To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Healthcare workers (HCWs) have been impacted psychologically due to their professional responsibilities over the prolonged era of the coronavirus disease 2019 (COVID-19) pandemic. The study aimed to identify the predictors of psychological distress, fear, and coping during the COVID-19 pandemic among HCWs.
A cross-sectional online survey was conducted among self-identified HCWs across 14 countries (12 from Asia and two from Africa). The Kessler Psychological Distress Scale, the Fear of COVID-19 Scale, and the Brief Resilient Coping Scale were used to assess the psychological distress, fear, and coping of HCWs, respectively.
A total of 2447 HCWs participated; 36% were doctors, and 42% were nurses, with a mean age of 36 (±12) years, and 70% were females. Moderate to very-high psychological distress was prevalent in 67% of the HCWs; the lowest rate was reported in the United Arab Emirates (1%) and the highest in Indonesia (16%). The prevalence of high levels of fear was 20%; the lowest rate was reported in Libya (9%) and the highest in Egypt (32%). The prevalence of medium-to-high resilient coping was 63%; the lowest rate was reported in Libya (28%) and the highest in Syria (76%).
COVID-19 has augmented the psychological distress among HCWs. Factors identified in this study should be considered in managing the wellbeing of HCWs, who had been serving as the frontline drivers in managing the crisis successfully across all participating countries. Furthermore, interventions to address their psychological distress should be considered.
Background: The emergence of antimicrobial resistance (AMR) is affecting public health management in developing countries, including Bangladesh. Irrational and inappropriate use of antibiotics in healthcare settings has led to widespread drug resistance. To optimize antimicrobial usage to combat AMR and enhance infection treatment, the competence of healthcare workers in antibiotic prescribing is indispensable. We sought to determine the perceptions about antimicrobial resistance, antibiotic stewardship programs (ASPs), and antibiotic prescribing approaches among physicians at tertiary-care public hospitals in Bangladesh. Methods: From September to December 2020, we conducted a mixed-methods study in 9 tertiary-care public hospitals. Using a self-administered, semistructured questionnaire, we collected data on antibiotic stewardship and prescribing practices from 452 on-duty physicians. In addition, we conducted 16 key-informant interviews to explore AMR perceptions and determinants. Results: Only 43.8% of physicians were aware of the ASP, and none of the hospitals had any ASP initiative in place. Most of the participants (70.6%) recommended tailored training and antibiotic prescribing guidelines (63.7%) for effective ASP initiatives. More than half of the physicians (54.7%) preferred to receive regular monitoring and feedback on their routine antibiotic prescriptions from the stewardship program. In terms of the antibiotic prescribing approach, only 25.9% of physicians relied on microbiology lab findings, whereas 69.5% routinely employed oral or intravenous antibiotics. Also, 40.0% of physicians considered the patient’s ability to afford the antibiotic cost when recommending antibiotics. The qualitative investigation identified the use of broad-spectrum antibiotics, absence of guidelines, and inadequate laboratory support as factors contributing to AMR in the healthcare setting. Self-medication, over-the-counter dispensing, and patients’ economic instability to complete the dosage were also attributed to the irrational use of antibiotics. As a priority step, physicians advocated for intensive training on antibiotic advising, mass awareness campaigns on safe antibiotic usage and dispensing, and a restriction on the widespread sale of antibiotics from pharmacies. Conclusions: Despite favorable perceptions, the fundamental understanding of physicians regarding ASPs and rational prescribing of antibiotics needs to be improved through context-specific educational interventions and capacity building. In addition, a coherent and comprehensive policy is required for the development and implementation of antibiotic usage guidelines along with integrated ASP initiatives to combat AMR.
