like other countries, Pakistan is also confronted with covid-19 calamities. The aim of the study is to examine the impacts of workplace measures (WM) on the job performance (JP) and covid-19 fears (CF) along with the moderating role of academic competence (AC) based on the organizational support theory (OST) and job demand and resources (JDR) theory. A quantitative approach was applied to collect data from 333 banking employees in Gujranwala (Pakistan), and the hypothesis were tested via structural equation modeling using SPSS and AMOS. The study findings indicate that workplace measures significantly affect covid-19 fears except for individual preventive measures (IPM). Similarly, workplace measures significantly impact on job performance apart from information about the pandemic (IAP). Moreover, academic competence insignificantly moderates between workplace measures and covid-19 fears, but a significant moderation is found between information about pandemic (IAP) and covid-19 fears. Meanwhile, academic competence significantly moderates between workplace measures and job performance instead of a relationship between information about pandemic and job performance. However, this study was limited only to the banking sector of Pakistan. So, it will open the doors for future researchers to investigate other cultural contexts and sectors. This research gives a holistic understanding of workplace measures and contributes to the body of knowledge by enlightening the moderating role of academic competence in the banking sector of Pakistan. These useful insights would enable practitioners and policy makers to develop more efficient strategies and workplace measures to enhance job performance and reduce the fears of covid-19 among employees.

Investigating The Role of Inflammatory Markers at Admission in Defining the Severity of Moderate-to-Critical COVID-19: A Cross-Sectional Analysis.

Background and aims: The spectrum of Coronavirus disease-2019 (COVID-19) has been clinically defined from asymptomatic carriers to critical illness. Different inflammatory markers have been used to account for the severity and outcomes of this disease in different settings. Our study aims to investigate the role of these inflammatory markers in defining COVID-19 severity. Methods: This cross-sectional study included 200 confirmed cases of COVID-19. Inflammatory markers including lymphocyte count, D-Dimers, Ferritin, CRP, LDH were noted at admission. The moderate-to-critical disease was defined according to the WHO criteria. Descriptive statistics were applied. Mann-Whitney U-test was applied to compare the difference of markers between moderate-severe and critical patients. ROC was plotted to determine the cut-off values of these markers. Binary logistics regression analysis was used to assess which markers significantly predict the severity of COVID-19. Results: A D-dimer value of >775 ng/ml and LDH >495 U/L had a sensitivity of 72.9% and 79.2% and specificity of 57.9% and 53.6% respectively for critical COVID-19 illness. CRP levels of >100.5 mg/dl has a sensitivity of 66.7%. All inflammatory markers were significantly higher in a critical group of patients (p < 0.05) except for lymphopenia. Binary logistics regression analysis shows that LDH levels and D-dimers were only significant predictors of severity in COVID-19 patients. Conclusion: Inflammatory markers at admission are very useful in defining the severity of COVID-19 in addition to the clinical criteria. This is also useful in predicting adverse outcomes.

Indirect effects of COVID-19 pandemic on reproductive, maternal, newborn and child health services in Pakistan.

Background: COVID-19 is having many impacts on health, economy and social life; some due to the indirect effects of closure of health facilities to curb the spread. Closures were implemented in Pakistan from March 2020, affecting provision of reproductive, maternal, newborn and child health (RMNCH) services. Aims: To appraise the effects of containment and lockdown policies on RMNCH service utilization in order to develop an early response to avoid the catastrophic impact of COVID-19 on RMNCH in Pakistan. Methods: Routine monitoring data were analysed for indicators utilization of RMNCH care. The analysis was based on Period 1 (January-May 2020, first wave of COVID-19); Period 2 (June-September 2020, declining number of cases of COVID-19); and Period 3 (October-December 2020, second wave of COVID-19). We also compared data from May and December 2020 with corresponding months in 2019, to ascertain whether changes were due to COVID-19. Results: Reduced utilization was noted for all RMNCH indicators during Periods 1 and 3. There was a greater decline in service utilization during the first wave, and the highest reduction (~82%) was among children aged < 5 years, who were treated for pneumonia. The number of caesarean sections dropped by 57%, followed by institutional deliveries and first postnatal visit (37% each). Service utilization increased from June to September, but the second wave of COVID-19 led to another decrease. Conclusion: To reinstate routine services, priority actions and key areas include continued provision of family planning services along with uninterrupted immunization campaigns and routine maternal and child services.

Clinical Characteristics and Outcomes of COVID-19 Acute Respiratory Distress Syndrome Patients Requiring Invasive Mechanical Ventilation in a Lower Middle-Income Country.

