Nursing Role Results in Higher Susceptibility of Women: Analyzing Family Clusters during COVID-19 Outbreaks

Background and Aim: Since public health measures are the only way to control the spread of COVID-19, strict quarantine measures have done around the world This condition will definitely not be without psychological effects The aim of this study was to determine the factors affecting the stress caused by COVID-19 in the medical staff and the general population Methods: This cross-sectional study was conducted by a researcher-made questionnaire on 326 people in Qazvin province, Iran in the spring of 2020 The questionnaire consisted of 40 questions, in 3 sections: demographic information, general and main questions related to COVID-19 stress The questionnaire was made available to the study population in Qazvin through virtual networks Results: Of the 326 participants (117 men and 209 women), 71 were medical staff members and 255 in the general population The mean stress scores of the general population, the medical staff in the corona and non-corona department, were reported 28 7±8 4, 30 1±9 and 27 3±7 8, respectively, with no statistically significant difference among the groups (p=0 374) In the medical staff, access to social response systems (p=0 02), considerable weight change (p=0 019) and reluctance to perform daily activities (p=0 001) were among the factors that had a significant relation with stress score For the general population, sex (p=0 001), the presence of a high risk elderly person in the family (p=0 001), having a fatal case due to COVID-19 in the family (p=0 014), exacerbation of the underlying disease (p=0 003), job closure (p=0 007), etc had significant relations with stress score Conclusion: According to the findings of the present study, the level of stress in the study population was mild, but the psychological effects of coronavirus epidemics are undeniable Access to psychological counseling systems can be an effective way to improve a person's mental state in quarantine © 2020 Baqiyatallah University of Medical Sciences All rights reserved

Uncovering the Devaluation of Nursing Home Staff During COVID-19: Are We Fuelling the Next Health Care Crisis?

Objective The purpose of this study was to investigate the state of depression and anxiety and assciated factors of back-to-school college students during the outbreak of COVID-19, so as to provide theoretical basis for emotional counseling and psychological crisis intervention after long-term school closure due to epidemic outbreak. Methods Cluster sampling was used to select the first batch of 2 697 back-to-school students in a high vocational college. The survey content includes basic information questionnaire, Depression Self-rating Scale (SDS) and Anxiety Self-rating Scale (SAS). Results The detection rate of depression and anxiety was 31.8% and 10.4% respectively. Multivariate Logistic regression analysis showed that the risk of depression in female college students was 1.28 times higher than that in male students. The risk of depression among college students with family loss experience caused by the outbreak of COVID-19 was 1.30 times that of those without family loss experience caused by the outbreak of COVID-19. Outgoing personality ( OR = 0.62), neutral ( OR = 0.55) and mild temper ( OR = 0.46), moderate frequency of physical exercise per week (1–2 times: OR = 0.73, 3–4 times: OR = 0.65) were protective effects for depression in college students.Low frequency of breakfast were the risk effects for depression in college. The risk of anxiety among college students who was the only child in the family was 1.61 times higher than that who was not the only child in the family. The risk of anxiety among college students with family loss experience caused by the outbreak of COVID-19 was 1.45 times higher than that college students without family loss experience caused by the outbreak of COVID-19. Neutral temper, mild temper and physical exercise 1–2 times a week were associated with lower level of anxiety in college students ( OR = 0.67, 0.56, 0.67). Breakfast skipping ( OR = 2.03) was associated with higher levvel of anxiety in college students. Conlusions During the outbreak of COVID-19, the first batch of back-to-school college students presented high level of depression. Colleges are suggested to promptly carry out effective emotional relief and psychological intervention for students, especially those whose family suffered in COVID-19, the only child in the family, with poor breakfast eating habits, as well as breakfast skipping and lack of physical exercise. 【摘要】 目的 了解新型冠状病毒肺炎流行期间返校大学生抑郁、焦虑情绪现况及其影响因素, 为后续开展有效的情绪 疏导和心理干预提供依据。 方法采用整群抽样的方法对安徽中医药髙等专科学校首批返校的2 697名大学生进行自编 问卷调査, 内容包括基本信息、抑郁自评量表 (Self-rating Depression Scale, SDS) 和焦虑自评量表 (Self-rating Anxiety Scale, SAS) 等。 结果 首批返校大学生抑郁检出率为31.8%, 焦虑检出率为10.4%。多因素Logistic回归分析显示, 女生产生抑 郁情绪的风险是男生的1.28倍;因疫情致家庭损失的大学生产生抑郁情绪的风险是无家庭损失的1.30倍;外向性格 ( OR = 0.62)、中性脾气 ( OR = 0.55)及温和脾气 ( OR = 0.46)、每周体育锻炼次数适中 (1~2次:OR = 0.73;3~4次:OR = 0.65)与大 学生产生抑郁情绪呈负相关;早餐次数较少与大学生产生抑郁情绪呈正相关。独生子女大学生产生焦虑情绪风险是非独 生子女的1.61倍;因疫情致家庭损失的大学生产生焦虑情绪的风险是无家庭损失的1.45倍;中性脾气 ( OR = 0.67)及温和 脾气 ( OR = 0.56)、每周体育锻炼1~2次 ( OR = 0.67)与大学生产生焦虑情绪呈负相关;从来不吃早餐 ( OR = 2.03)与大学生 产生焦虑情绪呈正相关。 结论新冠肺炎流行期间, 首批返校大学生群体抑郁检出率较髙。学校应针对有因疫情所致损 失经历、独生子女、具有不良早餐习惯、缺乏体育锻炼的学生及时开展有效情绪疏解和心理干预。

