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Over 200 health journals call on the United Nations, politi- cal leaders, and health professionals to recognize that climate change and biodiversity loss are one indivisible crisis and must be tackled together to preserve health and avoid catastrophe. This overall environmental crisis is now so severe as to be a global health emergency. The world is currently responding to the climate crisis and the nature crisis as if they were separate challenges. This is a dangerous mistake. The 28th Conference of Parties (COP) on climate change is about to be held in Dubai while the 16th COP on biodiversity is due to be held in Turkey in 2024. Read more in the PDF.

Background: When exposed to events that transgress one's moral beliefs, a plethora of negative consequences may follow, which are captured by the concept of moral injury (MI). Despite its relevance to experiences of healthcare workers during a global health emergency, there is lack of validated MI instruments adapted to the healthcare setting. Objective: The present study aims to provide a validation of the Italian version of the Moral Injury Events Scale (MIES) adjusted to the healthcare setting by assessing its factor structure, internal consistency and construct validity. Methods: A sample of 794 healthcare workers (46% nurses, 51% female) engaged in hospital facilities during the COVID-19 pandemic in Italy completed measures of MI, PTSD, anxiety, depression, burnout, meaning in life and positive affect. Results: Using an exploratory structural equation modelling (ESEM) we assessed the scale factor structure for the entire sample and separately for nurse professional and female healthcare worker groups. Findings support a three-factor solution: Factor 1 'perceived transgressions by others'; Factor 2 'perceived transgressions by self'; and Factor 3 'perceived betrayals by others'. Findings also indicate some level of convergence with measures of PTSD, anxiety, depression and burnout. Conclusion: Results suggest that the MIES may be useful in capturing unique experiences of moral injury amongst healthcare workers engaged in a global health emergency. The low range correlations with measures of psychological distress might potentially indicate that MI, which captures cognitive value judgements rather than manifest symptomatology, may uniquely explain a certain amount of variance. Implications for the development of new empirically derived and theoretical guided tools are discussed, highlighting the need for future research to examine the role of individualising and social binding moral principles in gaining a more nuanced understanding of moral injury experiences amongst healthcare professionals across different socio-cultural settings. The Italian validation of the MIES adapted to the healthcare setting yielded a three-factor structure: (a) 'perceived transgressions by self'; (b) 'perceived transgressions by others'; (c) 'perceived betrayals by others'. Findings suggest that the MIES may be useful in capturing unique experiences of moral injury amongst healthcare workers engaged in a global health emergency. Future research should consider the role of individualising and social binding moral principles in shaping moral injury experiences among healthcare professionals across different socio-cultural settings. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization has declared human monkeypox as a global health emergency on 23 July 2022. This indicates that the outbreak poses a serious risk to global health and requires a united worldwide response to stop the virus from spreading and possibly turning into a pandemic. Vaccines can play a vital role in this context, contributing to pre- and post-exposure prophylaxis. Methods: The aim of our rapid review was to go through the background of the vaccine approach for human monkeypox over the years and to find out what current guidelines are highlighting relating to it. A rapid review with a systematic search and manual searching have been performed here. Results: 22 relevant published articles from MEDLINE bibliographic database and 8 vaccine recommendations from manual searching have been deliberated here. Conclusion: The significant synopsis of this review is that the smallpox vaccine is the only immunization option for monkeypox so far, and it is up to 85% effective to prevent the infection. Third-generation smallpox vaccines are advised over first and second generations due to their minimal side effects. Healthcare providers and lab professionals at risk are on the priority list to get vaccinated, as well as pregnant women or lactating mothers, and immunocompromised or chronically ill patients can get vaccinated if they are surely exposed to the monkeypox infection. Lastly, JYNNEOS/IMVAMUNE is the current most preferable smallpox vaccine that is highly advised for the latest outbreak of human monkeypox but more clinical trials on humans should be conducted to evaluate its safety, efficacy, and adverse events.

Two experimental Ebola vaccines were deployed during the tenth Ebola epidemic (2018–20) in the Democratic Republic of the Congo (DRC). The first, the Ervebo vaccine manufactured by Merck, was used as part of a ring vaccination in the epicentre of the epidemic in North Kivu. In 2019, the prime- (Ad26.ZEBOV) and boost- (MVA-BN-Filo) vaccine manufactured by Johnson & Johnson (J&J) became the second vaccine against Ebola, deployed by the DRC-EB-001 vaccine trial in Goma, North Kivu. There was international debate as to the value and ethics of testing a second vaccine in an epidemic context. This article examines how this debate unfolded among actual and potential DRC-EB-001 trial participants in Goma. Drawing on ethnographic observation, interviews and focus groups, it explores how the trial was perceived and contested on the ground and situated in broader debates about the ethics of clinical trials, especially during the COVID-19 pandemic. We illustrate how debates around the ethics of clinical research are not simply centred on bioethical principles but are inseparable from local political dynamics and broader contests about governance, inequality and exclusion.

