Negative Emotions, Triggers, and Coping Strategies Among Postpartum Indian Women During Second Wave of COVID-19 Pandemic: Lessons for the Subsequent Waves and Beyond.

Introduction: The study aimed to evaluate COVID-19 associated psychological distress among pregnant and postpartum women during the second wave of COVID-19 in India. Methods: A cross-sectional survey was done using a pre-validated tool involving 491 participants attending a tertiary-care hospital during the second wave of COVID-19 in India. Results: Three-fourths of participants experienced negative emotions such as fear and various features of depression. Participants (75%) reported COVID-related news on TV/Radio/Newspapers including social media as the major trigger for these negative emotions. Loss of social support mainly affected postpartum women (p < 0.001) and working women (p < 0.001). Inability to access healthcare services had negative associations with age (p < 0.001), education (p < 0.001), and socioeconomic class (p < 0.001). Various coping strategies being followed by participants included watching TV/Videos or reading books (93%), resorting to social media (77%), spending more time praying and meditating (86%), and engaging in hobbies (56%). Conclusion: During the second wave, the COVID-19 pandemic had a significantly high negative impact on the psychological and social well-being of pregnant and postpartum women. Hence, it is important to initiate appropriate preventive and corrective steps by the policymakers for any future waves of the pandemic.

Impact of COVID-19 on Guillain-Barre Syndrome in India: A Multicenter Ambispective Cohort Study.

Introduction/Aims: Studies conducted during the coronavirus disease 2019 (COVID-19) pandemic have reported varied data regarding the incidence of Guillain-Barre syndrome (GBS). The present study investigated demographic and clinical features, management, and outcomes of patients with GBS during a specified period of the COVID-19 pandemic, and compared these features to those of GBS in the previous year. Methods: A multicenter, ambispective cohort study including 26 centers across India was conducted. Data from a pre-COVID-19 period (March 1 to August 31, 2019) were collected retrospectively and collected ambispectively for a specified COVID-19 period (March 1 to August 31, 2020). The study was registered with the Clinical Trial Registry India (CTRI/2020/11/029143). Results: Data from 555 patients were included for analysis: pre-COVID-19 (n = 334) and COVID-19 (n = 221). Males were more commonly affected during both periods (male:female, 2:1). Gastroenteritis was the most frequent antecedent event in 2019 (17.4%), whereas fever was the most common event in 2020 (10.7%). Paraparesis (21.3% versus [vs.] 9.3%, P = 0.001) and sensory involvement (51.1% vs. 41.3%; P = 0.023) were more common during COVID-19 in 2020, whereas back pain (26.3% vs. 18.4%; P = 0.032) and bowel symptoms (20.7% vs. 13.7%; P = 0.024) were more frequent in the pre-COVID period. There was no difference in clinical outcomes between the two groups in terms of GBS disability score at discharge and 3 months after discharge. Independent predictors of disability in the pre-COVID period included areflexia/hyporeflexia, the requirementfor intubation, and time to bulbar weakness; in the COVID-19 period, independent predictors included time from onset to admission, intubation, and intubation requirement. The mortality rate was 2.3% during the entire study period (13/555 cases). Discussion: Results of this study revealed an overall reduction in the frequency of GBS during the pandemic. The lockdown likely reduced the risk for antecedent infections due to social distancing and improved hygiene, which may have resulted in the reduction of the frequency of GBS.

Online survey to assess computer vision syndrome in children due to excessive screen exposure during the COVID 19 pandemic lockdown.

Background: During the COVID-19 pandemic lockdown, the normal daily routine activities of children were restricted as a result of the need to stay indoors. Consequently, children were forced to attend online classes provided by their educational institutions at their homes. Due to the subsequent increased screen exposure, children have started complaining of blurred vision, headache, and symptoms related to computer vision syndrome (CVS), predisposing them to myopia. Objective: To determine the prevalence of CVS symptoms, such as blurring of vision, headache, and watery eyes in children, due to increased screen time during the lockdown period of the COVID-19 pandemic. Methods: This was a non-randomized, questionnaire-based study conducted at the ophthalmology department of a tertiary care pediatric hospital. The participants were parents of children aged between 6 and 16 years attending regular school. Enrolled parents were interviewed through a Google Form after completing the online consent in English. Eligible participants were recruited by a circulation of this form through multiple groups on social media, namely, WhatsApp and email. Results: A total of 145 parents participated in the study. The children were classified according to the duration of exposure to digital devices ranging from less than 2 h to less than 6 h daily. There was a significant association between the increase in the number of activities and the development of CVS symptoms in children (r = 0.15; P = 0.036). Conclusion: COVID-19 lockdown has largely affected the lifestyle of school-going children by significantly decreasing their outdoor activities and increased online exposure to screen, thus predisposing them to myopia, ocular ill health, and increased dry eye symptoms. Increased exposure to online screen was detected during this lockdown period of the COVID-19 pandemic; this strongly supports the recommendation to decrease the number of hours of online screen exposure and encourages students to regularly get engaged in outdoor activities.

