Knowledge, attitudes, and practices related to the COVID-19 pandemic among Bangladeshi youth: a web-based cross-sectional analysis.

AIM: This study aimed to assess knowledge, attitudes, and practices (KAP) toward COVID-19 among youth in Bangladesh. SUBJECT AND METHODS: A cross-sectional survey was conducted from 5 May to 25 May 2020. People aged between 18 and 35 years were approached via social media to complete an online questionnaire that consisted of socio-demographic information and KAP toward COVID-19. Descriptive statistics, t-tests, one-way analysis of variance (ANOVA), and multiple logistic regression analyses were conducted. RESULTS: Out of 707 survey participants, 57.1% were male, the majority were students (60.3%), aged 24-29 years (61.5%), having a bachelor's degree (57%), having family income 25,000-50,000 BDT (40.5%) and living in urban areas (64.4%). Participants gathered information on COVID-19 mostly through social media (70.4%). Overall, 61.2% had adequate knowledge with 78.9% having a positive attitudes toward COVID-19 and only 51.6% had good practices. Most (86.8%) of the participants were confident that COVID-19 will be successfully controlled and Bangladesh was handling the COVID-19 health crisis well (84.20%). Only 75.2% of participants always washed their hands with soap or hand-sanitizer, and 70.6% wore a mask when going outside the home. Factors associated with adequate knowledge were being female, having a master's degree and above, and living in an urban area (p < 0.05). Participants having adequate knowledge of COVID-19 had higher likelihood of positive attitudes (OR: 6.41, 95% CI = 2.34-25.56, p = 0.000) and good practices (OR: 8.93, 95% CI = 3.92-38.42, p = 0.000). CONCLUSION: The findings highlight the need for tailored education programs for COVID-19 which incorporates consideration of associated factors to improve the level of public knowledge, attitudes, and practices.

An online observational study assessing clinical characteristics and impacts of the COVID-19 pandemic on mental health: a perspective study from Bangladesh.

PURPOSE: The pandemic of coronavirus disease 2019 (COVID-19) has cost numerous lives and induced tremendous mental stress among people. The purpose of this research was to determine anxiety and depression levels, clinical features, and the connections between demographic variables and depression prevalence as well as anxiety prevalence among reported COVID-19 cases in Bangladesh. METHODS: For the purpose of data collection, an online cross-sectional survey was carried out from May 26 to June 27, 2020, utilizing a Google adapted preformed questionnaire. The form was shared with a short overview and justification through Facebook, Twitter, Facebook messenger, Viber, and What's App. The Google form contains five parts: a brief introduction, an approval statement, demographics, clinical and radiological data, and mental health assessment by the Generalized Anxiety Disorder 7-item (GAD-7) scale and Patient Health Questionnaire (PHQ-9). Formal ethical clearance was taken from the Institute of Biological Science (IBSc), Bangladesh. Informed consent was ensured before participation. RESULTS: One hundred and fifty-three (153) patients with COVID-19 who had an average age of 39.43 ± 17.59 years with male predominance (72%) were included. A total of 32.7% were doing health-care related jobs, and 17.7% lost their jobs due to COVID-19. Patients had a median income of 30,000 Bangladesh taka (BDT). Of all, 12.4% of the participants showed asymptomatic features, whereas 87.6% of patients were symptomatic and presented with fever (79%), cough (58.8%), myalgia (24.2%), breathlessness (23.5%), sore throat (21.6%), fatigue (19.6%), headache (13.7%), nausea and/or vomiting (11.8%), runny nose (9.8%), chest pain (9.2%), diarrhea (8.5%), stuffy nose (3.2%), ARDS (2.6%), oral ulcer (2.6%), and conjunctivitis (1.9%). Overall, the prevalence of anxiety and depression was 63.5% and 56.6%, respectively. Among the participants, 13.2% had only anxiety, 6.3% had only depression, and 50.3% had both. CONCLUSION: In most cases, middle age, male, and healthy workers were patients. Fever and cough were the standard presentations. Approximately two-thirds or 66.67% of patients had anxiety and depression, one or both.

Gender and Fear of COVID-19 in a Cuban Population Sample.

The COVID-19 pandemic is a global health emergency that could potentially have a serious impact on public health. Fear has been one of the most frequent psychological reaction in the population during the current pandemic. The aim of this study was to compare fear of COVID-19 between genders and to examine whether the differences between genders may be predictors of fear of COVID-19 scores. A cross-sectional web-based survey design was adopted. The sample comprised 772 Cuban participants. The Fear of COVID-19 Scale was used to explore fear reactions in the sample. An independent-samples t test was conducted to compare the fear of COVID-19 scores between genders, and multinomial logistic regression was modeling to identify variables independently associated with fear of coronavirus. In our sample, on average, female participants experienced significantly greater fear of COVID-19 than men. The gender of participants significantly predicted the level of fear of COVID-19. Being female was a predictor of medium and high levels of fear of COVID-19. The odds of a female with middle fear levels compared to low fear was 3.13 times more than for a male, and the odds of a female with high fear levels compared to low fear was 3.45 times more than for a male. Our results corroborate international research that indicate a greater psychological vulnerability in women during the COVID-19 pandemic. This result points to the need to design interventions that reduce the negative impact of the current outbreak on women's mental health.