The ongoing multi-country human monkeypox (HMPX) outbreak was declared as a public health emergency of international concern. Considering the key role of healthcare workers (HCWs) in mitigating the HMPX outbreak, we aimed to assess their level of knowledge and their confidence in diagnosis and management of the disease, besides the assessment of their attitude towards emerging virus infections from a conspiracy point of view. An online survey was distributed among HCWs in Jordan, a Middle Eastern country, during May–July 2022 using a questionnaire published in a previous study among university students in health schools in Jordan. The study sample comprised 606 HCWs, with about two-thirds being either physicians (n = 204, 33.7%) or nurses (n = 190, 31.4%). Four out of the 11 HMPX knowledge items had <50% correct responses with only 33.3% of the study respondents having previous knowledge that vaccination is available to prevent HMPX. A majority of study respondents (n = 356, 58.7%) strongly agreed, agreed or somewhat agreed that the spread of HMPX is related to a role of male homosexuals. Confidence in the ability of diagnosis based on the available monkeypox virus diagnostic tests was reported by 50.2% of the respondents, while the confidence levels were lower for the ability to manage (38.9%) and to diagnose (38.0%) HMPX cases based on their current level of knowledge and skills. Higher confidence levels for HMPX diagnosis and management were found among physicians compared to nurses. The endorsement of conspiracy beliefs about virus emergence was associated with lower HMPX knowledge, the belief in the role of male homosexuals in HMPX spread, and with lower diagnosis and management confidence levels. The current study highlighted the gaps in knowledge regarding HMPX among HCWs in Jordan as well as the lack of confidence to diagnose and manage cases among physicians and nurses. Raising the awareness about the disease is needed urgently considering the rapid escalation in the number of cases worldwide with reported cases in the Middle East. The attitude towards male homosexuals' role in HMPX spread necessitates proper intervention measures to prevent stigma and discrimination among this risk group. The adoption of conspiratorial beliefs regarding virus emergence was widely prevalent and this issue needs to be addressed with proper and accurate knowledge considering its potential harmful impact. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first identified in December 2019 in Wuhan, the capital of China's Hubei province and has rapidly spread all over the world. The World Health Organization (WHO) declared the outbreak to be a Public Health Emergency of International Concern on 01/30/2020 and recognized it as a pandemic on 03/11/2020. The number of people diagnosed with COVID-19 worldwide crossed the one million mark on 04/02/2020; two million mark on 04/15/2020; three million mark on 04/27/2020 and the four million mark on 05/09/2020. Despite containment efforts, more than 187 countries have been affected with more than 4,178,346 cases in the world with maximum being in USA (1,347,936) followed by 227,436 in Spain and 224,422 in United Kingdom as of May, 2020. COVID-19 is the latest threat to face mankind cutting across geographical barriers in a rapidly changing landscape. This review provides an update on a rapidly evolving global pandemic. As we face the threat of emerging and re-emerging infectious diseases, this is a stark reminder to invest in population health, climate change countermeasures, a global health surveillance system and effective research into identifying pathogens, their treatment and prevention and effective health delivery systems.

The pandemic from COVID-19 causes a health threat for many countries and requires an internationally coordinated response due to the high spread of the infection. The current local and international situation gives rise to logistical and ethical considerations regarding the imbalance between needs for assistance and availability of health resources in the continuation of the emergency. A shortage condition will require healthcare professionals to choose between patients who will have access to respiratory support and those who will have to continue without. The sharing of criteria for the introduction of patients to the different therapeutic paths is fundamental to prevent the onset of ethical issues. The present paper analyzes the critical issues related to the scarcity of healthcare resources and the limitation of access to intensive care with the aim of proposing ethically sustainable principles for the management of the current pandemic situation.

