The danger of inappropriate use of personal protective equipment

The coronavirus pandemic is a global health emergency which has had widespread unforeseen mental health consequences. Those with borderline personality disorder are predisposed to poor coping strategies to manage such stress and require intense psychological input which was not widely available during the peak of the pandemic. It is likely that the coronavirus outbreak has had a significant impact on the mental stability of such patients aggravating deliberate self-harm behaviours. A 20-year old psychiatric in-patient with borderline personality disorder, held under Section III of the mental health act, presented to the adult plastic surgery team in Bristol with localised infection of her right forearm. Foreign bodies were easily palpable and imaging revealed linear metal objects. The patient reported that she had removed metal strips from her collection of face masks and inserted them into her forearm as an act of deliberate self-harm. The patient was taken to operating theatre for removal of these foreign bodies under general anaesthetic. After twenty-four hours of antibiotics she was discharged safely back to the psychiatric ward. Despite the epilogue of the COVID-19 pandemic facemasks are still mandatory within the hospital setting. Clinicians need to be aware of these unusual circumstances where a form of protective equipment was deconstructed to cause actual bodily harm. The purpose of this report is to promote awareness of this type of injury especially in those suffering from mental illness. The authors would suggest an alternative mask without any form of metal.

COVID-19 and dermatology

The aim of this manuscript is to investigate skin diseases associated with COVID-19 under three main headings: skin problems related to personal protective equipment and personal hygiene measures, skin findings observed in SARS-CoV-2 virus infections, and skin findings due to COVID-19 treatment agents. In PubMed and Google Scholar databases, publications on skin lesions related to personal protective equipment and personal hygiene measures, skin findings observed in SARS-CoV-2 virus infections and skin findings due to COVID-19 treatment agents subjects were searched in detail. Pressure injury, contact dermatitis, pruritus, pressure urticaria, exacerbation of preexisting skin diseases, and new skin lesion occurrence/new skin disease occurrence may be due to personal protective equipment. The incidence of skin lesions due to COVID-19 was reported to be between 0.2% and 29%. Many skin lesions including maculopapular, urticarial, vesicular, chilblain-like, thrombotic/ischemic, etc., are observed in COVID-19 patients. Some authors have stated that there is an absence of SARS-CoV-2 virus infection-specific skin rashes. Many skin lesions may appear as a result of COVID-19. Even in the absence of a COVID-19 diagnosis, skin findings should be evaluated carefully in the pandemic period.

The effect of coronavirus disease-19 lockdown on the incidence and profile of penetrating ocular injuries

Background: Perforating ocular injuries in particular carry a high risk of visual morbidity in all age groups. Risk factors associated with ocular trauma include gender, age, occupation, and lower socioeconomic status. Eye injuries are causing a major concern to the general ophthalmologists both in the developed and developing countries. Background: The objective of this article is to study the profile of penetrating ocular injuries before and during the period of lockdown. Materials and Methods: A study was done to make a comparative analysis of the penetrating ocular injuries occurring during the period of lockdown of 3 months (April 1, 2020-June 30, 2020) and 3 months (January 1, 2020-March 31, 2020) before lockdown. Results: The study included 33 patients hospitalized before lockdown and 45 hospitalizations during the lockdown in all age groups. Injuries were more common in males. The injuries reported in the age group of 0-15 years before lockdown were 36.36% while during lockdown 60% injuries were observed. Modes of injuries reported before lockdown were indoor injuries (36.36%) and road traffic accidents (36.36%) while during lockdown, the major mode of injuries were indoor injuries (76.6%) whereas the road traffic accidents (10.0%) declined. Conclusion: During the lockdown, indoor injuries were more common in comparison to the outdoor injuries such as road traffic accidents, the latter being more prevalent before lockdown. During lockdown, increase in the indoor leisure activities of children led to a rise in the cases of eye injuries and an increase of almost double the number was observed. In addition to this, immobilization led to a decrease in the injuries due to road traffic accidents. The coronavirus disease-19 lockdown did have an impact on the profile of penetrating ocular injuries.