\nIn December 2019, a novel coronavirus (2019-nCoV) was detected in Wuhan Hubei province, China. The virus has caused a global concern because of its high potential for transmission, high morbidity and mortality. COVID-19 spreads so rapidly across an increasing number of countries worldwide that it has been found in more than 200 countries so far. The World Health Organization (WHO) has declared COVID-19 a pandemic and public health threat. In general, COVID-19 is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A case fatality rate of approximately 2.3% has been reported for COVID-19. New fever, cough, lymphopenia and bilateral lung infiltrations are characteristic but not diagnostic for COVID-19. Sore throat, dyspnea, myalgia, diarrhea, and abdominal pain are other presentations of COVID-19. We should also be attentive to the probability of atypical presentations in patients who are immunocompromised. While the majority of cases result in mild respiratory tract symptoms like acute bronchitis, severe cases might end in severe pneumonia, acute respiratory distress syndrome (ARDS), septic shock and death due to multiorgan damage, so early recognition of patients with suspected COVID-19 infection is crucial. The burden of the virus is not limited to physical damage, but it also has a significant impact on the mental health of the public. It can lead to generalized anxiety disorders and depression during COVID-19 pandemic. Now many countries are in a state of crisis worldwide. Whenever the living environment changes, people feel unsafe. People's fear of COVID-19 makes them refrain from going to medical centers, which significantly impacts their access to medical care while they require acute treatment. COVID-19 outbreak in countries has pulled essential medical resources away from regular procedures. This has caused complications for patients who need treatment for other medical conditions that require timely and appropriate care. Cancer patients especially still require attention in curative or palliative settings, and women will still be delivering their infants. How can we care for these patients without exposing them to COVID-19?\n