Stress, Burnout, and Coping Strategies of Frontline Nurses During the COVID-19 Epidemic in Wuhan and Shanghai, China.

Background: Nurses at the frontline of caring for COVID-19 patients might experience mental health challenges and supportive coping strategies are needed to reduce their stress and burnout. The aim of this study was to identify stressors and burnout among frontline nurses caring for COVID-19 patients in Wuhan and Shanghai and to explore perceived effective morale support strategies. Method: A cross-sectional survey was conducted in March 2020 among 110 nurses from Zhongshan Hospital, Shanghai, who were deployed at COVID-19 units in Wuhan and Shanghai. A COVID-19 questionnaire was adapted from the previous developed "psychological impacts of SARS" questionnaire and included stressors (31 items), coping strategies (17 items), and effective support measures (16 items). Burnout was measured with the Maslach Burnout Inventory. Results: Totally, 107 (97%) nurses responded. Participants mean age was 30.28 years and 90.7% were females. Homesickness was most frequently reported as a stressor (96.3%). Seven of the 17 items related to coping strategies were undertaken by all participants. Burnout was observed in the emotional exhaustion and depersonalization subscales, with 78.5 and 92.5% of participants presenting mild levels of burnout, respectively. However, 52 (48.6%) participants experienced a severe lack of personal accomplishment. Participants with longer working hours in COVID-19 quarantine units presented higher emotional exhaustion (OR = 2.72, 95% CI 0.02-5.42; p = 0.049) and depersonalization (OR = 1.14, 95% CI 0.10-2.19; p = 0.033). Participants with younger age experienced higher emotional exhaustion (OR = 2.96, 95% CI 0.11-5.82; p = 0.042) and less personal accomplishment (OR = 3.80, 95% CI 0.47-7.13; p = 0.033). Conclusions: Nurses in this study experienced considerable stress and the most frequently reported stressors were related to families. Nurses who were younger and those working longer shift-time tended to present higher burnout levels. Psychological support strategies need to be organized and implemented to improve mental health among nurses during the COVID-19 pandemic.

Prevalence of SARS-CoV-2 in Spain (ENE-COVID): a nationwide, population-based seroepidemiological study.

BACKGROUND: Spain is one of the European countries most affected by the COVID-19 pandemic. Serological surveys are a valuable tool to assess the extent of the epidemic, given the existence of asymptomatic cases and little access to diagnostic tests. This nationwide population-based study aims to estimate the seroprevalence of SARS-CoV-2 infection in Spain at national and regional level. METHODS: 35 883 households were selected from municipal rolls using two-stage random sampling stratified by province and municipality size, with all residents invited to participate. From April 27 to May 11, 2020, 61 075 participants (75·1% of all contacted individuals within selected households) answered a questionnaire on history of symptoms compatible with COVID-19 and risk factors, received a point-of-care antibody test, and, if agreed, donated a blood sample for additional testing with a chemiluminescent microparticle immunoassay. Prevalences of IgG antibodies were adjusted using sampling weights and post-stratification to allow for differences in non-response rates based on age group, sex, and census-tract income. Using results for both tests, we calculated a seroprevalence range maximising either specificity (positive for both tests) or sensitivity (positive for either test). FINDINGS: Seroprevalence was 5·0% (95% CI 4·7-5·4) by the point-of-care test and 4·6% (4·3-5·0) by immunoassay, with a specificity-sensitivity range of 3·7% (3·3-4·0; both tests positive) to 6·2% (5·8-6·6; either test positive), with no differences by sex and lower seroprevalence in children younger than 10 years (<3·1% by the point-of-care test). There was substantial geographical variability, with higher prevalence around Madrid (>10%) and lower in coastal areas (<3%). Seroprevalence among 195 participants with positive PCR more than 14 days before the study visit ranged from 87·6% (81·1-92·1; both tests positive) to 91·8% (86·3-95·3; either test positive). In 7273 individuals with anosmia or at least three symptoms, seroprevalence ranged from 15·3% (13·8-16·8) to 19·3% (17·7-21·0). Around a third of seropositive participants were asymptomatic, ranging from 21·9% (19·1-24·9) to 35·8% (33·1-38·5). Only 19·5% (16·3-23·2) of symptomatic participants who were seropositive by both the point-of-care test and immunoassay reported a previous PCR test. INTERPRETATION: The majority of the Spanish population is seronegative to SARS-CoV-2 infection, even in hotspot areas. Most PCR-confirmed cases have detectable antibodies, but a substantial proportion of people with symptoms compatible with COVID-19 did not have a PCR test and at least a third of infections determined by serology were asymptomatic. These results emphasise the need for maintaining public health measures to avoid a new epidemic wave. FUNDING: Spanish Ministry of Health, Institute of Health Carlos III, and Spanish National Health System.

