Depressive Symptoms of Public Health Medical Residents during the COVID-19 Pandemic, a Nation-Wide Survey: The PHRASI Study.

Depression is a widespread condition, which increased during the COVID-19 pandemic among healthcare workers as well. The large workload of the pandemic response also affected Public Health Residents (PHRs) who played an important role in infection prevention and control activities. This work aims to assess depression in Italian PHRs, based on data collected through the PHRASI (Public Health Residents' Anonymous Survey in Italy) study. In 2022, 379 PHRs completed the self-administered questionnaire containing Patient Health Questionnaire-9 to evaluate clinically relevant depressive symptoms (PHQ-9 ≥ 10). Multivariate logistic regression shows that the intention (aOR = 3.925, 95% CI = (2.067-7.452)) and the uncertainty (aOR = 4.949, 95% CI = (1.872-13.086)) of repeating the test to enter another postgraduate school/general practitioner course and the simultaneous attendance of two traineeships (aOR = 1.832, 95% CI = (1.010-3.324)) are positively related with depressive symptoms. Conversely, the willingness to work in the current traineeship place (aOR = 0.456, 95% CI = (0.283-0.734)) emerged as a protective factor. Similar results were obtained considering mild-to-severe (PHQ-9 ≥ 5) depressive symptoms and/or stratifying by sex. The findings, suggesting the protective role of job satisfaction toward depression, might entail future interventions to improve the learning experience and promote work-life balance.

Feasibility, Reliability, and Safety of Remote Five Times Sit to Stand Test in Patients with Gastrointestinal Cancer.

Background: To determine the feasibility, reliability, and safety of the remote five times sit to stand test (5STS) test in patients with gastrointestinal cancer. Methods: Consecutive adult patients undergoing surgical treatment for lower gastrointestinal cancer at a major referral hospital in Sydney between July and November 2022 were included. Participants completed the 5STS test both face-to-face and remotely, with the order randomised. Outcomes included measures of feasibility, reliability, and safety. Results: Of fifty-five patients identified, seventeen (30.9%) were not interested, one (1.8%) had no internet coverage, and thirty-seven (67.3%) consented and completed both 5STS tests. The mean (SD) time taken to complete the face-to-face and remote 5STS tests was 9.1 (2.4) and 9.5 (2.3) seconds, respectively. Remote collection by telehealth was feasible, with only two participants (5.4%) having connectivity issues at the start of the remote assessment, but not interfering with the tests. The remote 5STS test showed excellent reliability (ICC = 0.957), with limits of agreement within acceptable ranges and no significant systematic errors observed. No adverse events were observed within either test environment. Conclusions: Remote 5STS for the assessment of functional lower extremity strength in gastrointestinal cancer patients is feasible, reliable, and safe, and can be used in clinical and research settings.

Demystifying EFL Teachers' Experiences During the Pandemic: A Study of the Psychosocial Risks Resulting from COVID-19

This study aims to identify the main psychosocial risks that COVID - 19 has caused in Ecuadorian EFL teachers and determine the factors associated with developing these risks. This study employed a quantitative approach and a non-experimental cross-sectional design, with a sample of 980 teachers from different educational levels from Ecuador. The data analysis was done using Stata 16 statistical program and a multivariate binary logistic regression (LR). The results showed that teachers are emotionally drained, isolated, frustrated with teaching, and exhausted because of teaching during the pandemic, being the women the most affected. The main factors that increased the probability of suffering these psychosocial effects were extra activities beyond working hours, status in the teacher's institutions, and gender. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Healthcare waste management protocols challenged by Covid-19: a case study

The resilience of a new national healthcare waste management protocol was compared in hospital and community settings in Ethiopia during the coronavirus disease 2019 (Covid-19) pandemic. The aim was also to evaluate the flexibility and implementation status of the guidelines for healthcare waste management in the context of a pandemic. The study was performed in a cross-sectional design by using a structured questionnaire and checklists and through a systematic review. Primary and secondary data were collected, including those from municipal sites, Yekatit 12 Hospital and other relevant stakeholders. Furthermore, the data were analysed and compared to the global practices and standards. The study revealed there was a comparable difference in the level of care taken in healthcare waste management between healthcare institutions and in the community in Addis Ababa city. The provision of awareness training to waste handlers in both the clinical and municipal setting was significantly deficient, which has to be addressed together with many other variables, starting with the formulation of a resilient waste management protocol. Furthermore, waste management protocols have to be expert-revised periodically. © 2023 ICE Publishing. All rights reserved.

