Knowledge, awareness and preparedness regarding coronavirus disease 2019 pandemic among community pharmacy practitioners working in Kathmandu, Nepal: A pilot study.
19 Nov 2020-Sage Open Medicine (SAGE PublicationsSage UK: London, England)-Vol. 8, pp 2050312120974513-2050312120974513
TL;DR: Good knowledge, awareness and preparedness regarding coronavirus disease 2019, among community pharmacy practitioners (CPPs), will enable them to provide correct information and support to patients, convey instructions from the public health authorities and protect their own health.
Abstract: Good knowledge, awareness and preparedness regarding coronavirus disease 2019, among community pharmacy practitioners (CPPs), will enable them to provide correct information and support to patients...
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TL;DR: In this paper, a cross-sectional study employing an online survey was conducted in two countries over a period of 6 weeks during 2020 to explore and compare the community pharmacists' roles, practices, implemented safety measures, and psychological toll in Croatia and Serbia during the COVID-19 pandemic.
Abstract: BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic poses a great challenge to health systems and their most accessible assets-community pharmacies. Pharmacists faced many challenges such as incorporating safety measures, changes in working schedule and workload, and meeting specific patients' needs. OBJECTIVES: This study aimed to explore and compare the community pharmacists' roles, practices, implemented safety measures, and psychological toll in Croatia and Serbia during the COVID-19 pandemic. METHODS: A cross-sectional study employing an online survey was conducted in 2 countries over a period of 6 weeks during 2020. The survey consisted of 65 items that explored sociodemographic characteristics of participants and their workplaces, including safety measures, pharmaceutical care, and their psychology while working during the COVID-19 pandemic. RESULTS: In total, 574 pharmacists participated in the study, of which, 90% were female, with a mean age of 38 years (interquartile range 30.5-47). The study identified new pharmacists' roles that evolved during the COVID-19 pandemic: manufacturing hand sanitizers in community pharmacies, online patient counseling, and home delivery of medicines. Croatian and Serbian pharmacists exhibited disparities in their incorporated safety measures (higher for Croatia; P ≤ 0.001) and satisfaction with work organization and counseling activities (higher for Serbia; P < 0.001). Serbian participants were less satisfied with the public perception of their role during the pandemic, and overall satisfaction was low, with a negative impact on mood and productivity. CONCLUSIONS: The study revealed the implications for community pharmacists during the pandemic in both countries. The extent of systematic and logistical support provided to them during the pandemic could be an explanation for the highlighted differences. It is imperative to develop a more effective strategy to counter potential health crises to ensure a better response from primary care pharmacists in the future.
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TL;DR: In this paper , an institutional-based cross-sectional study was conducted among 326 health care providers from August 10-25, 2021 in Gurage zonal public hospitals, where a simple random sampling technique was used to select the study participants.
Abstract: Introduction the provision of quality health care during the COVID-19 pandemic depends largely on the health of health care providers. Health care providers as frontline caregivers dealing with infected patients play a significant role in limiting the outbreak of the disease by implementing safety and prevention practices. However, low and middle-income countries experience barriers to preparedness due to limited resources. Methods an institutional-based cross-sectional study was conducted among 326 health care providers from August 10-25, 2021 in Gurage zonal public hospitals. A simple random sampling technique was used to select the study participants. A pretested self -administered structured questionnaire was used as a data collection tool. The data were entered into the Epi-data 3.1 and exported to Statistical package for the social sciences (SPSS) version 25.0 for analysis. Both descriptive statistics and inferential statistics were presented. Results this study showed that 53.1%, of health care providers, had adequate preparation against COVID-19 pandemics. The finding showed that monthly income, occupation, and working experience were found to be significantly associated with health care providers’ preparedness. Nearly one-quarter (24.8%), 28.3%, 34.5%, and 39.8% of health care providers had access to facemasks, alcohol sanitizer, glove, and isolation gowns respectively. Conclusion the levels of health care providers’ preparedness and health care protection against the third wave COVID-19 pandemic were found to be low. Based on our findings, the government and other stakeholders should design interventions to increase health care providers' preparedness to respond to the ongoing pandemic and purchase an adequate supply of personal protective equipment to protect the health care providers.