Stress and Anxiety among Healthcare Workers Associated with COVID-19 Pandemic in Russia.

BACKGROUND: Mental health of medical workers treating patients with COVID-19 is an issue of increasing concern worldwide. The available data on stress and anxiety symptoms among healthcare workers during the COVID-19 are relatively limited and have not been evaluated in Russia yet. SUBJECTS AND METHODS: The cross-sectional anonymous survey included 1,090 healthcare workers. Stress and anxiety symptoms were assessed using Stress and Anxiety to Viral Epidemics - 9 (SAVE-9) and Generalized Anxiety Disorder - 7 (GAD-7) scales. Logistic regression, Kaiser-Meyer-Olkin two component factor model, Cronbach's alpha and ROC-analysis were performed to determine the influence of different variables, internal structure and consistency, sensitivity and specificity of SAVE-9 compared with GAD-7. RESULTS: The median scores on the GAD-7 and SAVE-9 were 5 and 14, respectively. 535 (49.1%) respondents had moderate and 239 (21.9%) had severe anxiety according to SAVE-9. 134 participants (12.3%) had severe anxiety, 144 (13.2%) had moderate according to GAD-7. The component model revealed two-factor structure of SAVE-9: "anxiety and somatic concern" and "social stress". Female gender (OR - 0.98, p=0.04) and younger age (OR - 0.65, p=0.04) were associated with higher level of anxiety according to regression model. The total score of SAVE-9 with a high degree of confidence predicted the GAD-7 value in comparative ROC analysis. CONCLUSIONS: Healthcare workers in Russia reported high rates of stress and anxiety. The Russian version of the SAVE-9 displayed a good ratio of sensitivity to specificity compared with GAD-7 and can be recommended as a screening instrument for detection of stress and anxiety in healthcare workers.

Prevalence of and Risk Factors Associated With Mental Health Symptoms Among the General Population in China During the Coronavirus Disease 2019 Pandemic.

Importance: People exposed to coronavirus disease 2019 (COVID-19) and a series of imperative containment measures could be psychologically stressed, yet the burden of and factors associated with mental health symptoms remain unclear. Objective: To investigate the prevalence of and risk factors associated with mental health symptoms in the general population in China during the COVID-19 pandemic. Design, Setting, and Participants: This large-sample, cross-sectional, population-based, online survey study was conducted from February 28, 2020, to March 11, 2020. It involved all 34 province-level regions in China and included participants aged 18 years and older. Data analysis was performed from March to May 2020. Main Outcomes and Measures: The prevalence of symptoms of depression, anxiety, insomnia, and acute stress among the general population in China during the COVID-19 pandemic was evaluated using the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Insomnia Severity Index, and Acute Stress Disorder Scale. Logistic regression analyses were used to explore demographic and COVID-19-related risk factors. Results: Of 71 227 individuals who clicked on the survey link, 56 932 submitted the questionnaires, for a participation rate of 79.9%. After excluding the invalid questionnaires, 56 679 participants (mean [SD] age, 35.97 [8.22] years; 27 149 men [47.9%]) were included in the study; 39 468 respondents (69.6%) were aged 18 to 39 years. During the COVID-19 pandemic, the rates of mental health symptoms among the survey respondents were 27.9% (95% CI, 27.5%-28.2%) for depression, 31.6% (95% CI, 31.2%-32.0%) for anxiety, 29.2% (95% CI, 28.8%-29.6%) for insomnia, and 24.4% (95% CI, 24.0%-24.7%) for acute stress. Participants with confirmed or suspected COVID-19 and their family members or friends had a high risk for symptoms of depression (adjusted odds ratios [ORs], 3.27 [95% CI, 1.84-5.80] for patients; 1.53 [95% CI, 1.26-1.85] for family or friends), anxiety (adjusted ORs, 2.48 [95% CI, 1.43-4.31] for patients; 1.53 [95% CI, 1.27-1.84] for family or friends), insomnia (adjusted ORs, 3.06 [95% CI, 1.73-5.43] for patients; 1.62 [95% CI, 1.35-1.96] for family or friends), and acute stress (adjusted ORs, 3.50 [95% CI, 2.02-6.07] for patients; 1.77 [95% CI, 1.46-2.15] for family or friends). Moreover, people with occupational exposure risks and residents in Hubei province had increased odds of symptoms of depression (adjusted ORs, 1.96 [95% CI, 1.77-2.17] for occupational exposure; 1.42 [95% CI, 1.19-1.68] for Hubei residence), anxiety (adjusted ORs, 1.93 [95% CI, 1.75-2.13] for occupational exposure; 1.54 [95% CI, 1.30-1.82] for Hubei residence), insomnia (adjusted ORs, 1.60 [95% CI, 1.45-1.77] for occupational exposure; 1.20 [95% CI, 1.01-1.42] for Hubei residence), and acute stress (adjusted ORs, 1.98 [95% CI, 1.79-2.20] for occupational exposure; 1.49 [95% CI, 1.25-1.79] for Hubei residence). Both centralized quarantine (adjusted ORs, 1.33 [95% CI, 1.10-1.61] for depression; 1.46 [95% CI, 1.22-1.75] for anxiety; 1.63 [95% CI, 1.36-1.95] for insomnia; 1.46 [95% CI, 1.21-1.77] for acute stress) and home quarantine (adjusted ORs, 1.30 [95% CI, 1.25-1.36] for depression; 1.28 [95% CI, 1.23-1.34] for anxiety; 1.24 [95% CI, 1.19-1.30] for insomnia; 1.29 [95% CI, 1.24-1.35] for acute stress) were associated with the 4 negative mental health outcomes. Being at work was associated with lower risks of depression (adjusted OR, 0.85 [95% CI, 0.79-0.91]), anxiety (adjusted OR, 0.92 [95% CI, 0.86-0.99]), and insomnia (adjusted OR, 0.87 [95% CI, 0.81-0.94]). Conclusions and Relevance: The results of this survey indicate that mental health symptoms may have been common during the COVID-19 outbreak among the general population in China, especially among infected individuals, people with suspected infection, and people who might have contact with patients with COVID-19. Some measures, such as quarantine and delays in returning to work, were also associated with mental health among the public. These findings identify populations at risk for mental health problems during the COVID-19 pandemic and may help in implementing mental health intervention policies in other countries and regions.