Negative Emotions, Triggers, and Coping Strategies Among Postpartum Indian Women During Second Wave of COVID-19 Pandemic: Lessons for the Subsequent Waves and Beyond

Introduction The study aimed to evaluate COVID-19 associated psychological distress among pregnant and postpartum women during the second wave of COVID-19 in India. Methods A cross-sectional survey was done using a pre-validated tool involving 491 participants attending a tertiary-care hospital during the second wave of COVID-19 in India. Results Three-fourths of participants experienced negative emotions such as fear and various features of depression. Participants (75%) reported COVID-related news on TV/Radio/Newspapers including social media as the major trigger for these negative emotions. Loss of social support mainly affected postpartum women (p < 0.001) and working women (p < 0.001). Inability to access healthcare services had negative associations with age (p < 0.001), education (p < 0.001), and socioeconomic class (p < 0.001). Various coping strategies being followed by participants included watching TV/Videos or reading books (93%), resorting to social media (77%), spending more time praying and meditating (86%), and engaging in hobbies (56%). Conclusion During the second wave, the COVID-19 pandemic had a significantly high negative impact on the psychological and social well-being of pregnant and postpartum women. Hence, it is important to initiate appropriate preventive and corrective steps by the policymakers for any future waves of the pandemic.

Novel Scoring Systems to Predict the Need for Oxygenation and ICU Care, and Mortality in Hospitalized COVID-19 Patients: A Risk Stratification Tool.

INTRODUCTION: A rapid surge in cases during the COVID-19 pandemic can overwhelm any healthcare system. It is imperative to triage patients who would require oxygen and ICU care, and predict mortality. Specific parameters at admission may help in identifying them. METHODOLOGY: A prospective observational study was undertaken in a COVID-19 ward of a tertiary care center. All baseline clinical and laboratory data were captured. Patients were followed till death or discharge. Univariable and multivariable logistic regression was used to find predictors of the need for oxygen, need for ICU care, and mortality. Objective scoring systems were developed for the same using the predictors. RESULTS: The study included 209 patients. Disease severity was mild, moderate, and severe in 98 (46.9%), 74 (35.4%), and 37 (17.7%) patients, respectively. The neutrophil-to-lymphocyte ratio (NLR) >4 was a common independent predictor of the need for oxygen (p<0.001), need for ICU transfer (p=0.04), and mortality (p=0.06). Clinical risk scores were developed (10*c-reactive protein (CRP) + 14.8*NLR + 12*urea), (10*aspartate transaminase (AST) + 15.7*NLR + 14.28*CRP), (10*NLR + 10.1*creatinine) which, if ≥14.8, ≥25.7, ≥10.1 predicted need for oxygenation, need for ICU transfer and mortality with a sensitivity and specificity (81.6%, 70%), (73.3%, 75.7%), (61.1%, 75%), respectively.  Conclusion: The NLR, CRP, urea, creatinine, and AST are independent predictors in identifying patients with poor outcomes. An objective scoring system can be used at the bedside for appropriate triaging of patients and utilization of resources.

COVID-19 infection, and reinfection, and vaccine effectiveness against symptomatic infection among health care workers in the setting of omicron variant transmission in New Delhi, India.

