Testing the waters: A pilot trial of acceptance and commitment therapy (ACT) for alcohol use disorder.

Background: Psychosocial interventions help maintain alcohol abstinence. Third-wave psychotherapies have emerged as an alternative to cognitive behavioral therapies for Alcohol Use Disorder (AUD) treatment. However, third-wave therapies have not been tested in non-western settings or via telehealth. Aim: We assessed the acceptability and feasibility of Acceptance and Commitment Therapy (ACT) in moderate/severe AUD. Methods: This was a pre- and post-study design. All those who met the eligibility (n = 40) criteria consented to participate. A trained nurse delivered four sessions of ACT, either in-person or via video-conferencing, per participants' preference. Alcohol use, craving, relapse signs, and psychological flexibility were assessed three months post-intervention. Results: Twenty-eight participants (70%) attended all four sessions. There was a significant increase in abstinence and a decrease in alcohol use, frequency of drinking/heavy drinking, craving, relapse signs, and improved psychological flexibility. Outcomes were positive for either mode of delivery. Conclusion: ACT is feasible, acceptable, and probably effective in AUD.

The Psychological Morbidity among Health Care Workers During the Early Phase of Covid-19 Pandemic in India: A Systematic Review and Meta-Analysis.

Across India, there have been multiple studies conducted to address the issues of the mental health of healthcare workers during the COVID-19 pandemic. The present study estimated the pooled prevalence of psychological morbidity among healthcare workers during the early phase of the COVID 19 pandemic in India. We searched the following electronic bibliographic databases: PubMed, ScienceDirect, Wiley online library, and Google scholar for studies conducted from the onset of the COVID 19 pandemic until 25 September 2021. The methodological quality of each study was scored and outcome measures with uniform cut off scores as per various screening measurements were evaluated. According to the current meta analysis, the pooled estimates of depression, anxiety, stress, and insomnia among Indian healthcare workers during the COVID 19 pandemic are 20.1% (95% CI: 15.6 to 24.6%; n = 21 studies), 25.0% (95% CI: 18.4 to 31.6%; n = 20 studies), 36% (95% CI: 23.7 to 48.2%; n = 22 studies) and 18.9% (95% CI: 9.9 to 28.0%; n = 6 studies) respectively. In subgroup analyses, low quality studies based on the JBI checklist (Score < 3/9) and studies using DASS 21 showed a higher pooled prevalence of depression and anxiety. About 20-36% of the healthcare workers in India reported having depression, anxiety, and stress during the early phase of the COVID 19 pandemic. The present study provides a comprehensive review of the overall burden of mental health problems among healthcare workers during the COVID 19 pandemic in India necessitating appropriate intervention strategies to protect these frontline groups before the memory of the pandemic crisis starts to fade.

Occupational Stress- Addressing Woes of the Nurses in a Burn Unit.

Occupational stress can leave the nurses drained while caring for patients in the burn unit. This existential-phenomenological study aimed to explore burn unit nurses' lived experiences of occupational stressors and organizational support. Twenty-two nurses working in the burn unit were interviewed. Data were analyzed utilizing Colaizzi's 7-step method. Three themes were generated: stressful work environment; feelings of helplessness; need for organizational support. Nurses reported that organizational support should be available for dealing with the work-related stressors in the burn unit.

Reporting adverse events of ChAdOx1 nCoV-19 coronavirus vaccine (Recombinant) among the vaccinated healthcare professionals: A cross-sectional survey.

Background & objectives: The safety of the ChAdOx1 nCoV-19 vaccine is a cause of concern for many who have been vaccinated. The people have multiple concerns and fear regarding the adverse events of the vaccine. Thus, this study was undertaken to establish the safety profile of ChAdOx1 nCoV-19 Corona Virus Vaccine (Recombinant) among the healthcare professionals. Methods: This was a descriptive cross-sectional survey. After taking clearance from the institutional ethics committee 1500 healthcare professionals, who had their vaccination in the past two weeks were selected. They were provided with an online survey proforma regarding adverse events following immunization (AEFIs) of COVID-19 vaccine developed using google forms with an informed consent form affixed to it. Results: A total of 1036 individuals participated in the study. The mean and median (inter quartile range) age of the participants was 37.7 ±11.25 and 35 (29-46) yr, respectively. Of these, 52.1 per cent were female, 29.3 per cent were doctors, 33.4 per cent were nurses and 9.5 per cent were paramedical staff. Forty six per cent participants experienced one or more minor AEFIs such as pain, tenderness, redness, etc. at the injection site. Fatigue (31.75%), generalized feeling of unwell (28.57%), muscle pain (23.16%) and fever (21.71%) were the most commonly reported systemic AEFIs followed by headache (20.07%), dizziness (10.03%) and joint pains (15.25%). Most of them experienced these AEFIs within 24 h of the first dose of administration. About 42 per cent of the participants took oral antipyretics/analgesics for managing the AEFIs. Interpretation & conclusions: ChAdOx1 nCoV-19 Corona Virus Vaccine was found to be associated with mild local and systemic AEFIs that were more common after the first dose as compared to the second dose. There adverse events could be dealt with oral over-the-counter medications, with no requirement of hospitalization.