The Relationship Between Symptoms of Anxiety and Somatic Symptoms in Health Professionals During the Coronavirus Disease 2019 Pandemic.

BACKGROUND: The pandemic of coronavirus disease 2019 (COVID-19) has posed a threat to global health. Increasing studies have shown that the mental health status of health professionals is very poor during the COVID-19 epidemic. At present, the relationship between somatic symptoms and symptoms of anxiety of health professionals during the COVID-19 has not been reported. The purpose of this study was to explore the frequency of somatic symptoms and its related factors in health professionals with symptoms of anxiety during COVID-19 in China. METHODS: A total of 606 health professionals were assessed online with the Chinese version of the 7-item Generalized Anxiety Disorder (GAD-7) scale, 7-item Insomnia Severity Index (ISI) and the somatization subscale of Symptom Checklist 90 (SCL-90). RESULTS: The percentage of symptoms of anxiety, somatic symptoms and insomnia in all health professionals was 45.4%, 12.0%, and 32%, respectively. The frequency of somatic symptoms in health professionals with symptoms of anxiety was 22.9%. The SCL-90 somatization subscale score was significantly positively correlated with history of somatic diseases, GAD-7 score and ISI score in participants with symptoms of anxiety. CONCLUSION: During the COVID-19, symptoms of anxiety, insomnia, and somatic symptoms are commonly observed in health professionals. Insomnia and symptoms of anxiety are independently associated with somatic symptoms of health professionals with symptoms of anxiety.

How to fairly allocate scarce medical resources? Controversial preferences of healthcare professionals with different personal characteristics.

The scarcity of medical resources is widely recognized, and therefore priority setting is inevitable. This study examines whether Portuguese healthcare professionals (physicians vs nurses): (i) share the moral guidance proposed by ethicists and (ii) attitudes toward prioritization criteria vary among individual and professional characteristics. A sample of 254 healthcare professionals were confronted with hypothetical prioritization scenarios involving two patients distinguished by personal or health characteristics. Descriptive statistics and parametric analyses were performed to evaluate and compare the adherence of both groups of healthcare professionals regarding 10 rationing criteria: waiting time, treatment prognosis measured in life expectancy and quality of life, severity of health conditions measured in pain and immediate risk of dying, age discrimination measured in favoring the young over older and favoring the youngest over the young, merit evaluated positively or negatively, and parenthood. The findings show a slight adherence to the criteria. Waiting time and patient pain were the conditions considered fairer by respondents in contrast with the ethicists normative. Preferences for distributive justice vary by professional group and among participants with different political orientations, rationing experience, years of experience, and level of satisfaction with the NHS. Decision-makers should consider the opinion of ethicists, but also those of healthcare professionals to legitimize explicit guidelines.

Demographic and Attitudinal Factors of Adherence to Quarantine Guidelines During COVID-19: The Italian Model.

