The role of doulas in providing breastfeeding support during the COVID-19 pandemic.

BACKGROUND: Doulas have been instrumental in providing breastfeeding support to nursing mothers before and during the COVID-19 pandemic, as they can significantly impact a mother's ability to initiate and maintain breastfeeding. However, the COVID-19 pandemic, subsequent lockdowns, and social isolation created challenges for nursing mothers to access doulas' services, usually provided in person. In this study, we examined the role of doulas in providing breastfeeding support during the COVID-19 pandemic, exploring adaptation to COVID-19 guidelines and the challenges doulas face in providing breastfeeding support during the pandemic. METHODS: A systematic review was conducted following the PRISMA guidelines. Thirteen scientific databases and twenty peer-reviewed journals were searched for journal articles published in English between January 2020 and March 2022 using key search terms (e.g., Doula, Breastfeeding, COVID-19). Studies evaluating the role of doulas in providing breastfeeding support during COVID-19, and the impact of COVID-19 Guidelines on doula services, were included. Two reviewers independently performed the risk of bias assessment and data extraction. Summative content analysis was used to analyze the data. RESULTS: The majority of studies were conducted in developed nations. This systematic review includes eight articles, four qualitative, one survey, two mixed-methods studies, and one prospective research study. Seven of the eight studies were conducted in the United States, and the eighth was conducted in multiple countries. These studies have three main themes: (1) virtual breastfeeding support provided by doulas during the pandemic; (2) remote social support provided by doulas to breastfeeding mothers during the pandemic; and (3) barriers to doula service delivery due to COVID-19 restrictions, primarily the exclusion of doulas as essential workers. The eight studies showed that doulas found innovative ways to serve the needs of birthing and nursing mothers during the difficulties brought on by the pandemic. CONCLUSION: Doulas provided breastfeeding support during the COVID-19 pandemic by utilizing innovative service delivery methods while navigating changes in COVID-19 guidance. However, system-level integration of doulas' work and the acknowledgment of doulas as essential healthcare providers are needed to enhance doula service delivery capacity, especially during a pandemic, to help improve maternal health outcomes.

Guidelines between form and substance. The source system in the maelstrom of the pandemic emergency

The A. analyses the mix between mandatory standards and recommendations, a phenomenon that has seen its acme of complexity during the pandemic emergency, probing the responsiveness of the system of sources of the right to rapid social change. In particular, highlighting the consequences that the dynamics of the source system has on the fundamental structures of the constitutional State, including the protection of rights, intimately linked to the preservation of a sufficiently adequate degree of "legal certainty". © 2023, Societa Editoriale Federalismi s.r.l. All rights reserved.

Impact of Covid-19 on the Effectiveness of Safety Practices on Construction Projects: A Comparative Analysis Framework of Health and Risk Assessment

The health and safety of construction professionals have become one of the most critical concerns around the world. The construction industry is plagued by their ventures, which have been a challenge for years now. Given the sheer number of accidents in the construction industry and the repercussions for laborers, businesses, communities, and nations around the world, Construction Occupational Safety and Health (COSH) has become a very significant human resource problem for businesses and associates. The foremost aim of this research is to learn the implementation of the health and safety assessment before and after the COVID-19 outbreak to understand the risk management process in the construction projects and their respective security and mitigation strategies, as well as to consider a viable solution to the problem and to make a contribution to the knowledge of this topic. This paper composes of a literature review on health and risk safety management processes in construction. The data collection procedures and tools are based on a blended process technique, in which assumptions are taken in comparative analysis to the conceptual groundwork. Empirical data were obtained by the use of an online survey questionnaire and an in-depth semi-structured interview with key practitioners in the construction industry in the Philippines. The results of this research will be statistically analyzed with the data collection instruments of the study. Descriptive statistics utilizing histogram and inferential statistics utilizing Wilcoxon Test are considered. © 2023 DMICS.

A cross-cultural analysis of ridesharing intentions and compliance with COVID-19 health guidelines: The roles of social trust, fear of COVID-19, and trust-in-God

Ridesharing services such as Uber and Lyft have been substantially affected by the ongoing COVID-19 pandemic. Drawing on social capital theory, the current research investigates how social trust relates to three types of trust in compliance with COVID-19 guidelines and consumers' ridesharing intentions. Analyzing data from two economically and culturally distinct countries, the results suggest that social trust positively affects trust in platform companies' compliance with COVID-19 guidelines (TPC), but not (or to a lesser extent) trust in drivers' (TDC) and other riders (TRC) compliance with COVID-19 guidelines in both the United States and Bangladesh. Importantly, TPC, TDC, and TRC are positively related with consumers' ridesharing intentions in the United States but not in Bangladesh. Furthermore, the analysis reveals two counterintuitive moderating effects of fear of COVID-19 and trust in God. The results provide important insights on factors affecting the ridesharing industry in the context of the COVID-19 pandemic, and they emphasize the importance of considering cultural context in understanding consumers' intentions to engage in the sharing economy. © 2022 Elsevier Ltd

