Coronavirus disease 2019 (COVID-19) pandemic has substantially affected students around the globe due to the closure of educational institutes. However, student involvements and contributions are important in combating the disease; for this reason, the current study was designed to assess the knowledge-attitude-practice (KAP), preventive behavior, and risk perception among university students.

A cross-sectional survey-based study was conducted among medical and non-medical university students, from April 1 to June 30, 2020. The 68-item questionnaire was used to evaluate responses using statistical approaches (Student’s t-test, regression-analysis, and co-relation analysis) by considering a P-value <0.05 as statistically significant.

A total of 503 university students (medical and nonmedical) were selected, where majority of participants were females (83%) and 64.5% were of age ranged from 16 to 21 years old. The participants (80%) reported good disease knowledge with a mean score of 12.06 ± 1.75, which substantially higher among medical students (P < 0.05). Most of the respondents (72%) believed that COVID-19 will be effectively controlled through precautionary measures. In correlation subgroup analysis, a significant relationship (P = 0.025) between knowledge and positive attitude were indicated. Fear and knowledge of COVID-19 emerged as strong predictors (P < 0.001) of preventive behaviors towards disease.

This study demonstrated satisfactory knowledge, positive attitudes, and suitable practices among students toward COVID-19. University students can be involved in public education to aid the health authorities in achieving the targets of educational campaigns with maximum population coverage.

Thea aim of this study was to explore the relationship between Florida nursing home and assisted living facility characteristics and their ability to comply with a new emergency power rule in the aftermath of Hurricane Irma.

This study used characteristics data on Florida nursing homes (NHs) (N = 680) and assisted living facilities (ALFs) (N = 2940) in operation between September 2017 and January 2019. Logistic regressions were used to determine whether certain characteristics were associated with compliance with the emergency power rule by January 1, 2019.

A total of 219 (32.9%) NHs and 2219 (75.5%) ALFs had an emergency power plan implemented by January 1, 2019. Results suggest having a dementia care unit increased the odds of compliance for NHs, while chain membership, for-profit status, and a higher reliance on Medicaid decreased the odds. Additionally, smaller size, mental health specialty license, and higher reliance on supplemental state funding increased the odds of compliance for ALFs, while nursing care specialty license and for-profit status decreased the odds of compliance.

Policy implications from these results include informing policy-makers on the barriers faced by NHs and ALFs to implement a new regulation that may cause financial difficulties and compromise quality care.

The aim of this study is to ascertain the psychological impacts of coronavirus disease (COVID-19) among the Pakistani health care workers (HCWs) and their coping strategies.

This web-based, cross-sectional study was conducted among HCWs (N = 398) from Punjab Province of Pakistan. The generalized anxiety scale (GAD-7), patient health questionnaire (PHQ-9), and Brief-COPE were used to assess anxiety, depression, and coping strategies, respectively.

The average age of respondents was 28.67 years (SD = 4.15), with the majority being medical doctors (52%). Prevalences of anxiety and depression were 21.4% and 21.9%, respectively. There was no significant difference in anxiety and depression scores among doctors, nurses, and pharmacists. Females had significantly higher anxiety (P = 0.003) and depression (P = 0.001) scores than males. Moreover, frontline HCWs had significantly higher depression scores (P = 0.010) than others. The depression, not anxiety, score was significantly higher among those who did not receive the infection prevention training (P = 0.004). The most frequently adopted coping strategies were religious coping (M = 5.98, SD = 1.73), acceptance (M = 5.59, SD = 1.55), and coping planning (M = 4.91, SD = 1.85).

A considerable proportion of HCWs are having generalized anxiety and depression during the ongoing COVID-19 pandemic. Our findings call for interventions to mitigate mental health risks in HCWs.

Using physiological markers to detect patients at risk of deterioration is common. Deaths at music festivals in Australia prompted scrutiny of tools to identify critically unwell patients for transport to hospital. This study evaluated initial physiological parameters to identify patients selected for transport to hospital from a music festival.

A retrospective audit of 2045 presentations at music festivals in Victoria, Australia, was performed. Presentation heart rate, systolic blood pressure, respiratory rate, oxygen saturation, temperature, and Glasgow Coma Scale were assessed using area under the receiver operating characteristic curve (AUROC) analysis, with a prespecified threshold of 0.7.

