Jordi Casals-Ariet

Vaccines are highly thermo-sensitive materials whose potency requires a functional cold chain system which is dependent on the ability of health care workers to effectively manage the system toward eliminating vaccine-preventable diseases. This study assessed knowledge and practice of vaccination logistic management systems among primary health care workers in Osun state Nigeria. It was a descriptive cross-sectional study among 180 randomly selected health care workers who took part in a larger study on the design and pretesting of vaccine cold chain (VACOC) coolers. Research instruments were self-administered semi-structured pretested questionnaire that was analyzed using the SPSS version 23.0. The mean age was 36.7 ± 8.9 years, 87 (48.3%) could correctly explain the vaccination logistic management system, 132 (73.3%) had been trained on the system, 129 (71.7%) could assemble the ice packs used in the vaccine career box, 135 (75.0%) could assemble the vaccines, while 145 (80.6%) could assemble the diluents and thermometer. One hundred and fifty-one (83.9%) and 146 (81.1%) were found to have good knowledge and attitude to the management systems, respectively. Spending more than 5 years in profession, being a male, being a Community Health Officer were significant predictors of having a good practice of immunization logistic management system. Some gaps in knowledge, attitude, and practice of vaccination cold chain logistic system still exist among studied respondents, and these should be addressed by stakeholders in immunization programs.

Background Existing pulmonary rehabilitation services have been adapted to accommodate the excess demands for support for people with post-coronavirus disease syndrome. For many low- and middle-income countries, where pulmonary rehabilitation is not routinely available, interventions specific to local contexts are needed. Objective This study aimed to examine the views of healthcare workers in Nigeria on ways to support individuals’ recovery from post-coronavirus disease syndrome. Design An online survey repeated at two time points during the pandemic via social media. Setting Data collection occurred in April–July 2020 and January–July 2021, coordinated from Abuja, Nigeria. Participants A convenience sample of healthcare workers voluntarily completed the survey without any time constraints. Main outcome measures The survey comprised closed and open-ended questions, in English, with free text boxes for additional comments where necessary. The survey included questions on the key components of post-coronavirus disease support; appropriate location, timing and communication strategies; barriers to healthcare workers referring patients; and perceived barriers to patients accepting a referral. Results Two hundred and two fully completed responses were received from healthcare workers (52% male, 53% physiotherapists). The majority (88%) recommended support of hospitalised and non-hospitalised patients with home (57%) or community-based (70%) interventions combining video (57%) and telephone (74%) support. Priority components were aerobic exercise (69%), coping with the stigma of infection (68%), advice on nutrition (68%) and integrating back into the community (63%). Healthcare worker-perceived patient barriers to accepting support were cost of treatment (64%), patient stigmatisation (63%) and risk of patient re-infection (53%). The main healthcare worker barrier in referring patients was inadequate personal protective equipment (63%). Limitations This exploratory survey study recruited a convenience sample, was available only online and relied on social media for uptake, leading to probable selection bias. Limitations in staffing and resources meant that people with post-coronavirus disease syndrome were not recruited. Conclusion Post-coronavirus disease support was viewed as a high priority by healthcare workers in Nigeria. These results act as a foundation for developing suitable support interventions for post-coronavirus disease survivors with ongoing symptom burden. The suggested structure, content and delivery of post-coronavirus disease support fits well with the conventional structure of pulmonary rehabilitation. Future work The development of post-coronavirus disease support interventions in Nigeria. Funding This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Global Health Research programme as award number 17/63/20. A plain language summary of this research article is available on the NIHR Journals Library Website https://doi.org/10.3310/UTNT4760.

Psychological intimate partner violence (IPV) is a common but often under-recognised form of gender-based violence, particularly among women in low- and middle-income countries. Evidence on the burden and associated factors of psychological IPV among female healthcare workers in Nigeria remains limited, despite the potential implications for well-being and workforce performance. This study assessed the prevalence and correlates of psychological IPV among female healthcare workers in a Nigerian facility. A cross-sectional study was conducted among female healthcare workers in a tertiary health facility in southwest Nigeria. Psychological IPV was assessed using an adapted Psychological Partner Abuse (PPA) scale. Descriptive statistics were used to summarise the distribution of psychological IPV scores, while bivariate analyses examined associations between psychological IPV and selected socio-demographic characteristics. Participants’ informed consent and ethical approval were obtained. Of the 284 respondents included in the analysis, 98.2% scored within the mild range of the psychological abuse scale. The mean total PPA score was 38.79 ± 9.84 (possible range: 21–147), indicating that reported experiences were predominantly clustered near the lower threshold of the mild category. Jealous/control and ignoring behaviours were the most commonly endorsed dimensions, largely at mild severity levels. Psychological IPV scores were significantly associated with marital status and ethnicity, whereas occupation and years of service were not. Psychological IPV symptoms were widely reported across socio-demographic groups among female healthcare workers in this setting, with most reported experiences clustering at mild levels close to the scale threshold. These findings underscore the importance of increased awareness, routine screening, and accessible support mechanisms within healthcare institutions, while recognising the exploratory nature of the observed associations.