81st Annual Academic Sessions of the Galle Medical Association, Galle, Sri Lanka, 13-14 October 2022

This journal issue includes s of papers presented at the conference. Topics discussed are: sleeping characteristics among primary school children in Gampaha District, Sri Lanka;cosmetic effects of post thyroidectomy scar and evaluation of patient satisfaction;post-vaccination symptoms of COVID-19 vaccines among adults in Galle;multiple chest trauma in a victim of road traffic collision;anatomical variations of renal vein in a group of Sri Lankan cadavers;hospital acquired infections among patients in Intensive Care Units in Teaching Hospital, Karapitiya;serum Vitamin D level among 1 to 5-year-old children in Galle Municipality and Bope Poddala MOH area.

11th World Congress on Pediatric Intensive and Critical Care

These proceedings contain articles and presentations that discuss the research and clinical care of critically injured adults and children. These practical information is timely and much needed by pediatric intensivist caring for adults suffering from COVID-19. However, effective and safe care can only be delivered if a structured framework in place as an enabler. Thus, thoughtful preparation beyond the information provided in these articles are necessary to prepare pediatric units to care for adult patients.

Use of dexamethasone in COVID-19 patients: systematic review and meta-analysis

COVID-19 is associated with disseminated lung damage in patients, Dexamethasone can reduce lung injury caused by inflammation and there reduce the progression to respiratory failure and prevent death. This systematic review aimed to determine the benefits and safety of Dexamethasone in COVID-19 treatment. The study was performed by a comprehensive literature search which were published in several databases i.e., PubMed, Science Direct, VHL Regional Portal, and ClinicalTrials.gov within the search time of 28 November 2020. Inclusion criteria were articles on the study on COVID-19 patients who received Dexamethasone, observational and experimental studies on the outcomes use evaluation of Dexamethasone. Exclusion criteria are the articles that do not provide control in controlled studies and do not show clear research results on the use of Dexamethasone. An initial search from four databases by entering keywords resulted in 1,046 articles. After screening articles duplication we obtained 835 studies. Finally, 6 articles were obtained after we screened for the article that it can be obtained its full text and 5 articles joined in articles included in the meta-analysis. The analysis showed that Dexamethasone in Covid-19 patients could reduce the incidence of death within 28 days with RR of 0.78 (95% CI 0.57-0.97 P=0.13) compared with Methylprednisolone, Dexamethasone was compared without corticosteroids with RR 0.89 (95% CI 0.82-0.97 P=0.01). Dexamethasone also reduced mechanical ventilator use during treatment with RR 0.95 (95% CI = 0.86-1.05 P = 0.28) compared without corticosteroids. The conclusion from these results: the use of Dexamethasone can reduce the number of deaths in COVID-19 patients, especially severe and critically ill category patients.

Ambulatory visits, active component, U.S. Armed Forces, 2021

The aggregate numbers and rates of ambulatory care visits by active component service members in 2021 were the highest of the previous ten years. Most disease and injury categories experienced slight increases in both rates and numbers. From 19% of ambulatory care visits in 2020 to less than 15% in 2021, telehealth contacts were used less frequently. The statistics for 2021 demonstrate a return to pre-pandemic levels, notwithstanding the possibility that the response to the COVID-19 pandemic in 2020 was related with declines in the incidence of disease and injury diagnoses in the community of service members seeking ambulatory care. Additionally, the proportions of telehealth-delivered medical encounters have similarly decreased to the lower levels seen before the pandemic. Lessons learned may direct future actions to lower the frequency of disease and harm in the post-pandemic era. This study details the ambulatory health care visits made by active component members of the U.S. Army, Navy, Air Force, and Marine Corps in 2020 in terms of frequency, rates, trends, and other factors. U.S. service members' ambulatory visits to fixed military and nonmilitary medical treatment facilities (reimbursed through the Military Health System [MHS]) are recorded in standardized, computerized records. The Defense Medical Surveillance System (DMSS), the data source for this report, routinely archives these records for health surveillance purposes. This research excludes ambulatory visits that are not frequently and fully recorded using standardized electronic records (for example, during deployments, field training exercises, or at sea). As in previous MSMR reports, the primary (first-listed) diagnostic position of the visit records was used to categorize all records of ambulatory visits of active component service members according to the first four characters of the ICD-10 codes. In this research, a specific query of the DMSS records was carried out to identify ambulatory visits that were completed via "telehealth" encounters rather than in-person meetings (e.g., via telephone or video conferencing). Most data summaries included both types of encounters and did not make a distinction between them, however due to the rise in telehealth encounter usage during the coronavirus 2019 (COVID-19) pandemic, changes in the proportions of telehealth encounters were examined.