The only measured variable to exceed the prespecified cutpoint was initial systolic blood pressure, with an AUROC of 0.72 and optimal cutpoint of 122 mmHg. Using commonly accepted cutpoints for variables did not improve detection performance to acceptable levels, nor did using combination systems of cutpoints.

Initial physiological variables are poor predictors of the decision to transport to hospital from music festivals. Systolic blood pressure was significant, but only at a clinically insignificant value. Decisions on which patients to transport from an event site should incorporate more information than initial physiology. Senior clinicians should lead decision-making about hospital transport from music festivals.

Our hospital experienced a hospital shutdown and 2 week quarantine after a case of COVID-19 was diagnosed during hospitalization. We analyzed the reopening process following hospital closure and possible factors that prevented hospital spread.

We retrospectively reviewed the confirmed patient’s medical records and results of epidemiological survey available from the infection control team of our hospital.

A total of 117 hospital staff members were tested, 26 of whom were self-isolated. Of the 54 inpatients tested, 28 on the same floor, and 2 close contacts in the endoscopic room were quarantined in a single room. Finally, all quarantined hospital staff, inpatients and outpatients were tested for COVID-19 on the 14th day of close contact. The results were all negative, and the hospital work resumed completely.

Although closing and isolating the hospital appeared to have played a useful role in preventing the spread of COVID-19 inside the hospital and to the local community, it is still debated whether or not the duration of hospital closure or quarantine was appropriate. The lessons from the 2-week hospital closure suggest that wearing a mask, hand hygiene and the ward environment are important factors in preventing nosocomial outbreaks of COVID-19.

The aim of this study is to evaluate the knowledge of Brazilian dental students about biosafety measures that should be adopted in the clinical setting during the coronavirus disease (COVID-19) pandemic.

A cross-sectional study with 1050 dental students was conducted. A semi-structured questionnaire was shared with students. Mean knowledge score on biosafety guidelines during the COVID-19 pandemic was the outcome, with a maximum of 8 scores. Explanatory variables included sociodemographic and educational characteristics, aspects related to biosafety education, actions adopted by the dental schools during the pandemic, and sources of biosafety information. Multivariate linear regression analyses were performed.

Mean knowledge score was 5.19 (1.28). Female students (β = 0.346; 95% CI: 0.154–0.539), those enrolled in the intermediate (β = 0.525; 95% CI: 0.167–0.883) or final (β = 0.569; 95% CI: 0.200–0.937) stage of course, and those who had already received theoretical-practical training in biosafety (β = 0.464; 95% CI: 0.063–0.866) presented higher mean knowledge scores. Students who did not receive guidance on aerosol control measures before the pandemic (β = −0.324; 95% CI: −0.519 to −0.130) had the lowest score.

Students presented a medium level of knowledge about dental biosafety measures concerning the COVID-19 pandemic. Sociodemographic characteristics and those related to the institutional profile of the participants, and access to orientation and training in biosafety, may influence their knowledge.

The recent emerging respiratory disease caused by the novel type of Coronavirus has been named as COVID-19. This respiratory illness has received international attention and it is categorized as a high-threat disease in the US by the Center for Disease Control and Prevention. The purpose of the study was to assess the knowledge, attitude and practice of undergraduate nursing students towards COVID-19.

Descriptive cross-sectional design was used to assess knowledge, practice and attitudes of 255 undergraduate nursing students towards COVID-19. Study participants were recruited from the nursing college to Fakeeh College for Medical Sciences, between April and July, 2020.

The results of study participants showed that undergraduate nursing students had moderate knowledge of COVID-19. Also, participants had high level of knowledge regarding nature of diseases and precautionary measures by health care providers’ dimensions however, they expressed limited knowledge towards modes of transmission. Moreover, study participants demonstrated an optimistic attitude toward disease and good practice towards COVID-19.

The study results revealed that the study’s participants demonstrated good knowledge with favorable and accepted practice. This study suggests the importance of emphasis on infectious disease in the nursing curriculum.

The aim of this study was to investigate the performance of key hospital units associated with emergency care of both routine emergency and pandemic (COVID-19) patients under capacity enhancing strategies.