Background: Hand hygiene (HH) is a core element of patient safety and the single most essential strategy for preventing healthcare-associated infections (HAIs). Adherence to HH among healthcare workers (HCWs) varies greatly depending on a range of factors, including risk perceptions, institutional culture, auditing mechanisms, and availability of HH supplies. We observed HH compliance among HCWs to determine the factors influencing practices in tertiary healthcare facilities in Bangladesh. Methods: During September 2020–February 2021, we conducted nonparticipatory observations at 11 tertiary-care hospitals in Bangladesh using the WHO “Five Moments for Hand Hygiene” tool to record compliance among physicians, nurses, and cleaning staff. We also performed semistructured interviews to determine the key barriers to complying with hand hygiene. Furthermore, we noted the presence, location, and functionality of existing HH stations within each hospital ward. Results: We observed 14,668 HH opportunities among HCWs. The overall HH compliance was 25.3%, and compliance differed significantly by professional category (P < .001). Physicians had the highest HH compliance at 28.5% (2,264 of 7,930), followed by nurses at 25.4% (1,272 of 5,008). Cleaning staff had the lowest rates of HH at 9.9% (171 of 3,221). HCWs of public hospitals had significantly higher odds of complying with HH practices than those in private hospitals (27.4% vs 17.9%; aOR, 1.73; 95% CI, 1.55–1.93; P < .001). HH compliance also varied by WHO Five Moments indicators. HCWs were 3 times more likely to perform HH ‘after touching a patient’ than ‘before touching patient’ (aOR, 3.36; 95% CI, 2.90–3.90; P < .001). Common barriers to using hand sanitizer were insufficient supply (57.9%), skin reaction (26.3%), shortage of time (14.5%), and lack of awareness (11.9%). Regarding handwashing with soap, inadequate supplies (27.0%), high workload (26.3%), and lack of facilities (22.7%) were the key factors for low adherence. The HH infrastructure observation in 82 wards showed that running water and soap were available in 168 (86.2%) of 195 HCW-designated basins, compared to 51 (35.9%) of 142 for the patient- and attendant-assigned basins. Handwashing posters were found in only 44 (13.1%) of 337 basin surroundings, and no hand drying supplies were observed for patients or attendants. Conclusions: Hand hygiene compliance among HCWs fall significantly short of the standard for safe patient care. Inadequate HH supplies in a resource-constrained setting like Bangladesh demonstrates a lack of leadership in prioritizing, promoting, and investing in infection prevention and control. The findings of this study might help to motivate and design interventions for HH compliance, which will help reduce HAIs in the hospital setting.
Coronavirus disease 2019 (COVID-19) was first recognised in December 2019. The subsequent pandemic has caused 4.3 million deaths and affected the lives of billions. It has increased psychosocial risk factors for mental illness including fear, social isolation and financial insecurity and is likely to lead to an economic recession. COVID-19 is associated with a high rate of neuropsychiatric sequelae. The long-term effects of the pandemic on mental health remain uncertain but could be marked, with some predicting an increased demand for psychiatric services for years to come. COVID-19 has turned a spotlight on mental health for politicians, policy makers and the public and provides an opportunity to make mental health a higher public health priority. We review longstanding reasons for prioritising mental health and the urgency brought by the COVID-19 pandemic, and highlight strategies to improve mental health and reduce the psychiatric fallout of the pandemic.
Facebook has transformed social communication and offers the opportunity to share personal thoughts to people including suicide ideas, plans and attempts. Suicide after Facebook posts has been reported in different parts of the world and it has become a potential area of research for suicide prevention. The analysis of Facebook posts prior to suicide or Facebook live streaming may help in understanding the etiological factors, patterns of communication and possible prevention approaches for a particular community. However, there is a dearth of evidence about suicide incidents after Facebook posts and Facebook live streaming in low and middle-income countries. This study aims to explore the trends and phenomena of suicide after Facebook posts and live streaming in Bangladesh. We conducted an online search using the Google, Facebook and five daily online newspaper archives from 15th August to 15th September 2019. Two research assistants independently conducted the initial searching to find out people who committed suicide after Facebook posts or live streamed suicide in Bangladesh and documented 21 cases. After further evaluation of each of the 21 cases we confirmed 19 cases that met the selection criteria. All of them were under 35-years of age. We observed sucide after Facebook posts were more common in male(78%) e and students. Hanging was the most frequently used method of suicide followed by poisoning. Their Facebook posts and livestream videos indicated relationship problems, academic stress and mental disorders were the common stressors for their suicide. This study lays the foundation for the future researchers to work on suicidal posts on Facebook in Bangladesh and develop culture-specific, real-time suicide preventive systems using a social media platform.
Email your librarian or administrator to recommend adding this to your organisation's collection.