Maxillofacial emergency's care during the COVID-19 pandemic, Granma 2021

Introduction: during the COVID-19 pandemic, new safety measures were implemented in all sectors. However, the Maxillofacial Surgery specialty kept on, where emergency patients were not left unattended. Background: to characterize the maxillofacial emergencies attended at the Hospital Clinico Quirurgico Docente "Celia Sanchez Manduley" in Manzanillo, during the COVID-19 related epidemiological situation. Methods: an observational, descriptive, and cross-sectional study was applied on 358 patients in the period between September 2020 and April 2021. The variables studied were as follow: age groups, sex, month when patients were attended, maxillofacial emergency's motive, therapeutic behavior and patients with COVID-19 related symptoms. Results: the most affected age group was 60 (22.6%), with predominance in male sex (54.2%). Most patients were attended in November and December (20.3%), the predominated maxillofacial emergencies were those associated to maxillofacial trauma (31.8%), followed by facial cellulitis (23.7%). In terms of treatment, the highest percentage of conservative treatment was associated with the medicamentation (88.3%), while wound suturing practice predominated in surgical treatment (18.2%). The symptom with the highest incidence was fever (3.4%). The 61.5% of the maxillofacial surgeons were infected with COVID-19. Conclusions: maxillofacial emergencies are more frequent in males;maxillofacial trauma and facial cellulitis predominate. The maxillofacial surgery service is vulnerable to the coronavirus infection.

COVID-19, Hyper Vulnerabilities, Silenced Traumas, and Colonial Scars: Social Work Scholars Engaging in Critical Dialogue with Racialized Communities

The arrival of the COVID-19 pandemic has resulted not only in the closing of national borders but also in the revival of symbolic borders informed by colonial, orientalist, and white supremacist legacies that have entrenched socioeconomic and racial inequalities, resulting in devastating impacts on migrant and refugee communities in the Global South and on racialized communities in the Global North. At the same time, racialized and migrant communities, and their allies, continue to struggle and reformulate strategies of survival and resistance. As social work educators and scholars situated in Quebec, Canada, the authors of this chapter aim to engage in critical dialogue and reflection about the ways in which COVID-19 has reorganized how they engage in social work research and education alongside oppressed communities and within their university and school of social work. The authors witnessed of the impacts of COVID-19 were shaped by forms of hypervulnerability that revived feelings of belonging and rejection to dominant and oppressed communities as well as silenced and intergenerational traumas. These dynamics were informed by historical colonial heritages that are often erased but then resurfaced in the form of colonial scars. As COVID-19 broke upon these colonial scars, the authors engage in critical dialogue about the ways in which their varied social locations and experiences shaped how they navigated complex "insider/outsider” dynamics. Through deep listening and giving account to oneself, a decolonial feminist approach in responding to COVID-19 crises is proposed. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Taxonomy of stressors and traumas: An update of the development-based trauma framework (DBTF): A life-course perspective on stress and trauma