In Italy, a large outbreak of coronavirus disease 2019 (COVID-19) occurred from 2020 January 30, before the World Health Organization has stated that it is a pandemic. The nationwide quarantine had the desired impact of controlling the epidemic, although had presented many challenges, given its large economic and social costs. Complete adherence to recommendations can potentially decelerate and reduce infectious disease outbreaks. To date, it is not clear how compliant the Italian public has been with voluntary home quarantine, neither which factors have influenced an individual's decision to comply with a quarantine order. The purposes of this study were to investigate the degree of the adherence to quarantine restrictions and the factors associated with the self-reported adherence. During the third week of the national lockdown, 3,672 Italian quarantined adult residents (65% females; range, 18-85 years) participated in an online cross-sectional survey focused on the risk perception of contracting COVID-19 and their reported adherence to quarantine protocols. Analysis of variance showed significant differences among demographic groups in tendency to comply with quarantine orders, with women, most educated people, residents of Southern Italy, middle-aged individuals, and health workers more likely to adhere to quarantine guidelines. As well, participants exhibiting the perception, anxiety, and susceptibility of risk of contracting COVID-19 disease were found significantly more likely to adhere to quarantine guidelines. The results of this study can help public health policy makers to recognize target populations for COVID-19 prevention and health education and to understand how inform communication strategies aimed at minimizing the impact and spread of the disease.

Mental Health and Psychological Responses During the Coronavirus Disease 2019 Epidemic: A Comparison Between Wuhan and Other Areas in China.

OBJECTIVE: This study aimed to compare the mental health and psychological responses in Wuhan, a severely affected area, and other areas of China during the coronavirus disease 2019 (COVID-19) epidemic. METHODS: This cross-sectional study was conducted on February 10-20, 2020. A set of online questionnaires was used to measure mental health and responses. A total of 1397 participants from Wuhan (age, 36.4 ± 10.7 years; male, 36.1%) and 2794 age- and sex-matched participants from other areas of China (age, 35.9 ± 9.9 years; male, 39.0%) were recruited. RESULTS: Compared with their counterparts, participants from Wuhan had a significantly higher prevalence of any mental health problems (46.6% versus 32.2%; adjusted odds ratio [OR] = 1.89, 95% confidence interval [CI] = 1.65-2.17), anxiety (15.2% versus 6.2%; adjusted OR = 2.65, 95% CI = 2.14-3.29), depression (18.3% versus 9.7%; adjusted OR = 2.11, 95% CI = 1.74-2.54), suicidal ideation (10.5% versus 7.1%; adjusted OR = 1.60, 95% CI = 1.28-2.02), and insomnia (38.6% versus 27.6%; adjusted OR = 1.70, 95% CI = 1.48-1.96). Participants from Wuhan had a slightly higher rate of help-seeking behavior (7.1% versus 4.2%; adjusted OR = 1.76, 95% CI = 1.12-2.77) but similar rate of treatment (3.5% versus 2.7%; adjusted OR = 1.23, 95% CI = 0.68-2.24) for mental problems than did their counterparts. In addition, compared with their counterparts, participants from Wuhan gave higher proportions of responses regarding "fearful" (52% versus 36%, p < .001), "discrimination against COVID-19 cases" (64% versus 58%, p = .006), "strictly comply with preventive behaviors" (98.7% versus 96%, p = .003), and "fewer living and medical supplies" (<2 weeks: 62% versus 57%, p = .015). CONCLUSIONS: The COVID-19 epidemic has raised enormous challenges regarding public mental health and psychological responses, especially in the highly affected Wuhan area. The present findings provide important information for developing appropriate strategies for the prevention and management of mental health problems during COVID-19 and other epidemics.

Investigating the Impact of COVID-19 Lockdown on the Psychological Health of University Students and Their Attitudes Toward Mobile Mental Health Solutions: Two-Part Questionnaire Study.

BACKGROUND: The COVID-19 outbreak was first reported to the World Health Organization on December 31, 2019, and it was officially declared a public health emergency of international concern on January 30, 2020. The COVID-19 outbreak and the safety measures taken to control it caused many psychological issues in populations worldwide, such as depression, anxiety, and stress. OBJECTIVE: The objectives of this study were to assess the psychological effects of the lockdown due to the COVID-19 outbreak on university students in the United Arab Emirates (UAE) and to investigate the students' awareness of mobile mental health care apps as well as their attitudes toward the use of these apps. METHODS: A two-part self-administered web-based questionnaire was delivered to students at United Arab Emirates University. The first part of the questionnaire assessed the mental state of the participants using the 12-item General Health Questionnaire (GHQ-12), while the second part contained questions investigating the participants' awareness of and attitudes toward mental health care apps. Students were invited to fill out the web-based questionnaire via social media and mailing lists. RESULTS: A total of 154 students participated in the survey, and the majority were female. The results of the GHQ-12 analysis showed that the students were experiencing psychological issues related to depression and anxiety as well as social dysfunction. The results also revealed a lack of awareness of mental health care apps and uncertainty regarding the use of such apps. Approximately one-third of the participants (44/154, 28.6%) suggested preferred functionalities and characteristics of mobile mental health care apps, such as affordable price, simple design, ease of use, web-based therapy, communication with others experiencing the same issues, and tracking of mental status. CONCLUSIONS: Like many groups of people worldwide, university students in the UAE were psychologically affected by the lockdown due to the COVID-19 outbreak. Although apps can be useful tools for mental health care delivery, especially in circumstances such as those produced by the outbreak, the students in this study showed a lack of awareness of these apps and mixed attitudes toward them. Improving the digital health literacy of university students in the UAE by increasing their awareness of mental health care apps and the treatment methods and benefits of the apps, as well as involving students in the app creation process, may encourage students to use these tools for mental health care.