Background: Surge of SARS CoV-2 infections ascribed to omicron variant began in December 2021 in New Delhi. We determined the infection and reinfection density in a cohort of health care workers (HCWs) along with vaccine effectiveness (VE) against symptomatic infection within omicron transmission period (considered from December 01, 2021 to February 25, 2022. Methods: This is an observational study from the All India Institute of Medical Sciences, New Delhi. Data were collected telephonically. Person-time at risk was counted from November 30, 2021 till date of infection/ reinfection, or date of interview. Comparison of clinical features and severity was done with previous pandemic periods. VE was estimated using test-negative case-control design [matched pairs (for age and sex)]. Vaccination status was compared and adjusted odds ratios (OR) were computed by conditional logistic regression. VE was estimated as (1-adjusted OR)X100-. Findings: 11474 HCWs participated in this study. The mean age was 36⋅2 (±10⋅7) years. Complete vaccination with two doses were reported by 9522 (83%) HCWs [8394 (88%) Covaxin and 1072 Covishield (11%)]. The incidence density of all infections and reinfection during the omicron transmission period was 34⋅8 [95% Confidence Interval (CI): 33⋅5-36⋅2] and 45⋅6 [95% CI: 42⋅9-48⋅5] per 10000 person days respectively. The infection was milder as compared to previous periods. VE was 52⋅5% (95% CI: 3⋅9-76⋅5, p = 0⋅036) for those who were tested within 14-60 days of receiving second dose and beyond this period (61-180 days), modest effect was observed. Interpretation: Almost one-fifth of HCWs were infected with SARS CoV-2 during omicron transmission period, with predominant mild spectrum of COVID-19 disease. Waning effects of vaccine protection were noted with increase in time intervals since vaccination. Funding: None.

A cross sectional survey of 504 women regarding perceived risk factors and barriers to follow healthy lifestyle and association with sociodemographic factors and menopausal symptoms.

BACKGROUND AND AIMS: Midlife women undergoing menopausal transition are predisposed to weight gain. Weight gain in midlife is driven by two modifiable risk factors: menopausal symptom's severity and lifestyle practices. The independent and interactive nature of menopausal symptoms and lifestyle practices as risk factors of weight gain has not been investigated yet. This study was undertaken to study menopausal symptoms and lifestyle practices as risk factors for weight gain in midlife women and identify midlife -related barriers in managing corrective lifestyle practices. METHODS: In this cross-sectional study, menopausal symptom severity and lifestyle practices such as diet, exercise, and sleep were assessed using a pre-validated and reliable questionnaire on a convenience sample of midlife women (43-55 years) via an interview schedule. The association of lifestyle practices and its barriers with socio-demographics and menopausal symptoms were analysed. RESULT: A total of 504 women (mean age: 47.3 ± 4.1 years) were recruited. More than half of them followed corrective dietary practices, but only one-fourth engaged in moderate-intensity exercises. Total menopausal symptom severity was associated with increased food intake (P < 0.001), joint pain with limited physical activity and hot flashes and emotional volatility with sleep disturbances (P < 0.01). Demographic variables such as education, economic and employment status were associated with unhealthy lifestyle practices. CONCLUSION: Assessment of menopausal symptoms and lifestyle practices as risk factors and associated barriers must be the pivotal component to devise comprehensive women-centric weight management modules. Similar studies should be carried out in future when there is no clear effect of COVID19 on lifestyle factors.

Impact of the COVID-19 Pandemic on the Frequency, Clinical Spectrum and Outcomes of Pediatric Guillain-Barré Syndrome in India: A Multicentric Ambispective Cohort Study.

Objective: To study impact of COVID-19 pandemic on frequency, clinical/electrophysiological profile and treatment outcomes in pediatric Guillain-Barré syndrome (GBS). Background: GBS is the most frequent cause of pediatric acute flaccid paralysis. The effect of the COVID-19 pandemic on pediatric GBS is unclear in the literature. Methods: We conducted an ambispective, multicentric, cohort study involving 12 of 27 centres in GBS Consortium, during two periods: pre-COVID-19 (March-August 2019) and during COVID-19 (March-August 2020). Children ≤12 years who satisfied National Institute of Neurological Diseases and Stroke criteria for GBS/variants were enrolled. Details pertaining to clinical/laboratory parameters, treatment and outcomes (modified Rankin Scale (mRS) at discharge, GBS Disability score at discharge and 3 months) were analysed. Results: We enrolled 33 children in 2019 and 10 in 2020. Children in 2020 were older (median 10.4 [interquartile range 6.75-11.25] years versus 5 (2.5-8.4) years; P = 0.022) and had more sensory symptoms (50% versus 18.2%; P = 0.043). The 2020 group had relatively favourable mRS at discharge (median 1 (1-3.5) versus 3 (2-4); P = 0.042) and GBS disability score at 3 months (median 0 (0-0.75) versus 2 (0-3); P = 0.009) compared to 2019. Multivariate analysis revealed bowel involvement (P = 0.000) and ventilatory support (P = 0.001) as independent predictors of disability. No child in 2020 had preceding/concurrent SARS-CoV2 infection. Conclusions: The COVID-19 pandemic led to a marked decline in pediatric GBS presenting to hospitals. Antecedent illnesses, clinical and electrophysiological profile of GBS remained largely unchanged from the pre-pandemic era.

