Comparative analysis of COVID-19 guidelines from six countries: a qualitative study on the US, China, South Korea, the UK, Brazil, and Haiti.

BACKGROUND: In late January, a worldwide crisis known as COVID-19 was declared a Public Health Emergency of International Concern by the WHO. Within only a few weeks, the outbreak took on pandemic proportions, affecting over 100 countries. It was a significant issue to prevent and control COVID-19 on both national and global scales due to the dramatic increase in confirmed cases worldwide. Government guidelines provide a fundamental resource for communities, as they guide citizens on how to protect themselves against COVID-19, however, they also provide critical guidance for policy makers and healthcare professionals on how to take action to decrease the spread of COVID-19. We aimed to identify the differences and similarities between six different countries' (US, China, South Korea, UK, Brazil and Haiti) government-provided community and healthcare system guidelines, and to explore the relationship between guideline issue dates and the prevalence/incidence of COVID-19 cases. METHODS: To make these comparisons, this exploratory qualitative study used document analysis of government guidelines issued to the general public and to healthcare professionals. Documents were purposively sampled (N = 55) and analyzed using content analysis. RESULTS: The major differences in the evaluation and testing criteria in the guidelines across the six countries centered around the priority of testing for COVID-19 in the general population, which was strongly dependent on each country's healthcare capacity. However, the most similar guidelines pertained to the clinical signs and symptoms of COVID-19, and methods to prevent its contraction. CONCLUSION: In the initial stages of the outbreak, certain strategies were universally employed to control the deadly virus's spread, including quarantining the sick, contact tracing, and social distancing. However, each country dealt with differing healthcare capacities, risks, threats, political and socioeconomic challenges, and distinct healthcare systems and infrastructure. Acknowledging these differences highlights the importance of examining the various countries' response to the COVID-19 pandemic with a nuanced view, as each of these factors shaped the government guidelines distributed to each country's communities and healthcare systems.

Stress and depression in the context of migration among Haitians in the United States.

Our global communities are becoming increasingly more diverse and interwoven; thus, research that enhances our understanding of the multidimensional relationship between depression and migration among distinct ethnic groups is imperative. This study examined the relationship between migration-related stress and depression and the extent to which that relationship is modified by other factors, through the lens of the stress process model. This cross-sectional pilot study used purposive sampling methods to recruit 76 first-generation Haitian immigrants living in South and West Florida from February 2018-May 2018. Descriptive statistics, bivariate and multiple regressions were utilized to assess associations among migration-related stress (Demands of Immigration Scale), depression (Center for Epidemiological Studies Depression (CESD), Zanmi Lasante Depression Symptom Inventory (ZLDSI)), and key demographic variables. Findings showed a strong positive correlation between migration-related stress and depression (CESD (ß =.606, 95% CI [.296, .556]) and ZLDSI (ß = .624, 95% CI [.242, .440]). Relative to the standardized coefficient, migration-related stress was the strongest predictor of depression after controlling for other predictors. Presence at the 2010 earthquake was the only significant moderator, showing an amplifying effect between migration-related stress and depression (ZLDSI) for those in Haiti during the 2010 earthquake. Consideration of pre-migration factors and the degree of migration-related stress encountered while adapting to life post-migration is critical because they play a significant role in shaping immigrants' depression realities. Community-based services that incorporate or partner with established immigrants to strengthen support for the most vulnerable immigrants early on after migration could serve to mitigate migration-related stressors and facilitate mental health promotion and prevention.

Exploring the Relationship between Diarrhea and Fatigue that can occur during Cancer Treatment: Using Structural Equation Modeling.

OBJECTIVE: To examine the relationship of the symptoms of diarrhea and fatigue by testing a model that included multiple dimensions of the cancer related-symptom experience. METHODS: A secondary data analysis was conducted on data from the self-reports of 102 cancer patients co experiencing diarrhea and fatigue during treatment at a comprehensive cancer center in the Southeastern United States. Structural equational modeling was employed to examine the relationship between the 2variables. Fatigue and diarrhea were assessed using items from the Cancer Symptom Scale. RESULTS: The structural model results showed that (a) the model fit was adequate (b) diarrhea explained 7% of the variance in fatigue, and (c) the structural or path coefficient between diarrhea and fatigue was significant (0.267; p<0.05). Diarrhea had the strongest effect on fatigue interference (0.251). CONCLUSION: Diarrhea is a potential contributing factor to the symptom of fatigue and a potential target for interventions to prevent and ameliorate fatigue.

Differences in the Severity, Distress, Interference, and Frequency on Cancer-Related Symptoms Between Island Hispanic Puerto Ricans and Mainland Non-Hispanic Whites.

The knowledge base of cancer-related symptoms is increasing; yet, limited attention has been given to provide evidence on differences in the perception of cancer symptoms between ethnic groups, especially in the Hispanic Puerto Rican (PR) population. To examine whether there are significant differences in the severity, distress, interference, and frequency of cancer symptoms between island Hispanic PR and mainland non-Hispanic whites. In this secondary data analysis, data from 109 Hispanic PR was matched by age, gender and cancer diagnosis with data from non-Hispanic whites. Cancer symptoms were assessed using the Cancer Symptom Scale (CSS). Mann-Whitney statistical test was used to evaluate pairwise differences between Hispanic PR and non-Hispanic whites on symptoms from the CSS. There were significant differences on some symptoms including PR reporting: (a) more intense itching, swelling, taste change, difficulty sleeping, bloating, depression, sadness, worry, and nervousness; (b) significantly greater distress about taste change, appetite, anxiety, depression, worry, and feeling nervous; (c) rash, anxiety, depression, sadness, and nervousness interfered the most with their daily lives; and, (d) that the frequency of occurrence of the symptoms of pain, itching, dizziness, taste change, anxiety, sadness, and nervousness was higher compared to non-Hispanic whites. PR cancer patients are at increased risk for experiencing greater severity of cancer symptoms compared to non-Hispanic whites. But because the Hispanic oncology population does not always report symptoms, risking under-assessment and under-management, this suggests there may be a greater need for symptoms surveillance for this population.

Symptom Burden: Experiences of Puerto Rican Men With Prostate Cancer Prior to External Beam Radiation Therapy.

BACKGROUND: Prostate cancer is the most frequently diagnosed cancer in men in Puerto Rico, and external beam radiation therapy (EBRT) is a popular treatment. Although symptom management is a clinical priority of comprehensive oncology care, symptom assessment at the time of primary or adjuvant EBRT has received limited attention. OBJECTIVES: This article examines the prevalence and severity of symptoms experienced by 54 Puerto Rican men prior to EBRT. METHODS: Participants completed a demographic form and the MD Anderson Symptom Inventory. Descriptive statistics were generated. FINDINGS: Most participants had received hormonal treatment, and about a third had received no treatment prior to EBRT. About a third of those who received hormonal treatment reported experiencing side effects before EBRT, and disturbed sleep, numbness and tingling, fatigue, and dry mouth were the most severe. Puerto Rican men with prostate cancer who receive hormonal treatment are at increased risk for experiencing symptom burden prior to EBRT. Greater need for symptom surveillance, treatment, and control may be needed among this population.