Determinants of COVID-19 vaccine acceptance in the US.

BACKGROUND: The COVID-19 pandemic continues to adversely affect the U.S., which leads globally in total cases and deaths. As COVID-19 vaccines are under development, public health officials and policymakers need to create strategic vaccine-acceptance messaging to effectively control the pandemic and prevent thousands of additional deaths. METHODS: Using an online platform, we surveyed the U.S. adult population in May 2020 to understand risk perceptions about the COVID-19 pandemic, acceptance of a COVID-19 vaccine, and trust in sources of information. These factors were compared across basic demographics. FINDINGS: Of the 672 participants surveyed, 450 (67%) said they would accept a COVID-19 vaccine if it is recommended for them. Males (72%) compared to females, older adults (≥55 years; 78%) compared to younger adults, Asians (81%) compared to other racial and ethnic groups, and college and/or graduate degree holders (75%) compared to people with less than a college degree were more likely to accept the vaccine. When comparing reported influenza vaccine uptake to reported acceptance of the COVID-19 vaccine: 1) participants who did not complete high school had a very low influenza vaccine uptake (10%), while 60% of the same group said they would accept the COVID-19 vaccine; 2) unemployed participants reported lower influenza uptake and lower COVID-19 vaccine acceptance when compared to those employed or retired; and, 3) Black Americans reported lower influenza vaccine uptake and lower COVID-19 vaccine acceptance than all other racial groups reported in our study. Lastly, we identified geographic differences with Department of Health and Human Services (DHHS) regions 2 (New York) and 5 (Chicago) reporting less than 50 percent COVID-19 vaccine acceptance. INTERPRETATION: Although our study found a 67% acceptance of a COVID-19 vaccine, there were noticeable demographic and geographical disparities in vaccine acceptance. Before a COVID-19 vaccine is introduced to the U.S., public health officials and policymakers must prioritize effective COVID-19 vaccine-acceptance messaging for all Americans, especially those who are most vulnerable.

Concerns of Health-care Professionals Managing COVID Patients under Institutional Isolation during COVID-19 Pandemic in India: A Descriptive Cross-sectional Study.

OBJECTIVE: Health-care professionals (HCPs) are the frontline warriors in the time of this uncertain and unpredictable crisis of COVID. They face many challenges while caring for these patients, yet they are expected to cope with it and deliver their duties for the betterment of humankind. Our primary aim was to identify and assess the concerns of HCPs working in COVID area in a tertiary institutional isolation center. METHODOLOGY: An online Google-based questionnaire survey was distributed through various social media platforms after approval of the institutional review board to a total of 100 HCPs who were treating and managing COVID-positive patients. RESULTS: Of 100 responses, 72% were concerned about the risk of infection to self and family, while 46% reported disruption of their daily activities at a personal level. At the institutional level, 17% were concerned about inadequate personal protective equipment-related challenges. 20% had inadequate knowledge and training about COVID. 16% of participants were anxious all the time, 11% feared all the time, and 12% had stress all the time while treating COVID patients. Connectedness and communication with family and friends, word of appreciation, music, and TV were few strategies to cope up with these challenges. CONCLUSION: There is a need to identify and address the concerns and challenges faced by HCPs and to develop a comprehensive strategy and guideline to provide a holistic care and to ensure their security in the workplace.

[Survey of the effect of the SARS-CoV-2 outbreak on the job training members with high exercise intensity: Analysis of the factors causing infection spread and the effectiveness of the prevention measures].