Public Health Residents' Anonymous Survey in Italy (PHRASI): Study Protocol for a Cross-Sectional Study for a Multidimensional Assessment of Mental Health and Its Determinants.

The COVID-19 pandemic has evolved into a severe psychosocial crisis affecting patients, their relatives, friends, and healthcare professionals. In Italy, public health residents (PHRs) remain essential to the national response to the pandemic. To assess their mental sphere, the "Public Mental Health" working group of the medical residents' Assembly of the Italian Society of Hygiene and Preventive Medicine has designed the Public Health Residents' Anonymous Survey in Italy (PHRASI). This is a nation-wide cross-sectional study based on an 88-item self-administered voluntary survey that evaluates how sociodemographic variables are associated with mental issues, including wellness, eating disorders, sleeplessness, alcohol misuse, depression, and anxiety. Data will be gathered by disseminating a Google Forms link across the Assembly network of medical residents. All PHRs enrolled in a four-year program in one of the Italian postgraduate schools of public health will be qualified as participants. PHRASI aims to draw a comprehensive and detailed picture of the mental health state of Italian PHRs. PHRs are a significant group of healthcare professionals that may serve as a future benchmark for developing and enacting regulations intended to support the mental health of healthcare professionals.

Association Between Smoking and SARS-CoV-2 Infection: Cross-sectional Study of the EPICOVID19 Internet-Based Survey.

BACKGROUND: Several studies have reported a low prevalence of current smoking among hospitalized COVID-19 cases; however, no definitive conclusions can be drawn. OBJECTIVE: We investigated the association of tobacco smoke exposure with nasopharyngeal swab (NPS) test results for SARS-CoV-2 infection and disease severity accounting for possible confounders. METHODS: The nationwide, self-administered, cross-sectional web-based Italian National Epidemiological Survey on COVID-19 (EPICOVID19) was administered to an Italian population of 198,822 adult volunteers who filled in an online questionnaire between April 13 and June 2, 2020. For this study, we analyzed 6857 individuals with known NPS test results. The associations of smoking status and the dose-response relationship with a positive NPS test result and infection severity were calculated as odds ratios (ORs) with 95% CIs by means of logistic and multinomial regression models adjusting for sociodemographic, clinical, and behavioral characteristics. RESULTS: Out of the 6857 individuals (mean age 47.9 years, SD 14.1; 4516/6857, 65.9% female), 63.2% (4334/6857) had never smoked, 21.3% (1463/6857) were former smokers, and 15.5% (1060/6857) were current smokers. Compared to nonsmokers, current smokers were younger, were more educated, were less affected by chronic diseases, reported COVID-19-like symptoms less frequently, were less frequently hospitalized, and less frequently tested positive for COVID-19. In multivariate analysis, current smokers had almost half the odds of a positive NPS test result (OR 0.54, 95% CI 0.45-0.65) compared to nonsmokers. We also found a dose-dependent relationship with tobacco smoke: mild smokers (adjusted OR [aOR] 0.76, 95% CI 0.55-1.05), moderate smokers (aOR 0.56, 95% CI 0.42-0.73), and heavy smokers (aOR 0.38, 95% CI 0.27-0.53). This inverse association also persisted when considering the severity of the infection. Current smokers had a statistically significantly lower probability of having asymptomatic (aOR 0.50, 95% CI 0.27-0.92), mild (aOR 0.65, 95% CI 0.53-0.81), and severe infections (aOR 0.27, 95% CI 0.17-0.42) compared to those who never smoked. CONCLUSIONS: Current smoking was negatively associated with SARS-CoV-2 infection with a dose-dependent relationship. Ad hoc experimental studies are needed to elucidate the mechanisms underlying this association. TRIAL REGISTRATION: ClinicalTrials.gov NCT04471701; https://clinicaltrials.gov/ct2/show/NCT04471701.

