Baseline knowledge and attitudes on COVID-19 among hotels’ staff: A cross-sectional study in Kigali, Rwanda

Background The World Health Organization declared coronavirus disease 2019 (COVID-19) as a global pandemic on the 11th of March, 2020. Hotels and other public establishments have been associated with higher transmission rates. Sensitisation of staff and strengthening of Infection Prevention and Control (IPC) practices in such settings are important interventions. This study assessed the baseline knowledge and attitudes on COVID-19 among hotels’ representatives in Kigali, Rwanda. Methods A cross-sectional study was conducted among hotels’ staff in Kigali in July 2020. A structured questionnaire was self-administered to 104 participants. Baseline knowledge and attitudes were assessed using a number of pre-test questions and mean scores were used to dichotomise the participants’ responses as satisfactory or unsatisfactory. Results All of the 104 hotels’ staff completed the self-administered questionnaires. Sixty-seven percent (n = 70) were male and 58% (n = 60) were aged between 30 and 44 years. The satisfactory rate of correct answers was 63%±2.4 (n = 66) on knowledge and 68%±1.7 (n = 71) on attitudes evaluation. Participants with University education were more likely to have satisfactory knowledge (AOR: 2.6, 95% C.I: 1.07–6.58) than those with secondary education or less. The staff working in the front-office (AOR: 0.05; 95% CI 0.01–0.54) and housekeeping (AOR: 0.09; 95% C.I: 0.01–0.87) were less likely to have satisfactory attitudes than those working in the administration. Conclusions Hotels’ staff based in the capital of Rwanda have shown satisfactory knowledge and attitudes regarding appropriate IPC practices for preventing the COVID-19 transmission. Educational interventions are needed to improve their knowledge and attitudes for better prevention in this setting.

Aquaculture State, Challenges and Technologies in the Middle East

The aquaculture industry in the Middle East (ME) is still relatively new compared to other parts of the world, making this region highly dependent on other countries for the production of food and feed needs. Aquaculture activities in the world at current is mainly focused in China; this may be propelled by its own internal demand for seafood as determined by the United Nations Food and Agriculture Organization (FAO). Challenges faced in the ME has not been elucidated so far and the issues arising might be unique only to this region due to aquaculture being in the initial stages coupled with water access and limitations, climate and geography, in addition to pollution. This review paper will present and discuss global needs for seafood focusing later on the needs in the ME, followed by a discourse into the importance, types and challenges of aquaculture in the ME. Baseline knowledge and infrastructure to enhance knowledge is a pressing need at this stage of infancy. It is hope this sector will continue to develop, and with the support of stakeholders, aquaculture in the ME will achieve a state of independence.

Ventilator-Associated Pneumonia Bundle of Care Training of Nursing Officers Using Simulation and Its Impact on Their Knowledge and Incidence of Ventilator-Associated Pneumonia: A quasi-experimental Study

The objective of this study was to assess the effectiveness of simulation-based training (SBT) of a ventilator-associated pneumonia (VAP) bundle of care on the knowledge and practice of nursing officers working in the pediatric intensive care unit (PICU) and its impact on the incidence of VAP. This study was a single-center, pre- and postsimulation-based educational interventional tool conducted in a six-bed PICU located in Western Rajasthan, India. Thirty nursing officers working in the PICU participated in the study. Baseline knowledge and practice regarding VAP bundle of care were assessed using a questionnaire and practice checklist. It was followed by 1:1 SBT of the VAP bundle of care following which all participants were immediately reassessed and then again at 3 months postintervention. The incidence of VAP (events/1,000 ventilation days) was subsequently compared both at 6 months pre- and postintervention. Thirty nursing officers participated in the study of which 63% were male. Baseline knowledge and practice increased significantly immediately after the VAP bundle of care training and then again at 3 months in comparison to preintervention testing (baseline 20.27 ± 4.51, immediate postintervention 26.0 ± 3.67, 3 months postintervention 23.97 ± 4.69). The incidence of VAP showed a declining trend from 46.1 to 36.5/1,000 ventilation days; however, this finding was not statistically significant (p = 0.22). The simulation-based teaching program significantly enhanced nursing officers' knowledge and practice toward utilization of a preventive VAP bundle of care. There was decay in knowledge with time indicating that repetitive sessions are required at regular intervals to sustain this effect.

Interventional cardiologists’ attitudes towards pharmacogenetic testing and impact on antiplatelet prescribing decisions

Aim: To determine if interventional cardiologists’ knowledge and attitudes toward pharmacogenetic (PGx) testing influenced their antiplatelet prescribing decisions in response to CYP2C19 results. Materials & methods: Surveys were administered prior to participating in a randomized trial of CYP2C19 testing. Associations between baseline knowledge/attitudes and agreement with the genotype-guided antiplatelet recommendations were determined using multivariable logistic regression. Results: 50% believed that PGx testing would be valuable to predict medication toxicity or efficacy. 64% felt well informed about PGx testing and its therapeutic application. However, PGx experience, knowledge, nor attitudes were significantly associated with agreement to genotype-guided antiplatelet recommendations. Conclusion: Cardiologists’ knowledge and attitudes were not associated with CYP2C19-guided antiplatelet prescribing, but larger studies should be done to confirm this finding.