TL;DR: In this paper, a cross-sectional, paper-based study was conducted from June to August 2020 to survey the knowledge, attitude, and practices of Vietnamese pharmacists regarding the COVID-19 pandemic.
Abstract: Objective To survey the knowledge, attitude, and practices of Vietnamese pharmacists regarding the COVID-19 pandemic. Method This cross-sectional, paper-based study was conducted from June to August 2020. A validated questionnaire (Cronbach’s alpha = 0.84) was used to interview 1,023 pharmacists in nine provinces of Vietnam. Analysis of covariance was employed to identify factors associated with the knowledge of pharmacists. The best model was chosen by using the Bayesian Model Averaging method in R software version 4.0.4. Results The mean knowledge score was 12.02 ± 1.64 (range: 6–15), which indicated that 93.4% of pharmacists had good knowledge of COVID-19. There was no difference in the average score between males and females (p > 0.05). The multivariate linear regression model revealed that the knowledge was significantly associated with pharmacists’ age, education level, and residence (p < 0.001). About attitude and practices, pharmacists daily sought and updated information on the COVID-19 pandemic through mass media and the internet (social network and online newspapers). Nearly 48% of them conceded that they communicated with customers when at least one person did not wear a face mask at the time of the COVID-19 outbreak. At medicine outlets, many measures were applied to protect pharmacists and customers, such as equipping pharmacists with face masks and hand sanitizers (95.0%), using glass shields (83.0%), and maintaining at least one-meter distance between two people (85.2%). Conclusion The pharmacists’ knowledge of COVID-19 transmission, symptoms, and prevention was good. Many useful measures against the spread of this perilous virus were applied in medicine outlets. However, pharmacists should restrict forgetting to wear face masks in communication with medicine purchasers. The government and health agencies should have practical remedies to reduce the significant differences in the COVID-19 knowledge of pharmacists among provinces and education-level groups.
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Qun Li1, Xuhua Guan1, Peng Wu2, Xiaoye Wang1, Lei Zhou1, Yeqing Tong1, Ruiqi Ren1, Kathy Leung2, Eric H. Y. Lau2, Jessica Y. Wong2, Xuesen Xing1, Nijuan Xiang1, Yang Wu1, Chao Li1, Chen Qi1, Dan Li1, Tian Liu1, Jing Zhao1, Man Liu1, Wenxiao Tu1, Chuding Chen1, Lianmei Jin1, Rui Yang1, Qi Wang1, Suhua Zhou1, Rui Wang1, Hui Liu1, Yingbo Luo1, Yuan Liu1, Ge Shao1, Huan Li1, Zhongfa Tao1, Yang Yang3, Yang Yang4, Zhiqiang Deng5, Boxi Liu5, Zhitao Ma5, Yanping Zhang1, Guoqing Shi1, Tommy Tsan-Yuk Lam2, Joseph T. Wu2, George F. Gao6, George F. Gao1, Benjamin J. Cowling2, Bo Yang5, Gabriel M. Leung2, Zijian Feng1 •
TL;DR: There is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019 and considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere.
Abstract: Background The initial cases of novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020. We analyzed data on the...
13,101 citations
TL;DR: The meaning of Cronbach’s alpha, the most widely used objective measure of reliability, is explained and the underlying assumptions behind alpha are explained in order to promote its more effective use.
Abstract: Medical educators attempt to create reliable and valid tests and questionnaires in order to enhance the accuracy of their assessment and evaluations. Validity and reliability are two fundamental elements in the evaluation of a measurement instrument. Instruments can be conventional knowledge, skill or attitude tests, clinical simulations or survey questionnaires. Instruments can measure concepts, psychomotor skills or affective values. Validity is concerned with the extent to which an instrument measures what it is intended to measure. Reliability is concerned with the ability of an instrument to measure consistently.1 It should be noted that the reliability of an instrument is closely associated with its validity. An instrument cannot be valid unless it is reliable. However, the reliability of an instrument does not depend on its validity.2 It is possible to objectively measure the reliability of an instrument and in this paper we explain the meaning of Cronbach’s alpha, the most widely used objective measure of reliability.