• A climate and nature crisis have been postulated to threat global health. • It is indicated that the present-day climate change does not represent a crisis. • The nature crisis is not a consequence of climate change but of overpopulation. • Measures to counteract climate change and biodiversity decline are not effective. • Counteracting overpopulation should, instead, have the highest medical priority. [ABSTRACT FROM AUTHOR]

Introduction: COVID19* is a new disease with significant mortality risk. Because of the scarcity of the study on factors associated with the mortality in Tamil Nadu present study was done to determine the factors associated with the outcome of the COVID19 patients admitted in a tertiary care hospital, Madurai. Methodology: 4530 lab confirmed COVID19 patients admitted from March to August 31st, 2020; excluding the non-responders or who gave incomplete information were included in the study. Data retrieved from Case Investigation Forms *filled through telephonic interview. Chi -square test, Univariate and multivariate logistic regression were used to find out the association between the factors and risk of death(outcome). Results: Out of 4530 COVID19 positive patients 381(8.4%) died and 4149(91.6%) were discharged. Using multivariate logistic regression* following were the factors predicted to be associated with mortality:Age group

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Coronavirus disease 2019 (COVID-19) which caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) is the prevailing global health issue at this time, spreading rapidly despite various containment efforts. It is first reported in Wuhan, China in December 2019 and the total number of cases has reached 7,064,230 with 404,585 total deaths globally to date (June 7, 2020). SARS-CoV-2 is reported closely related to SARS-CoV and MERS-CoV, the virus causes only mild symptoms in the majority of cases. However, it can progress to pneumonia and acute respiratory distress syndrome (ARDS), eventually leading to multiple organ dysfunction, the major cause of mortality among affected patients. The primary modes of transmission include droplet and contact infection, and possibly respiratory aerosols in settings where aerosol-generating procedures (AGPs) occur. Diagnosis mainly relies on detecting the viral RNA in nasopharyngeal and oropharyngeal specimens, combined with imaging techniques such as chest X-ray and computerized tomography (CT) scan. Currently, no empirical therapy or vaccine is available yet for the virus, and supportive measures remain the mainstay of treatment. Information about the virus is being updated every day. This review article summarizes the current knowledge surrounding the outbreak, including epidemiology, virological facts, pathogenesis, clinical findings, diagnostic criteria, and currently available therapeutics and vaccines, with a special emphasis on Middle Eastern countries including Saudi Arabia. [ABSTRACT FROM AUTHOR]

Covid 2019 is spreading and emerging rapidly all over the world as a new social disaster. This virus is accountable for the continuous epidemic that causes severe respiratory problems and pneumonia related to contamination of humans, which leads to a dangerous condition of life. Due to the increasing threatening number of cases all over the world, the world health organization (WHO) declared coronavirus as a global health emergency. The pandemic disease affected nearly 80 million people positive cases were reported worldwide till now and cause the death of more than 1.7 million people. The virus has novel characteristics types of pathogens. Many clarifications are done and much more are still unknown and pending. The collaborative research will be useful during this pandemic time in order to meet the improvement of global health improvement. It will also help to know about the knowledge of this COVID-19. Recent advancements in nanotechnology proved that they can help in the production of vaccines in a brief timeframe. In this review, the requirement for quick immunization improvement and the capability and implementation of nanotechnology combat against coronavirus disease were discussed.

Introduction: The WHO announced on 30 January 2020 the respiratory tract infection outbreak caused by Coronavirus 2019 (COVID-19) that was first recognized in China to be a global public health emergency. Objective: To investigate healthcare professional's knowledge and awareness about COVID-19. Methods: The study was conducted across four hospitals in Saudi Arabia and two hospitals in Kuwait. The questionnaire was completed between 18th May and the end of June 2020. Results: A total of 460 healthcare professionals completed the questionnaire, 37.8%(n=174) were males. The age of the participants ranged from 18 to 64 and 80.4% (n=370) of the participants were aged 34 or below. Official government websites 54.8% (n=252) and social media 43.3% (n=199) were the major reliable information sources related to COVID-19. only 37% (n=170) mentioned that the coronavirus disease could transmit through contact. In addition, only 42% (n=191) of the study participants had the correct knowledge about the incubation period of the disease. Moreover, 43.5% (n=200) of the participants were able to identify the symptoms of COVID-19. Conclusion: The study recommended the need to focus more on educational and awareness programs targeting all healthcare professionals to ensure the best practice and provide the optimal care. [ABSTRACT FROM AUTHOR]