OBJECTIVES: Immediately before the state of emergency was declared, there was an outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among special training participants with severe physical stress. For promoting the optimization of infection prevention measures by identifying acts and situations with high risk of infection, we conducted a survey and analysis to understand the detailed process of infection spread in these cases. METHODS: A structured interview was conducted for the special training participants on their health status, changes in symptoms, training methods, and behavior history in their private lives. Additionally, a patrol of the training facility was carried out to understand the training environment, and antibody tests were conducted on the close contacts for more accurately grasping the spread of infection, by identifying subclinical infected persons. RESULTS: Within 10 days of COVID-19 onset in the first patient, 15 of the 19 original training participants developed symptoms, and 14 patients tested positive for RT-PCR. PCR tests were also performed on four patients who did not develop the disease - two were positive and negative, each. The two negatives turned positive on a later antibody test, suggesting that there was an asymptomatic infection. In addition, all five patients who participated in the training for only a day developed symptoms and tested positive for PCR in a few days. Of the 64 people who underwent testing for antibodies as close contacts, all but one who was living together with a patient were negative on antibody testing. CONCLUSIONS: The onset of COVID-19 occurred after the start of practice-based training continuously; therefore, the practice-based training was thought to be the main cause of the transmission. We speculate that the main factors behind the rapid spread of infection are as follows: during practice-based training, increased ventilation made it difficult to wear a mask; repeated loud vocalizations at close range; and the training pair was not fixed. Physical training without shouting and desk work, however, did not possess the risk of COVID-19, and avoiding certain situations at high risk of respiratory infections may have significantly reduced SARS-CoV-2 transmission. If personnel become infected with SARS-CoV-2, emergency measures should be devised by identifying patients and close contacts and facilitating the investigation of their behavioral history. Furthermore, evaluating and improving the effectiveness of infection control measures is necessary by ascertaining potentially infected persons by performing PCR tests, antigen tests, antibody tests, etc. in combination.

Efficacy and safety of short-wave diathermy treatment for moderate COVID-19 patients: a prospective, double-blind, randomized controlled clinical study.

BACKGROUND: Millions of human beings have suffered in the epidemic of Coronavirus disease 2019 (COVID-19), but until now the effective treatment methods have been limited. AIM: This study aimed to evaluate the efficacy and safety of short-wave diathermy (SWD) treatment for moderate COVID-19 patients. DESIGN: A prospective, double-blind, randomized controlled clinical study. SETTING: Inpatients Unit of a COVID-19 specialized hospital. POPULATION: Forty-two patients with moderate COVID-19 were randomly allocated at a 2:1 ratio to two groups: the SWD group and the control group. METHODS: Participants of the SWD group received SWD treatment, and participants of the control group received placebo SWD treatment for one session per day, 10 minutes per session, for no more than 14 days. Both groups were given standard care treatment. Primary outcome was the rate of clinical improvement according to a seven-category ordinal scale. Secondary outcomes included the rate of computed tomography (CT) improvement and the rate of potential adverse events. RESULTS: Clinical improvement occurred in 92.6% of patients in the SWD group by day 14 compared with 69.2% of patients in the control group (P=0.001). The Cox model indicated that the SWD group had a higher clinical improvement probability than the control group (hazard ratio: 3.045; 95% CI: 1.391-6.666; P=0.005). Similarly, CT improvement occurred in 85.2% of patients in the SWD group and 46.2% of patients in the control group respectively by day 14 (P=0.001). The Cox model indicated SWD group had a higher CT improvement probability than control group (hazard ratio: 3.720; 95% CI: 1.486-9.311; P=0.005). There was no significant difference in adverse events between the SWD group and the control group (2 of 27 [7.4%] SWD vs. 1 of 13 [7.7%] control, P=1.000), the most frequent of which were headache (1 of 27 [3.7%] SWD vs. 1 of 13 [7.7%] control patients) and dizziness (1 of 27 [3.7%] SWD vs. 0 of 13 [0%] control patients). CONCLUSIONS: SWD is a valid and reliable adjuvant therapy with a favorable safety profile for moderate COVID-19 patients. CLINICAL REHABILITATION IMPACT: Clinically relevant information is lacking regarding the efficacy and safety of SWD for patients with COVID-19. This study provides the first evidence that SWD is a promising adjuvant therapy for COVID-19.

Collegiate Athletic Trainers' Experiences With Work-Family Conflict and Work-Family Guilt Based Upon Organizational Factors.

CONTEXT: The collegiate athletic setting has been described as having high workloads and working demands. The extensive time commitment required of athletic trainers working in this setting has been identified as a precursor to work-family conflict (WFC) and work-family guilt (WFG). Although individualized, experiences in the work-life interface can largely be affected by organizational factors (ie, elements specific to the workplace). Staff size and patient load may influence the athletic trainer's feelings of WFC and WFG, yet these factors have not been directly studied. OBJECTIVE: To examine organizational factors and experiences of WFC and WFG among collegiate athletic trainers. DESIGN: Cross-sectional study. SETTING: Collegiate setting. PATIENTS OR OTHER PARTICIPANT(S): A total of 615 (females = 391, gender variant or nonconforming = 1, males = 222, preferred not to answer = 1) athletic trainers responded to an online survey. The average age of participants was 33 ± 9 years, and they were Board of Certification certified for 10 ± 8 years. A total of 352 participants (57.2%) worked in National Collegiate Athletic Association Division I, 99 in Division II (16.1%), and 164 in Division III (26.7%). MAIN OUTCOME MEASURE(S): Participants responded to demographic and workplace characteristic questions (organizational infrastructure, staff size, and number of varsity-level athletic teams). They completed WFC and WFG scales that have been previously validated and used in the athletic trainer population. RESULTS: Work-family conflict and WFG were universally experienced among our participants, with WFC scores predicting WFG scores. Participants reported more time-based conflict than strain- or behavior-based conflict. No differences in WFC and WFG scores were found among organizational infrastructures. Weak positive correlations were present between staff size and WFC scores and WFG scores. The number of athletic teams was not associated with WFC or WFG scores. CONCLUSIONS: Organizational factors are an important component of the work-life interface. From an organizational perspective, focusing on improving work-life balance for the athletic trainer can help mitigate experiences with WFC and WFG.