Objective To describe digital media use in college students during the coronavirus disease 2019 (COVID-19) outbreak. Methods A structured self-administered electronic questionnaire was designed and admin istered during February 4 to 12, 2020, collecting information on the use time of digital media and anxiety symptoms of college students in China during the COVID -19 outbreak. Data was analyzed by Chi-square test, univariate and multivariate Logistic regression models. Results A total of 11 787 university students were recruited. The detection rate of anxiety symptoms was 17.8%. The percentages of screen time ≤2, >2–4 and >4 h/d were 21.3%, 31.4% and 47.3%. The proportions of mobile phone use time ≤2, >2-4 and >4 h/d were 14.6%, 33.2% and 52.3%. The proportion of browsing information regarding COVID-19 ≤ 1, 1-2 and >2 h/d were 66.6%, 19.4% and 13.9%. The results of Logistic regression analysis revealed that the detection rate of anxiety symptoms was lower among the students having 2-4 h/d of screen time ( OR = 0.70, 95% CI = 0.61-0.81), but higher among the students having more than 4 h/ d of screen time ( OR = 1.13, 95% CI = 1.00-1.28) compared with those having ≤2 h/d of video usage time. Compared with the mobile phone usage ≤2 h/d group, the detection rate was lower among >2-4 h/d group ( OR = 0.78, 95% CI = 0.66-0.91). However, anxiety symptoms were more likely to occur in the group of > 4 h/d ( OR = 1.20, 95% CI = 1.04- 1.39). The detection of anxiety symptoms was higher in the group with more browsing time. The OR for anxiety symptoms detection rate was 1.55 (1.38-1.75) among the students with > 1-2 h/d of browsing information regarding COVID-19 and 2.15 (1.89-2.44) among the students with >2 h/d of browsing information regarding COVID-19 compared with those with ≤1 h/d of browsing information regarding COVID-19. Conclusion During the epidemic period, the use of >2-4 h/d digital media helps to reduce the occurrence of anxiety symptoms. But the use of computers and mobile phones for more than 4 h/d is associated with higher level of anxiety symptoms among college students. Less screen time spent on fact-checking on COVID-19 might help reduce anxiety sympotoms among college students. 【摘要】 目的 了解新型冠状病毒肺炎 (COVID-19)疫情期间大学生数字媒体使用情况, 为缓解大学生焦虑情绪提供参 考依据。 方法 设计并发放结构化自填电子问卷, 2020 年 2 月 4—12 日收集疫情期间中国 16 个省、市、自治区大学生数字 媒体使用时间与焦虑症状自评等信息, 采用妒检验、单因素和多因素Logistic回归模型分析不同类型数字媒体使用时间与 焦虑症状的关联。 结果 11 787 名大学生焦虑症状检出率为17.8%, 视屏时间 ≤2、>2~4 和 >4 h/d 的比例分别为 21.3%, 31.4% 和 47.3%;手机使用时间 ≤2、>2~4 和 >4 h/d 的比例分别为 14.6%, 33.2% 和 52.3%; 浏览 COVID-19 相关信息 ≤1、 >1~2 和 >2 h/d 的比例分别为 66.6%, 19.4% 和 13.9%。多因素 Logistic 回归分析结果显示, 相比于视屏时间 ≥2 h/d 组, > 2 ~4 h/d 的大学生焦虑症状检出率更低 ( OR = 0.70, 95% CI = 0.61 ~ 0.81), >4 h/d 的大学生更容易发生焦虑症状 ( OR =1.13, 95% CI =1.00~1.28); 相比于手机使用时间 ≤2 h/d 组, >2~4 h/d 的大学生焦虑症状检出率更低 ( OR = 0.78, 95% CI =0.66~ 0.91), >4 h/d 的大学生更容易发生焦虑症状 ( OR =1.20, 95% CI = 1.04~ 1.39); 随着浏览时间的增加焦虑症状检出风险增 髙, 浏览 COVID-19 相关信息时间>1~2 和 >2 h/d 组 [ OR 值 ( OR 值 95% CI )分别为 1.55 (1.38 ~ 1.75), 2.15 (1.89 ~ 2.44)]。 结论 疫情期间>2〜4 h/d 数字媒体使用有助于减少焦虑症状的发生, 但电脑和手机使用时间>4 h/d 均会增加大学生焦 虑症状的发生风险, 每日浏览 COVID-19 相关信息的时间越少越好。

The worldwide spread of the COVID-19 pandemic has disrupted the fieldwork of surveys. The data collection efforts via the face-to-face mode have been affected especially, including the ongoing surveys that were in the field during the COVID-19 outbreak and the planned surveys scheduled for fieldwork later in 2020. We provide an account of how COVID-19 has impacted two family studies in Germany: “The German Family Panel” (pairfam) and the “Generations and Gender Survey” (GGS) both of which will be part of the “Family Research and Demographic Analysis” (FReDA) infrastructure. Based on pairfam, we illustrate the effects of the pandemic on ongoing data collection and the measures taken to proceed with fieldwork, and we report on a special COVID-19 survey. Based on FReDA-GGS, we outline how COVID-19 has affected our planned survey schedules, what future challenges are expected when fieldwork becomes possible again, and how we have adapted our plans accordingly.