Clinical Features and Outcome of Stroke with COVID-19. COVID-19 Stroke Study Group (CSSG), India.

BACKGROUND AND PURPOSE: Occurrence of stroke has been reported among patients with COVID-19. The present study compares clinical features and outcomes of stroke patients with and without COVID-19. METHODS: The COVID-19 Stroke Study Group (CSSG) is a multicentric study in 18 sites across India to observe and compare the clinical characteristics of patients with stroke admitted during the current pandemic period and a similar epoch in 2019. The present study reports patients of stroke with and without COVID-19 (CoVS and non-CoVS, respectively) seen between February 2020 and July 2020. Demographic, clinical, treatment, and outcome details of patients were collected. RESULTS: The mean age and gender were comparable between the two groups. CoVS patients had higher stroke severity and extent of cerebral involvement on imaging. In-hospital complications and death were higher among CoVS patients (53.06% vs. 17.51%; P < 0.001) and (42.31% vs. 7.6%; P < 0.001), respectively. At 3 months, higher mortality was observed among CoVS patients (67.65% vs. 13.43%; P < 0.001) and good outcome (modified Rankin score [mRS]: 0-2) was seen more often in non-CoVS patients (68.86% vs. 33.33%; P < 0.001). The presence of COVID-19 and baseline stroke severity were independent predictors of mortality. CONCLUSIONS: CoVS is associated with higher severity, poor outcome, and increased mortality. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and baseline stroke severity are independent predictors of mortality.

Outcomes of multisystem inflammatory syndrome in children temporally related to COVID-19: a longitudinal study.

To study the clinical, laboratory characteristics and outcomes of multisystem inflammatory syndrome in children (MIS-C) temporally related to coronavirus disease 2019 (COVID-19) in a resource-limited setting. All children meeting the World Health Organization case definition of MIS-C were prospectively enrolled. Baseline clinical and laboratory parameters were compared between survivors and non-survivors. Enrolled subjects were followed up for 4-6 weeks for evaluation of cardiac outcomes using echocardiography. The statistical data were analyzed using the stata-12 software. Thirty-one children with MIS-C were enrolled in an 11-month period. Twelve children had preexisting chronic systemic comorbidity. Fever was a universal finding; gastrointestinal and respiratory manifestations were noted in 70.9% and 64.3%, respectively, while 57.1% had a skin rash. Fifty-eight percent of children presented with shock, and 22.5% required mechanical ventilation. HSP like rash, gangrene and arthritis were uncommon clinical observations.The median duration of hospital stay was 9 (6.5-18.5) days: four children with preexisting comorbidities succumbed to the illness. The serum ferritin levels (ng/ml) [median (IQR)] were significantly higher in non-survivors as compared to survivors [1061 (581, 2750) vs 309.5 (140, 720.08), p value = 0.045]. Six patients had coronary artery involvement; five recovered during follow-up, while one was still admitted. Twenty-six children received immunomodulatory drugs, and five improved without immunomodulation. The choice of immunomodulation (steroids or intravenous immunoglobulin) did not affect the outcome. Most children with MIS-C present with acute hemodynamic and respiratory symptoms.The outcome is favorable in children without preexisting comorbidities.Raised ferritin level may be a poor prognostic marker. The coronary outcomes at follow-up were reassuring.

Evaluation of the dose-effect association between the number of doses and duration since the last dose of COVID-19 vaccine, and its efficacy in preventing the disease and reducing disease severity: A single centre, cross-sectional analytical study from India.

