Family clusters were the main feature of the COVID-19 outbreak in Shenzhen in 2020, and the Shenzhen government rolled out a quick response to the epidemic. Non-pharmaceutical interventions and measures were proven to have effectively contained community transmission, limit the transmission to aggregation and reduce the scale of transmission within a household.

Surgical, anaesthesia and obstetric (SAO) care are essential, life-saving components of universal healthcare. In Chiapas, Mexico’s southernmost state, the capacity of SAO care is unknown. This study aims to assess the surgical capacity in Chiapas, Mexico, as it relates to access, infrastructure, service delivery, surgical volume, quality, workforce and financial risk protection.

A cross-sectional study of Ministry of Health public hospitals and private hospitals in Chiapas was performed. The translated Surgical Assessment Tool (SAT) was implemented in sampled hospitals. Surgical volume was collected retrospectively from hospital logbooks. Fisher’s exact test and Mann-Whitney U test were used to compare public and private hospitals. Catastrophic expenditure from surgical care was calculated.

Data were collected from 17 public hospitals and 20 private hospitals in Chiapas. Private hospitals were smaller than public hospitals and public hospitals performed more surgeries per operating room. Not all hospitaucture, workforce availability and data collection are needed.

Girl child, early and forced marriage (CEFM) persists in South Asia, with long-term consequences for girls. CARE’s Tipping Point Initiative (TPI) addresses the causes of CEFM by challenging repressive gender norms and inequalities. The TPI engages different participant groups on programmatic topics and supports community dialogue to build girls’ agency, shift inequitable power relations, and change community norms sustaining CEFM.

The Nepal TPI impact evaluation has an integrated, mixed-methods design. The quantitative evaluation is a three-arm, cluster randomised controlled trial (control; Tipping Point Programme (TPP); TPP+ with emphasised social norms change). Fifty-four clusters of ~200 households were selected from two districts (2727) with probability proportional to size and randomised. A household census ascertained eligible study participants, including unmarried girls and boys 12-16 years (12421242) and women and men 25+ years (270270). Baseline participation was 1134 girls, 1154 boys, 270 womenF and CARE guidelines for ethical research involving children and gender-based violence. Study materials are here or available on request. We will share findings through clinicaltrials.gov, CARE reports/briefs and publications.

NCT04015856.

NCT04015856.

The improvements in short-term outcome after severe trauma achieved through early resuscitation and acute care can be offset over the following weeks by an acute systemic inflammatory response with immuneparesis leading to infection, multiorgan dysfunction/multiorgan failure (MOF) and death. Serum levels of the androgen precursor dehydroepiandrosterone (DHEA) and its sulfate ester DHEAS, steroids with immune-enhancing activity, are low after traumatic injury at a time when patients are catabolic and immunosuppressed. Addressing this deficit and restoring the DHEA(S) ratio to cortisol may provide a range of physiological benefits, including immune modulatory effects.

Our primary objective is to establish a dose suitable for DHEA supplementation in patients after acute trauma to raise circulating DHEA levels to at least 15 nmol/L. Secondary objectives are to assess if DHEA supplementation has any effect on neutrophil function, metabolic and cytokine profiles and which route of administration (oral vs sublinaCT 2016-004250-15) and ISRCTN (12961998). It has also been adopted on the National Institute of Health Research portfolio (CPMS ID38158).

The study recruited its first patient on 2 April 2019 and held its first data monitoring committee on 8 November 2019. DHEA dosing has increased to 100 mg in both male cohorts and remains on 50 mg in across all female groups.

The study recruited its first patient on 2 April 2019 and held its first data monitoring committee on 8 November 2019. DHEA dosing has increased to 100 mg in both male cohorts and remains on 50 mg in across all female groups.

Cancer burden is predicted to double by 2030 in sub-Saharan Africa; access to healthcare services for cancer management is a priority in the region. In Nigeria, National Cancer Control Plan aims to ensure >50% cancer screening of eligible populations by 2022 for all Nigerians. We describe healthcare utilisation, cancer screening activities and potential barriers to accessing cancer care within an understudied rural community-based adult population in South West Nigeria.

In April 2018, we conducted a cross-sectional study of community-based adults (>18 years) ~130 km east of Ibadan, 250 km from Lagos in Osun State, South West Nigeria. Participants completed a face-to-face survey in local dialect. We used a questionnaire to assess demographics, health status, income, medical expenditures, doctor visits and cancer screening history.

We enrolled 346 individuals with median age of 52 years and 75% women. Of the entire cohort, 4% had medical insurance. 46% reported a major medical cost in the last year.location may help expand access in Nigeria.

Despite national increases in cancer cases, we highlight a deficiency in cancer screening and universal healthcare coverage within a community-based adult Nigerian population. Subject to availability of governmental resources, increasing financial risk protection, awareness and targeted resource allocation may help expand access in Nigeria.