This investigation was conducted using whole-hospital, resource-constrained, patient-based, stochastic, discrete-event, simulation models of a generic 200-bed urban U.S. tertiary hospital serving routine emergency and COVID-19 patients. Systematically designed numerical experiments were conducted to provide generalizable insights into how hospital functionality may be affected by the care of COVID-19 pandemic patients along specially designated care paths, under changing pandemic situations, from getting ready to turning all of its resources to pandemic care.

Several insights are presented. For example, each day of reduction in average ICU length of stay increases intensive care unit patient throughput by up to 24% for high COVID-19 daily patient arrival levels. The potential of 5 specific interventions and 2 critical shifts in care strategies to significantly increase hospital capacity is also described.

These estimates enable hospitals to repurpose space, modify operations, implement crisis standards of care, collaborate with other health care facilities, or request external support, thereby increasing the likelihood that arriving patients will find an open staffed bed when 1 is needed.

Health-Care Coalitions (HCCs) provide an important emergency response safety net function across the United States in preparedness and responses to disasters. A key challenge is the variation in the maturity and operational readiness of HCCs. The purpose of this study was to identify key tenets that define high-functioning HCCs and help mature HCCs into a higher-functioning state of operations.

This was a qualitative study based on grounded theory methodology using semi-structured interviews for data collection and thematic analysis. Participants were stakeholders (n = 39) of HCCs from across the United States at local, state, and federal levels.

Through an institutional logics lens, the 3 key attributes for high functioning-HCCs were identified as (1) having an established and growing partnership, (2) being value-driven culture, and (3) being response ready. In addition, 3 logics were deemed essential for guiding HCCs: sources of governance, sources of partner engagement, and sources of sustainability. Participant responses describe the importance of these attributes and logics in influencing decision-making processes, supporting a community’s resilience during a disaster, and fostering robust relationships among community partners.

Addressing these attributes and logics in planning and management of HCCs can help establish the foundation for partner collaborations and high-functioning HCCs.

This study aimed to examine the effects of flooding due to Typhoon Hagibis on the incidence of cardiovascular/cerebrovascular events in Nagano City.

The SAVE trial retrospectively enrolled 2426 patients hospitalized for cardiovascular/cerebrovascular disease in 5 hospitals in Nagano City from October 1 to December 31 in 2017 and 2018 (pre-disaster period) and in 2019 (post-disaster period). From these, 280 patients who were hospitalized in a district flooded in 2019 were recruited for the same period (October 12 to December 31) over the 3 years. The baseline characteristics of and the incidence of cardiovascular/cerebrovascular disease in cases from the flooded district in 2019 were compared with those of cases in the flooded district in 2017 and 2018.

The total number of patients with acute myocardial infarction did not differ significantly between the post- and pre-disaster periods. The incidence of unstable angina pectoris was significantly higher in 2019 (n = 4, 5.1%) than in 2017 and 2018 (n = 0, 0.0%) (P = 0.001).

This study did not prove the impact of flood due to a typhoon on the incidence of cardiovascular/cerebrovascular events.

The huge explosion that occurred at Beirut Port led to a high number of casualties. Consequently, 7 field hospitals (FHs) were deployed in Lebanon. The purpose of this study is to explore the challenges that emergency medical teams (EMTs) faced and explain the gaps at the national level related to deploying a FH.

A qualitative study was conducted. To collect the data, semi-structured interviews were done with 8 key informants (5 from the FHs, 2 from Lebanese Army Forces, and 1 from Ministry of Public Health). In this study, purposive sampling was used and data were analyzed using Braun and Clarke (2006) thematic analysis and MAXQDA software.

Three major themes (logistical challenges, staff challenges, and coronavirus disease [COVID-19] pandemic) and 10 subthemes emerged for the challenges that EMTs faced. The gaps at the national level were categorized into 2 themes (absence of needs-based response and limited effective coordination between the host country and donor countries) and 5 sub-themes.

Lebanon focuses on response rather than preparedness for disasters. EMTs that arrived didn’t meet the medical needs. Hence, there is a need to strengthen the national capacities and to ensure better communication and coordination between the disaster-affected country and the EMTs.

Preschool-age children experience many home accidents, and school nurses play a role in preventing these accidents.