Improving the Knowledge on Distribution, Food Preferences and DNA Barcoding of Natura 2000 Protected Species Paracossulus thrips (Lepidoptera, Cossidae) in Romania

Paracossulus thrips (Lepidoptera, Cossidae) is one of the locally distributed and endangered species. In Europe, it is also one of the few protected moth species, through Annexes II and IV of the Council Directive 92/43/EEC, Annex II of the Bern Convention. To date, little is known about the biology and ecology of this species. Our study was conducted in Transylvania, Romania. Romania hosts some of the strongest populations of the species in the European region. As part of the study, we conducted field observations, vegetation analyses, and genetic analyses. In our paper, we show the habitat types where we encounter P. thrips in Transylvania and confirm Phlomis tuberosa as a host plant. Furthermore, a piece of important information for habitat conservation is given. In this paper, we present the eggs and larvae of P. thrips, the first DNA barcoding sequences, and four new populations of P. thrips in Romania. Our study provides baseline knowledge about the biology and ecology of P. thrips, which is important for conservation and establishing management measures.

Decision-making for prenatal genetic screening: how will pregnant women navigate a growing number of aneuploidy and carrier screening options?

Background Prenatal genetic screens, including carrier screening (CS) and aneuploidy screening (AS), comprise an important component of reproductive healthcare delivery. Clinical practice guidelines emphasize the importance of informed decision-making and patient’s preferences regarding the use of these screens. Yet, it is unclear how to achieve this ideal as prenatal genetic screening options rapidly become more complex and increasingly available to patients. With increased complexity and availability of reproductive testing options, decision-support strategies are critical to prepare patients to consider AS and/or CS. Methods A self-administered survey evaluated knowledge and decision-making preferences for expanded carrier (CS) and aneuploidy (AS) prenatal screening. The survey was administered to participants before their first prenatal visit to assess baseline decision-making needs and preference at the initiation of prenatal care. Analysis was approached as a descriptive process. Results Participants had similar familiarity with the concepts associated with AS compared to CS; mean knowledge scores for CS was 0.59 [possible range 0.00 to 1.00] and 0.55 for AS. Participants reported preferences to learn about a range of conditions, including those with severe or mild impact, childhood-onset, and adult-onset. Decision-making preference with respect to learning about the associated disease phenotypes for the contained on AS and CS panel shifted with the complexity of the panel, with a greater preference to learn about conditions post-test compared pre-test education as panels increased from 5 to 100 conditions. Conclusion Patients’ baseline knowledge of prenatal genetic screens coupled with evolving decision-making preferences presents challenges for the delivery of prenatal genetic screens. This calls for the development and implementation of innovative approaches to support pregnant patients’ decision-making commensurate with advances in prenatal genomics.

Coal pit lakes in abandoned mining areas in León (NW Spain): characteristics and geoecological significance

Mining activity introduces severe changes in landscapes and, subsequently, in land uses. One of the most singular changes is the existence of pit lakes, which occur in active and, more frequently, abandoned mines. Pit lakes are produced by water table interception when open-pit mines deepen. Their characteristics are highly variable, depending on the type of mine, the environment or the climate. In León province there is a long tradition of coal mining that dates back to the nineteenth century, and hundreds of open pits from the 1970s to 2018 have been opened, producing permanent landscape changes. This work analyses the main parameters, including morphological measurements, depth and pH values obtained from aerial photos and field work, of 76 coal pit lakes more than 30 m in length. The vast majority of these pit lakes were unknown until now and were not included in inventories or maps. The data obtained provide baseline knowledge that will allow, in the future, potential uses (storage of water for various uses, recreational use, wildlife habitat, and geological heritage sites) for these pit lakes and establish their importance as a new geoecological environment.