Awareness and Attitude of Undergraduate Medical Students towards 2019-novel Corona virus.

OBJECTIVE: To assess the knowledge, awareness and attitudes of medical students towards recently discovered coronavirus disease-19 (COVID-19). METHODS: This was a cross sectional study conducted on medical students in CMH Lahore Medical College,(LMC), Institute of Dentistry (IOD). A questionnaire containing demographic information, 14 knowledge and eight attitude items was completed by 384 participants. RESULTS: Overall, >90% people were aware about the etiology, mode of transmission and possible symptoms; however, very few of them knew about the in-depth details. Knowledge score revealed that 80% of participants had sufficient knowledge about coronavirus. MBBS students and nursing Students had significantly better knowledge in comparison with other students. In terms of attitude, >80% of students showed positive attitudes among which the nursing students were dominant. CONCLUSION: The medical students of CMH LMC showed a satisfactory level of awareness and attitudes towards COVID-19 with an obvious difference with regard to disciplines. More educational efforts with periodic educational interventions are still needed about the current pandemic.

COVID-19-Related Factors Associated with Sleep Disturbance and Suicidal Thoughts among the Taiwanese Public: A Facebook Survey.

Coronavirus disease 2019 (COVID-19) pandemic has impacted many aspects of people's lives all over the world. This Facebook survey study aimed to investigate the COVID-19-related factors that were associated with sleep disturbance and suicidal thoughts among members of the public during the COVID-19 pandemic in Taiwan. The online survey recruited 1970 participants through a Facebook advertisement. Their self-reported experience of sleep disturbance and suicidal thoughts in the previous week were collected along with a number of COVID-19-related factors, including level of worry, change in social interaction and daily lives, any academic/occupational interference, levels of social and specific support, and self-reported physical health. In total, 55.8% of the participants reported sleep disturbance, and 10.8% reported having suicidal thoughts in the previous week. Multiple COVID-19-related factors were associated with sleep disturbance and suicidal thoughts in the COVID-19 pandemic. Increased worry about COVID-19, more severe impact of COVID-19 on social interaction, lower perceived social support, more severe academic/occupational interference due to COVID-19, lower COVID-19-specified support, and poorer self-reported physical health were significantly associated with sleep disturbance. Less handwashing, lower perceived social support, lower COVID-19-specified support, poorer self-reported physical health, and younger age were significantly associated with suicidal thoughts. Further investigation is needed to understand the changes in mental health among the public since the mitigation of the COVID-19 pandemic.

The Toll of Feeling Older: Subjective Age Moderates the Associations Between Anxiety Sensitivity and Symptoms of Anxiety and Depression During the COVID-19 Epidemic.

OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic is an ongoing stressor that may have detrimental effects on mental health. Theoretical and empirical literature implies that individuals who are characterized by catastrophic appraisals of somatic cues, a tendency known as anxiety sensitivity, as well as by older subjective age, might be particularly vulnerable to depression and anxiety during the pandemic. Furthermore, subjective age might moderate the relations between anxiety sensitivity with depression and anxiety symptoms. Yet, research to date has not explored the contribution of both anxiety sensitivity and subjective age in explaining distress following stress in general, nor in light of the current COVID-19 pandemic. METHOD: Filling this gap, a convenience sample of 828 participants (Mage = 43.98, SD = 14.06) filled questionnaires measuring background variables, COVID-19-related stressors, anxiety sensitivity, subjective age, and anxiety and depression symptoms during the pandemic. RESULTS: Positive associations were found between anxiety sensitivity and subjective age, on the one hand, and anxiety and depression symptoms, on the other. Furthermore, subjective age moderated the relations between anxiety sensitivity with depression and anxiety symptoms. Although higher levels of anxiety sensitivity were related to depression and anxiety during the pandemic, these relations were significantly stronger among participants with an older subjective age. DISCUSSION: The findings are consistent with theories that view subjective age as an intraindividual construct involved in modulating important mental health outcomes in the context of coping with stress.