AIMS: To evaluate the dose-effect association between COVID-19 vaccination and probability of turning RT-PCR positive and to assess the correlation between disease severity and vaccination status. METHODS: A single centre cross-sectional study was conducted amongst 583 individuals presenting to COVID-19 testing clinic and 55 hospitalized COVID-19 patients. Vaccination status was assessed by the number of doses and duration since the last dose. Disease severity was evaluated by the requirement of hospitalisation and ICU admission/death. The association between the vaccination status and development of disease and its severity were statistically analyzed. RESULTS: The mean age of the population was 36.6 years and 82.6% had no comorbidities. The odds of turning RT-PCR positive was 0.17(95% CI: 0.11-0.27) among the clinical suspects who had taken both doses of the vaccine at least 14 days before (fully vaccinated). The odds of hospitalisation was 0.12(95% CI: 0.03-0.45) and ICU admission/death was 0.07(95% CI: 0.01-0.36) among fully vaccinated individuals. The protective role of vaccination was observed to start 14 days after receiving the first dose. CONCLUSIONS: COVID-19 vaccination provides dose-dependent protection against the development of the disease. It also lowers the risk of hospitalisation and ICU admission/death in RT-PCR positive patients in a dose-dependent manner.

Association of Sociodemographic Parameters With Depression, Anxiety, Stress, Sleep Quality, Psychological Trauma, Mental Well-Being, and Resilience During the Second Wave of COVID-19 Pandemic: A Cross-Sectional Survey From India.

Objective This study was conducted to assess the traumatic impact of the second wave of coronavirus disease 2019 (COVID-19) pandemic on depression, anxiety, stress, sleep quality, mental well-being, and resilience among the general population of India. Methods An online cross-sectional survey was conducted in May-June, 2021 via Google Forms, which included adult individuals who were willing to participate in the study. The purposive and snowball sampling technique was used to ensure the principle of maximum diversity. Standardised tools [Depression Anxiety and Stress Scale (DASS), Pittsburgh Sleep Quality Index (PSQI), Impact of Event-Revised (IES-R), Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS), and the Brief Resilience Scale (BRS)] were used to collect data. Results A total of 1,109 responses were analysed for this study. Participants of different age groups (mean age: 32.98 ±14.72 years) and different sociodemographics were enrolled. The younger population group (18-34 years) was found to be the most affected among all the age groups. The findings revealed that 44.18% showed posttraumatic stress disorder (PTSD)-like symptoms. About 48.87%, 65.56%, and 22.09% of the participants had significant depression, anxiety, and stress symptoms respectively, and 11.27% had disturbed sleep patterns. Mental well-being was found to be disturbed for 74.75% of the study population, out of which only 4.15% showed high resilience capacity. Conclusion The associated collective psychological trauma mapped out by this paper is a pandemic in itself and needs to be addressed on a scale similar to the efforts being made to curb the physical symptoms of COVID-19.

Clinical profile and outcome of non-COVID strokes during pandemic and the pre pandemic period: COVID-Stroke Study Group (CSSG) India.

BACKGROUND: As the health systems around the world struggled to meet the challenges of COVID-19 pandemic, care of many non-COVID emergencies was affected. AIMS: The present study examined differences in the diagnosis, evaluation and management of stroke patients during a defined period in the ongoing pandemic in 2020 when compared to a similar epoch in year 2019. METHODS: The COVID stroke study group (CSSG) India, included 18 stroke centres spread across the country. Data was collected prospectively between February and July 2020 and retrospectively for the same period in 2019. Details of demographics, stroke evaluation, treatment, in-hospital and three months outcomes were collected and compared between these two time points. RESULTS: A total of 2549 patients were seen in both study periods; 1237 patients (48.53%) in 2019 and 1312 (51.47%) in 2020. Although the overall number of stroke patients and rates of thrombolysis were comparable, a significant decline was observed in the month of April 2020, during the initial period of the pandemic and lockdown. Endovascular treatment reduced significantly and longer door to needle and CT to needle times were observed in 2020. Although mortality was higher in 2020, proportion of patients with good outcome were similar in both the study periods. CONCLUSIONS: Although stroke admissions and rates of thrombolysis were comparable, some work flow metrics were delayed, endovascular stroke treatment rates declined and mortality was higher during the pandemic study period. Reorganization of stroke treatment pathways during the pandemic has likely improved the stroke care delivery across the globe.

End-stage kidney disease and COVID-19 in an urban safety-net hospital in Boston, Massachusetts.