Cochrane reviews are currently of limited use as many healthcare professionals and patients have no access to them. Most member states of the Organisation for Economic Co-operation and Development (OECD) choose not to pay for nationwide access to the reviews, possibly uncertain whether there is enough demand to warrant the costs of a national subscription. This study estimates the demand for review downloads and summary views under free access across all OECD countries.

The study employs a retrospective design in analysing observational data of web traffic to Cochrane websites in 2014. Specifically, we model for each country downloads of Cochrane reviews and views of online summaries as a function of free access status and alternative sources of variation across countries. The model is then used to estimate demand if a country with restricted access were to purchase free access. We use these estimates to perform a cost-benefit analysis.

For one group of eight OECD countries, the additional downloads und and Israel. These countries may be encouraged by our findings to provide free access to their citizens.

This study was conducted to systematically review the existing literature examining the prevalence of anxiety among hospital staff and identifying the contributing factors to address the complications of this disorder and develop effective programmes for reducing the complications of this mental health problem.

We searched the electronic databases including PubMed, EMBASE, Scopus, Web of Science and Google Scholar from January 2020 to February 2021. To perform meta-analysis, the random effects model was used. To assess the statistical heterogeneity of the included studies, the I

index was used, and 95% CI was estimated. Data analysis was performed by R software.

In the final analysis, 46 articles with the total sample size of 61 551 hospital staff members were included. Accordingly, anxiety prevalence among healthcare workers (HCWs) was 26.1% (95% CI 19% to 34.6%). The prevalence rates of anxiety in health technicians and medical students were 39% (95% CI 13% to 73%) and 36% (95% CI 15% to 65%), respese working groups in order to appropriately manage anxiety during the COVID-19 pandemic.

Little is known about the structure, accessibility, service provision and needs of palliative and hospice day-care in Germany and abroad. Researchers, healthcare providers and policy makers would benefit from a systematic overview.

The aim was to identify, describe and summarise available evidence on status, demand and practice models of palliative day-care clinics and day hospices. A secondary aim was to disclose research gaps and present recommendations for clinical practice and future research.

The scoping review followed the methodological framework of Arksey and O’Malley. The analysed publications included studies of varying kinds to describe the current state of the art.

Using a highly sensitive search strategy, the authors searched PubMed, Web of Science Core Collection, CINAHL and Google Scholar within the publication window of inception to 12 June 2020. An additional hand search of the reference lists of the identified review articles was conducted.

The authors screened the titles and abstracts of 2643 studies, retrieved 197 full texts and included 32 articles in the review. The review identified nine major themes (1) the referral process, (2) models of care, (3) patient characteristics, (4) demand, (5) the discharge process, (6) perceptions of services, (7) funding and costs, (8) outcome measurement and (9) education.

There is a need for further research to identify groups of patients who would receive the most benefit from palliative and hospice day-care and to determine any necessary revisions in admission criteria.

There is a need for further research to identify groups of patients who would receive the most benefit from palliative and hospice day-care and to determine any necessary revisions in admission criteria.

The aims of this survey of healthcare interpreters were to assess the impacts of difficult conversations such as discussions involving explanation of a serious diagnosis, goals-of-care or death or dying and to discover interpreters’ opinions on ways to improve these conversations.

A purpose derived survey incorporating the Professional Quality of Life measure 5 was distributed to all healthcare interpreters in an Australian state. Outcome measures were to quantify levels of compassion satisfaction (CS), burn-out and secondary traumatic stress (STS), as well as to determine how well interpreters believed difficult conversations were being conducted and suggestions for improvement.

There were 94 respondents all scoring moderate (34.1%) or high (65.9%) on the CS score. No respondents scored high on burn-out or STS scales. Significant subgroup analysis was those aged 18-30 with higher burn-out scores. The two most common concerns raised were (1) not knowing the content prior to a discussion and (2) feeling guilty about delivering bad news. The two most frequent suggestions for improvement were (1) prebriefing with medical teams prior and (2) allowing opportunity to explain cultural concerns.

Interpreters surveyed were not experiencing burn-out or STS and had moderate or high CS scores. Recommendations are further training and evidence-based guidelines for medical staff and healthcare interpreters in the facilitation of difficult conversations; prebriefing and debriefing for interpreters; further research to delineate the characteristics that predispose to compassion fatigue.

Interpreters surveyed were not experiencing burn-out or STS and had moderate or high CS scores. Recommendations are further training and evidence-based guidelines for medical staff and healthcare interpreters in the facilitation of difficult conversations; prebriefing and debriefing for interpreters; further research to delineate the characteristics that predispose to compassion fatigue.