Acceptance and Preparedness to be COVID Warriors: Self Narratives of Frontline Nurses of a Tertiary Care Center.

AIM: Aim of this study is to gain insight into how frontline nurses accepted and prepared themselves before COVID posting. METHODS: It is a qualitative and phenomenological study design. Eighteen in-depth interviews were conducted with the nurses who provided care to confirmed COVID 19 patients in a tertiary hospital of North India from September to November 2020. The interviews were transcribed and analyzed using Colaizzi's phenomenological method. The consolidated criteria for reporting qualitative research (COREQ) were followed in this study. RESULTS: In this study, the reported experiences were divided into five main themes: (I) Getting ready to be at the frontlines (II) Family and peer support (III) I Can Handle it! (IV) I have to be Strong! (V) Training is key to confidence. The risk of infection, fear of being a source of infection to the family, the worry of staying away from family, uncertainty, and nervousness related to personal protective equipment were the most common thoughts that disturbed the participants. However, taking a good diet, practicing yoga and meditation, having a sense of serving their country and community, faith in God, family support, faith in the organization, and good training helped the participants to prepare for the COVID posting. CONCLUSION: Despite facing various challenges, the nurses showed great strength and resilience. To promote a resilient health system, supportive supervision and adequate administrative support, training and workshops, peer group support, counseling cells, and spiritual support may be considered.

Attitude and Perception of Nursing Personnel Involved in Real Time Remote Audio-Visual Aided (RT-RAVA) Monitoring of Doffing for the Prevention of Covid-19 Infection among the Health Care Workers.

The study was carried out to explore the attitude and perception of observers involved in monitoring of doffing through Real Time Remote Audio-Visual aided (RT-RAVA), the first well-sophisticated surveillance system. A 21-item online-survey proforma was used to collect the data amongst 150 nursing personnel. 3/4th of the participants strongly agreed that they helped in reducing the doffing errors through RT-RAVA doffing. 97.3% perceived that the system is highly effective in reducing the infection during doffing. There was significant correlation between attitude and perception of the observers. The system was perceived as highly effective and was recommended for doffing.

Feasibility and preliminary effectiveness of internet-mediated 'relapse prevention therapy' for patients with alcohol use disorder: A pilot study.

INTRODUCTION: To assess the feasibility, acceptability and preliminary effectiveness of synchronous internet-mediated relapse prevention therapy (i-RPT) in alcohol use disorder. METHODS: This was a pilot, quasi-experimental study. Thirty-two adult men with alcohol use disorder were recruited through purposive sampling from an outpatient setting. We assessed patterns of drinking, craving, motivation and coping. Patients received five twice-weekly sessions of i-RPT. They were reassessed 12 weeks post-intervention (CTRI Trial REF/2020/09/036392). RESULTS: Thirty-two (48%) of the 67 patients fulfilled the eligibility criteria and all consented to the study. All participants completed at least two sessions and 23 (71.9%) completed all five sessions. Two-thirds of participants reported high satisfaction in the Telehealth Satisfaction Questionnaire. We observed modest intervention effects on days of abstinence in both per-protocol (P <0.001; r = 0.6) and worst-case (P <0.001, r = 0.5) analyses. There were also reductions in the amount of alcohol use, frequency of drinking and heavy drinking, craving and maladaptive coping behaviours. Per-protocol analysis revealed a positive post-intervention change in the motivational level to change alcohol use. CONCLUSION: iRPT appears to be feasible, acceptable and possibly effective in alcohol use disorder.

Performance of Health Care Workers in Doffing of Personal Protective Equipment Using Real-Time Remote Audio-Visual Doffing Surveillance System: Its Implications for Bio-Safety Amid COVID-19 Pandemic.

Background Very little has been reported about health care workers' (HCWs) adherence to the Centers for Disease Control and Prevention (CDC) guidelines of doffing personal protective equipment (PPE) amid the COVID-19 pandemic. Real-time remote audio-visual doffing surveillance (RADS) system for assisting doffing might reduce the risk of self-contamination. We used this system to determine the incidence of the breach in biosafety during doffing of PPE among HCWs involved in the care of Covid-19 patients. Methods A total of 100 HCWs were enrolled in this observational study who performed duties in the COVID intensive care unit (ICU) of our tertiary care centre. With a real-time RADS system, trained observers from remote locations assisted HCWs during doffing of PPE and noted breach at any step using the CDC doffing checklist. The breach was considered major if committed during removal of gloves/gown/N-95 or if ≥3 errors occurred in any other steps. Results Overall, 40% of the HCWs committed a breach during doffing at least one step. The majority of the errors were observed during hand hygiene (34%), followed by glove removal (12%) and N-95 removal (8%). Nineteen percent of HCWs committed the major breach, out of which 37.5% were done by house-keeping sanitation staff (p = 0.008 and RR 2.85; 95% CI of 1.313-6.19), followed by technicians (22.5%), nursing staff (16.7%) and resident doctors (6.5%). Conclusions Performing doffing using a real-time RADS system is associated with a relatively low incidence of a breach in biosafety compared with earlier studies using an onsite standard observer. Overall adherence of HCWs to the CDC guidelines of doffing PPE was satisfactory. This study highlights the importance of the RADS system during doffing of PPE in a health care setting amid the COVID-19 pandemic.