COVID-19 challenged the current paradigms of traumatic stress. Although there are diagnostic taxonomies of mental disorders such as Diagnostic and Statistical Manual of Mental Disorders and International Statistical Classification of Diseases and Related Health Problems, the taxonomy of stressors and traumas that contribute significantly to such disorders is lacking. The current article tried to fill parts of this gap by proposing an update and refinement of the development-based taxonomy of stressors and traumas from a life-course perspective. We discussed the different trends in defining trauma and their limitations considering the recent empirical data that provided evidence for the limited predictive validity of the current posttraumatic stress disorder model and when confronting serious real-life events such as the COVID-19 pandemic. The updated taxonomy presented in this paper included preidentity (complicated birth, attachment disruptions, early childhood adversities), identity traumas (physical, personal, and social), interdependence (primary, secondary, and tertiary), and aging stressors and traumas, with the severity of stressors, is categorized on a scale from I to III. We identified 4 primary sources and pathways of these development-based stressors: intrapersonal, interpersonal, systemic, and environmental. The systemic sources are further divided into systemic "A," including traumas perpetrated by groups, institutions, or governments, and systemic "B," traumas such as recessions and global warming. The environmental sources and pathways are further divided into environmental "A" (physical), traumas such as earthquakes and hurricanes, and environmental "B" (biological/pathogenic), traumas such as pandemics. The macrodynamics of accumulation and proliferation and the interaction among preidentity, identity, and postidentity stressors and traumas determine their total mental health impact from a life-course perspective. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Differentiating infectious from non-infectious respiratory disease in the cat and dog

This paper describes the clinical signs and use of differential laboratory diagnostic techniques (computed tomography, cytology, histopathology, antigen/antibody detection and polymerase chain reaction) for infectious (viral, bacterial, fungal and parasitic) and non-infectious (inflammatory/immune mediated, neoplastic, cardiac, malformation, foreign body, smoke inhalation, aspiration of caustic material, non-cardiogenic, pulmonary oedema, traumativ, pneumothorax, pulmonary contusions and idiopathic) causes of respiratory diseases in cats and dogs in Ontario, Canada.

XXI ExpoPPGIm Annual Meeting of the Graduate Program in Immunology, Online, 1-3 September 2021

These proceedings contains 30 articles that covered various topics related to immunology and related fields. The conference papers presented focused on investigating the role of genetics, microbiome, and immunological pathways in disease pathogenesis and treatment. Studies presented at the conference explored the genetic factors associated with obesity in Brazilian children, the role of flavonoids in reprogramming microglia towards a neuroprotective inflammatory profile, the gut microbiome in asthmatic individuals, and the involvement of the MTOR gene and its variants in the severity of COVID-19. Other studies evaluated the immunodiagnostic potential of a protein exclusive to Corynebacterium pseudotuberculosis, genetic markers associated with alcohol dependence and asthma, and the effects of nicotine on glial cells in Parkinson's disease. The conference also presented research on the molecular mechanisms associated with the anti-glioma and immunomodulatory effects of flavonoids, the influence of Trypanosoma cruzi co-infection on the immune response and clinical outcome of patients with cutaneous leishmaniasis, and the association of metalloproteinase gene variants with periodontitis. Furthermore, the papers presented discussed the production of Zika virus singular peptide for the development of serological immunassays, and the role of genetic polymorphisms in the IL1B and IL6 genes in periodontitis. Lastly, the conference included research on the immunological response of broiler chickens fed with diet supplemented with zinc, and the modulatory effects of Agatis flavone on the glial response in an ex vivo model of brain trauma.

Education as a protective factor for mental health risks among youth living in highly dangerous regions in Afghanistan.

BACKGROUND: Children in Afghanistan live in dangerous areas, and have been exposed to traumatic events and chaotic education. Progress has been made on access to education for girls who were the most affected by traditional attitudes against engagement in education. OBJECTIVES: The objectives were to evaluate the mental health of Afghan children living in regions of conflict and the association of mental health with school attendance for girls and boys. METHOD: The study included 2707 school aged children in eight regions of Afghanistan (16 provinces) residing in households recruited through a multi-stage stratified cluster sampling strategy in 2017. The level of terrorist threat was evaluated by the intensity of terrorist attacks recorded that year in each province. Child mental health was assessed with the parental report Strengths and Difficulties Questionnaire (SDQ) along with information on school attendance, sociodemographic characteristics and geographic location. RESULTS: A total of 52.75% of children had scores above threshold for the SDQ total difficulties score, 39.19% for emotional difficulties, 51.98% for conduct challenges, and 15.37% for hyperactivity/inattention. Peer relationship problems were high (82.86%) and 12.38% reported that these problems impacted daily life. The level of terrorist threat was associated with SDQ total difficulties (Adjusted Odds Ratio [AOR] = 4.08, P < 0.0001), with youth in regions with high levels of terrorist threat more likely to have problems than youth in regions with low or medium levels of danger, independent of region and ethnicity. School attendance was negatively associated with emotional symptoms (AOR = 0.65, P < 0.0001) and mental health difficulties with impairment (AOR = 0.67, P = 0.007), but positively associated with peer relationships difficulties (AOR = 1.96, P > 0.0001). Conduct (AOR = 1.66, P < .0001) and SDQ total difficulties (AOR = 1.22, P = 0.019) were higher among boys. Overall, gender did not modify the relationship between school attendance and child mental health. CONCLUSION: Attending school is essential for children's mental health, across gender, and should be supported as a priority in Afghanistan despite the return of the Taliban.