Pre-Testing Muhammadiyah COVID-19 Guidelines in Jakarta Province

Muhammadiyah, being one of the religious-based organizations, has its affiliated members comprising 14,9% of the general Indonesian population. The Muhammadiyah Central Board declared an ad-hoc group called the Muhammadiyah COVID-19 Command Centre (MCCC) to combat COVID-19. Among the used media were the third COVID-19 guidelines publications by the MCCC. This study aimed to determine the Muhammadiyah members' understanding of the COVID-19 Revision III Guidelines based on their consistency, clarity, relevance, credibility, and interest. This research was a descriptive qualitative type of study. The eleven informants who participated in this study, determined by purposive sampling, were Muhammadiyah members who lived and worked in the Jakarta. These Informants consisted of various professions, including health workers, teachers, district board members, nurses, drivers, traders, house-wives, and students. Data collection was by online focus group discussions through the zoom cloud meetings platform. Informants discussed the five aspects of the guideline which included consistency, clarity, relevancy, credibility and interest. The contents of the guideline were found to be consistent with other similar guidelines published by the Ministry of Health (MOH). In addition, being affiliated members of the Muhammadi-yah group, informants felt more comfortable trusting the Muhammadiyah-published COVID-19 guidelines. From the clarity and relevance aspect, the informants had positive perspectives on the guidelines. The design of the published guidelines attracted their interest in reading, implementing, and sharing the guidelines with others. However, the guideline did not contain the names of its drafting team nor the introduction by the Central Board leadership. It would have been a very important strategy in strengthening the credibility of the media published by the MCCC. The MCCC needed more enticing plans and methods in the dissemination of its online or printed media to the population. For online media, the published number of pages should be fixed to a less readable number. © 2022, Universitas Negeri Semarang. All rights reserved.

A cross-cultural analysis of ridesharing intentions and compliance with COVID-19 health guidelines: The roles of social trust, fear of COVID-19, and trust-in-God

Ridesharing services such as Uber and Lyft have been substantially affected by the ongoing COVID-19 pandemic. Drawing on social capital theory, the current research investigates how social trust relates to three types of trust in compliance with COVID-19 guidelines and consumers' ridesharing intentions. Analyzing data from two economically and culturally distinct countries, the results suggest that social trust positively affects trust in platform companies' compliance with COVID-19 guidelines (TPC), but not (or to a lesser extent) trust in drivers' (TDC) and other riders (TRC) compliance with COVID-19 guidelines in both the United States and Bangladesh. Importantly, TPC, TDC, and TRC are positively related with consumers' ridesharing intentions in the United States but not in Bangladesh. Furthermore, the analysis reveals two counterintuitive moderating effects of fear of COVID-19 and trust in God. The results provide important insights on factors affecting the ridesharing industry in the context of the COVID-19 pandemic, and they emphasize the importance of considering cultural context in understanding consumers’ intentions to engage in the sharing economy.

The Association between the Sense of Coherence and the Self-Reported Adherence to Guidelines during the First Months of the COVID-19 Pandemic in Israel.

(1) Background: Social distancing became a central strategy employed to limit the spread of the SARS-CoV-2 virus. We explore self-reported adherence (SRA) and factors associated with SRA among Israeli adults at the end of the first national lockdown in Israel. (2) Methods: We conducted a cross-sectional consumer panel survey of 820 Israeli adults aged 18 to 70 in May and June 2020. We collected data on the SRA to the social distancing measures, sociodemographic variables, perceptions of pandemic-related danger and of protection provided by the social distancing measures, as well as Sense of Coherence (SoC). (3) Results: 60% of respondents reported complying with 7 measures. Higher SoC was associated with higher SRA (p = 0.04), and was related to income, marital status, age, profession, and education. The SRA was higher among Jews than Arabs (Jews: Mean = 10.5, SD = 4.5; Arabs: Mean = 9.1, SD = 4.1, p < 0.001) and among males (Males: Mean = 10.8, SD = 4.7; Females: Mean = 9, SD = 4.1; p = 0.003). SoC, perception of protection and perception of danger were associated with higher SRA (p = 0.42, p < 0.001 and p = 0.005 respectively). Single people reported higher levels of SRA than people in relationships (Partnered: Mean = 9.7, SD = 4.2, Non-partnered: Mean = 10.9, SD = 4.7, p = 0.033). (4) Conclusions: At the time of exit from the first lockdown, compliance with social distancing measures was high, with Jewish, single and male Israelis more likely to adhere to the guidelines. We identified the populations at risk for non-adherence and associated factors, reporting for the first time the correlation between SoC and SRA. Further research is needed to assess the role of these factors in Jewish and Arab populations.

