Relationship between self-perceived driving ability and neuropsychological performance in neurological and psychiatric patients.

BACKGROUND: Neurological and psychiatric patients want to keep driving but several sensory, motor, and cognitive deficits could limit this purpose. However, some drivers "self-regulate" driving behavior to minimize the risk of accidents. A good predictor of this behavior seems to be the self-perceived driving ability. The purpose of this study was to evaluate whether the neuropsychological profile of neurological and psychiatric active drivers correlates to self-reported and caregiver-referred driving behavior. METHODS: Sixty-three active drivers diagnosed with a neurological or psychiatric condition were enrolled and underwent cognitive assessment plus two behavioral questionnaires (Driver Behavior Questionnaire - DBQ and Barratt Impulsiveness Scale-version 11). DBQ and IADL (Instrumental Activities of Daily Living) were also administered to thirty-nine caregivers, to assess autonomy in daily life and the frequency of errors and violations committed by drivers. Spearman's Rho non-parametric analysis was used to investigate the relationship between performances at neuropsychological tests and DBQ responses. Cohen's weighted kappa coefficient was also adopted to verify the strength of agreement between the two groups at the DBQ. RESULTS: Results suggested an overall agreement between self-reported and caregiver-referred driving behavior; moreover, a relationship between self-referred driving behavior and impulsiveness was found. However, neuropsychological performances were not related to self-perceived driving ability. CONCLUSIONS: These results provide new insight regarding the risk of incurring road accidents and can be useful to promote a more appropriate evaluation of risk accidents in neurological and psychiatric patients.

Epidemiological progression of COVID-19 positive cases among transnational truck drivers in the East African Region.

COVID-19 triggered a range of border controls to curb the spread of the disease. Containment measures and restrictions were put in place to mitigate cross border transmission while maintaining the flow of essential goods and services in the East and Horn of Africa Region. The first cases of COVID-19 detection among truck drivers, triggered and strengthened cross-border collaboration for detecting and responding to COVID-19 pandemic. Infection was significantly common among truck drivers in the region. As at 13 January 2021, there were 3,457 reported cumulative cases among truck drivers in the EHoA region. About 2,879 (83.3%) of the cases were reported in Uganda, 374 (10.8%) cases reported in Kenya, 190 (5.5%) cases reported in Rwanda and 14 (0.4%) cases reported in South Sudan. The reduction in the number of documented new COVID-19 cases among truck drivers declined with collaborative, timely and cooperative border point screening, and so preventing COVID-19 spread in the region. With most East African countries setting the stage for reopening borders and air spaces, sustained comprehensive surveillance is crucial for maintaining the gains from the collaborative response.

Health system considerations related to voluntary and forced displacement in the Eastern Mediterranean Region: a critical analysis of the available literature.

BACKGROUND: The WHO Region for the Eastern Mediterranean has had a history of complex migration patterns, with high levels of migration to, from and within the Region, overlaid by massive recent forced displacement. Relatively little is known about the health system response to this large-scale mobility. AIMS: To review the literature on the Region critically, identify gaps and suggest areas needing research and policy attention. METHOD: A search of the published literature using MEDLINE and POPLINE was conducted on health and migration focusing on the WHO health system building blocks with no date or language limitations. RESULTS: Out of 4679 retrieved articles published between 1964 and January 2019, 140 met our inclusion criteria; 45 additional articles were included in a December 2020 update. Most publications focused on refugees and on the delivery of services. CONCLUSIONS: Few studies explored the responsiveness of health system to refugees and migrants compared with those for host communities, or assessed the quality of services or refugees'/migrants' perceptions of available health services. Few suggested new approaches to financing health care access for these populations or new governance arrangements.

'It is a disease which comes and kills directly': What refugees know about COVID-19 and key influences of compliance with preventive measures.

BACKGROUND: Refugees are at increased risk for COVID-19 infection in part due to their living conditions, which make it harder to adopt and adhere to widely accepted preventive measures. Little empirical evidence exists about what refugees know about COVID-19 and what they do to prevent infection. This study explored what refugee women and their health care workers understand about COVID-19 prevention, the extent of their compliance to public health recommendations, and what influences the adoption of these measures. METHODS: In October 2020, we conducted 25 in-depth interviews with facility and community health care staff (n = 10) and refugee women attending antenatal and postnatal care services (n = 15) in Eastleigh, Nairobi. FINDINGS: While researchers found a high level of awareness about COVID-19 and related prevention and control measures among refugee women, various barriers affected compliance with such measures, due in part to poverty and in part to rampant misconceptions informed by religious beliefs and political narratives about the virus. CONCLUSIONS: These findings indicated that Kenya's Ministry of Health needs to institute a concerted and continuous education program to bring refugee communities up to speed about COVID-19 and its prevention. In addition to disseminating information about the need to wear masks and repeatedly wash hands, supplies-masks, soap and access to water-need to be made available to poor refugee communities. Future research could explore which measures for disseminating factual information work best in refugee populations with different cultural norms and how best to target interventions to these groups.

"We have a lot of home deliveries" A qualitative study on the impact of COVID-19 on access to and utilization of reproductive, maternal, newborn and child health care among refugee women in urban Eastleigh, Kenya.

