COVID-19 pandemic moral injury in healthcare professionals: a systematic review

AimsMoral injury (MI) refers to psychological distress resulting from witnessing or participating in events which violate an individual's moral code. Originating from military experiences, the phenomenon also has relevance for healthcare professionals dealing with wars, natural disasters and infectious diseases. The deontological basis of medicine prioritises duty to the individual patient over duty to wider society. These values may place healthcare professionals at increased risk of moral injury, particularly in crisis contexts where they may be party to decisions to withdraw or divert care based on resource availability.We conducted a systematic review of medical literature to understand the extent and clinical and socio-demographic correlates of moral injury during the COVID-19 pandemic.MethodWe conducted a systematic review of reports included in MEDLINE, PsycINFO, BNI, CINAHL, EMBASE, EMCARE and HMIC databases using search terms: “moral injury” AND “covid” OR “coronavirus” OR “pandemic”. We also searched Google Scholar and Ovid Database and conducted reference searching. We searched for published quantitative primary research as well as advance online publications and pre-print research. Findings are reported in line with Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA). Two authors independently assessed the included studies’ methodological quality using a seven-item checklist.ResultOur databases search identified 498 records and other sources identified 4 records. We screened 391 records after removing duplicates. 4 reports met our protocol requirements.Three papers used cross-sectional designs. One reported longitudinal outcomes of their sample already described in one of the three papers. Only one study used a MI scoring system validated for healthcare professionals. Others used scoring validated in military populations. These papers reported outcomes from 3334 subjects, with a higher proportion of females. The largest study (3006 subjects) reported MI in 41.3% of their sample. Overall, factors associated with greater MI included: providing direct care to COVID-19 patients; sleep troubles; being unmarried; aged <30 years; female gender; and Buddhist/Taoist faith. Nurses reported a greater severity of MI than physicians. MI significantly correlated with anxiety, depression and burnout. The longitudinal study reported that more stressful and less supportive work environments predicted greater MI at 3 months follow-up.The average quality assessment score of these studies was 4/7.ConclusionIt is important that we are able to address moral injury awareness training as part of workforce preparedness and burnout prevention during the COVID-19 pandemic and other disaster responses across the globe.

Development of a Database Quality Assurance Score (dQAS) to Validate the Nigeria AIDS Indicator and Impact Survey (NAIIS) Database (Preprint)

BACKGROUND In 2018, Nigeria implemented the world’s largest HIV survey “The Nigeria AIDS Indicator and Impact survey (NAIIS)”, with the overarching goal of obtaining more reliable metrics regarding the national scope of HIV epidemic control in Nigeria. OBJECTIVE To (1) describe the processes involved in the development of a new database evaluation tool (“Database Quality Assurance Score [dQAS]) (2) Assess the application of the dQAS in the evaluation and validation of the NAIIS database. METHODS With the assistance of expert review panelists, the dQAS tool was created using an online Delphi (e-Delphi) methodology. Thematic categories were developed to form superordinate categories that grouped themes together. Subordinate categories were then created that decomposed themes down for more specificity. A validation score was employed to assess the technical performance of the NAIIS database. This culminated in the development of the dQAS. RESULTS The finalized dQAS tool was composed of 34 items with a total score of 81.The tool has two sections; a validation item section - which contains 5 sub-sections; and a quality assessment score section, which assigns a score of “1” for “Yes” to indicate that the performance measure item was present and “0” for “No” to indicate that the measure was absent. There were also additional scaling scores ranging from “0” to a maximum of “4” depending on the measure. The NAIIS database achieved 78 out of the maximum total score of 81, yielding an overall technical performance score of 96.3%, which placed it in the highest category denoted as “Exceptional”. CONCLUSIONS This study showed the feasibility of remote internet-based collaboration for the development of dQAS - a tool to assess the validity of a locally-created database infrastructure for a developing setting. Using dQAS, the NAIIS database was found to be valid, reliable and a valuable source of data for future population-based HIV-related studies.

Formalin in fish trading: an inefficient practice for sustaining fish quality

The illegal use of formalin for quality control purposes is a widespread practice in today’s fish industry. Therefore, the present study was undertaken to assess the quality characteristics of formalin treated (5% formalin for 30 min) mrigel carp, Cirrhinus mrigala, Hamilton, stored on ice. The formalin detected was 12.19 ±0.814 μg g-1 for freshly treated samples and 8.10 ± 0.068 μg g-1 for treated samples stored on ice. In the control fish, the formalin concentration was almost negligible. The assessment of the organoleptic characteristics of the treated fish revealed that the gills had blackened, the eyes had become whitish and opaque, the muscles had lost tenderness, and the fish had stiffened. The quality assessment score of the control batch was significantly higher than that of the treated batch. The microbes in the fish were still lower than the amount specified for fish spoilage. Lipid hydrolysis in the treated fish was much higher than that of control, especially when storage time increased. High levels of trichloroacetic acid (TCA) soluble protein in the treated fish, as compared to that of the control fish, were observed throughout the storage period. Considering the low organoleptic status and poor nutritional quality, formalin treatment in the fish industry is not recommended even though the formalin content and the microbiological counts were still below permissible limits.

PENGEMBANGAN TARGET NET SEBAGAI ALAT PEMBELAJARAN PUKULAN BULUTANGKIS DI SEKOLAH MENENGAH PERTAMA

Penelitian ini bertujuan untuk mengembangkan dan menghasilkan alat target net untuk memudahkan peserta didik SMP memelajari dan meningkatkan kemampuan teknik dasar pukulan net, smash, drive, dan short serve. Dalam penelitian pengembangan ini, langkah-langkah yang harus ditempuh meliputi: (1) potensi dan masalah, (2) pengumpulan data, (3) desain produk, (4) validasi desain dan instrument, (5) revisi desain, (6) uji coba produk, (7) revisi, dan (8) produksi/implementasi produk. Uji coba penelitian dilakukan terhadap 168 peserta didik dari SMP se-Kecamatan Piyungan, Bantul, Yogyakarta. Teknik analisis data terdiri dari teknik analisis data deskriptif kuantitatif dan teknik analisis data deskriptif kualitatif. Hasil akhir dari penelitian ini adalah sebuah produk alat pembelajaran target net dan buku manual target net yang memiliki kualitas yang sangat baik. Hal tersebut dibuktikan dengan diperolehnya rerata persentase skor penilaian kualitas produk alat pembelajaran dan buku manual target net sebesar 98,66%. DEVELOP TARGET NET AS A TOOL FOR SHOT LEARNING IN BADMINTON AT JUNIOR HIGH SCHOOL Abstract This research aims to produce and develop target net tools in facilitating JHS students to improve the basic techniques of net shots, smashes, drives, dan short serves. This research and development study follows the steps of: (1) the potential and problems identification, (2) data collection, (3) product design, (4) the design and validation of the instrumen, (5) revision of the design, (6) product trials, (7) revision, and (8) production/implementation of the product. The trials were conducted to 168 students from JSH in Piyungan districts, Bantul, Yogyakarta. The technique of data analysis is descriptive quantitative analysis and qualitative descriptive analysis. The result of this research is a learning tool of target net product and manual book of the target product, that have a very good quality. Which is proved by the average percentage quality assessment score of the learning tools and manuals targeted net being 98.66%. Key words: development, target net, badminton, junior high school