Calculating alpha has become common practice in medical education research when multiple-item measures of a concept or construct are employed. This is because it is easier to use in comparison to other estimates (e.g. test-retest reliability estimates)3 as it only requires one test administration. However, in spite of the widespread use of alpha in the literature the meaning, proper use and interpretation of alpha is not clearly understood. 2, 4, 5 We feel it is important, therefore, to further explain the underlying assumptions behind alpha in order to promote its more effective use. It should be emphasised that the purpose of this brief overview is just to focus on Cronbach’s alpha as an index of reliability. Alternative methods of measuring reliability based on other psychometric methods, such as generalisability theory or item-response theory, can be used for monitoring and improving the quality of OSCE examinations 6-10, but will not be discussed here.
What is Cronbach alpha?
Alpha was developed by Lee Cronbach in 195111 to provide a measure of the internal consistency of a test or scale; it is expressed as a number between 0 and 1. Internal consistency describes the extent to which all the items in a test measure the same concept or construct and hence it is connected to the inter-relatedness of the items within the test. Internal consistency should be determined before a test can be employed for research or examination purposes to ensure validity. In addition, reliability estimates show the amount of measurement error in a test. Put simply, this interpretation of reliability is the correlation of test with itself. Squaring this correlation and subtracting from 1.00 produces the index of measurement error. For example, if a test has a reliability of 0.80, there is 0.36 error variance (random error) in the scores (0.80×0.80 = 0.64; 1.00 – 0.64 = 0.36).12 As the estimate of reliability increases, the fraction of a test score that is attributable to error will decrease.2 It is of note that the reliability of a test reveals the effect of measurement error on the observed score of a student cohort rather than on an individual student. To calculate the effect of measurement error on the observed score of an individual student, the standard error of measurement must be calculated (SEM).13
If the items in a test are correlated to each other, the value of alpha is increased. However, a high coefficient alpha does not always mean a high degree of internal consistency. This is because alpha is also affected by the length of the test. If the test length is too short, the value of alpha is reduced.2, 14 Thus, to increase alpha, more related items testing the same concept should be added to the test. It is also important to note that alpha is a property of the scores on a test from a specific sample of testees. Therefore investigators should not rely on published alpha estimates and should measure alpha each time the test is administered.14
Use of Cronbach’s alpha
Improper use of alpha can lead to situations in which either a test or scale is wrongly discarded or the test is criticised for not generating trustworthy results. To avoid this situation an understanding of the associated concepts of internal consistency, homogeneity or unidimensionality can help to improve the use of alpha. Internal consistency is concerned with the interrelatedness of a sample of test items, whereas homogeneity refers to unidimensionality. A measure is said to be unidimensional if its items measure a single latent trait or construct. Internal consistency is a necessary but not sufficient condition for measuring homogeneity or unidimensionality in a sample of test items. 5, 15 Fundamentally, the concept of reliability assumes that unidimensionality exists in a sample of test items16 and if this assumption is violated it does cause a major underestimate of reliability. It has been well documented that a multidimensional test does not necessary have a lower alpha than a unidimensional test. Thus a more rigorous view of alpha is that it cannot simply be interpreted as an index for the internal consistency of a test. 5, 15, 17
Factor Analysis can be used to identify the dimensions of a test.18 Other reliable techniques have been used and we encourage the reader to consult the paper “Applied Dimensionality and Test Structure Assessment with the START-M Mathematics Test” and to compare methods for assessing the dimensionality and underlying structure of a test.19
Alpha, therefore, does not simply measure the unidimensionality of a set of items, but can be used to confirm whether or not a sample of items is actually unidimensional.5 On the other hand if a test has more than one concept or construct, it may not make sense to report alpha for the test as a whole as the larger number of questions will inevitable inflate the value of alpha. In principle therefore, alpha should be calculated for each of the concepts rather than for the entire test or scale. 2, 3 The implication for a summative examination containing heterogeneous, case-based questions is that alpha should be calculated for each case.