Influenza virus infection is a respiratory infectious disease that can seriously affect human health. Influenza viruses can have frequent antigenic variation and changes, which can result in rapid and widespread transmission resulting in annual epidemics and outbreaks in places of public gathering such as schools, kindergartens and nursing homes. The World Health Organization (WHO) estimated that seasonal influenza epidemics have caused an annual 3 to 5 million severe cases, and 290000 to 650000 deaths globally. Pregnant women, young children, the elderly, and persons with chronic illnesses are at high risk for severe illness and death associated with influenza virus infection. Especially, COVID-19 pandemic might co-circulate with other respiratory infectious diseases such as influenza in the coming winter-spring season. Seasonal influenza vaccination is the most effective way to prevent influenza virus infection and complications from infection. Currently, China has licensed trivalent inactivated influenza vaccine (IIV3) which includes split-virus influenza vaccine and subunit vaccine, quadrivalent inactivated influenza vaccine (IIV4) which is split, and trivalent live attenuated influenza vaccine(LAIV3) which was newly licensed. Except for a few major cities, influenza vaccine is a category Ⅱ vaccine, which means influenza vaccination is voluntary, and recipients must pay for it. In 2018 and 2019, the Chinese Center for Disease Control and Prevention issued the"Technical Guidelines for Seasonal Influenza Vaccination in China". In the past year, new research evidences home and abroad have been published, and new seasonal influenza vaccine has been licensed in China. To strengthen the technical guidance for prevention and control of influenza and operational research on influenza vaccination in China, the National Immunization Advisory Committee (NIAC) Influenza Vaccination Technical Working Group (TWG), updated the 2019-2020 technical guidelines and compiled the "Technical guidelines for seasonal influenza vaccination in China (2020-2021)". The main updates in this version include the following: First, new research evidences especially studies of China, including disease burden, effectiveness, Vaccine-avoidable disease burden, vaccine safety monitoring, and cost-effectiveness and cost-benefit. Second, policies and measures for influenza prevention and control issued by National Health Commission(PRC)in the past year. Thirdly, new type seasonal influenza vaccine licensed and issued in 2020-2021 in China. Fourth, northern hemisphere influenza vaccination composition for the 2020-2021 season which included trivalent and quadrivalent influenza vaccine. Fifth, Influenza vaccination recommendations for 2020-2021 influenza season. The recommendations described in this report include the following: Points of Vaccination clinics (PoVs) should provide influenza vaccination to all persons aged 6 months and above who are willing to be vaccinated and do not have contraindications. No preferential recommendation is made for one influenza vaccine product over another for persons for whom more than one licensed, recommended, and appropriate product is available. Considering the situation of globally pandemic of COVID-19, to decrease the risk of influenza virus infection and minimize the impact on COVID-19 prevention and control, we recommend the following priority for seasonal influenza vaccination: (1) healthcare workers, including clinical doctors and nurses, public health professionals, quarantine professionals; (2) Vulnerable groups living in nursing homes or welfare homes and staffs who take care those vulnerable groups; (3) People in some key places, such as teachers and students in kindergartens, primary and secondary school, prisoners and staffs of prisons; (4) Other high risk group of influenza, including adults ≥60 years of age, children aged 6-59 months, persons with specific chronic diseases, the family members and caregivers of infants <6 months of age, and pregnant women or women who plan to become pregnant during the influenza season. Children aged 6 months through 8 years require 2 doses of influenza vaccine administered a minimum of 4 weeks apart during their first season of vaccination for optimal protection. People whoever get IIV or LAIV all apply to the principle. If they were vaccinated in 2019-2020 influenza season or a prior season, 1 dose is recommended. People more than 8 years old require 1 dose of influenza vaccine. It is recommended that people receive their influenza vaccination by the end of October. Influenza vaccination should be offered as soon as the vaccination is available. For the people unable to be vaccinated before the end of October, influenza vaccination will continue to be offered for the whole season. Influenza vaccine is also recommended for use in pregnant women during any trimester. These guidelines are intended for use by staff members of the Centers for Disease Control and Prevention at all levels who work on influenza control and prevention, PoVs staff members, healthcare workers from the departments of pediatrics, internal medicine, and infectious diseases, and staff members of maternity and child care institutions at all levels. These guidelines will be updated periodically as new evidence becomes available.