in Nigeria, studies on mpox among primary healthcare workers are scarce despite increasing incidence of mpox disease between 2017-2022. This study aimed to assess primary healthcare workers knowledge and perception of mpox in Nigeria. we conducted a cross-sectional survey among primary healthcare workers in Nigeria (Oyo, Lagos, and Jigawa) to represent different health system capacities and socio-economic contexts. Knowledge of mpox was evaluated in four domains: general knowledge, transmission, signs and symptoms, and prevention and treatment. Each correct response received a score of 1. We categorize the level of knowledge based on the score using the mean score as the cut-off by re-classifying the composite score of respondents for each state into a binary outcome of "good knowledge" if the mean composite score was greater or equals to the mean of overall knowledge score for the three states (16.1), and "poor knowledge" if the mean score equals to sixteen or less than sixteen (≤16). Factors associated with mpox knowledge were explored using multivariable logistic regression at a 5% significance level. Perception of mpox was assessed using five constructs from the health belief model, measured on 3-point Likert scales. Factors associated with each construct were analyzed using Kruskal-Wallis and Mann-Whitney-U tests. in our study on healthcare workers, 78.3% (n=239) were aware of mpox disease. Their overall knowledge was moderate, particularly regarding transmission. Meanwhile, less than 50% knew mpox can be transmitted through sharing utensils, and 65.3% (n=156) understood contact with infected animals could lead to transmission. Lagos had lower overall knowledge scores (15.3±2.3) compared to Jigawa (16.9±2.3) and Oyo (16.3±2.5) (p<0.001). Perceived susceptibility was similar across states (p=0.127), and 97.5% (n=233) believed mpox can affect anyone, while 47.3% (113) felt they couldn't contract it. Jigawa exhibited higher perceived severity (p<0.001) and barriers to prevention (p<0.001). primary healthcare workers in all settings had limited knowledge of mpox transmission, with the perception of mpox varying by state and participants' socio-economic characteristics. The responsibility of HCW encompasses a range of activities that include diagnosis, patient care and education, and public health interventions amongst others. Hence it is important to educate HCWs on mpox disease to successfully curtail the spread of mpox.

Background: The COVID-19 pandemic has had a profound effect on healthcare workers (HCWs) worldwide, where it intensified preexisting weaknesses in the healthcare system. Health anxiety (HA) among HCWs emerged as a significant concern, fueled by factors such as extended work hours, limited access to personal protective equipment, and fear of contracting or spreading the virus. This study aimed to estimate the prevalence of HA among facility-based and community-based HCWs in Nigeria during the pandemic, examine the socio-demographic factors associated with HA, and explore their coping mechanisms, challenges, and concerns. Materials and Methods: A cross-sectional study used a purposive sampling technique and an online Google Form to collect data from 327 HCWs across Akwa Ibom, Cross River, and Lagos states during the COVID-19 lockdown. Descriptive statistics and binary logistic regression were employed to analyze the data and identify associations between sociodemographic variables and HA symptoms. Results: The findings revealed that 42.2% of HCWs reported experiencing HA, with 35.5% showing clinically elevated symptoms. Younger workers aged 18–29 were significantly more likely to exhibit heightened anxiety. Gender identity and location were also influential, with transgender and gender non-conforming individuals, along with HCWs in Lagos, experiencing higher levels of HA. Major challenges included restricted access to clients and heightened concerns about personal safety. Coping strategies reported by HCWs included participating in online learning and maintaining social connections. Conclusion: The study underscores a notably high prevalence of HA among HCWs in Nigeria during the COVID-19 crisis, pointing to the urgent need for targeted mental health support and interventions to alleviate the psychological burden on these essential workers.

Factors Associated With Stigma Among Caregivers of Patients With Bipolar Disorder in the STEP-BD Study