Accordingly, this study aimed to evaluate the effectiveness of training preschool-age children through an imagined hide-and-seek game using a model home environment, in cases that may pose an accident risk. This pretest–posttest control-group study was conducted between March and June 2019. In total, 72 preschool students were included in the study. The study group’s education through the model home environment and game was assessed using the Determination of Home Environment Risks Form.

The post-education mean accident risk scores of the children in the study group increased in the kitchen (pre-education: 4.89 ± 3.258; post-education: 9.56 ± 3.549), children’s room (pre-education: 6.17 ± 3.776; post-education: 8.56 ± 3.722), and garden (pre-education: 4.39 ± 2.697; post-education: 6.72 ± 2.953). In the study group, the mean scores of children for recognizing the circumstances that pose a risk of accident in the home environment were determined to increase significantly (P < 0.001). The corresponding scores of the children in the control group did not change in the kitchen (pre-education: 3.89 ± 2.025; post-education: 3.44 ± 2.006), children’s room (pre-education: 3.72 ± 1.667; post-education: 3.50 ± 2.158), or garden (pre-education: 2.83 ± 1.813; post-education: 2.17 ± 2.049).

The new techniques, which will help children learn while having fun, should be integrated into preschool children’s education programs to reduce home accidents.

Preparedness in different sections of a society can improve the reactions of individuals at the time of disasters and strengthen the cooperation and coordination between people and organizations. The present study aimed to investigate the preparedness of households in Ardabil Province of Iran in the face of disasters in 2020.

This descriptive, cross-sectional study was conducted in Ardabil Province in Iran in 2020. The target population included the households living in Ardabil Province. The study was conducted on 10 502 participants. The data were collected using a questionnaire completed by trained questioners by referring to the participants’ houses. It should be noted that the questionnaires were completed by one of the household parents. The questionnaire contained 15 questions related to taking and not taking disaster preparedness measures at specific times. EXCEL 2016 (Microsoft, Redmond, WA) and SPSS 23 software (IBM Corp, Armonk, NY) were used for data analysis.

Considering the score of 1 for each action, the mean score of households’ disaster preparedness in Ardabil Province was 31.09%. The preparedness level of 51.4%, 42.31%, and 6.29% of the households in the province against disasters was at low, moderate, and good levels, respectively. Among the items of preparedness in the face of disasters, the highest value was related to the familiarity of family members with the initial warnings of significant hazards (5162 households, 49.15%) followed by planning for coping with disasters (43.12%) and assessing the non-structural vulnerability (38.93%). Furthermore, the results showed that the level of household preparedness was higher in the center of the province compared to other cities.

Evaluating the level of preparedness of different societies in the face of disasters can be very useful in identifying the challenges to improve preparedness and, consequently, achieving sustainable development. This assessment can be considered a resource for provincial policy-making and planning to achieve the priorities set out in the Sendai framework. However, such assessments should be performed periodically, for example, annually, to reflect the effectiveness of the interventional measures in improving preparedness. Considering the low level of households’ preparedness in the present study, there is a gap between what people know and what they do, and comprehensive studies are needed on various factors that encourage people to take preparedness measures.

During the coronavirus disease (COVID-19) pandemic, health care workers, including nurses and their family members, experienced various psychological problems. Coping skills may help them deal with the current challenge and maintain their mental health and improve their quality of life. Therefore, this study investigated the relation of coping skills with mental health and quality of life of the nurses’ family members during the COVID-19 pandemic.

This cross-sectional study was conducted on the family members of the nurses working at Hajar Hospital of Shahrekord dedicated to admission and hospitalization of COVID-19 infected patients using a census sampling method in 2020. Participation in this study was voluntary and finally 220 persons were included in this study. To prevent the spread of COVID-19 through respiratory droplets or contact, a weblog was created using blogging software that contained questionnaires for collecting data on demographic information, mental health (PHQ-9), coping skills (coping responses inventory [CRI], Billings & Moos), and quality of life (SF-36). The collected data were analyzed using descriptive and inferential statistical tests in SPSS software version 22 (IBM Corp, Armonk, NY).