The Effects of Type III Traumatic Stressors of the Protracted Conflict and Prolonged COVID-19 on Syrians Internally Displaced: A Validation Study of Type III Continuous Traumatic Stressors and Their Impact

This study aimed to validate the Type III continuous traumatic stress model assumptions and use it to assess the effect of intersected traumas of civil war and COVID-19 stressors on internally displaced Syrian people. We recruited 891 Syrians from camps (46.5% females, aged 18 90 years [M = 30.81, SD = 12.04]). We measured COVID-19 stressors, posttraumatic stress disorder (PTSD), complex PTSD (CPTSD), depression, anxiety, and executive functions to assess the variables related to peri-post Type III mental health syndrome. We measured Type I, II, and III traumas and Type III trauma subtypes. To explore the significance of differences between correlation sizes and the comparative severity of each trauma type, we calculated Fisher z scores. We performed path analysis with trauma Types III and II as correlated independent variables and COVID-19 stressors impact on peri-post Type III trauma mental health syndrome to check their proliferation and impact. Of the sample, COVID-19 had infected 45.9%, 33.1% fit the diagnostic criteria for CPTSD, and 13.9% fit the diagnostic criteria for PTSD. All trauma types were associated with mental health, cognitive deficits, and COVID-19 severity, with a significantly higher association with trauma Type III. Type III-a subtype (intersected discrimination) had the highest associations with each variable. Type III was bidirectionally correlated with Type II and proliferated to Type I traumas (single past events) and COVID-19 stressors, with Type III having a larger effect size on peri-post Type III trauma mental health syndrome. The clinical and conceptual implications of the findings are discussed. © 2022 Hogrefe Publishing.

Traumatic Brain Injury during the SARS-CoV-2 Pandemics in Slovenia: A Single Center Study.

(1) Background: The SARS-CoV-2 pandemic had a significant impact on the management of traumatic brain injury (TBI). We aimed to compare the clinical characteristics and outcomes of TBI patients before and during the SARS-CoV-2 pandemic.; (2) Methods: We analyzed depicted data from existing medical records on sex, age, mechanism of injury, clinical performance at admission and discharge, neuroimaging, laboratory values at admission, mortality, duration of hospitalization, and referrals after discharge from the traumatology department for all adult patients during the SARS-CoV-2 pandemic and a year before. Variables were compared using the Chi-square or t-test between both groups.; (3) Results: Most patients had mild (n = 477), followed by moderate (11) and severe (11) TBI. Mild TBI was less frequent during the SARS-CoV-2 period (n = 174 vs. n = 303). The incidence of high falls increased during the SARS-CoV-2 period (14.5% vs. 24.7%; p < 0.05) in the group with mild TBI. Patients had similar mean Glasgow Coma Scales (GCS), Glasgow Outcome Scales-Extended (GOSE), and glucose levels at admission before and during the pandemic. Serum ethanol levels were significantly lower during the SARS-CoV-2 period (1.3 ± 0.7 mmol/L vs. 0.7 ± 1.2 mmol/L; p < 0.001). At discharge, the mean GCS was significantly lower (14.7 ± 1.8 vs. 14.1 ± 0.5; p < 0.05) for patients treated during the SARS-CoV-2 period than before the SARS-CoV-2 period. There were no differences in GOSE; (4) Conclusions: our results demonstrated a significant impact of SARS-CoV-2 pandemic on the frequency, mechanism, and consequences of TBI, and may help improve care for our patients.

