Effect of Contact-Restricted Basic Life Support Training During the Nation's Contact Restriction Policy on Learning Outcomes.

Objective: Basic life support (BLS) training aimed at building knowledge and skills in cardiopulmonary resuscitation. During training, there is the possibility of airborne COVID-19 transmission. The aim was to evaluate students' knowledge, skills, and course satisfaction following contact-restricted BLS training under the contact restriction policy. Methods: From July 2020 to January 2021, a prospective, descriptive study was conducted among fifth-year dental students. Contact-restricted BLS training consisted of online learning, online pre-testing, non-contact training with automated real-time feedback manikins, and remote monitoring. The participants' skills, knowledge through online testing, and course satisfaction were all evaluated after training. At three months and six months after training, their knowledge was re-evaluated through online testing. Results: Fifty-five participants were included in this study. Their mean (SD) knowledge scores after training, at three and six months, were 81.5 (10.8)%, 71.1 (16.4)%, and 65.8 (14.5)%, respectively. The percentage of participants, who passed the skills test on their first, second, and third attempts had been 83.6%, 94.5%, and 100%, respectively. The mean (SD) satisfaction score with the course was 4.87 (0.34) on a five-point Likert score. After training, no participants had COVID-19 infection. Conclusion: Training in contact-restricted BLS had produced acceptable knowledge, skills, and satisfaction results. Knowledge tests, competence tests, and course satisfaction were comparable to conventional pre-pandemic trainings with similar participants. Due to the significant dangers of aerosol disease transmission, it became a viable training alternative. Trial Registration: TCTR20210503001 (Thai Clinical Trials Registry).

The association of care satisfaction and COVID-19 contact restrictions with quality of life in long-term care homes residents in Germany: a cross-sectional study.

BACKGROUND: Quality of life (QoL) is a widely recognised outcome in residents of long-term care homes. However, little is known about the impact of care satisfaction on QoL. The aim of this study was to assess the association between care satisfaction and QoL in residents of long-term care homes. Additionally, we were able to assess the impact of the Covid-19 contact restrictions on QoL. METHODS: We applied a cross-sectional study in N = 40 long-term care homes in Baden-Wuerttemberg, Germany. Using regression models, we analysed the association between QoL (operationalised through the World Health Organization Quality of Life Assessment-Old Module [WHOQOL-OLD]) and self-rated nursing care satisfaction. The date on which the questionnaire was completed was used to calculate whether the completion was prior the emergence of the Covid-19 contact restrictions. Further potential confounders were included in the analysis. RESULTS: N = 419 residents of long-term care homes participated. Explained variance of QoL was low in our models at 2 to 16%. Self-rated nursing care satisfaction was the strongest predictor of QoL and positively linked to the following subdimensions of QoL: autonomy; past, present and future activities; social participation; intimacy. The Covid-19 contact restrictions were negatively linked to social participation. CONCLUSION: Nursing care satisfaction was associated with QoL in residents of long-term care homes. Future research should focus on the direction of the association and different aspects of nursing care satisfaction with QoL. Furthermore, we showed the impact of contact restriction during the Covid-19 lockdown on social participation. TRIAL REGISTRATION: WHO UTN: U1111-1196-6611; DRKS-ID: DRKS00012703 (Date of Registration in DRKS: 2017/08/23).

Can Acting Out Online Improve Adolescents' Well-Being During Contact Restrictions? A First Insight Into the Dysfunctional Role of Cyberbullying and the Need to Belong in Well-Being During COVID-19 Pandemic-Related Contact Restrictions.