Motivation and Job Performance at the Regional Health Management of La Libertad During COVID-19

The impact of the COVID-19 pandemic directly affected labor dynamics, especially the motivation of health personnel. In this context, the objective of this study was to determine the behavior of the relationship between motivation and job performance of the staff of the Regional Health Management - La Libertad during COVID-19. We use the descriptive correlational analysis with a quantitative method and cross-sectional design in the methodology. For this study, a sample of 106 workers (100%) was identified in which two types of survey instruments were used. The first is for job motivation, and the second is for job performance and its dimensions, such as cognitive, affective, and psychomotor skills. The Spearman correlation coefficient was used to determine the relationship between job motivation versus job performance and its dimensions. The results affirm a significant relationship (p < 0.05) between the motivation and performance variables with their dimensions. Furthermore, it was found that there is a moderate positive correlation with Rho = 0.633. Most of the workers (Nº = 52, 49.1%) during the COVID-19 pandemic presented a low-level behavior in motivation and the psychomotor capability of the job performance of the Regional Health Management - La Libertad. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Quality and User Satisfaction of the Telemedicine Service in Cardiology During COVID-19

The objective of this study was to determine the relationship between the quality of telemedicine service in cardiology and user satisfaction during COVID-19 at the Victor Lazarte Echegaray Hospital - Trujillo, Peru, in 2021. The research methodology used is the hypothetical method deductive with a non-experimental quantitative approach and descriptive correlational analysis with cross-sectional design. For this study, a total of n = 96 patients (100%) were surveyed and received care in the telemedicine services in cardiology. Two types of survey instruments were used, the first SERVQHOS is to evaluate the quality of the telemedicine service, and the Second SERVQUAL is for user satisfaction and its dimensions such as reliability, responsiveness, security, empathy, and tangibility. We used the Spearman correlation coefficient to determine the association between telemedicine service quality versus user satisfaction and its dimensions. The results show a significant relationship of p < 0.05 between the two variables and a moderate positive correlation of Rho = 0.525. In addition, most of the patients surveyed (41.7%) during the COVID-19 pandemic indicated that the telemedicine service is regular and safety is acceptable. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Job Motivation and Mental Health Status of Care Person at the District Hospital La Esperanza During COVID-19

The objective of this study was to determine the relationship between job motivation and the mental health status of care personal of the District Hospital of Jerusalén - La Esperanza during COVID-19. The methodology used was descriptive correlational analysis with a hypothetical deductive method with a non-experimental quantitative approach and cross-sectional design. A total of 154 health care workers participated. Two types of surveys were considered;the first was for job motivation (JM) and the second for general mental health (PHQ-9) and its dimensions such as General Anxiety Disorder (GAD-7), Insomnia Severity (ISI), and Impact of Events Reviewed (IES-R). The Spearman correlation coefficient was used to determine the association between the two variables and their dimensions. In the results, we observed that most of the workers (56.5%) reflect a medium job motivation and a Mild level of depression (Rho = 0.872, p < 0.000). In addition, we observed that 41.6% of the workers reflect a medium job motivation and a mild general anxiety disorder (Rho = 0557, p < 0.000). © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

SARS-CoV-2 Neutralizing Antibodies in Chile after a Vaccination Campaign with Five Different Schemes.

Using levels of neutralizing antibodies (nAbs), we evaluate the successful Chilean SARS-CoV-2 vaccine campaign, which combines different vaccine technologies and heterologous boosters. From a population-based study performed in November 2021, we randomly selected 120 seropositive individuals, organized into six groups of positive samples (20 subjects each) according to natural infection history and the five most frequent vaccination schemes. We conclude that the booster dose, regardless of vaccine technology or natural infection, and mRNA vaccines significantly improve nAbs response.

Comparing the resilience of healthcare waste management during Covid-19: A case study

The resilience of a new national healthcare waste management protocol was compared in hospital and community settings in Ethiopia during the Covid-19 pandemic. The aim was also to evaluate the flexibility and implementation status of the guidelines for healthcare waste management in the context of a pandemic. The study was performed in a cross-sectional design by using a structured questionnaire, checklists, and through a systematic review. Primary and secondary data were collected, including those from municipal sites, Yekatit 12 Hospital and other relevant stakeholders. Furthermore, the data were analysed and compared to the global practices and standards. The study revealed there was a comparable difference in the level of care taken during healthcare waste management between health care institutions and in the community in Addis Ababa city. Provision of awareness training to waste handlers in both the clinical and municipal setting were great deficiencies, which has to be addressed together with many other variables beginning from the formulation of a resilient waste management protocol. Furthermore, waste management protocols have to be expert-revised periodically. © 2022 ICE Publishing: All rights reserved.

