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Background: The COVID-19 pandemic had a considerable impact on the lives of the world's population, which led to the closure of educational institutions including in Mozambique. In March 2020, the state emergency forced students and professors to change in-person classes to online learning because of the pandemic . Objectives: To access students’ capacities in terms of technological resources to participate in the 5th-year online classes of the Eduardo Mondlane University Medical School and the difficulties they encountered throughout the year. Additionally, psychological symptoms associated with confinement and how that affected participation in psychiatry and mental health classes were assessed. Methods: A cross sectional social online questionnaire survey was conducted among 32 students enrolled in the 5th-year psychiatry and mental health classes of the Eduardo Mondlane University Medical School during May and June 2021. Results: A total of 47 students were invited to participate in this survey, of which 32 students (68%) participated. Of the participants, 16.7% reported the presence of psychological symptoms associated with confinement. All students could participate in online classes using cell phones, computers, and tablets. However, 34.4% did not have a laptop. In this study, 87.5% of the respondents reported poor internet quality, and 12.5% ​​of students did not have internet and had to join colleagues to participate in classes and to interact with the members of their groups. Most of the students (90.6%) were not prepared or knew how to use google classroom, Skype, and Zoom, before the lockdowns. Conclusions: The study suggests that the abrupt and radical change from in-person teaching and learning methods to remote online methods showed the weaknesses of students in terms of resources (computers, tablets, internet) and knowledge for the implementation of online classes. Psychological symptoms were present but did not affect student participation in remote psychiatry and mental health classes.

BackgroundThere is an urgent need to identify tools able to provide reliable information on the cause of death in low-income regions, since current methods (verbal autopsy, clinical records, and complete autopsies) are either inaccurate, not feasible, or poorly accepted. We aimed to compare the performance of a standardized minimally invasive autopsy (MIA) approach with that of the gold standard, the complete diagnostic autopsy (CDA), in a series of adults who died at Maputo Central Hospital in Mozambique.Methods and findingsIn this observational study, coupled MIAs and CDAs were performed in 112 deceased patients. The MIA analyses were done blindly, without knowledge of the clinical data or the results of the CDA. We compared the MIA diagnosis with the CDA diagnosis of cause of death. CDA diagnoses comprised infectious diseases (80; 71.4%), malignant tumors (16; 14.3%), and other diseases, including non-infectious cardiovascular, gastrointestinal, kidney, and lung diseases (16; 14.3%). A MIA diagnosis was obtained in 100/112 (89.2%) cases. The overall concordance between the MIA diagnosis and CDA diagnosis was 75.9% (85/112). The concordance was higher for infectious diseases and malignant tumors (63/80 [78.8%] and 13/16 [81.3%], respectively) than for other diseases (9/16; 56.2%). The specific microorganisms causing death were identified in the MIA in 62/74 (83.8%) of the infectious disease deaths with a recognized cause. The main limitation of the analysis is that both the MIA and the CDA include some degree of expert subjective interpretation.ConclusionsA simple MIA procedure can identify the cause of death in many adult deaths in Mozambique. This tool could have a major role in improving the understanding and surveillance of causes of death in areas where infectious diseases are a common cause of mortality.

Background and aimsComplete diagnostic autopsies (CDA) remain the gold standard in the determination of cause of death (CoD). However, performing CDAs in developing countries is challenging due to limited facilities and human resources, and poor acceptability. We aimed to develop and test a simplified minimally invasive autopsy (MIA) procedure involving organ-directed sampling with microbiology and pathology analyses implementable by trained technicians in low- income settings.MethodsA standardized scheme for the MIA has been developed and tested in a series of 30 autopsies performed at the Maputo Central Hospital, Mozambique. The procedure involves the collection of 20 mL of blood and cerebrospinal fluid (CSF) and puncture of liver, lungs, heart, spleen, kidneys, bone marrow and brain in all cases plus uterus in women of childbearing age, using biopsy needles.ResultsThe sampling success ranged from 67% for the kidney to 100% for blood, CSF, lung, liver and brain. The amount of tissue obtained in the procedure varied from less than 10 mm2 for the lung, spleen and kidney, to over 35 mm2 for the liver and brain. A CoD was identified in the histological and/or the microbiological analysis in 83% of the MIAs.ConclusionsA simplified MIA technique allows obtaining adequate material from body fluids and major organs leading to accurate diagnoses. This procedure could improve the determination of CoD in developing countries.

The major reviews of the literature support the idea that a significant proportion of patients with schizophrenia present cognitive deficits in several domains, more marked in the domains of verbal memory, vigilance and attention, memory, intellectual quotient, language and executive functioning. Such deficits appear to be one of the main determinants of these patients' functional outcome. More recently, social cognition deficits have been described. Social cognition may be understood as a separate and independent dimension of neurocognition or non-social cognition and may constitute a mediator between the neurocognition and functioning. However, there has been controversy concerning the real meaning of deficits observed due to the diversity of analysis methodologies employed and the fact that the available neuropsychological tests and batteries have not been specifically designed to evaluate cognitive deficits in patients with schizophrenia. In this paper, the Working Group on Schizophrenia (GTE) describes and highlights the existing clinical and scientific evidence, performs a critical review of cognitive functioning, social cognition and its impact on functional outcome, in patients with schizophrenia. The authors review definitions of (neuro)cognition, social cognition and functioning, analyze the existing methods for its assessment, describe the treatments available in this context and summarize the evidence of dysfunctions in these three concepts, taking into account their interconnection. Overall, the GTE considered the need for a standardized battery of tests to measure neurocognition, social cognition and functioning, consensually accepting the use of MATRICS as the standard tool for assessing neurocognition in schizophrenia. It was also recognized that verbal memory and vigilance deficits may be the best predictors of functional outcome in schizophrenia. In addition, the GTE has established social cognition as a priority area in the study of schizophrenia, however, the limitations in terminology and assessment methodologies do not allow a consensus in this area. The GTE considers that further longitudinal studies with larger samples are needed, so that a more adequate therapeutic armamentarium becomes available for patients with schizophrenia.