Social Motivation to Comply with COVID-19 Guidelines in Daily Life in South Korea and the United States.

Collectivism assessed at the national level has been suggested as a psychological factor that affects compliance with COVID-19 guidelines in daily life. The level of assessment and conceptual construct of collectivism, however, vary across studies, which calls for the need to clarify the power of collectivism in explaining individuals' compliance behaviour. With this aim, we investigated individual-level collectivism, the unique variance and other relevant factors, such as altruism (e.g., for the family, community, and humanity) and impression management (e.g., what others would think of me) in explaining compliance with COVID-19 guidelines in US and South Korean participants. The results of hierarchical regression analysis showed that collectivism was a significant factor that explained compliance only in the US participants, whereas impression management was significant and explained the additional variance over collectivism in compliance in both the US and South Korean participants. The findings suggest the importance of elucidating the overlap between collectivism and impression management in studies exploring COVID-19 guideline adherence in daily life.

Acute kidney injury: a COVID-19 update

Claire Main, Interim Manager of Critical Care and Major Trauma at Cardiff and Vale University Health Board and ANN UK executive board member, gives an update on acute kidney injury and the impact of the COVID-19 pandemic

Vascular surgery triage during the coronavirus disease 2019 pandemic.

OBJECTIVE: The coronavirus disease 2019 (COVID-19) pandemic has resulted in a marked increase in hospital usage, medical resource scarcity, and rationing of surgical procedures. This has created the need for strategies to triage surgical patients. We have described our experience using the American College of Surgeons (ACS) COVID-19 guidelines for triage of vascular surgery patients in an academic surgery practice. METHODS: We used the ACS guidelines as a framework to direct the triage of vascular surgery patients during the COVID-19 pandemic. We retrospectively analyzed the results of this triage during the first month of surgical restriction at our hospital. Patients undergoing surgery were identified by reviewing the operating room schedule. We reviewed the electronic medical records (EMRs) and assigned an ACS category, condition, and tier class to each completed surgery. Surgeries that were postponed during the same period were identified from a prospectively maintained list. We reviewed the EMRs for all postponed surgeries and assigned an ACS category, condition, and tier class to each surgery. We reviewed the EMRs for all postponed procedures to identify any adverse events related to the treatment delay. RESULTS: We performed 69 surgeries in 52 patients during the study period. All surgeries were performed to treat emergent, urgent, or time-sensitive elective diagnoses. Of the 69 surgeries, 47 (68%) were from tier 3 and 22 (32%) from tier 2b. We did not perform any surgeries from tier 1 or 2a. We postponed surgery for 66 patients during the same period, of which 36 (55%) were from tier 1, 22 (33%) from tier 2a, 5 (8%) from tier 2b, and 3 (5%) could not be assigned a tier class. No tier 3 surgeries were postponed. Of the 66 patients, 3 (4.5%) experienced an adverse event that could be attributed to the treatment delay. CONCLUSIONS: The ACS triage guidelines provided an effective method to decrease vascular surgical volumes during the COVID-19 pandemic without an increase in patient morbidity. We believe the clinical utility of the guidelines would be strengthened by incorporating the SURGCON/VASCCON (surgical activity condition/vascular activity condition) threat level alert system.

The theoretical impact on corrective upper limb elective services following analysis of distal radius fractures managed nonoperatively during COVID-19 pandemic.

AIMS: To assess the proportion of patients with distal radius fractures (DRFs) who were managed nonoperatively during the COVID-19 pandemic in accordance with the British Orthopaedic Association BOAST COVID-19 guidelines, who would have otherwise been considered for an operative intervention. METHODS: We retrospectively reviewed the radiographs and clinical notes of all patients with DRFs managed nonoperatively, following the publication of the BOAST COVID-19 guidelines on the management of urgent trauma between 26 March and 18 May 2020. Radiological parameters including radial height, radial inclination, intra-articular step-off, and volar tilt from post-reduction or post-application of cast radiographs were measured. The assumption was that if one radiological parameter exceeds the acceptable criteria, the patient would have been considered for an operative intervention in pre-COVID times. RESULTS: Overall, 92 patients formed the cohort of this study with a mean age of 66 years (21 to 96); 84% (n = 77) were female and 16% (n = 15) were male. In total, 54% (n = 50) of patients met at least one radiological indication for operative intervention with a mean age of 68 years (21 to 96). Of these, 42% (n = 21) were aged < 65 years and 58% (29) were aged ≥ 65 years. CONCLUSION: More than half of all DRFs managed nonoperatively during the COVID-19 pandemic had at least one radiological indication to be considered for operative management pre-COVID. We anticipate a proportion of these cases will require corrective surgery in the future, which increases the load on corrective upper limb elective services. This should be accounted for when planning an exit strategy and the restart of elective surgery services.Cite this article: Bone Joint Open 2020;1-10:612-616.

