Instruments to measure fear of COVID-19: a diagnostic systematic review.

BACKGROUND: The COVID-19 pandemic has become a source of fear across the world. Measuring the level or significance of fear in different populations may help identify populations and areas in need of public health and education campaigns. We were interested in diagnostic tests developed to assess or diagnose COVID-19-related fear or phobia. METHODS: We performed a systematic review of studies that examined instruments diagnosing or assessing fear or phobia of COVID-19 (PROSPERO registration: CRD42020197100). We utilized the Norwegian Institute of Public Health's Live map of covid-19 evidence, a database of pre-screened and pre-categorized studies. The Live map of covid-19 evidence identified references published since 1 December 2019 in MEDLINE, Embase, and the Centers for Disease Control and Prevention. Following biweekly searches, two researchers independently categorized all studies according to topic (seven main topics, 52 subordinate topics), population (41 available groups), study design, and publication type. For this review, we assessed for eligibility all studies that had been categorized to the topic "Experiences and perceptions, consequences; social, political, economic aspects" as of 25 September 2020, in addition to hand-searching included studies' reference lists. We meta-analyzed correlation coefficients of fear scores to the most common reference tests (self-reports of anxiety, depression, and stress), and reported additional concurrent validity to other reference tests such as specific phobias. We assessed study quality using the QUADAS-2 for the minority of studies that presented diagnostic accuracy statistics. RESULTS: We found 18 studies that validated fear instruments. Fifteen validated the Fear of COVID-19 scale (FCV-19S). We found no studies that proposed a diagnosis of fear of COVID-19 or a threshold of significant/clinical versus non-significant/subclinical fear. Study quality was low, with the most common potential biases related to sampling strategy and un-blinded data analysis. The FSV-19S total score correlated strongly with severe phobia (r = 0.703, 95%CI 0.634-0.761) in one study, and moderately with anxiety in a meta-analysis. CONCLUSIONS: The accuracy of the FSV-19S needs to be measured further using fear-related reference instruments, and future studies need to provide cut-off scores and normative values. Further evaluation of the remaining three instruments is required.

The immune status of migrant populations in Europe and implications for vaccine-preventable disease control: a systematic review and meta-analysis.

BACKGROUND: Ensuring vaccination coverage reaches established herd immunity thresholds (HIT) is the cornerstone of any vaccination programme. Diverse migrant populations in European countries have been associated with cases of vaccine-preventable diseases (VPD) and outbreaks, yet it is not clear to what extent they are an under-immunised group. METHODS: We did a systematic review and meta-analysis to synthesise peer-reviewed published primary research reporting data on the immune status of migrants in EU/EEA countries, the UK and Switzerland, calculating their pooled immunity coverage for measles, mumps, rubella, and diphtheria using random-effects models. We searched on Web of Science, Embase, Global Health and MEDLINE (January 1st 2000 to June 10th 2022), with no language restrictions. The protocol is registered with PROSPERO (CRD42018103666). FINDINGS: Of 1103 abstracts screened, 62 met eligibility criteria, of which 39 were included in the meta-analysis. The meta-analysis included 75 089 migrants, predominantly from outside Europe. Pooled immunity coverage among migrant populations was well below the recommended HIT for diphtheria (n = 7, 57.4% [95% CI: 43.1-71.7%] I2 = 99% vs HIT 83-86%), measles (n = 21, 83.7% [95% CI: 79.2-88.2] I2 = 99% vs HIT 93-95%), and mumps (n = 8, 67.1% [95% CI: 50.6-83.6] I2 = 99% vs HIT 88-93%), and midway for rubella (n = 29, 85.6% [95% CI: 83.1-88.1%] I2 = 99% vs HIT 83-94%), with high heterogeneity across studies. INTERPRETATION: Migrants in Europe are an under-immunised group for a range of important VPDs, with this study reinforcing the importance of engaging children, adolescents, and adults in 'catch-up' vaccination initiatives on arrival for vaccines, doses, and boosters they may have missed in their home countries. Co-designing strategies to strengthen catch-up vaccination across the life-course in under-immunised groups is an important next step if we are to meet European and global targets for VPD elimination and control and ensure vaccine equity.

[Case-based learning with practical exercises in the course hygiene and microbiology as a model for the implementation of the new medical licensing regulations]. / Ein fallbasiertes Unterrichtskonzept mit praktischen Übungen im Fach Hygiene und Mikrobiologie: ein nachhaltiges Unterrichtskonzept zur Umsetzung der neuen Approbationsordnung in klinisch-theoretischen Fächern.

