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The development of the SD model in this study is grounded in design science research which fundamentally builds on prior research of modelling complex systems. Results The SD model satisfactorily replicates the general trend of COVID-19 infections and recovery for South Africa within the first 100 days of the pandemic. The model further confirms that the decision to lockdown the country was a right one, otherwise the country's health capacity would have been overwhelmed. Going forward, the model predicts that the level of infection in the country will peak towards the last quarter of 2020, and thereafter start to decline. Conclusions Ultimately, the model structure and simulations suggest that a systems dynamics model can be a useful tool in monitoring, predicting and testing interventions to manage COVID-19 with an acceptable margin of error. Moreover, the model can be developed further to include more variables as more facts on the COVID-19 emerge.Background Working conditions have a vital role to play in determining health and disability. So, the objective of this study was to assess the work conditions of small slaughterhouses in the Thi-Qar governorate in Iraq. Design and methods This study is a cross-sectional field survey. A total of twenty-six (26) small slaughterhouses were included as a sample size from the Thi-Qar governorate. WNK463 The data collection was done by observations of the authors using a questionnaire and specific questions were also directed to the slaughterhouse workers if needed. It was conducted between February and April 2018. The study was planned to demonstrate the current status of small slaughterhouses in terms of water supply facilities, quality of small slaughterhouses building, sanitation practices. Results All of the small slaughterhouses had a water supply and all they had hot and cold water. Most of the small slaughterhouses had water tanks and put water pipes away from slaughter sites. The proportions ranged from 76.9 to 96.0 for the quality of small slaughterhouses building. With regard to fire safety measures, 96.2% of buildings are supplied with mobile fire extinguishing equipment according to safety and security requirements. Concerning rodent and insects' control, sixteen (61.5%) of small slaughterhouses use insecticides and pesticides and only six (23.1%) of them use traps for rodents. Most of the small slaughterhouses' windows (88.5%) were covered with a thin net to prevent the insects from entering. Conclusions The finding of this study indicated that work conditions of small slaughterhouses were generally adequate in terms of water supply facilities, sanitation practices, ventilation, fire safety measures, and rodents and insects' control.To date, there is no definite effective treatment for the COVID- 19 pandemic. We performed an update network meta-analysis to compare and rank COVID-19 treatments according to their efficacy and safety. Literature search was performed from MEDLINE and CENTRAL databases from inception to September 5, 2020. Randomized clinical trials (RCTs) which compared the effect of any pharmacological drugs versus standard care or placebo 28-day after hospitalization in adult patients with COVID-19 disease were included. Risk ratio (RR) and 95% CI were calculated for 28-day all-cause mortality, clinical improvement, any adverse event (AEs), and viral clearance. A total of 25 RCTs, evaluating 17 different treatments, and 11,597 participants were analyzed. Remdesivir for 10- day compared to standard care (RR 0.69, 95% CI [0.48-0.99]), and a low dose compared to a high dose of HCQ (0.38, [0.17-0.89]) were associated with a lower risk of death. A total of 2,766 patients experienced clinical improvement, a 5-day course of remdesivir was associated with a higher frequency of clinical improvement compared to standard care (RR 1.21, 95% CI [1.00-1.47]). Compared to standard care, remdesivir for both 5 and 10 days, lopinavir/ritonavir, and dexamethasone reduced the risk of any severe AEs by 52% (0.48, 0.34-0.67), 24% (0.77, 0.63-0.92), 40% (0.60, 0.37-0.98), and 50% (0.50, 0.25-0.98) respectively. In this study of hospitalized patients with COVID-19, administration of remdesivir for 10-day compared to standard care was associated with lower 28-day all-cause mortality and serious AEs, and higher clinical improvement rate.Background Burnout and presenteeism are two emerging occupational health challenges which share same locus among healthcare workers, and the trend is rising. We aim to define the magnitude of burnout and presenteeism among frontline members of the health workforce and explore any correlation between the two in order to provide empirical data from our socioeconomic and geographical background. Design and Methods We used self-administered questionnaire to conduct a cross-sectional study among the physicians and nurses in a regional trauma centre in Enugu, Eastern Nigeria; with the respondents selected by stratified random sampling. The Oldenburg burnout inventory and Stanford presenteeism scale were used to measure burnout and presenteeism respectively, while the 2-item patient-health questionnaire (PHQ-2) was used to screen for depression. The level of statistical significance was determined by a p value of less then 0.05. Results Among the healthcare workers surveyed (n=155); 34 (21.9%) were physicians, while 121 (78.1%) were nurses. Burnout prevalence was 69%. Burnout was associated with self-rated health status and length of years in professional service but not the occupation or depression screen status of the worker. Sixty-two healthcare workers (40%) screened positive for depression. A positive screen for depression was the only factor that had significant association with lower presenteeism scores (p=0.002). The mean presenteeism scores