Psychological Burden and Associated Factors of the COVID-19 Pandemic on People in Quarantine and Isolation Centers in Ethiopia: A Cross-Sectional Study

Background: Globally, a lot of countries put into practice early quarantine measures as an essential COVID-19 prevention mechanism. Other than physical effects, quarantine has a major result on mental health and well-being at both the individual as well as the community level at large. Therefore, this study aimed to assess the psychological burden of COVID-19 on the people in quarantine and isolation centers and to identify associated factors for early and effective psychosocial intervention during the pandemic and beyond.Method: A cross-sectional study was done among 392 suspected cases of COVID-19 that were in quarantine and isolation centers found in Eastern Ethiopia in 2020. Participants were selected by the convenience sampling method. The common mental disorder was measured by the Self Reporting Questionnaire-20 (SRQ-20). Logistic regression was done to identify predictive factors, and a P < 0.05 was considered statistically significant.Results: The common mental disorder among suspected cases of COVID-19 in Ethiopia was found to be 13.5% (95% CI: 10.2, 17.1%). Female (AOR = 1.52, 95% CI: 1.1, 2.92), known chronic medical illness (AOR = 7.0, 95% CI: 2.2, 21.8), inadequate accessibility of personal protective equipment (AOR = 6.1, 95% CI: 2.8, 13.3), poor awareness about the pandemic (AOR = 2.90, 95% CI: 2.71, 7.54), presence of symptoms of the disease (AOR = 5.3, 95% CI: 2.57, 11.1), and substance use (AOR = 2.7, 95% CI: 1.2, 6.1) were found to be associated with a common mental disorder.Conclusion: The current study revealed that the common mental disorder was relatively high among suspected cases of COVID-19 in quarantine and isolation centers as compared with the general population. The results of the present study demonstrate that some subpopulations are more vulnerable to the pandemic's deleterious effects on mental health. Therefore, providing appropriate psychosocial intervention for the populations at risk is important to decrease the effect of common mental disorders among suspected cases of COVID-19.

Prevalence of Substance use Among Depressed Female Patients

Depressive disorder is a common mental disorder and one of the leading causes of disability around the globe. It is characterized by depressed mood, lack of enjoyment, decreased activity, negative thoughts and reduced concentration for at least two weeks. Globally 350 million people are suffering from depression and 18.34 million people from Southeast Asia alone. Major depressive disorder is growing in overall disease burden around the world. It is predicted to be the leading cause of disease burden by 2030, and it is already the leading cause in women worldwide. Depression affects the prefrontal cortex, cingulate gyrus, amygdala, hippocampus, thalamus and hypothalamus. These brain regions are involved in the regulation of motivation, eating, sleeping, energy level, circadian rhythm, and responses to rewarding and aversive stimuli, which are all abnormal in depressed people.

Releasing Anxiety

<p>Being the most common mental disorder, anxiety is especially co-related with busy urban environments. The rise of urbanisation and modern technology has created a world that has significantly heightened our levels of stress and anxiety. In this context, our social responsibility and accountability as architects is increasing. How can we design with peoples’ health and wellbeing in mind? Through iterative design processes, I will create an emotional experience that connects the body with architecture, heightens the occupant’s self-awareness, and engages with site, creating a place of calm and belonging. Sensory design will be used to model the four levels of anxiety (mild, moderate, severe, panic level). The final design will create a narrative journey that stimulates a transition from anxiousness to calming. The research proposition will be tested on a site located in a highly developed area on the corner of Elliott, Albert and Victoria Streets in Auckland’s business hub. This site was chosen not only for its central location but because it is the site of a new metro station (predicted to be the busiest station in the Auckland rail network) as well as a linear park connecting Victoria and Albert Parks. Together these infrastructural additions will increase pressure on an already over-stimulated environment. The station (Aotea station) will be incorporated into the design, creating an urban park that provides access from the concourse level to street level, drawing people up into a protected landscape area intended to relieve anxiety and provide a place of respite.</p>

Vocational Rehabilitation Professionals’ Perceptions of Facilitators and Barriers to Return to Work: A Qualitative Descriptive Study

This is a qualitative descriptive study of professionals’ perceptions of facilitators and barriers for returning to work for women on long-term sick leave due to musculoskeletal pain and/or common mental disorder who participated in a vocational rehabilitation project. Data were collected through semi-structured interviews with 13 purposefully selected professionals from the Swedish Social Insurance Agency, the Swedish Public Employment Service, the health care services, and the municipal services. The interviews were analyzed with a manifest content analysis. The main facilitators were the close cooperation between the professionals and the individual support that was offered to the project participants. The main barriers were differences among the stakeholders’ missions and goals, limitation in project duration and within the labor market, and the project participants’ personal factors. These results emphasize the importance of cooperation between the professionals from the various stakeholders and focus on the individual’s resources and needs. The study highlights the value of including health care professionals in vocational rehabilitation to benefit from their specific knowledge of the target group and their strengths and needs. Moreover, the study highlights the need to incorporate collaboration with employers and align with the local labor market in the development of vocational rehabilitation interventions.