New era at the NIH

Back to table of contents Previous article Next article Clinical & Research NewsFull AccessSuicidal Ideation Abates After Ketamine InfusionJun YanJun YanSearch for more papers by this authorPublished Online:16 Oct 2009https://doi.org/10.1176/pn.44.20.0021Research conducted in the past few years shows that ketamine leads to a rapid antidepressant effect within hours of administration. A recent study has demonstrated how this mood change translates into a tangible protection against suicidal ideation in treatment-resistant patients with depression (see Original article: Ketamine Leaves BDNF Unchanged for more on ketamine treatment).Ketamine is an anesthetic given intravenously that is often used in surgery and in veterinary medicine. It is known to cause psychosis and has raised abuse concerns. In a paper published in the September 1 Biological Psychiatry, researchers at Mount Sinai School of Medicine, Rutgers University, and Harvard University conducted two clinical studies in which they assessed suicidal ideation in patients with treatment-resistant depression. The study was funded by the National Institutes of Health.Twenty-six patients participated in the first study, in which each received a single infusion of ketamine at a dose of 0.5 mg/kg and was then kept in the hospital for 28 hours. Outcomes were measured 24 hours after the infusion using the single suicide-related item in the Montgomery-Asberg Depression Rating Scale (MADRS-SI). Scores ranged from 0 to 6, with a score of 6 indicating “explicit plans for suicide when there is an opportunity” or “active preparations for suicide.”Subjects' mean score on the MADRS-SI scale decreased from 2.85 before the ketamine infusion to 0.77 at 24 hours after the infusion, which was statistically significant. Before the infusion, 13 patients had a score of 4 or above on the scale. Twenty-four hours after the infusion, eight of the 13 patients had a score of 0 or 1 and three had a score of 2 or 3; two remained at or above a score of 4.Ten of the 26 patients also completed the Implicit Association Test, a behavioral-assessment instrument the researchers used to measure the implicit suicidal intention before and after the infusion. The implicit and explicit suicidal association scores also decreased significantly after the ketamine infusion.Ten of the patients who had been deemed responders in the first study participated in the second study and received repeated ketamine infusions three times a week in a period of 12 days for up to six infusions. Their average MADRS-SI score was 3.0 at baseline. Nine patients scored 0 on the MADRS-SI scale after every repeated infusion. One patient had a score of 2 after the first infusion (baseline score 4). The patient was dropped from further infusion because of lack of response in overall depressive symptoms, defined as at least 50 percent reduction in MADRS total score.The effect of ketamine on suicidal ideation was likely an indirect result of the antidepressant effect of the drug, the authors concluded after they analyzed the correlation between the total score of the nonsuicide-related items in the MADRS and the suicide-related item score. The 26 patients in the single-dose study had an average preinfusion MADRS total score of 37 (scale range 0-60), which decreased to 15 at 24 hours after the infusion. Seventeen of these patients had a 50 percent reduction in MADRS total score.All study participants had moderate to severe depression as indicated by an Inventory of Depression Symptomatology score of 32 or above at baseline and had failed at least two adequate antidepressant trials in the current depressive episode. They had been suffering from major depressive disorder for a mean of 29 years. All had been in the current depressive episode for at least two years and failed an average of six antidepressants in the current episode. Five of the 26 participants had a history of suicide attempts.No patient experienced hallucinations during the studies, Rebecca Price, M.S., a Ph.D. candidate in psychology at Rutgers University and the lead author of the article, told Psychiatric News. The psychotomimetic side effects observed in the studies were “minimal” at this low dose of ketamine, she said, and additional results and analyses are pending publication.The rapid antidepressant effect of ketamine infusion has previously been reported in small clinical trials conducted by researchers at the Mood and Anxiety Disorders Program at the National Institute of Mental Health (NIMH). The NIMH researchers also demonstrated that ketamine's mechanism of action may lie in its antagonism of the NMDA (N-methyl d-aspartate) receptors and subsequent activation of the AMPA (amino-3-hydroxy-5 methylisoxazole-4-propionic acid) receptors; both are biologically activated by the neurotransmitter glutamate (Psychiatric News, September 7, 2007).An abstract of “Effects of Intravenous Ketamine on Explicit and Implicit Measures of Suicidality in Treatment-Resistant Depression” is posted at<www.journals.elsevierhealth.com/periodicals/bps/article/S0006-3223(09)00519-8/abstract>.▪ ISSUES NewArchived

From the Mount Sinai School of Medicine, New York, NY. Received for publication August 16, 2012; accepted August 20, 2012. Reprints: Charles H. Kellner, MD, One Gustave L. Levy Place, New York, NY 10029 (e-mail: [email protected]). The author receives research support from the National Institute of Mental Health. The author has no conflict of interest to disclose.

Alzheimer's disease polysomes which show reduced protein synthetic activity contain ribosomes that exhibit no functional or structural abnormalities : J. Gotlib, N. Khowong, D. Vanderputten, R. Poglod, C. Merril, V. Haroutunian, L. Bierer, D. Perl, W. Wallace National Institute of Mental Health, Washington, D.C. (D.V., R.P., C.P.) and Department of Psychiatry and Center for Neurobiology, Mount Sinai School of Medicine

APA Task Force to Address ‘What’s Next?’ for Ketamine

The outbreak of the coronavirus disease (COVID-19) in December 2019 and its spread to 216 countries within the first eight months has created a huge strain on health systems across the world. Health care workers (HCWs) at the fore-front of combating the pandemic are largely at risk of infection with the number of infected HCWs increasing daily in many countries. Prior to the outbreak of COVID-19, focus of laws and policies have largely been on the responsibilities of HCWs with little or no attention paid to their rights and protection. The increased rate of infection among health workers and the inadequate conditions under which HCWs have carried out their life- saving responsibilities during the pandemic has created the need to change the narrative by focusing on policy formulation and implementation to ensure that HCWs rights are protected. We endorse the widespread use of the WHO recommendations on Coronavirus Disease (COVID-19) Outbreak: Rights, Roles and Responsibilities of Health workers, including key considerations for occupational safety and health.