BACKGROUND: Little is known about how pregnant refugee women, and the frontline health care workers who serve them, are affected by the COVID-19 pandemic in terms of health, and health service access. Women refugees are classified as a vulnerable group with regard to pregnancy outcomes and access to maternal care, and may be disproportionally at risk for COVID-19 infection as they are likely to face unique barriers to information and access to reproductive health services during the pandemic. Few studies identify gaps that could inform potential interventions to improve service uptake for refugee women, particularly in the context of COVID-19. Yet, understanding how pregnant refugees are impacted in the context of the pandemic is critical to developing and implementing strategies and measures that can help in their care and the delivery of health services. AIMS: This study aimed to improve understanding of the impact of COVID-19 on women refugees' access to and utilisation of antenatal care, delivery and postnatal care in Eastleigh, Kenya. METHODS: The study was conducted in Eastleigh, a semi-urban centre in Nairobi. We conducted 25 in-depth interviews with facility and community health care staff (n = 10) and women attending antenatal (n = 10) and postnatal care services (n = 5) in October 2020. Data was analysed using NVIVO 12 software. FINDINGS: Our findings suggest that within the first eight months of COVID-19, preferences for home deliveries by refugee women increased and health care workers reported having observed reduced utilisation of services and delayed care. Fear, economic challenges and lack of migrant-inclusive health system policies were key factors influencing home deliveries and delayed and low uptake of facility-based care. CONCLUSIONS: The findings highlight the need to mitigate and lower barriers that prevent refugee women from seeking care at health facilities. One approach includes the development of refugee-inclusive public health policies, particularly during a pandemic, and the need to tailor health care services for refugees at facilities and in the communities.

Illicit drug use: can it predict adherence to antiretroviral therapy?

This study analysed the level of adherence to anti-HIV therapies in illegal drug users compared to non-users. Out of 214 patients interviewed. 60 (28%) reported current use of one or more illegal drugs (heroin, cocaine), alcohol (>6 U/day), psychoactive drugs and others. Within the two groups reporting use of heroin and cocaine, the percentage of patients achieving good levels of compliance was higher than among patients who reported not using any substance (50 and 46% vs. 42.3%), among the users of psychoactive pharmaceuticals and alcohol the percentage of high-compliant patients tended to be lower (respectively 26.6 and 30%), but the difference was not significant.

Utilização de máscara facial cirúrgica descartável no ambiente cirúrgico / Use of disposable surgical face masks at the surgical environment / Utilización de la máscara facial quirúrgica desechables en lo ambiente quirúrgico

As máscaras faciais cirúrgicas são essenciais tanto para a proteção individual dos membros da equipe da Unidade de Centro Cirúrgico (UCC), quanto para a proteção do paciente durante o procedimento. Esse estudo teve como objetivo analisar a utilização da máscara facial cirúrgica pelos acadêmicos e profissionais de saúde na UCC quanto ao tempo, local e forma de utilização. Foram observados 33 acadêmicos e profissionais de um Hospital de Clínicas, no período de janeiro a fevereiro de 2008. Para a coleta dos dados foi utilizado um instrumento específico do tipo checklist e a análise feita segundo estatística descritiva, em freqüência absoluta, relativa e média. Os principais resultados encontrados foram: 81,8% acadêmicos e profissionais utilizaram a máscara cirúrgica cobrindo boca e nariz, 72,7% acadêmicos e profissionais colocaram a máscara no início do procedimento cirúrgico, e 60,6% acadêmicos e profissionais retiraram a máscara pelas tiras. Assim, observou-se que a máscara cirúrgica foi, no geral, utilizada de maneira adequada conforme preconizado por órgãos nacionais e internacionais, fato provavelmente relacionado ao ambiente acadêmico do Hospital analisado, onde há divulgação constante de normas e padrões recomendados.

Surgical masks are essential as for the individual protection of Surgical Center team members as for the patient's protection during the procedure. The present study objective was to assess the wearing of surgical masks by surgical site students and professionals according to time, local and way of use. Thirty-three students and professionals were observed in a Clinic Hospital, from January to February 2008. For data collection, a specific instrument of checklist kind was used, and the evaluation was made based on descriptive statistics and absolute, relative and medium frequency. The main results obtained were: 81,8% of the students and professionals wear the surgical mask covering mouth and nose, 72,7% of the students and professionals wear the mask in the beginning of the procedure, and 60,6% of the students and professionals discarded the mask from the strips. So, the surgical mask was, in general, used in a correct way according to what is advocated by national and international organizations, fact probably connected to the academic environment of the analyzed hospital, where recommended guidelines and patterns divulgation is constant.

Máscaras faciales quirúrgicas son esenciales tanto para la protección individual de los miembros del equipo del Centro Quirúrgico, cuanto para la protección del paciente durante el procedimiento. Este estudio tuvo como objetivo analizar la utilización de la máscara quirúrgica por los acadêmicos y profesionales de salud en la Unidad del Sitio Quirúrgico con relación al tiempo, localidad y forma de utilización. Fueron observados 33 académicos y profesionales de Hospital de Clínicas, en el periodo de Enero a Febrero de 2008. Para la coleta de los datos, fue utilizado un instrumento especifico del tipo checklist, y su análisis hecha según estadística descriptiva, en frecuencia absoluta, relativa y media. Los principales resultados encontrados fueron: 81,8% de los acadêmicos y profesionales utilizaran la máscara quirúrgica cubriendo la boca y nariz, 72,7% de los acadêmicos y profesionales punieron la máscara en el inicio de lo procedimiento quirúrgico, y 60,6% de los acadêmicos y profesionales retiraran la máscara por las tiras. Así, fue observado que la máscara quirúrgica fue, en general, utilizada de manera adecuada conforme preconizado por órganos nacionales y internacionales, facto probablemente relacionado al ambiente académico del Hospital analizado, donde hay divulgación constante de normas y padrones recomendados.