INTRODUCTION: End-stage kidney disease (ESKD) patients are at a high risk for Coronavirus Disease 2019 (COVID-19). In this study, we compared characteristics and outcomes of ESKD and non-ESKD patients admitted with COVID-19 to a large safety-net hospital. METHODS: We evaluated 759 adults (45 with ESKD) hospitalized with COVID-19 in Spring of 2020. We examined clinical characteristics, laboratory measures and clinical outcomes. Logistic regression analyses were performed to investigate the associations between ESKD status and outcomes. RESULTS: 73% of ESKD and 47% of non-ESKD patients identified as Black (p = 0.002). ESKD patients were older and had higher rates of comorbidities. Admission ferritin was approximately 6-fold higher in ESKD patients. During hospitalization, the rise in white blood cell count, lactate dehydrogenase, ferritin and C-reactive protein, and the decrease in platelet count and serum albumin were all significantly greater in ESKD patients. The in-hospital mortality was higher for ESKD [18% vs. 10%; multivariable adjusted odds ratio 1.5 (95% CI, 0.48-4.70)], but this did not reach statistical significance. CONCLUSIONS: Among hospitalized COVID-19 patients, ESKD patients had more co-morbidities and more robust inflammatory response than non-ESKD patients. The odds ratio point estimate for death was higher in ESKD patients, but the difference did not reach statistical significance.

Socio-behavioural impact of COVID-19 on general population: A cross-sectional survey of one thousand seventy-nine participants across India between the first and the second wave of pandemic.

BACKGROUND AND AIMS: COVID-19 is expected to have a significant impact on the socio-behavioural aspect of citizens' lives, although the effects are expected to manifest differently in different population groups. The current study was conducted to assess the socio-behavioural impact of COVID-19 among the general population across India between the first and the second wave of pandemic. METHODS: A web-based cross-sectional study was conducted from 15th March -25th March 2021 using a pre-validated validated questionnaire upon the general population using e-survey, telephonic and face-to-face interview. The participants were recruited from the different regions of India by the purposive and snowball sampling technique following the principle of maximum diversity. Appropriate statistical tests were applied to study the association between the various sociodemographic variables and different behaviours. RESULTS: A total of 1079 responses were analysed for the study. Almost half of the participants feared contracting the COVID-19 infection. Overall, female participants, elderly people (more than 60 years of age) and urban dwellers reported a greater fear in the survey. More than half of the participants (53.39%) reported significant difficulties due to home confinement. People have become more inclined to adopt healthy lifestyles. There are mixed responses in the area of following preventive practices. CONCLUSION: People have a significant amount of fear and anxiety related to the pandemic, leading to several social and behavioural changes that might have a considerable impact on their everyday lives.

Knowledge, barriers and facilitators regarding COVID-19 vaccine and vaccination programme among the general population: A cross-sectional survey from one thousand two hundred and forty-nine participants.

BACKGROUND AND AIMS: The success of the COVID-19 vaccination program is dependent on people's knowledge and attitude regarding the vaccination program. Higher vaccine acceptance can be ensured by strengthening the facilitators and limiting the barriers being observed among the general population. MATERIAL AND METHODS: Indexed study is a cross-sectional web-based survey using a pre-validated questionnaire to assess knowledge, barriers and facilitators of COVID-19 vaccine and vaccination programme administered on adults across India using a Google online survey platform. RESULTS: A total of 1294 responses (age: 38.02 ± 13.34 years) were collected. Most of the participants had limited knowledge regarding the eligibility of vaccines in vulnerable population groups such as people with allergies (57.89%) and immune-compromised patients (62.98%), pregnant and lactating women (41.89%) and patients with chronic illness (34.78%). Older participants (>45 years) were more willing to take the COVID-19 vaccine (p < 0.001) as they believed the vaccine is not harmful and considered it as societal responsibility. Younger participants (<45 years) and those residing in urban settings raised concerns on the availability of the vaccine and authenticity of the vaccine (p < 0.001). CONCLUSION: There is a scope for improvement in people's knowledge regarding COVID-19 vaccine and the vaccination programme by addressing the barriers and facilitators which can improve the participants' turnover at vaccination centres.

Development of a Questionnaire to Assess the Psychosocial Effects of COVID-19 on Peripartum Women.