In January 2020, during China’s COVID-19 outbreak, the NASA Earth Observatory captured aerial images indicating significantly lower emissions of nitrogen dioxide (NO2), a major air pollutant, across China’s mainland.[1] Scientists across the globe have reported preliminary empirical data that amid shelter-in-place directives and the shutting down of large-scale economic activity, the environment is flourishing. Abnormal sightings of wild animals roaming freely in deserted cities have been widely reported. For example, monkeys in Lopburi, Bangkok and leatherback turtles on deserted beaches in Florida, US are thriving.[2] This pandemic has given mother earth a chance to ‘breathe.’ Environmentalists are asking how long the breather will last and whether it will sustain the earth for years to come, when business as usual returns bringing environmental challenges. This pandemic has shaken up business as usual including major economic drivers of supply and demand. At the moment, the demand for oil is at an all-time low whereas personal protective equipment (PPE) markets are booming. The world has entered into a recession, with estimates of a US $2 trillion loss. Approximately 11 million people are being pushed into poverty.[3] People are functioning differently: there is a shift toward working remotely, micro gardening in urban settings, more mindful use of resources, and spending more time at home with friends and family. These trends may put less strain on people as well as on the environment. As people find a better work-life balance and commute less, the 77.5% of pollution caused by car and air travel, may be reduced.[4] Some scientists also argue that if the planet were healthier we would see fewer viruses take hold.[5] Although scientists estimate that the impact of COVID-19 on the environment may be temporarily positive, long-lasting action and commitment are necessary to mitigate climate change. The Sustainable Development Goals (SDGs) adopted by United Nations member states in 2015 aim to achieve climate action, sustainable cities, and sustainable use of the earth and ocean’s resources by 2030. While there is a short-term environmental benefit of lower emissions, the long-term goals may be set back due to the COVID-19 pandemic.[6] The SDGs include eliminating poverty, protecting the planet, and ensuring prosperity and peace for all people.[7] The SDGs are a stark reminder that the pre-COVID-19 world was far from perfect. Most countries’ economies are driven by exponential capitalist growth in which the environment and people are exploited for the sake of profit. Nearly half the world lives on less than $5.50 a day.[8] 44 percent of the world’s net worth belongs to 0.8 percent of the world’s individuals[9]. This crisis has exposed systemic flaws even more, as those who have lower socio-economic standing are disproportionately affected by this pandemic. They are more susceptible because they do not have access to basic sanitation and are often forced to live in places affected worse by climate change and pollution. In 2019 Greta Thunberg, the 15-year-old environmental activist, made the case that the economics to solve the current environmental constraints did not yet exist. In 2020, amid the pandemic, the United Nations (UN) reported that there is a need to rebuild economies differently.[10] Individuals and governments may be spurred to change their approach to climate action requiring a shift of societal norms to value the environment and people’s happiness more than profit growth. In Amsterdam, donut economics will be used to help the economy recover.[11] Donut economics originated from Kate Raworth of Oxford University’s Environmental Change Institute’s book, ‘Donut Economics: seven ways to think like a 21st century economist.’ The inner ring of the donut refers to the minimum that people need to live a good life, which is based on the UN’s SDGs (such as food, clean water, housing, sanitation, energy, education, healthcare, gender equality, income, and political voice). Any person who does not have access to these minimum standards of living is described as living in the doughnut’s hole. The outer ring of the doughnut, where the sprinkles go, represents the ecological outer parameters, drawn up by earth-system scientists. These outer parameters delineate the boundaries which humanity should not progress beyond if it is to avoid damage to the ozone layer, oceans, freshwater resources, and abundant biodiversity. In developing countries such as South Africa, the opportunity to rebuild the economy by means of donut economics seems idealistic because a large percentage of the population lives inside the doughnut hole. The immediate challenges of debt, poverty, and food shortage brought about by the COVID-19 lockdown are pressing.