ABSTRACT
The Sendai Framework for Disaster Risk Reduction 2015-2030 (UNDRR 2015) advocates for incorporating Indigenous knowledges and practices to complement scientific knowledge for effective and inclusive emergency and disaster management. Such traditional and local knowledge is an important contribution to developing strategies, policies and plans tailored to local contexts. A comparative analysis of local disaster management plans in Australia was undertaken as part of a larger project on emergency and disaster management in Indigenous communities and was performed to benchmark against the Sendai Framework priorities. A comprehensive search of publicly available local disaster management plans and subplans in selected local government areas was undertaken. Eighty-two plans were identified as well as 9 subplans from a list of Indigenous communities and associated local government areas. This study found a wide disparity in the organisation, presentation and implementation of knowledges and practices of local communities. While some plans included evidence of engagement and consultation with members of local communities, overall, there was little evidence of knowledges or traditional practices being identified and implemented. This analysis was conducted during the COVID-19 pandemic (2020-21) and most councils had local pandemic management subplans. However, many were not publicly available and targeted approaches for Indigenous communities were not evident on council websites. To reflect the priorities of the Sendai Framework, better consultation with local communities and leaders at all levels of government needs to occur and subplans need to be easily available for review by policy analysts and academics.
ABSTRACT
Introduction: Mississippi ranks second for childhood obesity prevalence (22%) above the national average of 16% with significant racial and health disparities. Since March 2020, stay-at home orders, virtual learning, stress, and poor lifestyle may have provided a perfect setup leading to new diagnosis of diabetes and accounting for record high hospitalizations. Objective(s): To determine the impact of the COVID-19 pandemic on the rate and clinical characteristics of newly diagnosed pediatric diabetes at University of Mississippi Medical Center. Method(s): Chart review and data comparison completed for patients with new-onset-diabetes between January 2019-February 2020 (pre pandemic);and between March 2020-October 2020 (pandemic). Result(s): Females were predominant in both groups (53% vs. 52%). There was no significant difference in the racial distribution in the two groups. A 34% were Whites while 61% were Africans Americans in the prepandemic group. The pandemic group comprised of 30% Whites and 63% African Americans. There was no significant difference in BMI percentile in the two groups. African Americans were disproportionately diagnosed with diabetes (64%). A 80% of obese patients had type 2 diabetes with 38% presenting in DKA, 3 patients in HHS. Four patients were COVID-19 positive on admission. Conclusion(s): Our observations corroborate the steep rise in the number of new-onset type 1 and type 2 diabetes, particularly in African Americans, in a highly prevalent obese pediatric population. Additional studies are required to determine the detailed effects of SARS-CoV-2 infection and pandemic associated psychosocial/ physical effects on development of diabetes in the pediatric population.
ABSTRACT
Introduction: In this modern era of technology, Information and Communication Technology (ICT) has made a very big revolution. Telemedicine is an emerging concept in health care services in Kerala, its implementation has not been satisfactory and successful. It is cost effective and provides easy access to healthcare services for people anywhere and especially during pandemic situations like this. A study is required in the domain of awareness and skill of doctors to facilitate its adoption and implementation. There was an urgent need to devise means for patients to consult doctors during Coronavirus Disease 2019 (COVID-19) pandemic. Aim: To assess the level of awareness and skill among doctors practicing modern medicine during COVID-19 pandemic. Materials and Methods: A cross-sectional study was conducted among 535 modern medicine doctors of Kerala from June 2020 to May 2021, using a structured self-administered questionnaire designed for the study. The total scores of awareness and skill calculated and categorised as poor, moderate, and good. Data was analysed by Statistical Package for the Social Sciences (SPSS) version 20.0 software by IBM. The Chi-square test/Fisher's-Exact test was used as test of significance. Results: Mean age of the study participants were 40.44±10.66 years, with majority 326 (60.94%) been females. Among the 535 doctors participated, 68.22% had moderate skill, 27.85% have good skill and only 3.92% have poor skill. Years of experience of doctors ranged from 1 to 48 with mean of 13.47±10.46 years. In majority, 431 (80.56%) of the participants, had moderate awareness about the telemedicine practice. Poor awareness was present in 19 (3.55%) doctors. 46.54% believes that specific software training is required for practicing telemedicine. Conclusion: The study showed that 15.89% had good awareness, while 80.56% of the participants had moderate awareness about the telemedicine. Only 27.85% of doctors had good skill, while 68.22% had moderate skill. Even though, awareness and skill of doctors practicing modern medicine are favourable, more webinars or workshops are needed to improve their knowledge.