As of 14th July 2020, 12,964,809 confirmed cases of coronavirus (COVID-19) and 570,288 deaths had been reported globally. In Kuwait, the numbers stood at 55,508 confirmed cases and 393 deaths. The disease seems to be hitting hard on the country despite the measures that have been put in place. The current study sought to examine healthcare workers HCWs awareness and perceptions of coronavirus disease in Kuwait hospitals. A prospective study design was used to examine the development of the disease among 28 HCWs between mid-May and the start of June 2020. The primary findings were as follows; most of the study participants had attended lectures/ discussions on COVID-19, only few HCWs could identify the incubation period of the novel coronavirus. However, the majority could identify the most common symptoms of the disease as fever, cough, headache, sore throat, runny nose, and skin rashes. Most of the HCWs were aware that the virus transmitted through contact. A good number of the study participants also identified pneumonia, respiratory failure and death as complications associated with coronavirus disease. The study recommends running health education programs in Kuwait to promote knowledge on the coronavirus and help the HCWs develop positive attitudes and uphold important practices. [ABSTRACT FROM AUTHOR]

Globally nurses and midwives are working hard to detect cases of COVID‐19, to save lives or give comfort in the face of death, to educate themselves and the public about protective measures to stop the viral spread, while still caring for those not infected with the virus. In many countries nurses are working under virtual siege from this pandemic, with not enough resources or personal protective equipment, overwhelming numbers of patients, staff shortages, underprepared health systems and supply chain failures. Nurses and other health and emergency workers are suffering physical and emotional stress, and moral distress from conflicting professional values. They are faced with unpalatable and complex ethical issues in practice, with moral conflicts, high levels of acuity and patient deaths, and long working hours. A rising number of nurses are infected with SARS‐CoV‐2 or dying in the line of duty. Nurses need strong moral courage, stamina and resilience to work on the front lines of the pandemic, often while separated from their loved ones. [ABSTRACT FROM AUTHOR]

Background: Unprecedented outbreak of COVID-19 emerged in December 2019 in Wuhan City in China. It spread across the world and captivated India on 30th January, 2020. Today the cases have reached 93322 and are still spreading at a rapid pace. Detection is becoming difficult with the periodic mutation of the virus as it shows no or mild symptoms. To manage the spread Global containment and quarantine efforts have been currently enforced. This review provides an outlook of COVID-19 with the existing literatures focusing on public health, emergency response, and diagnosis, impact of global disaster, preparedness and challenges as well as current state of art. Materials and Methods: Information's from PubMed, CDC, WHO, website of MOHFW, ICMR, NIH along with the journals and papers has been searched and compiled the appropriate information for awareness of people and current challenges on transmission, asymptomatic and symptomatic virus shedding, and diagnosis and future challenges of viral pathogenesis. Result: Cooperation from public is utmost appreciable and the only need of time endeavor to overcome of this emergency. Lockdown, steps for regular self and environmental sanitization, social distancing, self-quarantine, follow-up guidelines are more effective while dealing with coronavirus. Various articles on recommendations, clinical trials, PPE, Mask and Sanitizer production, State Lockdown strategies, testing strategies, understanding of clinical pathways has been discussed with facts and figures on COVID-19. Conclusion: As the huge efforts made by scientist all over world is still continued for prevention and awareness by government to deal with pandemic. Unfortunately, many of lessons from past outbreaks have not been learnt, even disease control professionals, scientists and practicing physicians are reverently in the fight against SARSCoV-2. In past few weeks many interesting papers have been published on genomic sequence, potential target for antiviral development and clinical characteristics on COVID-19. Based on these findings, the urgent needs in prevention and control of COVID-19 is required to understand the mechanism. Many challenges and research questions have arisen in the field from our personal perspective. [ABSTRACT FROM AUTHOR]

An unprecedented outbreak of pneumonia of unknown aetiology in Wuhan City, Hubei province in China emerged in December 2019. A novel coronavirus was identified as the causative agent and was subsequently termed COVID-19 by the World Health Organization (WHO). Considered a relative of severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), COVID-19 is caused by a betacoronavirus named SARS-CoV-2 that affects the lower respiratory tract and manifests as pneumonia in humans. Despite rigorous global containment and quarantine efforts, the incidence of COVID-19 continues to rise, with 90,870 laboratory-confirmed cases and over 3,000 deaths worldwide. In response to this global outbreak, we summarise the current state of knowledge surrounding COVID-19. [ABSTRACT FROM AUTHOR]