Self-Reported Alcohol Abuse and the Desire to Receive Mental Health Counselling Predict Suicidal Thoughts/Thoughts of Self-Harm among Female Residents of Fort McMurray.

Suicidal ideation and thoughts of self-harm continue to be challenging public health problems. It is presently unknown what the prevalence and correlates of suicidal thoughts and self-harm are in female residents of Fort McMurray, a city that has endured wildfires, flooding, and the COVID-19 pandemic in the last five years. This study aimed to determine the prevalence and correlates of suicidal ideation and thoughts of self-harm among female residents of Fort McMurray. A cross-sectional study using an online survey questionnaire was used to collect sociodemographic and clinical information from the residents of Fort McMurray between 24 April and 2 June 2021. Suicidal ideation and thoughts of self-harm among females were assessed using the ninth question of the Patient Health Questionnaire-9, a validated screening tool used to assess depression symptoms. Likely generalized anxiety disorder (GAD), major depressive disorder (MDD), post-traumatic stress disorder (PTSD) and low resilience were measured using standardized rating scales. Data were analyzed with SPSS version 25 using chi-squared tests and multivariate logistic regression analysis. Among Fort McMurray residents, 249 accessed the online survey, while 186 ultimately completed it, yielding a survey completion rate of 74.7%. Of these, 159 (85%) were females. After controlling for other variables in the regression model, respondents who expressed a desire to receive mental health counselling were more than seven times more likely to report suicidal ideation and thoughts of self-harm compared to the respondents who did not desire to receive mental health counselling (OR: 7.29; 95% CI: 1.19-44.58). Similarly, respondents who reported having abused alcohol in the past year were nearly four times more likely to report suicidal ideation or thoughts of self-harm compared to the respondents who said they had not abused alcohol in the past year (OR: 3.91; 95% CI: 1.05-14.57). A high prevalence of suicidal thoughts and thoughts of self-harm were reported among female residents of Fort McMurray. Timely access to adequate mental health support should be offered to female residents of communities impacted by multiple natural disasters, particularly residents who self-report alcohol abuse or desire to receive mental health counselling.

A review of pleiotropic potential of erythropoietin as an adjunctive therapy for COVID-19

Coronavirus disease 2019 (COVID-19) is a severe acute respiratory disease with a high prevalence. According to the research and statistical data, in January 2021, there have been 92,262,621 confirmed cases of COVID-19 and more than two million deaths. Infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the main cause of this disease. In addition to the respiratory system, the disease affects the gastrointestinal tract, central-peripheral nervous system, circulatory system, and kidneys. Therefore, any therapeutic action to reduce COVID-19-related symptoms and complications is essential. In this study, we conducted a systematic review of the published literature and preprints on the efficacy of erythropoietin (EPO) and recombinant human EPO as a safe stimulant and tissue protector in the treatment of COVID-19. We also briefly described the structure of coronavirus, its pathogenesis, and the structure of EPO and recombinant human EPO. All relevant articles published in the Science Direct, PubMed, and Google Scholar databases were searched. According to the results, EPO is a cytoprotective cytokine induced by hypoxia. The pleiotropic effects of EPO are associated with its erythrocyte-forming, anti-apoptotic, anti-inflammatory activities. It also exerts protective effects on the heart, lungs, kidneys, arteries, and central and peripheral nervous systems. It has been demonstrated that EPO can increase hemoglobin levels, thereby increasing oxygen delivery to the tissues. Therefore, recombinant human EPO therapy can be used for counteracting the adverse effects of COVID-19 including hypoxic myocarditis, acute renal failure, pulmonary edema, and brain-spinal cord ischemic injury. Overall, the use of EPO and recombinant human EPO therapy increases blood coagulation, tumor growth, thromboembolism, and purification of red blood cells, which must be accompanied by anticoagulants such as heparin.

