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Ivan Mugisha Taremwa,1 Scholastic Ashaba,2,3 Barbara Rita K Naggayi,4 Badru Kayongo,2 Christine Nimwesiga,5 Carlrona Ayebazibwe,1 Manasseh Tumuhimbse,6 John Frank7 1Institute of Allied Health Sciences, Clarke International University, Kampala, Uganda; 2Department of Psychiatry, Mbarara Regional Referral Hospital, Mbarara, Uganda; 3Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda; 4Faculty of Interdisciplinary Studies, Mbarara University of Science and Technology, Mbarara, Uganda; 5Uganda Nurses and Midwives Council, Ministry of Health, Kampala, Uganda; 6Faculty of Business and Management Sciences, Mbarara University of Science and Technology, Mbarara, Uganda; 7Professorial Fellow, Usher Institute, University of Edinburgh, Edinburgh, UKCorrespondence: Ivan Mugisha Taremwa, Institute of Allied Health Sciences, Clarke International University, P.O Box 7782, Kampala, Uganda, Tel +256 774 346 368, Email imugisha@ymail.comBackground: As a novel global health pandemic, Coronavirus Disease-2019 (COVID-2019) has posed various challenges to frontline healthcare providers (FHCPs). This study explored the social and psychological challenges of COVID-19 to the FHCPs at Mbarara Regional Referral Hospital, southwestern Uganda.Methods: This was a cross-sectional study with a qualitative approach. Participants were purposively selected, consented, and interviewed. Interviews were audio-recorded and transcribed. Data were entered into NVivo 10 software and analyzed using a thematic analysis approach.Results: Fourteen FHCPs with diverse roles, including 8 men, were interviewed. Participants’ median age was 38 years (range: 26– 51 years) and eleven of them were married. The subjects’ experiences were explored in relation to perceived social and psychological challenges of working during the COVID-19 pandemic, and coping mechanisms in the COVID-19 pandemic situation. The social challenges identified were burnout, domestic violence, and a financially constrained environment. A further, psychological challenge was anxiety, as well as fear and distress. FHCPs responded with a variety of coping mechanisms, including situational acceptance, religious coping, coping through emotional support of others, and bulk purchase of supply-constrained basic necessities.Conclusion: FHCPs experienced numerous social and psychological challenges, which negatively affected their quality of life amidst a wavering pandemic. As the pandemic rages on, creative and low-cost psychosocial interventions for FHCPs are needed, possibly including more formal peer support, and an improved flow of information about ongoing infectious disease control interventions, so FHCPs feel more knowledgeable about what is ahead.Keywords: psychosocial risks, COVID-19, healthcare providers, coping

Why is tipping for service customary in the United States, but not Australia? With origins in sixteenth-century England, then moving onto Continental Europe, tipping was introduced to both Australi...

Thomas McKeown was right in his primary claim that changing environments, rather than improved medical care, were responsible for much of the long wave of historical mortality decline in the UK since 1700. He was, however, apparently unaware that the beginning of the decline in infant and early-childhood mortality lagged behind that for adults by a few decades, and therefore that its causes might have been fundamentally different. In fact, current evidence indicates that his suggestion, that ‘improved nutrition’ was the underlying factor in the overall decline, now appears to have been essentially correct for the much earlier decline in adult mortality, especially due to tuberculosis. However, the current consensus is that changing reproductive patterns, occasioned by a changing socio-cultural and perhaps legal environment, related to child labor laws, lay behind the much later and very rapid decline in early-life mortality. One must therefore give McKeown great credit for his grasp of both the importance...

The sexual and reproductive health needs of young people perinatally infected with HIV in Uganda remain largely unaddressed by existing HIV/AIDS programs mostly because, such programs encourage young HIV-positive clients to refrain from or postpone sexual activity. This study examines the sexual expressions and experiences as well as the preventive practices of 732 adolescent boys and girls aged 15-19 years who were born with HIV with a view to identifying the preventive service needs of these young people and the implications of these needs for HIV/AIDS programs. The data come from a project on the sexuality of young people perinatally infected with HIV conducted in 2007 in four districts of Uganda, that is, Kampala, Wakiso, Masaka, and Jinja. The analysis involves both quantitative and qualitative approaches: the quantitative approach entails cross-tabulations with chi-square tests as well as significance tests of proportions while the qualitative approach involves an analysis of individual case stories, in-depth probes and focus group discussions for content. The findings show disconnect between: (1) the information the service providers give to the young people and their actual needs and desires; (2) the fears of the adolescents and their actual preventive practices; and (3) the high level of reported condom use and the frequency of use. Programs will therefore need to recognize that young people perinatally infected with HIV are sexually active or anticipate being so in future. Thus, both sexually active and non-sexually active young people require information and services on prevention of unwanted pregnancies as well as avoiding infecting their sexual partners with HIV and re-infecting themselves. Programs will need to devise ways of responding to these needs which should include emphasizing the disclosure of HIV status to the partner as well as the need to accompany such disclosure with consistent condom use.

(2001). Flights from modernity: German and australian utopian colonies in paraguay 1886‐1896. Journal of Australian Studies: Vol. 25, From the Frontier, pp. 49-62.

There are many possible means of determining exposure ranging from self-reports of physical exposure to measures of muscle activations and estimated spinal loads. In epidemiologic studies, issues of validity make instrumented measures preferable, however issues of cost and practicability tend to force investigators to less costly but less valid and less reliable measures of exposure, such as self-report questionnaires. This paper presents a method by which estimates of exposure from self-report questionnaires, expert observers, work sampling, video analysis and electromyograms can be reported in a common metric, Newtons of force on a tissue, and show, as an example of its application, estimation of spinal compression on auto workers. A common metric allows a flexible approach to selection of measurement methods in occupational settings: no matter which instrument is used the results can be combined to provide an overall picture of exposure. This approach to exposure assessment for the low back allows for comparability across studies and settings.