Of the 220 participants in this study, 101 participants were male and 119 were female. The mean age of the subjects was 35.78 years, and 56.4% of them had an academic education level. The Pearson correlation analysis showed a significant relationship between coping skills and mental health, quality-of-life items, total quality-of-life score, and demographic variables of participants (except education) (P < 0.05). This was a direct relationship in such a way that as the score of coping skills increases, so does the score of mental health and quality of life. Based on the results of regression analysis, the predictive power of mental health, coping skills, and education level was obtained to be 0.634. The coping skill variable was the strongest predictor (ß = 0.467), and after that, the mental health variable (ß = 0.421) had the highest predictive power.

The obtained results showed that coping skill is the association between psychological health and quality of life such that the coping skill has a significant direct effect on psychological health and quality of life. The results also showed that, at the time of crisis, further attention should be paid to coping skills to develop and improve the quality of life and psychological health.

The effectiveness of filtering facepiece respirators such as N95 respirators is heavily dependent on the fit. However, there have been limited efforts to discover the size of the gaps in the seal required to compromise filtering facepiece respirator performance, with prior studies estimating this size based on in vitro models. In this study, we measure the size of leak necessary to compromise the fit of N95 respirators.

Two methods were used to create a gap of specific dimensions. A set of 3D-printed resin spacers and hollow steel rods were used to generate gaps in N95 respirators while worn on 2 participants. Occupational Safety and Health Administration (OSHA) quantitative fit testing methods were used to quantify mask performance with gaps between 0.4 and 2.9-mm diameters.

Gap size was regressed against fit factor, showing that overall, the minimum gap size to compromise N95 performance was between 1.5 mm2 and 3 mm2.

These findings suggest the fit of a N95 respirator is compromised by gaps that may be difficult to visually detect. The study also adds to the body of evidence supporting the routine use of quantitative fit testing to ensure that masks are well-fitting.

Variations in the demand for Emergency Medical Services (EMS) exist when observed at a local level. This unspecified heterogeneity leads to an investigation of social factors contributing to EMS demand.

Data for this study were collected from publicly available EMS reports from Florida and Oklahoma for 2009 - 2015. Health and social data were gathered from County health rankings and roadmap reports. Data were combined into a single dataset, and pooled ordinary-least-squares models with time-fixed effects were utilized for tests of inference. EMS call volume was log-transformed to derive a semi-elasticity function.

A total of 874 county-year observations were analyzed. Increases in poor/fair health (95% CI: 0.6% - 3.9%), binge drinking (95% CI: 1.6% - 3.5%), teen birth rate (95% CI: 1.1% - 5.2%), unemployment rate (95% CI: 0.5% - 3.9%), and violent crime rate (95% CI: 1.0% - 3.0%) were associated with an increase in the EMS demand rate.

The data supports the notion that some community measures have an effect on EMS demand as counties with higher levels of poor health, binge drinking, teen births, unemployment, and violent crime saw higher EMS demand. These factors may have been treated as spurious, or overlooked by policy makers and EMS leadership.

The consensus is that psychological first aid is a practical, early psychosocial intervention to mitigate the distress caused by disasters. This review aimed to investigate PFA training’s efficacy in the existing studies and evaluate these programs’ impact on trainees.

MEDLINE (National Library of Medicine, Bethesda, MD), EMBASE (Elsevier, Amsterdam, Netherlands), PsycInfo (American Psychological Association, Washington, DC), and Cochrane Library (John Wiley & Sons, Hobken, NJ, USA) were searched on August 1, 2020 without language and date limitation. The Cochrane Risk of Bias tool for randomized controlled trials and the Risk of Bias in Non-Randomized Studies - of Interventions (ROBINS-I) (Cochrane, London, UK) were used to assess the quality of the studies included. SPSS (IBM Corp., Endicott, NY, USA) was used for descriptive, comparative, and correlational summaries.

From 376 articles, only 9 studies met the criteria and were included after screening. The most common outcome was knowledge improvement, followed by increased confidence, and competence. Other outcomes encompassed Attitude, preparedness, and therapeutic engagement.

PFA is the most suggested early intervention aftermath and could be acquired by professionals and non-professionals in the mental health area. Nonetheless, to obtain the desired outcome, PFA training programs’ quality is vital. This review revealed that most training programs’ duration was short, without scenario-based interactions and post-training supervisions. More controlled trials are required to measure the effectiveness of PFA training on the providers.