More importantly, alpha is grounded in the ‘tau equivalent model’ which assumes that each test item measures the same latent trait on the same scale. Therefore, if multiple factors/traits underlie the items on a scale, as revealed by Factor Analysis, this assumption is violated and alpha underestimates the reliability of the test.17 If the number of test items is too small it will also violate the assumption of tau-equivalence and will underestimate reliability.20 When test items meet the assumptions of the tau-equivalent model, alpha approaches a better estimate of reliability. In practice, Cronbach’s alpha is a lower-bound estimate of reliability because heterogeneous test items would violate the assumptions of the tau-equivalent model.5 If the calculation of “standardised item alpha” in SPSS is higher than “Cronbach’s alpha”, a further examination of the tau-equivalent measurement in the data may be essential.
Numerical values of alpha
As pointed out earlier, the number of test items, item inter-relatedness and dimensionality affect the value of alpha.5 There are different reports about the acceptable values of alpha, ranging from 0.70 to 0.95. 2, 21, 22 A low value of alpha could be due to a low number of questions, poor inter-relatedness between items or heterogeneous constructs. For example if a low alpha is due to poor correlation between items then some should be revised or discarded. The easiest method to find them is to compute the correlation of each test item with the total score test; items with low correlations (approaching zero) are deleted. If alpha is too high it may suggest that some items are redundant as they are testing the same question but in a different guise. A maximum alpha value of 0.90 has been recommended.14
Summary
High quality tests are important to evaluate the reliability of data supplied in an examination or a research study. Alpha is a commonly employed index of test reliability. Alpha is affected by the test length and dimensionality. Alpha as an index of reliability should follow the assumptions of the essentially tau-equivalent approach. A low alpha appears if these assumptions are not meet. Alpha does not simply measure test homogeneity or unidimensionality as test reliability is a function of test length. A longer test increases the reliability of a test regardless of whether the test is homogenous or not. A high value of alpha (> 0.90) may suggest redundancies and show that the test length should be shortened.
8,701 citations
01 Jan 2020
TL;DR: Globally, as of 10,47am CEST, 28 May 2020, there have been 5,556,679 confirmed cases of COVID-19, including 351,866 deaths, reported to WHO.
Abstract: Globally, as of 10:47am CEST, 28 May 2020, there have been 5,556,679 confirmed cases of COVID-19, including 351,866 deaths, reported to WHO
2,785 citations
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Abstract: According to the World Health Organization (WHO), viral diseases continue to emerge and represent a serious issue to public health In the last twenty years, several viral epidemics such as the severe acute respiratory syndrome coronavirus (SARS-CoV) in 2002 to 2003, and H1N1 influenza in 2009, have been recorded Most recently, the Middle East respiratory syndrome coronavirus (MERS-CoV) was first identified in Saudi Arabia in 2012 In a timeline that reaches the present day, an epidemic of cases with unexplained low respiratory infections detected in Wuhan, the largest metropolitan area in China's Hubei province, was first reported to the WHO Country Office in China, on December 31, 2019 Published literature can trace the beginning of symptomatic individuals back to the beginning of December 2019 As they were unable to identify the causative agent, these first cases were classified as "pneumonia of unknown etiology " The Chinese Center for Disease Control and Prevention (CDC) and local CDCs organized an intensive outbreak investigation program The etiology of this illness is now attributed to a novel virus belonging to the coronavirus (CoV) family, COVID-19 On February 11, 2020, the WHO Director-General, Dr Tedros Adhanom Ghebreyesus, announced that the disease caused by this new CoV was a "COVID-19," which is the acronym of "coronavirus disease 2019" In the past twenty years, two additional coronavirus epidemics have occurred SARS-CoV provoked a large-scale epidemic beginning in China and involving two dozen countries with approximately 8000 cases and 800 deaths, and the MERS-CoV that began in Saudi Arabia and has approximately 2,500 cases and 800 deaths and still causes as sporadic cases This new virus seems to be very contagious and has quickly spread globally In a meeting on January 30, 2020, per the International Health