Choosing Non-Malignant Hematologic Care Wisely: An Educational Pilot Study for Internal Medicine Residents

Introduction: Choosing Wisely ® (CW ®)is an initiative of the American Board of Internal Medicine Foundation created to guide the selection of care that is 1) supported by evidence, 2) not duplicative, 3) free from harm, and 4) truly necessary. Between 2013-14, the American Society of Hematology (ASH) published 10 recommendations in accordance with CW ® principles relevant to hematologic care. Previous studies have demonstrated that clinical exposure to non-malignant hematology (NMH) improves trainee understanding of evidence-based, cost effective care as outlined by ASH CW ®. However, dedicated clinical rotations in NMH for internal medicine (IM) residents are not consistently available. Therefore, we created a condensed educational curricular experience using a small group, case-based structure designed to teach the fundamentals of ASH CW ® in NMH to first year IM residents. With a pilot of 6 sessions, we investigated resident baseline knowledge, evaluated the curricular session, and assessed knowledge retention. Methods: The educational intervention focused on 3 content areas in ASH CW ®: venous thromboembolism (VTE), heparin-induced thrombocytopenia (HIT), and sickle cell disease (SCD) (Table 1). Participants included 21 first year IM residents at a large academic medical center. A 1-hour small group teaching session was scheduled monthly as an assigned didactic for the 2020-21 academic year. A total of 6 sessions were provided, and each session had 2-4 residents assigned. The first 4 sessions were in-person and the final 2 were virtual due to the COVID-19 pandemic. The first author was the instructor at all sessions. To assess baseline knowledge of the 3 content areas, participants completed an online assessment with 5 case-based multiple-choice questions at the beginning of the session. The instructor then guided participants to again complete the questionnaire together, now using internet access via a personal computer and a recommended list of online resources, including ASH Clinical Practice Guidelines and Pocket Guides. The instructor then led discussion on how each correct answer or guideline recommendation achieves the 4 CW ® principles. At the conclusion of the session, participants completed an online survey to evaluate the educational intervention using a modified Likert scale. To assess knowledge retention, participants received the original online multiple-choice assessment by email 3 months later. Results: All participants (21/21, 100%) completed the baseline knowledge assessment. The average number of questions correct out of 5 total was 3.3 (67%), with a range of correct answers from 1 to 5. Table 2 includes the content area of each question and the number of correct responses. The question with the lowest total correct (9/21, 43%) addressed the use of transfusion in an uncomplicated pain crisis in SCD. Seventeen participants (81%) completed the curricular evaluation. All respondents (17/17, 100%) either agreed or strongly agreed 1) that the session filled a gap in their NMH training and 2) that they learned something that would change their clinical practice. Only 1 participant (5%) reported completing a rotation in NMH prior to the session. Six participants (29%) completed the repeat knowledge assessment at 3 months. All respondents (100%) achieved a perfect score on the multiple choice questions. When asked if the knowledge gained had influenced their clinical practice, 3 (50%) strongly agreed, 2 (33%) agreed, 1 (17%) was neutral, and none disagreed or strongly disagreed. Conclusion: Our results demonstrate a successful educational pilot to improve the knowledge of ASH CW ® initiatives in NMH for first year IM residents using small group interactive case-based learning. Participants were overwhelmingly receptive to this intervention, expressed high satisfaction and confirmed that the session positively influenced their clinical practice. Although participation in the repeat assessment of knowledge was limited, those that did participate demonstrated high knowledge retention. We intend to expand this pilot initiative by providing the educational session for all incoming IM residents at our institution. We then plan to assess its impact on clinical practice (i.e. use of transfusion in SCD, use of thrombophilia testing, documentation of 4Ts score calculation) to apply the principles of ASH CW ® for improved patient care. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

Population Fluctuations and Abundance Indices of Mosquitoes (Diptera: Culicid), as the Potential Bridge Vectors of Pathogens to Humans and Animals in Mazandaran Province, Northern Iran

Background: Seasonal activity patterns of mosquitoes are essential as baseline knowledge to understand the transmis­sion dynamics of vector-borne diseases. This study was conducted to evaluate the monthly dynamics of the mosquito populations and their relation to meteorological factors in Mazandaran Province, north of Iran. Methods: Mosquito adults and larvae were collected from 16 counties of Mazandaran Province using different sam­pling techniques, once a month from May to December 2014. “Index of Species Abundance” (ISA) along with “Stand­ardized ISA” (SISA) was used for assessing the most abundant species of mosquitoes based on the explanations of Rob­ert and Hsi. Pearson’s correlation coefficient (R) was used to assess the relationships between the monthly population fluctuations and meteorological variables. Results: Overall, 23750 mosquitoes belonging to four genera and nineteen species were collected and identified. The highest population density of mosquitoes was in July and the lowest in May. The ISA/SISA indices for Culex pipiens were both 1 for larvae and 1.25/0.973 for adults in total catch performed in human dwellings. For Cx. tritaeniorhynchus, the ISA/SISA were 1.68/0.938 in pit shelter method. A significant positive correlation was observed between population fluctuations of Cx. tritaeniorhynchus and mean temperature (R: 0.766, P< 0.027). Conclusions: The results indicated that the mosquitoes are more active in July, and Cx. pipiens and Cx. tritaeniorhyn­chus were the most abundant species. Considering the potential of these species as vectors of numerous pathogens, con­trol programs can be planed based on their monthly activity pattern in the area.