had strong negative correlation with both the exhaustion (p less then 0.001) and disengagement (p less then 0.001) domains of burnout. Conclusion Burnout is high among the healthcare workers and correlates with presenteeism scores. The mental health of the workforce greatly impaired their productivity.Background Oral rehydration salts (ORS) therapy for diarrheal diseases is considered an effective therapy that can be applied in many resource-poor settings. Nevertheless, it has been consistently underutilized, and as a result, its potential to reduce child mortality has not been fully exploited. In Ethiopia, the use of ORS therapy for children under five has been inadequate. Like any other health behavior, the provision of ORS therapy to children during diarrheal episodes by caregivers is complex and context dependent. Identifying the factors may help promote wider application. Design and methods We used data from the 2016 Ethiopia Demographic and Health Survey (EDHS-2016). Samples were selected by a two-stage stratified cluster sampling method. We used data on children under five years of age whose mothers (aged 15-49 years) reported that the child had had diarrhea within two weeks before the survey was conducted (n=1221). The dependent variable was whether these children received ORS therapy. The contextual independent factors were socio-demographic variables (mothers' age, child's age, child's sex, child's place of residence, household wealth, and mother/ husband/partner's education levels and work status), as well as media exposure and healthcare utilization. Results The prevalence of ORS therapy use among the children was 30%. Mothers who had made at least four prenatal visits during their last pregnancy were 87% more likely to use ORS therapy for their children than those who had fewer prenatal visits (OR=1.874; CI 1.140-3.082; p=0.013). Conclusions Integrating efforts for scaling-up ORS use with prenatal health care services may have an extra benefit of promoting children's wellbeing and survival.Erectile dysfunction (ED) is a common disorder in adult males that results in withdrawal from sexual intimacy, psychosocial problems (ie, poor self-esteem, depression, anxiety), decreased work productivity, and reduction in quality of life for both the men suffering from ED and their female partners. A pragmatic literature review was undertaken using PUBMED to identify original research studies published over the past 20 years that assessed the impact of ED on a male's quality of life, the impact of ED on a female partner's quality of life, or the economic impact of ED on employers. Twenty studies were selected for inclusion. This review showed that men with ED have a poorer quality of life than men without ED (n=9 studies). Results from a global burden of illness study showed that men with ED report substantially lower SF-36 Mental and Physical Component Summary scores and SF-6D scores compared to men without ED (p less then 0.001). Similarly, the partner is also negatively impacted by ED due to relationship difficulties and decreased sexual satisfaction (n=8 studies). Results from the Female Experience of Men's Attitudes to Life Events and Sexuality study showed that females were significantly less satisfied and engaged in sexual activity less frequently after their partner developed ED (p less then 0.001). ED also poses a substantial economic burden on employers (n=3 studies). An observational study in men aged 40-70 showed that men with ED had significantly higher rates of absenteeism (2x) and work productivity impairment compared to men without ED (p less then 0.001). Overall, this contemporary review demonstrated that ED imposes a substantial quality of life burden on men and their female partners as well as a significant economic burden on their employers. These findings underscore the need for more education and awareness of the burden of ED and greater access to appropriate ED treatments to help alleviate this burden.The larvae of the insect Galleria mellonella, have recently been established as a non-mammalian infection model for the Mycobacterium tuberculosis complex (MTBC). To gain further insight into the potential of this model, we applied proteomic (label-free quantification) and transcriptomic (gene expression) approaches to characterise the innate immune response of G. mellonella to infection with Mycobacterium bovis BCG lux over a 168 h time course. Proteomic analysis of the haemolymph from infected larvae revealed distinct changes in the proteome at all time points (4, 48, 168 h). Reverse transcriptase quantitative PCR confirmed induction of five genes (gloverin, cecropin, IMPI, hemolin, and Hdd11), which encoded proteins found to be differentially abundant from the proteomic analysis. However, the trend between gene expression and protein abundance were largely inconsistent (20%). Overall, the data are in agreement with previous phenotypic observations such as haemocyte internalization of mycobacterial bacilli (hemolin/β-actin), formation of granuloma-like structures (Hdd11), and melanization (phenoloxidase activating enzyme 3 and serpins). Furthermore, similarities in immune expression in G. mellonella, mouse, zebrafish and in vitro cell-line models of tuberculosis infection were also identified for the mechanism of phagocytosis (β-actin). Cecropins (antimicrobial peptides), which share the same α-helical motif as a highly potent peptide expressed in humans (h-CAP-18), were induced in G. mellonella in response to infection, giving insight into a potential starting point for novel antimycobacterial agents. We believe that these novel insights into the innate immune response further contribute to the validation of this cost-effective and ethically acceptable insect model to study members of the MTBC.
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