Regulations (IHR, 2005), the outbreak was declared by the WHO a Public Health Emergency of International Concern (PHEIC) as it had spread to 18 countries with four countries reporting human-to-human transmission An additional landmark occurred on February 26, 2020, as the first case of the disease, not imported from China, was recorded in the United States Initially, the new virus was called 2019-nCoV Subsequently, the task of experts of the International Committee on Taxonomy of Viruses (ICTV) termed it the SARS-CoV-2 virus as it is very similar to the one that caused the SARS outbreak (SARS-CoVs) The CoVs have become the major pathogens of emerging respiratory disease outbreaks They are a large family of single-stranded RNA viruses (+ssRNA) that can be isolated in different animal species For reasons yet to be explained, these viruses can cross species barriers and can cause, in humans, illness ranging from the common cold to more severe diseases such as MERS and SARS Interestingly, these latter viruses have probably originated from bats and then moving into other mammalian hosts — the Himalayan palm civet for SARS-CoV, and the dromedary camel for MERS-CoV — before jumping to humans The dynamics of SARS-Cov-2 are currently unknown, but there is speculation that it also has an animal origin The potential for these viruses to grow to become a pandemic worldwide seems to be a serious public health risk Concerning COVID-19, the WHO raised the threat to the CoV epidemic to the "very high" level, on February 28, 2020 Probably, the effects of the epidemic caused by the new CoV has yet to emerge as the situation is quickly evolving World governments are at work to establish countermeasures to stem possible devastating effects Health organizations coordinate information flows and issues directives and guidelines to best mitigate the impact of the threat At the same time, scientists around the world work tirelessly, and information about the transmission mechanisms, the clinical spectrum of disease, new diagnostics, and prevention and therapeutic strategies are rapidly developing Many uncertainties remain with regard to both the virus-host interac ion and the evolution of the epidemic, with specific reference to the times when the epidemic will reach its peak At the moment, the therapeutic strategies to deal with the infection are only supportive, and prevention aimed at reducing transmission in the community is our best weapon Aggressive isolation measures in China have led to a progressive reduction of cases in the last few days In Italy, in geographic regions of the north of the peninsula, political and health authorities are making incredible efforts to contain a shock wave that is severely testing the health system In the midst of the crisis, the authors have chosen to use the "Statpearls" platform because, within the PubMed scenario, it represents a unique tool that may allow them to make updates in real-time The aim, therefore, is to collect information and scientific evidence and to provide an overview of the topic that will be continuously updated
2,161 citations
TL;DR: This innovative approach to patient care is described, including the conceptual framework used in its development and the main achievements of patient partners in education, health care, and research.
Abstract: The prevalence of chronic diseases today calls for new ways of working with patients to manage their care. Although patient-centered approaches have contributed to significant advances in care and to treatments that more fully respect patients' preferences, values, and personal experiences, the reality is that health care professionals still hold a monopoly on the role of healer. Patients live with their conditions every day and are experts when it comes to their own experiences of illness; this expertise should be welcomed, valued, and fostered by other members of the care team. The patient-as-partner approach embodies the ideal of making the patient a bona fide member of the health care team, a true partner in his or her care. Since 2010, the University of Montreal, through the Direction of Collaboration and Patient Partnership, has embraced this approach. Patients are not only active members of their own health care team but also are involved in research and provide valuable training to health sciences students. Including patients as full partners in the health care team entails a significant shift in both the medical practice and medical education cultures. In this perspective, the authors describe this innovative approach to patient care, including the conceptual framework used in its development and the main achievements of patient partners in education, health care, and research.
228 citations