[12] However, visionary leaders should take a long-term perspective as there is opportunity to do so now. For example, during this time President Cyril Ramaphosa aims to reduce the number of ‘people living inside the donut’s hole’ by improving housing infrastructure in rural areas. Rebuilding a more ethical post-COVID-19 world of both environmental and human flourishing[13] will require a planetary health perspective.[14] The Lancet[15] suggests that a planetary perspective must move beyond an emergency response toward resilience and prevention planning. In “Happiness explained: What human flourishing is and what we can do to promote it,” Paul Aland explains that the principles of human flourishing are fairness, autonomy, community, and engagement. These principles may be the pillars for post-COVID-19 environmental policies. Amid the chaos and trauma of this pandemic, it is up to individuals, leaders, scientists, and bioethicists to take a breather to reflect. It is time to dare to imagine what human and environmental flourishing may look like in a more sustainable post-COVID-19 world and start rebuilding it one step at a time. Photo by RawFilm on Unsplash [1] “These Satellite Photos Show How COVID-19 Lockdowns Have Impacted Global Emissions,” World Economic Forum, March 25, 2020, https://www.weforum.org/agenda/2020/03/emissions-impact-coronavirus-lockdowns-satellites/. [2] Harry Kretchmer, “These Locked-down Cities Are Being Reclaimed by Animals,” World Economic Forum, April 17, 2020, https://www.weforum.org/agenda/2020/04/covid-19-cities-lockdown-animals-goats-boar-monkeys-zoo/. Deena Robinson, “Endangered Sea Turtles Thriving Amid COVID-19 Restrictions,” April 20, 2020, https://earth.org/endangered-sea-turtles-thriving-amid-covid-19-restrictions/. [3] World Economic Forum, “Why We Cannot Lose Sight of the Sustainable Development Goals during Coronavirus,” April 23, 2020, https://www.weforum.org/agenda/2020/04/coronavirus-pandemic-effect-sdg-un-progress/. [4] Hiroko Tabuchi, “‘Worse Than Anyone Expected’: Air Travel Emissions Vastly Outpace Predictions,” The New York Times (Online), September 19, 2019, https://www.nytimes.com/2019/09/19/climate/air-travel-emissions.html. [5] “First Person: COVID-19 Is Not a Silver Lining for the Climate, Says UN Environment Chief,” United Nations News, April 5, 2020, https://news.un.org/en/story/2020/04/1061082. [6] The World Bank, “Poverty,” April 16, 2020, https://www.worldbank.org/en/topic/poverty/overview. [7] United Nations Development Programme, “What Are the Sustainable Development Goals?,” 2015, https://www.undp.org/content/undp/en/home/sustainable-development-goals.html. [8] The World Bank, “Nearly Half the World Lives on Less than $5.50 a Day,” October 17, 2018, https://www.worldbank.org/en/news/press-release/2018/10/17/nearly-half-the-world-lives-on-less-than-550-a-day. [9] James Davies, Rodrigo Lluberas, and Anthony Shorrocks, “Global Wealth Report 2018,” Credit Suisse Research Institute, 2018. [10] “First Person: COVID-19 Is Not a Silver Lining for the Climate, Says UN Environment Chief,” United Nations News, April 5, 2020, https://news.un.org/en/story/2020/04/1061082. [11] Daniel Boffey, “Amsterdam to Embrace ‘doughnut’ Model to Mend Post-Coronavirus Economy,” April 8, 2020, https://www.theguardian.com/world/2020/apr/08/amsterdam-doughnut-model-mend-post-coronavirus-economy. [12] A van den Heever et al., “South Africa Needs a Post-Lockdown Strategy That Emulates South Korea,” The Conversation, April 18, 2020, https://theconversation.com/south-africa-needs-a-post-lockdown-strategy-that-emulates-south-korea-136678. “‘People Need to Eat’: South Africa Eases Coronavirus Lockdown,” Aljazeera, January 5, 2020, https://www.aljazeera.com/news/2020/05/eat-south-africa-eases-coronavirus-lockdown-200501072927207.html. [13] Rose Deller, “Book Review: Happiness Explained: What Human Flourishing Is and How We Can Promote It by Paul Anand,” The London School of Economics and Political Science, August 24, 2016, https://blogs.lse.ac.uk/lsereviewofbooks/2016/08/24/book-review-happiness-explained-what-human-flourishing-is-and-how-we-can-promote-it-by-paul-anand/. [14] Alistair Brown and Richard Horton, “A Planetary Health Perspective on COVID-19: A Call for Papers,” The Lancet 395 (April 4, 2020): 1099. [15] Brown and Horton.