Dynamic Panel Estimate-Based Health Surveillance of SARS-CoV-2 Infection Rates to Inform Public Health Policy: Model Development and Validation.

BACKGROUND: SARS-CoV-2, the novel coronavirus that causes COVID-19, is a global pandemic with higher mortality and morbidity than any other virus in the last 100 years. Without public health surveillance, policy makers cannot know where and how the disease is accelerating, decelerating, and shifting. Unfortunately, existing models of COVID-19 contagion rely on parameters such as the basic reproduction number and use static statistical methods that do not capture all the relevant dynamics needed for surveillance. Existing surveillance methods use data that are subject to significant measurement error and other contaminants. OBJECTIVE: The aim of this study is to provide a proof of concept of the creation of surveillance metrics that correct for measurement error and data contamination to determine when it is safe to ease pandemic restrictions. We applied state-of-the-art statistical modeling to existing internet data to derive the best available estimates of the state-level dynamics of COVID-19 infection in the United States. METHODS: Dynamic panel data (DPD) models were estimated with the Arellano-Bond estimator using the generalized method of moments. This statistical technique enables control of various deficiencies in a data set. The validity of the model and statistical technique was tested. RESULTS: A Wald chi-square test of the explanatory power of the statistical approach indicated that it is valid (χ210=1489.84, P<.001), and a Sargan chi-square test indicated that the model identification is valid (χ2946=935.52, P=.59). The 7-day persistence rate for the week of June 27 to July 3 was 0.5188 (P<.001), meaning that every 10,000 new cases in the prior week were associated with 5188 cases 7 days later. For the week of July 4 to 10, the 7-day persistence rate increased by 0.2691 (P=.003), indicating that every 10,000 new cases in the prior week were associated with 7879 new cases 7 days later. Applied to the reported number of cases, these results indicate an increase of almost 100 additional new cases per day per state for the week of July 4-10. This signifies an increase in the reproduction parameter in the contagion models and corroborates the hypothesis that economic reopening without applying best public health practices is associated with a resurgence of the pandemic. CONCLUSIONS: DPD models successfully correct for measurement error and data contamination and are useful to derive surveillance metrics. The opening of America involves two certainties: the country will be COVID-19-free only when there is an effective vaccine, and the "social" end of the pandemic will occur before the "medical" end. Therefore, improved surveillance metrics are needed to inform leaders of how to open sections of the United States more safely. DPD models can inform this reopening in combination with the extraction of COVID-19 data from existing websites.

Ocular oncology practice guidelines during COVID-19 pandemic-An expert consensus.

The outbreak of rapidly spreading COVID-19 pandemic in December 2019 has witnessed a major transformation in the health care system worldwide. This has led to the re-organization of the specialty services for the effective utilization of available resources and ensuring the safety of patients and healthcare workers. Suspension of oncology services will have major implications on cancer care due to delayed diagnosis and treatment leading to irreversible adverse consequences. Therefore various oncology organizations have called for a continuation of cancer care during this crisis with diligence. The COVID-19 pandemic has forced the clinicians to transform the components of care from screening to outpatient care and primary management. The purpose of this article is to establish guidelines and recommendations for ocular oncology in the management of ocular tumors set by a multidisciplinary team of experts including ocular, medical and radiation oncologists, and pathologists. As the pandemic is evolving fast, it will require constant updates and reformation of health strategies and guidelines for safe and quality health care.

Realigning Pakistan's Bioethics Center during Covid-19.

The arrival of the Covid-19 pandemic in Pakistan necessitated that the Centre of Biomedical Ethics and Culture in Karachi realign its activities to changing realities in the country. As Pakistan's only bioethics center, and with no guidelines available for allocation of scarce medical resources, CBEC developed "Guidelines for Ethical Healthcare Decision-Making in Pakistan" with input from medical and civil society stakeholders. The CBEC blog connected to the center's bioethics programs for students from Pakistan and Kenya shifted to Covid-related issues specific to the context of existing social and political realities within these countries. As part of its outreach activities, CBEC initiated a popular Facebook series, #HumansofCovid, as an experience-sharing platform for health care professionals and members of the public. Narratives received vary from those by frustrated physicians under quarantine to those concerning street vendors left jobless and a transsexual person in whose opinion "social distancing" is not a new phenomenon for their communities.