Releasing Anxiety

<p>Being the most common mental disorder, anxiety is especially co-related with busy urban environments. The rise of urbanisation and modern technology has created a world that has significantly heightened our levels of stress and anxiety. In this context, our social responsibility and accountability as architects is increasing. How can we design with peoples’ health and wellbeing in mind? Through iterative design processes, I will create an emotional experience that connects the body with architecture, heightens the occupant’s self-awareness, and engages with site, creating a place of calm and belonging. Sensory design will be used to model the four levels of anxiety (mild, moderate, severe, panic level). The final design will create a narrative journey that stimulates a transition from anxiousness to calming. The research proposition will be tested on a site located in a highly developed area on the corner of Elliott, Albert and Victoria Streets in Auckland’s business hub. This site was chosen not only for its central location but because it is the site of a new metro station (predicted to be the busiest station in the Auckland rail network) as well as a linear park connecting Victoria and Albert Parks. Together these infrastructural additions will increase pressure on an already over-stimulated environment. The station (Aotea station) will be incorporated into the design, creating an urban park that provides access from the concourse level to street level, drawing people up into a protected landscape area intended to relieve anxiety and provide a place of respite.</p>

Encapsulated Escitalopram and Paroxetine Intranasal Co-Administration: In Vitro/In Vivo Evaluation

Depression is a common mental disorder. Its treatment with selective serotonin reuptake inhibitors (SSRIs) is effective only in a fraction of patients, and pharmacoresistance is increasing steadily. Intranasal (IN) drug delivery to the brain stands out as a promising strategy to improve current therapeutic approaches by operating as a shuttle to overcome the blood–brain barrier. This work aimed to simultaneously administer escitalopram and paroxetine by IN route to mice. For this purpose, three nanostructured lipid carriers (NLC1, NLC2, and BorNLC) and one nanoemulsion (NE) were tested for drug loading. After their characterization, investigation of their impact on nasal cell viability and SSRI permeability assays were performed, using a human nasal RPMI 2650 cell line in air–liquid interface. In vitro assays demonstrated that NLCs, including borneol (BorNLC), significantly increased escitalopram permeability (p &lt; 0.01) and paroxetine recovery values (p &lt; 0.05) in relation to the other formulations and non-encapsulated drugs. IN and intravenous (IV) pharmacokinetic studies performed in vivo with a single dose of 2.38 mg/kg demonstrated similar results for escitalopram brain-to-plasma ratios. IN administrations delayed escitalopram peak concentrations in the brain for 15–60 min and no direct nose-to-brain delivery was detected. However, encapsulation with BorNLC considerably decreased escitalopram exposure in the lungs (124 μg min/g) compared with free escitalopram by IN (168 μg min/g) and IV (321 μg min/g) routes. Surprisingly, BorNLC IN instillation increased concentration levels of paroxetine in the brain by five times and accelerated brain drug delivery. Once again, lung exposure was considerably lower with BorNLC (AUCt = 0.433 μg min/g) than that with IV administration (AUCt = 1.01 μg min/g) and non-encapsulated IN formulation (AUCt = 2.82 μg min/g). Direct nose-to-brain delivery was observed for paroxetine IN administration with a direct transport percentage (DTP) of 56.9%. If encapsulated, it increases to 74.2%. These results clearly emphasize that nose-to-brain delivery and lung exposure depend on the formulation and on the characteristics of the drug under investigation. NLCs seem to be an advantageous strategy for nose-to-brain delivery of lipophilic molecules, since they reduce systemic and lung exposure, thereby decreasing adverse effects. For hydrophilic compounds, NLCs are particularly important to decrease lung exposure after IN administration.

Comprehensive occupational health services for healthcare workers in Zimbabwe during the SARS-CoV-2 pandemic

Background Healthcare workers are disproportionately affected by COVID-19. In low- and middle- income countries, they may be particularly impacted by underfunded health systems, lack of personal protective equipment, challenging working conditions and barriers in accessing personal healthcare. Methods In this cross-sectional study, occupational health screening was implemented at the largest public sector medical centre in Harare, Zimbabwe, during the “first wave” of the country’s COVID-19 epidemic. Clients were voluntarily screened for symptoms of COVID-19, and if present, offered a SARS-CoV-2 nucleic acid detection assay. In addition, measurement of height, weight, blood pressure and HbA1c, HIV and TB testing, and mental health screening using the Shona Symptom Questionnaire (SSQ-14) were offered. An interviewer-administered questionnaire ascertained client knowledge and experiences related to COVID-19. Results Between 27th July and 30th October 2020, 951 healthcare workers accessed the service; 210 (22%) were tested for SARS-CoV-2, of whom 12 (5.7%) tested positive. Clients reported high levels of concern about COVID-19 which declined with time, and faced barriers including lack of resources for infection prevention and control. There was a high prevalence of largely undiagnosed non-communicable disease: 61% were overweight or obese, 34% had a blood pressure of 140/90mmHg or above, 10% had an HbA1c diagnostic of diabetes, and 7% had an SSQ-14 score consistent with a common mental disorder. Overall 8% were HIV-positive, with 97% previously diagnosed and on treatment. Conclusions Cases of SARS-CoV-2 in healthcare workers mirrored the national epidemic curve. Implementation of comprehensive occupational health services during a pandemic was feasible, and uptake was high. Other comorbidities were highly prevalent, which may be risk factors for severe COVID-19 but are also important independent causes of morbidity and mortality. Healthcare workers are critical to combatting COVID-19; it is essential to support their physical and psychological wellbeing during the pandemic and beyond.