Management of a Delivery Suite During the COVID-19 Epidemic

During the c o vid 19 pandemic, the Indonesian Ulema Council issued Fatwa Number 14/2020 concerning the Implementation of Worship in a C o vid 19 Outbreak Situation. The contents of the fatwa are, among others, in order to maintain health so as not to be exposed to the corona virus, it is recommended to pray at home only. This is in accordance with the Islamic religion to keep us physically protected from disease. Thus, the MUI Fatwa is in accordance with the principles of the Islamic religion, namely avoiding harm by practicing what is good for human survival. The reason for this MUI Fatwa is known as the mashlahah mursalah which al-Ghazali explains in several of his books. Al-Ghazali stated that mashlahah mursalah is a matter of goodness that is considered by humans which in fact is in accordance with Islamic law. Keywords : Mashlahah Mursalah, al-Ghazali, and Fatwa MUI.

During the outbreak of COVID-19, this paper aimed to discuss its potential risks on reproductive health, which was underpinned by the virus, drugs, disinfectants and psychological problems. The literatures review on previous and latest studies showed that COVID-19 may have potential effects on both men’s and women’s reproductive systems; that contraception should be recommended during antiviral treatment and for at least eight months after the end of antiviral treatment, but there is no evidence to support the termination of pregnancy without medical indicators during early pregnancy; and that chlorine disinfectants are not recommended for assisted reproduction laboratories. Medical professionals should make a comprehensive assessment according to the patient’s fertility needs, disease status and psychological level, in order to provide reasonable fertility guidance and counselling. Key words: COVID-19; Infectious disease; Reproductive health

Optimizing Best Vascular Access Practice in Patients on Dialysis during the COVID-19 Pandemic Period

Since the outbreak of COVID-19 in Wuhan, cabin hospitals have played an important role in preventing the spread of the epidemic and admitting all the patients and suspected ones. As one of the first three cabin hospitals in Wuhan, Jianghan cabin hospital under care of Wuhan Union Hospital has efficiently fulfilled its purpose of admitting patients of mild symptoms. Measures taken by the cabin hospital include clearing its positioning, optimizing its layout, establishing organization structure, setting up the rules and regulations, and strengthening the prevention and control of hospital infection. This article briefly summed up the operation and management practices of the cabin hospital, and analyzed its management difficulties, hence putting forwards suggestions on medical emergency management system of China, for references of hospitals and authorities in charge. Key words: COVID-19; Cabin hospital; Prevention and treatment; Operation management; Emergency management

Objective We sought to learn the cognition and attitude of doctors, nurses, patients and patients' family members for male nurses and compare the differences in nursing skills between men and women in order to provide basic information and a basis for further improving the quality of hospital care and promote the comprehensive development of nursing disciplines. Methods Some doctors, female nurses, patients and their family members of patients from the five top hospitals were randomly selected as research subjects to investigate the cognitive attitudes towards male nurses. 50 male nurses from the five top hospitals were randomly selected, then 50 female nurses with the same academic level and specialty were selected as the control group, and nursing skills were compared between the two groups. Results This study investigated a total of 304 doctors, 522 female nurses, 258 patients, 176 patients' family members. The cognition attitude to male nurses by doctors, female nurses, patients and their families showed statistically significant differences. Emergency department, operating room, intensive care unit were four departments which were considered to be in great need of male nurses. The differences were statistically significant between men and women nurses in scores of aseptic technique, intravenous infusion operation, suction operation, single unarmed CPR skills. Pearson correlation analysis was conducted between education, working years and scores and total score of four operation skills, the results showed that working life was correlated with aseptic technique score of female nurses, the correlation coefficient was 0.409, the scores of the remaining skills did not showed correlation with education and working years yet. Conclusions Doctors, female nurses, patients and patients' families showed a certain degree of acceptance and positive attitude to male nurses. Male nurses showed advantages in the emergency department, operating room, intensive care unit and other nursing post. Male and female nurses demonstrated the same level of basic nursing skills. Key words: Male nurses; Cognitive attitude; Operational skills; Investigation