The effects of type III traumatic stressors of the protracted conflict and prolonged COVID-19 on Syrians internally displaced: A validation study of type III continuous traumatic stressors and their impact

This study aimed to validate the Type III continuous traumatic stress model assumptions and use it to assess the effect of intersected traumas of civil war and COVID-19 stressors on internally displaced Syrian people. We recruited 891 Syrians from camps (46.5% females, aged 18-90 years [M = 30.81, SD = 12.04]). We measured COVID-19 stressors, posttraumatic stress disorder (PTSD), complex PTSD (CPTSD), depression, anxiety, and executive functions to assess the variables related to peri-post Type III mental health syndrome. We measured Type I, II, and III traumas and Type III trauma subtypes. To explore the significance of differences between correlation sizes and the comparative severity of each trauma type, we calculated Fisher z scores. We performed path analysis with trauma Types III and II as correlated independent variables and COVID-19 stressors' impact on peri-post Type III trauma mental health syndrome to check their proliferation and impact. Of the sample, COVID-19 had infected 45.9%, 33.1% fit the diagnostic criteria for CPTSD, and 13.9% fit the diagnostic criteria for PTSD. All trauma types were associated with mental health, cognitive deficits, and COVID-19 severity, with a significantly higher association with trauma Type III. Type III-a subtype (intersected discrimination) had the highest associations with each variable. Type III was bidirectionally correlated with Type II and proliferated to Type I traumas (single past events) and COVID-19 stressors, with Type III having a larger effect size on peri-post Type III trauma mental health syndrome. The clinical and conceptual implications of the findings are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved) Impact Statement This study helps understand the intersection between intergroup conflicts and intersected discrimination with COVID-19 pandemic stressors that amplifies its impact on mental health and cognitive functioning in Syrian internally displaced people. This study addresses the United Nations sustainable development goals of empowering and promoting the social, economic, and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic, or other status by unpacking some of the powerful mechanisms behind intergroup conflicts and intersected discrimination interfaced with COVID-19. This study validates the continuous stress Type III trauma framework and proposes corrective and treatment strategies that address inequalities and discrimination and their impact. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Strengthening health systems from the bottom up: example from Lesotho

In Africa, there is frequently an extreme need for nurses and other healthcare professionals. Overcrowding, a lack of administrative oversight, and a lack of resources are all problems in health settings. Health professionals may develop psychological damage referred to as "insufficient resource trauma" as a result of these difficulties, which can lower morale and motivation. Such trauma reduces the standard of treatment provided and causes professional "burn-out," a problem that has become more significant in the wake of the SARS-CoV-2 pandemic. One of the nurses who received training in PSBH-N in 2006 was promoted to the position of MoH Nursing Director by 2019. This nurse reflected on her personal experience and said, "The nurses trained in PSBH are among the top nurses in the country today," when she learned of the new PSBH training for MoH QAU employees. In order to train all 877 registered nurses and 373 licensed practical nurses (LPNs) in the nation during the following three to five years, the director requested that LeBoHA host PSBH-N workshops. The countrywide rollout's training and evaluation are now under progress. Priority setting may result from centralized, "top-down," problem-solving techniques that are not always appropriate for the district. A poll of healthcare professionals in South African hospitals revealed that administrators of hospitals were regarded as effective leaders if their leadership style encouraged engagement and problem-solving. An emphasis on a decentralised and egalitarian (equity-fostering) approach, where problem-solving is the duty of all health workers, is emphasized in a national quality assurance plan that includes PSBH.

Incidence and risk of sports injuries in registered athletes in Mazandaran province;reports of the years before and after COVID- 19 pandemic

Background and purpose: World condition has changed since the Coronavirus disease 2019 (COVID-19) emerged and its rapid spread affected people's social and sports life. In this study, we aimed at investigating the incidence of sports injuries in Mazandaran province, Iran and the effects of COVID- 19 pandemic on frequency of sports injuries. We also studied the relationship between sports injuries and age, gender, sports specialties and severity of injury. Materials and Methods: In this descriptive-analytical study, information of all/injured athletes registered in Mazandaran Sport Medicine Center between 2018 and 2020 were analyzed in SPSS V23. In order to investigate the relationship between injured limb and age, gender, sports specialty, injured side, and surgery, Chi-square test was applied.