ABSTRACT
Introduction: Mental health and well-being is as important as physical health during pregnancy. But the Coronavirus Disease 2019 (COVID-19) pandemic has caused more anxiety and stress among pregnant women. The augmented levels of anxiety and stress may have detrimental effects on antenatal women. Anxiety and depression in pregnancy can lead to adverse pregnancy outcomes like increased risk of abortions, preterm labour and even foetal deaths. Aim: To assess the anxiety and stress levels among pregnant women attending a tertiary care hospital in Thiruvananthapuram, Kerala during the COVID-19 pandemic and to determine the associated factors. Materials and Methods: A cross-sectional study was conducted among 348 pregnant women attending a tertiary care teaching hospital in Thiruvananthapuram District in Kerala during the period October and November 2020 using a validated tool, Pandemic Anxiety Stress Scale for pregnant women. Higher scores indicating higher perceived anxiety stress with a maximum score of 60, categorised as normal, mild, moderate and severe with score between 0-14, 15-29, 30-44, and 45-60, respectively. Qualitative variables were expressed in frequency and percentage. Multivariate logistic regression was done to determine the factors associated with anxiety and stress. The p-value <0.05 was considered significant. Results: Mild anxiety and stress were seen in 160 (45.98%) pregnant women, 89 (25.57%) had moderate and 7 (2.01%) had severe anxiety and stress, 92 women had no anxiety. A total of 145 (41.67%) pregnant women were scared of vertical transmission to their baby. Multivariate logistic regression revealed that residents in urban area and pregnant women with other co-morbidities associated with pregnancy were the two significant factors (p<0.05) associated with anxiety-stress. Conclusion: About one-fourth of pregnant women had moderate or severe level of anxiety and stress. Antenatal women with pregnancy related diseases and those living in urban area had more anxiety and stress during pandemic. Measures need to be taken by health system to address the mental health of pregnant women.
ABSTRACT
Validation of AG-Q COVID-19 N-Antigen Self- VTest in comparison with Real Time RT-PCR Ajaikumar Sukumaran, Arun Krishnan, Rhema Thomas, Jofy Paul, D M Vasudevan Introduction Currently, RT-PCR and the rapid antigen test (RAT) are the major stakeholders in COVID-19 diagnosis. The RTPCR is the gold standard testing method and RAT is considered for mass screening of COVID-19. In order to improve the accessibility and pace of diagnosis, ICMR had given permission for COVID-19 self-test by the public. AG-Q COVID-19 N-Antigen Self-Test kit is a home based rapid test kit developed by Agappe Diagnostics Limited. The kit has been validated at NIMS Medicity, Trivandrum and compared the performance with the RT-PCR Ct value. Aim Validation and comparison of AG-Q COVID-19 N-Antigen self-test with RT-PCR. Materials & Methods The AG-Q COVID19 N-Antigen self-test is a lateral flow immunochromatography based rapid test. The Covipath COVID-19 RT-PCR kit from ThermoFisher Scientific was used for the comparison study. A total of 72 subjects were recruited (30 positive & 42 negative subjects) for the study with the Institutional Ethical Committee approval and informed consent from the subjects. To perform the comparison study, a nasal swab sample in lysis buffe for RAT and a nasopharyngeal swab sample in VTM for RT-PCR were collected from each participants. Result The AG-Q COVID-19 N-Antigen self-test offers 100% specificity with sensitivity of 83.33%. Conclusion As per the study result, the AG-Q COVID-19 N-Antigen self-test is satisfying the ICMR recommended specificity and sensitivity for rapid antigen self-test as compared with the RT-PCR.
ABSTRACT
Introduction: During the COVID-19 pandemic the healthcare workers are most valuable resource for every country. They are going through a tough time exposing themselves at risk while working at hospitals and clinics. Along with the concerns for their own personal safety, they are anxious about passing the infection to their families. Health-care workers who care for elderly parents or young children will be drastically affected by school closures, social distancing policies, reverse quarantine needs and disruption in the transport facilities, food and other essentials. This study aimed to identify the psychological response of Healthcare workers and stigma experienced during initial phase of COVID-19 Pandemic in Kerala. Materials and Methods: A cross-sectional study conducted among doctors, nurses and other paramedical hospital staff in Kerala during May-June 2020. About 605 healthcare providers from different districts participated in the study by filling an online semi structured, self-administered questionnaire in Google forms. Data were analyzed by SPSS18 software, using descriptive statistics and chi square test used as test of significance.