Trajectories of community resilience over a multi-crisis period: A repeated cross-sectional study among small rural communities in Southern Israel

Community resilience is posited as a cornerstone in communities’ ability to cope with crises;however, the majority of studies that measured community resilience do not account for the dynamics over time and in the face of different adversities. Using a repeated cross-sectional design, analyzing a succession of surveys spanning a period of six years, we characterized changes in community resilience over a multi-crisis period among small communities in Southern Israel. Our results suggest that man-made threats, particularly armed conflicts, erode resiliency to a greater degree than do the Covid-19 viral pandemic. We also identify weak links (such as parents of young children) and highlight a potential path towards the building of safety nets around them, for example by encouraging bonds with healthy veteran residents during peacetime.

Prevalence of depression and anxiety among general population in Pakistan during COVID-19 lockdown: An online-survey.

The present study's aim is to find the prevalence of two of the common indicators of mental health - depression and anxiety - and any correlation with socio-demographic indicators in the Pakistani population during the lockdown from 5 May to 25 July 2020. A cross-sectional survey was conducted using an online questionnaire sent to volunteer participants. A total of 1047 participants over 18 were recruited through convenience sampling. The survey targeted depression and anxiety levels, which were measured using a 14 item self-reporting Hospital Anxiety and Depression Scale (HADS). Out of the total sample population (N=354), 39.9% suffered from depression and 57.7% from anxiety. Binary logistical regressions indicated significant predictive associations of gender (OR=1.410), education (OR=9.311), residence (OR=0.370), household income (OR=0.579), previous psychiatric problems (OR=1.671), and previous psychiatric medication (OR=2.641). These were the key factors e associated with a significant increase in depression. Increases in anxiety levels were significantly linked to gender (OR=2.427), residence (OR=0.619), previous psychiatric problems (OR=1.166), and previous psychiatric medication (OR=7.330). These results suggest depression and anxiety were prevalent among the Pakistani population during the lockdown. Along with other measures to contain the spread of COVID-19, citizens' mental health needs the Pakistani government's urgent attention as well as that of mental health experts. Further large-scale, such as healthcare practitioners, should be undertaken to identify other mental health indicators that need to be monitored.

Sex- and gender-related differences linked to SARS-CoV-2 infection among the participants in the web-based EPICOVID19 survey: the hormonal hypothesis.

Objective To investigate sex- and gender-based differences linked to SARS-COV-2 infection and to explore the role of hormonal therapy (HT) in females. Study design Data from the self-administered, cross-sectional, web-based EPICOVID19 survey of 198,822 adults living in Italy who completed an online questionnaire during the first wave of the epidemic in Italy (April-May 2020) were analyzed. Main outcomes measures Multivariate binary logistic and multinomial regression models were respectively used to estimate the odds ratios (ORs) with 95% confidence intervals (CIs) for positive nasopharyngeal swab (NPS) test results and severe SARS-CoV-2 infection. Results The data from 6,873 participants (mean age 47.9 ± 14.1 years, 65.8% females) who had a known result from an NPS test were analyzed. According to the multivariate analysis, females had lower odds of a positive result from the NPS test (aOR 0.75, 95%CI 0.66-0.85) and of having a severe infection (aOR 0.46, 95%CI 0.37-0.57) than did their male counterparts. These differences were greater with decreasing age in both sexes. In addition, females aged ≥60 years receiving HT (N = 2,153, 47.6%) had a 46% lower probability of having a positive NPS test (aOR 0.54, 95%CI 0.36-0.80) than their same-aged peers who had never used HT; there were no differences in the younger age groups with respect to HT status. Conclusion Female sex was associated with an age-dependent lower risk of having a severe SARS-CoV-2 infection than their male counterparts. Age seemed to modify the relationship between HT status and infection: while the two were not related among younger participants, it was negative in the older ones. Future prospective studies are needed to elucidate the potential protective role sex hormones may play. Trial registration ClinicalTrials.gov NCT04471701.

The coronavirus (COVID-19) fatality risk perception of US adult residents in March and April 2020.

The study compares empirical results on the coronavirus SARS-CoV-2 (causing COVID-19) fatality risk perception of US adult residents stratified for age, gender, and race in mid-March 2020 (N1  = 1,182) and mid-April 2020 (N2  = 953). While the fatality risk perception has increased from March 2020 to April 2020, our findings suggest that many US adult residents severely underestimated their absolute and relative fatality risk (i.e., differentiated for subgroups defined by pre-existing medical conditions and age) at both time points compared to current epidemiological figures. These results are worrying because risk perception, as our study indicates, relates to actual or intended health-protective behaviour that can reduce SARS-CoV-2 transmission rates.