Healthcare workers, both globally and in Nigeria, have an increased risk for SARS-CoV-2 infection compared with the general population due to higher risk contacts, including occupational exposures. In addition, primary healthcare workers represent an important group for estimating prior infection to SARS-CoV-2 because they work at the first point-of-contact for most patients yet have not been included in prior COVID-19 seroepidemiology research in Nigeria. We sought to evaluate baseline seroprevalence, rates of seroconversion (IgG- to IgG+) and seroreversion (IgG+ to IgG-), change in IgG concentration at 3- and 6-month follow-up, and factors associated with seropositivity. From June 2020 to December 2020, we conducted a longitudinal seroepidemiology study among frontline health care workers in Nigeria using a validated dried blood spot assay. Among 525 participants, mean (SD) age was 39.1 (9.7) years, 61.0% were female, and 45.1% were community health workers. The six-month follow-up rate was 93.5%. Seropositivity rates increased from 31% (95% CI: 27%, 35%) at baseline to 45% (95% CI: 40%, 49%) at 3-month follow-up, and 70% (95% CI: 66%, 74%) at 6-month follow-up. There was a corresponding increase in IgG levels from baseline (median = 0.18 ug/mL) to 3-month (median = 0.35 ug/mL) and 6-month follow-up (median = 0.59 ug/mL, Ptrend < .0001). A minority of participants reported symptoms from February 2020 until baseline (12.2%) or during 3-month (6.6%) or 6-month (7.5%) follow-up. only 1 participant was hospitalized. This study demonstrated high baseline, 3-month and 6-month follow-up prevalence of IgG antibodies to SARS-CoV-2 during the first two waves of the COVID-19 pandemic in Nigeria among a cohort of unvaccinated frontline healthcare workers, including primary healthcare workers despite low symptomatology. These results may have implications in state- and national-level disease pandemic modeling. Trial registration: NCT04158154.

To determine mental health literacy levels and their predictors among primary health care workers across Nigeria's five geopolitical zones, and to identify common patient presentations and rates of suspected psychological illness. A cross-sectional, mixed-methods study using a census method. The National Refresher Course Centre of the National Association of Community Health Practitioners of Nigeria, held at Wesley University, Ondo State. 66 members of the National Association of Community Health Practitioners of Nigeria. A semi-structured questionnaire to collect socio-demographic data and Focus Group Discussions were also conducted among Community Health Practitioners in each zone. Mental health literacy and the predictors. Mental health literacy among primary health care workers was low, with only 12.1% demonstrating above-average knowledge, mainly associated with longer work experience and a family history of mental illness. Patients commonly presented with physical complaints and symptoms such as fever, headache, insomnia, weight loss, and weakness, while underlying mental health conditions like anxiety, depression, and substance use disorders were often unrecognised. Routine mental health assessment was rare, and referrals to psychiatric services were infrequent, with most workers reporting only two to three referrals in the past year. The mental health literacy of primary health care workers in Nigeria is critically low, highlighting an urgent need for extensive capacity building to improve the detection of psychological illness for comprehensive healthcare delivery. None declared.

The aim of this study was to assess the prevalence of work-related symptoms among oral health workers other than the dentist in Nigeria and the preventive measures put in place to reduce exposure to hazardous agents and practices. The study was by means of self-administered questionnaires filled by all cadres of oral health staff who attended two National update courses as well as in all the four teaching hospitals and all public hospitals in Lagos State. Ninety (90) questionnaires were returned properly filled out of one hundred and ten (110) distributed. Forty-five(50%) of them responded positively to the question on the presence of work-related illnesses. There was a significant relationship between answering positively to the question and working in awkward positions (p=0.0006), lifting heavy equipments (p=0.01), working with noisy equipments (p=0.02) and being over 40 years of age (p=0.03). However, gender and years of practice were not significantly associated with a positive response. Use of preventive measures was inadequate. Hepatitis B vaccination coverage was found only in 33(36.7%) of them while workplace control measures were not satisfactory. In conclusion, proper regulation of the dental work environment as well as personal protection of employee especially mandatory uptake of hepatitis B vaccination is advocated. Keywords: work-related, occupational, symptoms, oral health workers Nigerian Journal of Health and Biomedical Sciences Vol. 5 (2) 2006: 62-65