Connecting with peers online to overcome social isolation has become particularly important during the pandemic-related school closures across many countries. In the context of contact restrictions, feelings of isolation and loneliness are more prevalent and the regulation of these negative emotions to maintain a positive well-being challenges adolescents. This is especially the case for those individuals who might have a high need to belong and difficulties in emotional competences. The difficult social situation during contact restrictions, more time for online communication and maladaptive emotion regulation might lead to aggressive communication patterns in the form of cyberbullying perpetration. In an online study with N = 205 adolescents aged 14-19 (M = 15.83, SD = 1.44; 57% girls), we assessed the frequency of online and offline contacts, need to belong, emotion regulation problems, feelings of loneliness, and cyberbullying perpetration as predictors of adolescents' well-being. In particular, we explored whether cyberbullying perpetration might function as a maladaptive strategy to deal with feelings of loneliness and therefore predicts well-being. This effect was expected to be stronger for those with a higher need to belong and with higher emotion regulation problems. Results of a hierarchical regression analysis revealed that well-being was significantly predicted by less emotion regulation difficulties, less feeling isolated and more cyberbullying perpetration. We also tested whether the need to belong or emotion regulation problems moderated the association between cyberbullying and well-being. While the results for emotion regulation problems were not significant, the moderation effect for the need to belong was significant: For students with a high need to belong, well-being was more strongly related to cyberbullying perpetration than for students with a medium need to belong. For students with a low need to belong, cyberbullying was not significantly associated with well-being. That cyberbullying perpetration predicted well-being positively is rather surprising in the light of previous research showing negative psychosocial outcomes also for cyberbullying perpetrators. The moderation analysis provides a hint at underlying processes: In times of distance learning and contact restrictions, cyberbullying may be a way of coming into contact with others and to regulate loneliness maladaptively.

[Teaching during the COVID-19 pandemic: how do medical students evaluate interactive video-based distance bedside teaching in otorhinolaryngology?] / Ausbildung in COVID-19-Pandemie-Zeiten: Wie bewerten Medizinstudierende einen interaktiven, videobasierten Distanzunterricht am Patienten im Fach Hals-Nasen-Ohren-Heilkunde?

BACKGROUND: The first wave of the SARS-CoV­2 pandemic required substantial changes in the teaching of medical students, with strict avoidance of direct contact between students and patients. Therefore, the teaching format "bedside teaching" was implemented and conducted as an interactive video-based distance bedside teaching. OBJECTIVE: The objective of this study was to analyze a students' evaluation of this teaching concept in otorhinolaryngology. MATERIALS AND METHODS: From an ENT examination room, the situation was transmitted live to the students in a lecture hall, who could interact with the patients through a video connection. Macro-, micro-, and endoscopic images were transmitted into the lecture hall in real time. Evaluation was performed by means of an online questionnaire with 13 questions (Likert scale) as well as by free-text feedback. RESULTS: The response rate was 16.8% (42 of 250 students). Overall, 85.7% had a positive impression, and it was generally considered that the concept was well implemented in light of the special situation. However, students would rather not renounce direct patient contact, even if a certain compensation by video transmission was reported. Overall, this teaching concept was considered as educative, and students could imagine using such a teaching concept more often in the future. CONCLUSION: This teaching model cannot replace classical bedside teaching, but represents a good alternative-particularly in otorhinolaryngology-if classical bedside teaching is not possible due to the pandemic situation. Aspects of the interactive video-based distance bedside teaching could be implemented into classical teaching concepts in the future.

[Measures to cope with the COVID-19 pandemic in Germany: nonpharmaceutical and pharmaceutical interventions]. / Maßnahmen zur Bewältigung der COVID-19-Pandemie in Deutschland: nichtpharmakologische und pharmakologische Ansätze.

When the emerging novel SARS-CoV­2 virus first appeared in December 2019, neither specific therapeutic options nor vaccinations were available. The role of nonpharmaceutical interventions (NPIs) became of central importance. At the Robert Koch Institute, a multilayer strategy consisting of population-based and individual preventive measures to control the pandemic was developed, which built upon existing influenza pandemic plans as well as generic plans. This paper explains the recommended NPIs and illustrates the pharmaceutical approaches developed in parallel.Among others, general contact bans, providing material for infection prevention and control, ban of events, closing educational institutions, and restricting travel are counted among population-based measures. Additional individual preventive measures are necessary, e.g., keeping a minimum distance, reducing contacts, and wearing a mouth-nose covering as well as quarantine and isolation. Measures within the health system are based on recommendations of the Commission on Hospital Hygiene and Infection Protection (Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO)) and specified and implemented by professional societies. Since November 2020, an antiviral therapy with remdesivir and treatment with the glucocorticoid dexamethasone have been available as pharmaceutical interventions. Monoclonal antibodies are at this time not approved. Therapeutic anticoagulation is recommended.Recommendations are constantly adapted to the increasing knowledge on the pathogen and its means of transmission. A challenge is to strengthen the trust of the population. Many measures have to be applied on an individual basis in order to work together.