Randomized Controlled Trial on the Promotion of Sexual Health Using "Self-Care Interventional Package" in Men Who have Sex with Men.

PURPOSE: Men who have sex with men (MSM) is a vulnerable group, who have been neglected and discriminated. Such discrimination decreases their access to health care and increases the spread of sexually transmitted infections (STIs) and human immunodeficiency virus (HIV). AIMS AND OBJECTIVE: The objective is to evaluate the effectiveness of "self-care interventional package" on the promotion of sexual health, among MSM. MATERIALS AND METHODS: A randomized controlled trial was conducted on MSM from two nongovernmental organization centers of Chandigarh, which were randomized by simple random sampling into a control and experimental group. Over a period of 1 month, a total of 115 MSM were found eligible; 55 in control group and 60 in experimental group. Data were collected by a personal interview, after taking consent, in a comfortable and private environment. The Self-Care Interventional Package on the promotion of sexual health was developed in the form of flash book and booklet, and delivered by one-to-one interaction. Three follow-ups were done weekly for motivation in both the groups. Postintervention assessment was conducted after 1 month. RESULTS: There was a statistically significant (P < 0.01) improvement in knowledge about prevention and management of STIs and HIV, getting vaccinated for Hepatitis B and regular self check-up. Statistically significant reduction in unsafe sexual practices was noted among the MSM of experimental group. CONCLUSION: The self-care interventional package for the promotion of sexual health was effective in improving the sexual heath of the MSM population.

Effectiveness of an Interventional Package on the Level of Anxiety, Depression, and Fatigue among Patients with Cervical Cancer.

OBJECTIVE: To evaluate the effectiveness of interventional package on the level of anxiety, depression, and fatigue. METHODS: The study was conducted in room no. 5, first floor, B Block, Department of Radiotherapy, Nehru Hospital, Postgraduate Institute of Medical Education and Research, Chandigarh Quasi experimental pretest-posttest design was used in the study. A total of 60 patients receiving radiotherapy/chemotherapy were assigned in two groups of 30 each, through total enumeration sampling technique. The tools used for the study were Zung Anxiety Scale, Beck Depression inventory, and Fatigue Scale. The protocol used for the study includes the Jacobson's Progressive muscle relaxtion technique, counsling and home care techniques. RESULTS: Sociodemographic variables and clinical profile of participants in both groups were comparable. Interventional package significantly reduces the anxiety, depression, and fatigue (P < 0.001 in 3 variables) in experimental group. CONCLUSIONS: Interventional package for patients with cervical cancer proved to be an effective modality in reducing the anxiety, depression, and fatigue.

Using the first drop of blood for monitoring blood glucose values in critically ill patients: An observational study.

CONTEXT: Using the first drop or second drop of blood while measuring blood glucose (BG) values. OBJECTIVE: The study was planned to compare the BG values from the first and second drops of blood. RESEARCH SETTINGS: The study was conducted at the Main Intensive Care Unit, PGIMER, Chandigarh, India. RESEARCH DESIGN: This study was a comparative study. MATERIALS AND METHODS: Ninety patients aged 2-93 years were enrolled in this study. BG values from the first and second drops of blood were taken and compared. STATISTICAL ANALYSIS USED: Agreement between two drops was assessed using Bland-Altman analysis. A bias of <10 mg/dl was considered clinically acceptable. Linear regression of the mean difference (bias) with the BG readings was performed. RESULTS: One thousand four hundred and seven pairs of BG readings were taken from the enrolled patients. BG values had a bias of 3.9 ± 14.9 mg/dl. Nearly 96.7% of BG readings were within the limits of agreement. The absolute difference between first and second drops of blood was calculated; nearly 75.4% of the readings had fallen between 0 and 10 mg/dl, i.e. clinically acceptable range. CONCLUSION: There is no compete concordance of values of blood glucose between the first and the second drops of blood; any of the drops can be used for measuring BG values as the difference is not statistically significant. However, if hands are visibly clean and to decrease the blood loss in the critically ill patients where the BG values are measured frequently, using the first drop of blood is advised.