Objective The social and behavioral changes brought about by the coronavirus disease 2019 (COVID-19) pandemic have led to adverse consequences on the psychosocial functioning of peripartum women. Therefore, we developed and validated a tool to assess the psychosocial effect of the pandemic among these women. Methods The questionnaire was developed using a scientifically accepted systematic methodology comprising literature search, focus-group discussion (FGD), expert evaluation, pretesting, and validation. Results The final questionnaire consists of 38 questions, and it has a Cronbach's α value of 0.90 and a Kaiser-Meyer-Olkin (KMO) value of 0.773. Conclusion The questionnaire has good reliability and face, content, and construct validity. It can be used to assess the psychosocial functioning of peripartum women in low middle-income countries and help perinatal mental health specialists to devise strategies to cope with the psychological impact of COVID-19-like pandemics on peripartum women.

Development and validation of a questionnaire to assess knowledge, attitude, practices, and concerns regarding COVID-19 vaccination among the general population.

BACKGROUND AND AIMS: There seems to be hesitation in the general population in accepting COVID 19 vaccine because of associated myths and/or misinformation. This study is dedicated to develop and validate a tool to interpret vaccine acceptance and/or hesitancy by assessing the knowledge, attitude, practices, and concerns regarding the COVID vaccine. MATERIAL AND METHODS: Mixed methods study design was used. In phase 1, the questionnaire was developed through literature review, focus group discussion, expert evaluation, and pre-testing. In phase 2, the validity of the questionnaire was obtained by conducting a cross-sectional survey on 201 participants. The construct validity was established via principal component analysis. Cronbach's alpha value was used to assess the reliability of the questionnaire. RESULTS: The 39-item questionnaire to assess the knowledge, attitude, practices, and concerns regarding the COVID-19 vaccine was developed. The Cronbach's alpha value of the questionnaire was 0.86 suggesting a good internal consistency. CONCLUSION: The developed tool is valid to assess the knowledge, attitude, practices and concerns regarding the COVID-19 vaccine acceptance and/or hesitancy. It has the potential utility for healthcare workers and government authorities to further build vaccine literacy.

Development and validation of a questionnaire to assess socio-behavioural impact of COVID-19 on the general population.

BACKGROUND AND AIM: The aim of the study is to develop a valid and reliable tool to assess sociobehavioural changes due to COVID among the general population. METHODS: This mixed method study has two phases. Phase I for questionnaire development (literature review, focus group discussion, expert evaluation and pilot testing). Phase II for establishing construct validity via factor analysis and internal consistency via Cronbach's ɑ by administering the questionnaire on 179 participants. RESULTS: A questionnaire comprising 33 questions and five domains was developed having Cronbach's α of 0·82. CONCLUSION: The developed questionnaire is a concise, easy to administer and valid tool to assess socio-behavioural changes.

Are health care workers following preventive practices in the COVID-19 pandemic properly? - A cross-sectional survey from India.

BACKGROUND AND AIMS: Health care workers (HCWs) are at increased risk of getting infected with Coronavirus disease 2019 (COVID-19) and suboptimal preventive practices have been identified as an important risk factor in this regard. This study was done to evaluate the preventive practices being followed by health care workers and identify reasons for suboptimal compliance. METHODS: A cross-sectional survey was done in HCWs belonging to various occupational roles and socio-cultural backgrounds across India through online platforms and telephonic interviews from July 30, 2020 to August 30, 2020. A scientifically designed and pre-validated questionnaire with good validity (CVR = 0.87, S-CVI/Av = 0.978) and internal consistency (Cronbach's alpha coefficient = 0.85) was used. RESULTS: The responses of 956 participants were analysed. Various suboptimal practices like touching outer surface of masks, lack of social distancing in cafeteria and duty rooms, inability to wash hands for adequate duration and properly follow steps of hand hygiene, inability to don and doff PPE properly, carrying PPE to duty rooms before completely doffing, use of personal mobile phones during duty and improper sleep were identified. Lack of knowledge, long duty hours, shortage of PPE, high patient workload, and casual attitude regarding own safety were identified as important barriers. Resident doctors and paramedical staff in the age group 18-30 years reported lower adherence. CONCLUSIONS: Suboptimal compliance in preventive practices like handling PPE, distancing in cafeteria/duty rooms and hand hygiene is not uncommon in HCWs. Certain barriers are identified which should be addressed to ensure adequate safety of HCWs against COVID-19.