[Psychosocial effects of the pandemic on staff and residents of nursing homes as well as their relatives-A systematic review]. / Psychosoziale Auswirkungen der Pandemie auf Pflegekräfte und Bewohner von Pflegeheimen sowie deren Angehörige ­ Ein systematisches Review.

BACKGROUND: Following the COVID-19 pandemic residents of nursing homes, their visitors and families as well as employees are faced with new challenges. Protective measures have a strong impact on the well-being of all these groups of persons. MATERIAL AND METHODS: A systematic search was carried out for studies investigating the psychosocial consequences of the COVID-19 pandemic for residents, their visitors and families as well as nursing home staff. Results were analyzed by narrative synthesis. RESULTS: A total of 756 studies were screened and 15 studies were included. These studies were conducted between February and June 2020 with participants from 14 countries. Participants reported loneliness, grief and depressive symptoms among residents. Some gave an account of fear as a reaction of residents to social distancing. Residents with cognitive impairment suffered more although there are conflicting reports. The well-being of visitors and friends was compromised and their feeling of loneliness increased. Nursing home personnel reported fear of getting infected and of infecting residents or their own families. Infected workers in the USA expressed anger about a lack of protection. Furthermore, an increase in workload was reported. CONCLUSION: Studies conducted during the first months of the pandemic reported negative consequences for the psychosocial well-being of residents, their visitors and nursing home staff. Individual needs for future support of these groups are distinct and need further evaluation during the on-going pandemic.

Effects of Coronavirus Disease (COVID-19) Related Contact Restrictions in Germany, March to May 2020, on the Mobility and Relation to Infection Patterns.

In an effort to contain the spread of COVID-19, Germany has gradually implemented mobility restrictions culminating in a partial lockdown and contact restrictions on 22 March. The easing of the restrictions began 1 month later, on 20 April. Analysis of the consequences of these measures for mobility and infection incidence is of public health interest. A dynamic cohort of about 2,000 individuals in Germany aged 16-89 years provided individual information on demographic variables, and their continuous geolocation via a smartphone app. Using interrupted time series analysis, we investigated mobility by age, sex, and previous mobility habits from 13 January until 17 May 2020, measured as median daily distance traveled before and after restrictions were introduced. Furthermore, we have investigated the association of mobility with the number of new cases and the reproduction number. Median daily distance traveled decreased substantially in total and homogeneously across all subgroups considered. The decrease was strongest in the last week of March followed by a slight increase. Relative reduction of mobility developed parallel with number of new cases and the daily estimated reproduction number in the weeks after contact restrictions were implemented. The increase in mobility from mid-April onwards, however, did not result in increased case numbers but in further decrease. Other behavioral changes, e.g., wearing masks, individual distancing, or general awareness of the COVID-19 hazards may have contributed to the observed further reduction in case numbers and constant reproduction numbers below one until mid-July.

Spread and dynamics of the COVID-19 epidemic in Italy: Effects of emergency containment measures.

The spread of coronavirus disease 2019 (COVID-19) in Italy prompted drastic measures for transmission containment. We examine the effects of these interventions, based on modeling of the unfolding epidemic. We test modeling options of the spatially explicit type, suggested by the wave of infections spreading from the initial foci to the rest of Italy. We estimate parameters of a metacommunity Susceptible-Exposed-Infected-Recovered (SEIR)-like transmission model that includes a network of 107 provinces connected by mobility at high resolution, and the critical contribution of presymptomatic and asymptomatic transmission. We estimate a generalized reproduction number ([Formula: see text] = 3.60 [3.49 to 3.84]), the spectral radius of a suitable next-generation matrix that measures the potential spread in the absence of containment interventions. The model includes the implementation of progressive restrictions after the first case confirmed in Italy (February 21, 2020) and runs until March 25, 2020. We account for uncertainty in epidemiological reporting, and time dependence of human mobility matrices and awareness-dependent exposure probabilities. We draw scenarios of different containment measures and their impact. Results suggest that the sequence of restrictions posed to mobility and human-to-human interactions have reduced transmission by 45% (42 to 49%). Averted hospitalizations are measured by running scenarios obtained by selectively relaxing the imposed restrictions and total about 200,000 individuals (as of March 25, 2020). Although a number of assumptions need to be reexamined, like age structure in social mixing patterns and in the distribution of mobility, hospitalization, and fatality, we conclude that verifiable evidence exists to support the planning of emergency measures.