BACKGROUND: Within the scope of an educational improvement project, the teaching concept of the course hygiene and microbiology at the Goethe-University in Frankfurt was transferred from an organ system-based teaching concept into a case-based teaching concept. Concomitantly, this transformation was qualitatively reviewed to evaluate self-perceived learning success. METHODS: 54 participants were included in this qualitative study. 45 students were interviewed in homogeneous focus groups of up to five. Nine physicians were interviewed individually. Following anonymization and transcription, a structured and qualitative text analysis was conducted. RESULTS: Both groups, students and physicians, prefer a case-based teaching concept in hygiene and microbiology, especially in combination with a hands-on approach to learn practical skills. Students taught with the case-based approach were more satisfied and reported better knowledge retention. The practical elements of the course hygiene and microbiology were positively remembered by all participants. Regardless of the teaching concept, the individual lecturer is considered most essential in shaping motivation. CONCLUSIONS: Overall, the implementation of a case-based teaching concept with practical elements in the course hygiene and microbiology increases the ability of medical students to understand the relevance of core knowledge and improves self-perceived learning. The fusion of theoretical and clinical contents elements in the course hygiene and microbiology meets the new national medical licensing regulations in Germany and promises to be a sustainable concept for clinical-theoretical subjects like hygiene and microbiology.

The mental health impact of the covid-19 pandemic on healthcare workers, and interventions to help them: A rapid systematic review.

The covid-19 pandemic has heavily burdened healthcare systems throughout the world. We performed a rapid systematic review to identify, assess and summarize research on the mental health impact of the covid-19 pandemic on HCWs (healthcare workers). We utilized the Norwegian Institute of Public Health's Live map of covid-19 evidence on 11 May and included 59 studies. Six reported on implementing interventions, but none reported on effects of the interventions. HCWs reported low interest in professional help, and greater reliance on social support and contact. Exposure to covid-19 was the most commonly reported correlate of mental health problems, followed by female gender, and worry about infection or about infecting others. Social support correlated with less mental health problems. HCWs reported anxiety, depression, sleep problems, and distress during the covid-19 pandemic. We assessed the certainty of the estimates of prevalence of these symptoms as very low using GRADE. Most studies did not report comparative data on mental health symptoms before the pandemic or in the general population. There seems to be a mismatch between risk factors for adverse mental health outcomes among HCWs in the current pandemic, their needs and preferences, and the individual psychopathology focus of current interventions.

Occupational health outcomes among international migrant workers: a systematic review and meta-analysis.

BACKGROUND: Globally, there are more than 150 million international migrant workers-individuals who are employed outside of their country of origin-comprising the largest international migrant group. A substantial number of migrants work in hazardous and exploitative environments, where they might be at considerable risk of injury and ill health. However, little data on occupational health outcomes of migrant workers exist, with which to inform global policy making and delivery of health services. METHODS: For this systematic review and meta-analysis, we searched Embase, MEDLINE, Ovid Global Health, and PsychINFO databases for primary research published between Jan 1, 2008, and Jan 24, 2018, reporting occupational health outcomes among international migrant workers (defined as individuals who are or have been employed outside their country of origin), without language or geographical restrictions. We excluded studies containing mixed cohorts of migrants and native workers in which migrant data could not be disaggregated, and studies that did not explicitly report migrant status. The main outcome was prevalence of occupational health outcomes (defined as any injury, mortality, or physical or psychiatric morbidity due to an individual's work or workplace environment) among international migrant workers. Summary estimates were calculated using random-effects models. The study protocol has been registered with PROSPERO, number CRD42018099465. FINDINGS: Of the 1218 studies identified by our search, 36 studies were included in our systematic review, and 18 studies were included in the meta-analysis. The systematic review included occupational health outcomes for 12 168 international migrant workers employed in 13 countries and territories, mostly employed in unskilled manual labour. Migrant workers originated from 25 low-income and middle-income countries, and worked in the following sectors: agriculture; domestic, retail, and service sectors; construction and trade; and manufacturing and processing. Migrant workers had various psychiatric and physical morbidities, and workplace accidents and injuries were relatively common. In the meta-analysis, among 7260 international migrant workers, the pooled prevalence of having at least one occupational morbidity was 47% (95% CI 29-64; I2=99·70%). Among 3890 migrant workers, the prevalence of having at least one injury or accident, including falls from heights, fractures and dislocations, ocular injuries, and cuts was 22% (7-37; I2=99·35%). INTERPRETATION: International migrant workers are at considerable risk of work-related ill health and injury, and their health needs are critically overlooked in research and policy. Governments, policy makers, and businesses must enforce and improve occupational health and safety measures, which should be accompanied by accessible, affordable, and appropriate health care and insurance coverage to meet the care needs of this important working population. FUNDING: Wellcome Trust.