Background: COVID-19 related acute respiratory distress syndrome (ARDS) requires intensive care, which is highly expensive in lower-income countries. Outcomes of COVID-19 patients requiring invasive mechanical ventilation in Pakistan have not been widely reported. Identifying factors forecasting outcomes will help decide optimal care levels and prioritise resources. Methods: A single-centre, retrospective study on COVID-19 patients requiring invasive mechanical ventilation was conducted from 1st March to 31st May 2020. Demographic variables, physical signs, laboratory values, ventilator parameters, complications, length of stay, and mortality were recorded. Data were analysed in SPSS ver.23. Results: Among 71 study patients, 87.3% (62) were males, and 12.7% (9) were females with a mean (SD) age of 55.5(13.4) years. Diabetes mellitus and hypertension were the most common comorbidities in 54.9% (39) patients. Median(IQR) SOFA score on ICU admission and at 48 hours was 7(5-9) and 6(4-10), and median (IQR) APACHE-II score was 15 (11-24) and 13(9-23), respectively. Overall, in-hospital mortality was 57.7%; 25% (1/4), 55.6% (20/36) and 64.5% (20/31) in mild, moderate, and severe ARDS, respectively. On univariate analysis; PEEP at admission, APACHE II and SOFA score at admission and 48 hours; Acute kidney injury; D-Dimer>1.5 mg/L and higher LDH levels at 48 hours were significantly associated with mortality. Only APACHE II scores at admission and D-Dimer levels> 1.5 mg/L were independent predictors of mortality on multivariable regression (p-value 0.012 & 0.037 respectively). Admission APACHE II scores, Area under the ROC curve for mortality was 0.80 (95%CI 0.69-0.90); sensitivity was 77.5% and specificity 70% (cut-off ≥13.5). Conclusion: There was a high mortality rate in severe ARDS. The APACHE II score can be utilised in mortality prediction in COVID-19 ARDS patients. However, larger-scale studies in Pakistan are required to assess predictors of mortality.

Knowledge management process, knowledge based innovation: Does academic researcher's productivity mediate during the pandemic of covid-19?

Drucker's knowledge-worker productivity theory and knowledge-based view of the firm theory are widely employed in many disciplines but there is little application of these theories in knowledge-based innovation among academic researchers. Therefore, this study intends to evaluate the effects of the knowledge management process on knowledge-based innovation alongside with mediating role of Malaysian academic researchers' productivity during the Pandemic of COVID-19. Using a random sampling technique, data was collected from 382 academic researchers. Questionnaires were self-administered and data was analyzed via Smart PLS-SEM. Knowledge management process and knowledge workers' productivity have a positive and significant relationship with the knowledge-based innovation among academic researchers during the Pandemic of COVID-19. In addition, knowledge workers' productivity mediates the relationship between the knowledge management process (knowledge creation, knowledge acquisition, knowledge sharing, and knowledge utilization) and knowledge-based innovation during the Pandemic of COVID-19. Results have also directed knowledge sharing as the key factor in knowledge-based innovation and a stimulating task for management discipline around the world during the Pandemic of COVID-19. This study provides interesting insights on Malaysian academic researchers' productivity by evaluating the effects of knowledge creation, acquisition, sharing, and application on the knowledge-based innovation among academic researchers during the Pandemic of COVID-19. These useful insights would enable policymakers to develop more influential educational strategies. By assimilating the literature of defined variables, the main contribution of this study is the evaluation of knowledge creation, acquisition, sharing, and utilization into knowledge-based innovation alongside the mediating role of knowledge workers productivity in the higher education sector of Malaysia during the Pandemic of COVID-19.

The Relation of ABO Blood Group to the Severity of Coronavirus Disease: A Cross-Sectional Study From a Tertiary Care Hospital in Karachi.

Background Blood groups are considered to have an impact on the occurrence and severity of coronavirus disease. While among Chinese and Caucasian, blood group O individuals were less and group A were more likely to have severe disease and mortality, data on South Asians aren't available.  Objective This study aimed to find out the association of disease severity with blood group among coronavirus disease 2019 (COVID-19) patients. Materials and methodology Data were collected on a predesigned questionnaire containing details of patient demographics, medical comorbidities, clinical presentation, and laboratory parameters. Multiple logistic regression was used to determine the association of the blood group with the severity of coronavirus disease. Result Among the study participants, blood group B has the highest distribution (39.8%), followed by O (30.0), A (21.9%), and AB (8.1%). About three-fourths (69.9%) had mild to moderate disease while 30.0% had severe disease. Age, gender, hypertension, diabetes mellitus, and hemoglobin level were all associated with disease severity among COVID-19 patients in univariate analysis on P-value for selection (<0.25). The final model showed that the odds of disease severity is 3.62 times higher among males (OR: 3.62, 95% CI: 2.15-6.08) and 2.00 times higher among diabetic patients (OR: 2.00, 95% CI: 1.10-3.01) as compared to female and non-diabetic respectively. However, there was no significant association found between blood group and disease severity. Conclusion Blood groups don't have any role in forecasting the severity of coronavirus disease. However, the male gender and diabetics are prone to have severe disease.

Risk factors for bacterial infections in patients with moderate to severe COVID-19: A case-control study.

Adverse outcomes in coronavirus infection disease-19 (COVID-19) patients are not always due to the direct effects of the viral infection, but often due to bacterial coinfection. However, the risk factors for such bacterial coinfection are hitherto unknown. A case-control study was conducted to determine risk factors for bacterial infection in moderate to critical COVID-19. Out of a total of 50 cases and 50 controls, the proportion of cases with severe/critical disease at presentation was 80% in cases compared to 30% in controls (p < 0.001). The predominant site was hospital-acquired pneumonia (72%) and the majority were Gram-negative organisms (82%). The overall mortality was 30%, with comparatively higher mortality among cases (42% vs. 18%; p = 0.009). There was no difference between procalcitonin levels in both groups (p = 0.883). In multivariable logistic regression analysis, significant independent association was found with severe/critical COVID-19 at presentation (AOR: 4.42 times; 95% CI: 1.63-11.9) and use of steroids (AOR: 4.60; 95% CI: 1.24-17.05). Notably, 64% of controls were administered antibiotics despite the absence of bacterial coinfection or secondary infection. Risk factors for bacterial infections in moderate to critically ill patients with COVID-19 include critical illness at presentation and use of steroids. There is widespread empiric antibiotic utilization in those without bacterial infection.