METHODS: This was a prospective, international, multicenter cohort study of out-of-hospital cardiac arrest in the Asia-Pacific. Arrests caused by trauma, patients who were not transported by emergency medical services (EMS), and pediatric out-of-hospital cardiac arrest cases (<18 years) were excluded from the analysis. Modifiable out-of-hospital factors (bystander cardiopulmonary resuscitation [CPR] and defibrillation, out-of-hospital defibrillation, advanced airway, and drug administration) were compared for all out-of-hospital cardiac arrest patients presenting to EMS and participating hospitals. The primary outcome measure was survival to hospital discharge or 30 days of hospitalization (if not discharged). We used multilevel mixed-effects logistic regression models to identify factors independently associated with out-of-hospital cardiac arrest survival, accounting for clustering within each community.
RESULTS: Of 66,780 out-of-hospital cardiac arrest cases reported between January 2009 and December 2012, we included 56,765 in the analysis. In the adjusted model, modifiable factors associated with improved out-of-hospital cardiac arrest outcomes included bystander CPR (odds ratio [OR] 1.43; 95% confidence interval [CI] 1.31 to 1.55), response time less than or equal to 8 minutes (OR 1.52; 95% CI 1.35 to 1.71), and out-of-hospital defibrillation (OR 2.31; 95% CI 1.96 to 2.72). Out-of-hospital advanced airway (OR 0.73; 95% CI 0.67 to 0.80) was negatively associated with out-of-hospital cardiac arrest survival.
CONCLUSION: In the PAROS cohort, bystander CPR, out-of-hospital defibrillation, and response time less than or equal to 8 minutes were positively associated with increased out-of-hospital cardiac arrest survival, whereas out-of-hospital advanced airway was associated with decreased out-of-hospital cardiac arrest survival. Developing EMS systems should focus on basic life support interventions in out-of-hospital cardiac arrest resuscitation.
METHOD: This online-based cross-sectional study was conducted among 1280 healthcare providers aged ≥18 years from 30 primary care clinics in the state of Selangor, Malaysia. The Fear of COVID-19 Scale was used to assess the level of fear, and the results were analysed using multiple linear regression.
RESULTS: The mean age of the respondents was 36 years, and the mean working experience was 11 years. The majority of the respondents were women (82.4%) and Malays (82.3%). The factors that were significantly correlated with higher levels of fear were underlying chronic disease (ß=1.12, P=0.002, 95% confidence interval [CI]=0.08, 3.15), concern about mortality from COVID-19 (ß=3.3, P<0.001, 95% CI=0.19, 7.22), higher risk of exposure (ß=0.8, P<0.001, 95% CI=0.14, 5.91), concern for self at work (ß=2.8, P=0.002, 95% CI=0.08, 3.10) and work as a nurse (ß=3.6, P<0.001, 95% CI=0.30, 7.52), medical laboratory worker (ß=3.0, P<0.001, 95% CI=0.12, 4.27) and healthcare assistant (ß=3.9, P<0.001, 95% CI=0.17, 5.73). The level of fear was inversely correlated with a higher work-related stress management score (ß=-0.9, P<0.001, 95% CI=-0.14, -5.07) and a higher sleep quality score (ß=-1.8, P<0.001, 95% CI=-0.28, -10.41).
CONCLUSION: Family physicians should be vigilant and identify healthcare providers at risk of developing COVID-19-related fear to initiate early mental health intervention.
METHODS: This is a systematic review protocol describing essential reporting items based on the PRISMA for systematic review protocols (PRISMA-P) (Registration number: CRD42020220636). We aim to review the effectiveness, tolerability, and safety of hf-rTMS at DLPFC in randomised controlled trials (RCTs) as migraine prophylactic treatment. We will search Scopus, Cumulative Index to Nursing and Allied Health Literature Plus, PubMed, Cochrane Central Register of Controlled Trials and Biomed Central for relevant articles from randomised controlled clinical trials that used hf-rTMS applied at DLPFC for the treatment of migraine. The risk of bias will be assessed using the version 2 "Risk of bias" tool from Cochrane Handbook for Systematic Reviews of Interventions Version 6.1. We will investigate the evidence on efficacy, tolerability and safety and we will compare the outcomes between the hf-rTMS intervention and sham groups.
DISCUSSION: This systematic review will further determine the efficacy, safety, and tolerability of hf-rTMS applied at DLPFC for migraine prophylaxis. It will provide additional data for health practitioners and policymakers about the usefulness of hf-rTMS for migraine preventive treatment.