The coronavirus outbreak firstly emerged from Wuhan, the economic hub of Hubei province, China, and within a short period, it appeared as a global threat. In response to the outbreak, COVID-19 has been declared as a global health emergency by the World Health Organization (WHO) on January 30, 2020. To contain the virus, the governments of the Coronavirus affected countries enforced lockdowns to ensure social distancing among the people. Additionally, people have been asked to use hand sanitizers, face masks, and gloves, etc. to prevent the effect of the disease. The lockdowns and excessive utilization of medical supplies around the globe has resulted in numerous positive and negative ecological impacts. Therefore, this study aims to review the existing literature on the environmental effects of COVID-19. [ABSTRACT FROM AUTHOR]

The 2013-2016 West African Ebola outbreak was both a catastrophic public health disaster and a rare research opportunity. This paper analyses how the tensions between the humanitarian imperatives of disease control and the epistemic conventions of bioscientific inquiry played out in the accelerated development, testing and licensure of Ebola vaccines. Beginning with the epidemiological projections of the disease’s spread, the paper develops the notion of evidentiary charisma to capture the power of experimental designs and data packages to marshal public health salience, recruit moral legitimacy and short-circuit scientific contestation. Attention to the charismatic dimensions of Ebola vaccine R&D helps to unpick the simultaneous appeals to exception and convention in the unfolding of a global health crisis, and to trace the normative and technical contours of the emerging paradigm of emergency research. [ABSTRACT FROM AUTHOR]

Background : Public Health Emergencies (PHE) demand expeditious research responses to evaluate new or repurposed therapies and prevention strategies. Alternative Design Trials (ADTs) and Adaptive Platform Trials (APTs) have enabled efficient large-scale testing of biomedical interventions during recent PHEs. Design features of these trials may have implications for engagement and/or informed consent processes. We aimed to rapidly review evidence on engagement and informed consent for ADTs and APTs during PHE to consider what (if any) recommendations can inform practice. Method : In 2022, we searched 8 prominent databases for relevant peer reviewed publications and guidelines for ADTs/APTs in PHE contexts. Articles were selected based on pre-identified inclusion and exclusion criteria. We reviewed protocols and informed consent documents for a sample of large platform trials and consulted with key informants from ADTs/APT trial teams. Data were extracted and summarised using narrative synthesis. Results : Of the 49 articles included, 10 were guidance documents, 14 discussed engagement, 10 discussed informed consent, and 15 discussed both. Included articles addressed ADTs delivered during the West African Ebola epidemic and APTs delivered during COVID-19. PHE clinical research guidance documents highlight the value of ADTs/APTs and the importance of community engagement, but do not provide practice-specific guidance for engagement or informed consent. Engagement and consent practice for ADTs conducted during the West African Ebola epidemic have been well-documented. For COVID-19, engagement and consent practice was described for APTs primarily delivered in high income countries with well-developed health service structures. A key consideration is strong communication of the complexity of trial design in clear, accessible ways. Conclusion : We highlight key considerations for best practice in community engagement and informed consent relevant to ADTs and APTs for PHEs which may helpfully be included in future guidance. Protocol : The review protocol is published online at Prospero on 15/06/2022: registration number CRD42022334170., Competing Interests: No competing interests were disclosed., (Copyright: © 2023 Davies A et al.)

BackgroundIn December 2019, a pneumonia caused by a novel coronavirus (SARS-CoV-2) emerged in Wuhan, China and has rapidly spread around the world since then.AimThis study aims to understand the research gaps related to COVID-19 and propose recommendations for future research.MethodsWe undertook a scoping review of COVID-19, comprehensively searching databases and other sources to identify literature on COVID-19 between 1 December 2019 and 6 February 2020. We analysed the sources, publication date, type and topic of the retrieved articles/studies.ResultsWe included 249 articles in this scoping review. More than half (59.0%) were conducted in China. Guidance/guidelines and consensuses statements (n = 56; 22.5%) were the most common. Most (n = 192; 77.1%) articles were published in peer-reviewed journals, 35 (14.1%) on preprint servers and 22 (8.8%) posted online. Ten genetic studies (4.0%) focused on the origin of SARS-CoV-2 while the topics of molecular studies varied. Nine of 22 epidemiological studies focused on estimating the basic reproduction number of COVID-19 infection (R 0 ). Of all identified guidance/guidelines (n = 35), only ten fulfilled the strict principles of evidence-based practice. The number of articles published per day increased rapidly until the end of January.ConclusionThe number of articles on COVID-19 steadily increased before 6 February 2020. However, they lack diversity and are almost non-existent in some study fields, such as clinical research. The findings suggest that evidence for the development of clinical practice guidelines and public health policies will be improved when more results from clinical research becomes available.