BackgroundThe COVID-19 pandemic has created disruptions in HIV prevention and sexual health services for men who have sex with men (MSM).ObjectiveThis study compared HIV testing utilization in 3 different reference periods (period 1: before the COVID-19 outbreak, November 2019-January 2020; period 2: after the outbreak, February-April 2020; and period 3: after the pandemic was under initial control, May-July 2020). Factors associated with HIV testing utilization after the COVID-19 outbreak (combined periods 2 and 3) were also investigated.MethodsParticipants were MSM aged ≥18 years living in Shenzhen, China. Those self-reporting as HIV positive were excluded. A total of 595 participants recruited through multiple sources completed a self-administered online survey during August-September 2020. HIV testing utilization after the COVID-19 outbreak was the dependent variable, and multivariate logistic regression models were fitted.ResultsHIV testing utilization was significantly lower in period 2 than in period 1 (n=262 vs 363, 44.0% vs 61.0%, P<.001). However, HIV testing utilization was not significantly higher in period 3 than in period 2 (n=277 vs 262, 46.6% vs 44.0%, P=.21). The prevalence of HIV testing utilization after the COVID-19 outbreak was seen in 331 (55.6%) participants. After adjusting for significant background characteristics, condomless anal intercourse (CAI) with regular male sex partners (RPs; adjusted odds ratio [AOR] 2.15, 95% CI 1.29-3.57) and sexualized drug use (SDU; AOR 2.94, 95% CI 1.41-6.06) both before and after the COVID-19 outbreak, CAI with RPs (AOR 2.07, 95% CI 1.06-4.07) and nonregular male sex partners (NRPs; AOR 3.57, 95%CI: 1.43-8.89) only after the COVID-19 outbreak was positively associated with the dependent variable. Regarding HIV prevention service utilization, HIV testing utilization before the COVID-19 outbreak (AOR 10.75, 95% CI 7.22-16.02) and the use of sexually transmitted infection (STI) testing (AOR 7.02, 95% CI 4.10-12.02), other HIV/STI prevention (AOR 3.15, 95% CI 2.16-4.60), and preexposure prophylaxis (PrEP; AOR 3.58, 95% CI 1.54-8.34) after the COVID-19 outbreak were associated with higher HIV testing utilization. The current perceived risk of HIV infection was higher than that before the COVID-19 outbreak (AOR 1.15, 95% CI 1.01-1.30), and perceived COVID-19 preventive measures taken by HIV testing service providers to be effective (AOR 1.52, 95% CI 1.29-1.78) and perceived higher behavioral control to undergo HIV testing (AOR 1.18, 95% CI 1.00-1.40) were positively associated with HIV testing utilization. Concerns about COVID-19 infection during HIV testing (AOR 0.78, 95% CI 0.68-0.89), avoiding crowded places (AOR 0.68, 95% CI 0.48-0.98), and HIV testing service providers reducing their working hours (AOR 0.59, 95% CI 0.48-0.98) were negatively associated with the dependent variable.ConclusionsHIV testing utilization among Chinese MSM declined after the COVID-19 outbreak and did not increase after the pandemic was under initial control. Removing structural barriers to accessing HIV testing caused by COVID-19, modifying perceptions related to HIV testing, and making use of HIV self-testing (HIVST) might be useful strategies to improve HIV testing among MSM during the pandemic.