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[EN] Since the end of 2019, the COVID-19 pandemic has been weighing heavily on countries worldwide. Different measures have been taken in Germany to combat this pandemic. In addition to nonpharmacological measures, vaccination strategies have been used to contain the pandemic. A retrospective survey was conducted to get a snapshot of what the population thinks about these measures and how they prefer to be informed. It collected attitudes of the inhabitants of Ansbach towards the COVID-19 situation in June 2020, June 2021 and December 2021. The survey shows that there was a change of opinion regarding the measures and the behaviour on the part of the government as the pandemic progressed. While occupational restrictions decreased, the positive opinion of the undertaken measures decreased. The fear of infection is steadily decreasing. After a sharp rise of the fear of economic consequences in June 2021, it decreases again in December 2021.

Backgrounds: Non-pharmacological measures (NPMs) introduced to prevent the spread of SARS-CoV-2 affected the incidence of respiratory viruses, but not with the same effect on all types of respiratory viruses. The aim of our research was to compare the incidence of enveloped versus naked respiratory viruses before and during NPMs in Croatia. Methods: In four years period (5/2017-3/2021), specimens obtained from 957 children up to 18 years of age which were hospitalized due to respiratory infection were collected and tested for fifteen respiratory viruses using multiplex PCR. Results: One or more respiratory viruses were detected in 739 (77.2%) patients, of which one virus in 496 (67.1%) and two or more viruses in 243 (32.8%) cases. The most frequently detected was rhinovirus (343 ; 35.8%), followed by: respiratory syncytial virus type A and B (162 ; 16.9%), adenovirus (145 ; 15.2%), parainfluenza viruses types 1-4 (101 ; 10.6%), bocavirus (73 ; 7.6%), influenza viruses type A and B (69 ; 7.2%), enterovirus (61 ; 6.4%), coronaviruses OC43 and 229E/NL63 (54 ; 5.6%) and metapneumovirus (30 ; 3.1%). Incidence of all tested viruses did not differ between seasons 2017/18, 2018/19 and 2019/20, while significantly dropped in 2020/21 when NPMs were in use (P

Background and rationale: No effective pharmacological treatments for Covid-19 have currently been found. This situation is renewing interest in non-pharmacological measures meant to slow the spread of respiratory viruses such as SARS-CoV-2. Although children appear to remain relatively protected from complications of Covid-19 this might not be the case with the next pandemic pathogen and residential staff looking after children in care are at risk of contracting the disease when at work. Even if they are spared from the direct effects of the virus children in care may still suffer from not being able to physically meet with their parents or from being isolated from their peers. Objective: To investigate, summarize and categorize non-pharmacological measures taken in children’s homes affected by respiratory outbreaks reported in the scientific literature. Study design Cross-sectional secondary analysis of published scientific literature identified in a recently published rapid scoping review Methods: All 37 studies included in a recent scoping review of the literature on respiratory outbreaks in children’s homes were read in full and non-pharmacological measures manually sought from the study reports and summarized in a premade data collection form along with supporting quote(s) or excerpts. Data was then categorized under 10 categories: social distancing, hygiene, institutional rules, children/residents, families of residents, organizational, management of residents with respiratory disease (real or suspected), educational, mixed-interventions or other. Results: The 37 included articles reported data on respiratory outbreaks which occurred between 1957 and 2011. 13 articles did not report data on non-pharmacological measures taken and data was not extracted from 5 articles deemed out of scope; a final sample of 18 articles provided data for analysis. 83 non-pharmacological measures were reported in these 18 articles. Articles reported anywhere from 1 to 23 unique non-pharmacological measures. Overall, a total of 51 unique non-pharmacological measures were identified. Discussion: A range of non-pharmacological measures taken by residential staff appear to remain unreported in the literature. No measures specifically designed to support residents’ families or meant to improve residents’ school outcomes during outbreaks were found in included articles. Articles typically reported few non-pharmacological measures taken which makes it difficult to assess if other measures were or were not taken and if they could have impacted study outcomes. When non-pharmacological measures were reported few details were provided for stakeholders. The development and use of a reporting guideline meant for outbreak investigations in residential institutions may help clarify which key non-pharmacological measures to describe in reports and use of the TIDieR intervention reporting checklist may help make non-pharmacological measures more reproducible and implementable by residential staff. Funding: No funding was received for this work. Registration: See https://osf.io/fkctw/ (see previous versions) Data and materials: See https://osf.io/q94n3/ and https://osf.io/nt9dx/; all other data is otherwise included within the manuscript. Keywords: Residential care, cross-sectional analysis, respiratory outbreaks, children’s home, non-pharmacological measures, children

Kurzfassung Einleitung: Das Delir ist einer der häufigsten auftretenden Begleiterkrankungen, die im intensivmedizinischen Bereich auftreten können. Die Inzidenz eines Delirs ist bei 15- 90%. Ein Delir kann negative Auswirkungen auf das klinische Outcome haben. Ebenso ist das Behandeln eines Delirs mit einem höheren pflegerischen Arbeitsaufwand verbunden. Deshalb ist es umso wichtiger, präventiv mit nicht-pharmakologischen Maßnahmen zu handeln, um eine Sedierung durch pharmakologische Maßnahmen zu vermeiden. Das pflegerische Handeln sollte aus diesem Grund an die Erkennung, Reduktion und an die Elimination eines Delirs orientieren. Ziel: Das Ziel dieser Bachelorarbeit ist es anhand von wissenschaftlicher Literatur aufzuzeigen, welchen Einfluss nicht-pharmakologische Interventionen auf das Entstehen und bei einem vorhandenen Delir haben. Ebenso soll die Arbeit aufzeigen, wie wichtig es ist, ein Delir frühzeitig zu erkennen, um möglichst schnell nicht-pharmakologische Maßnahmen setzen zu können. Methode: Anhand einer systematischen Literaturrecherche in den Datenbanken Academic Search Elite, CINAHL und PubMed wurden 13 Studien herausgesucht, tabellarisch dargestellt, synthetisiert und kritisch bewertet. Ergebnisse: Zusammenfassend sind adäquate nicht-pharmakologische Maßnahmen einer der effektivsten Möglichkeiten, um ein Delir vorzubeugen und weitreichende Komplikationen zu vermeiden. Die beste Prophylaxe laut den Studien ist es, verschiedene nicht-pharmakologische Maßnahmen zu kombinieren, die auch ABCDEBündel genannt werden. Dieses ABCDE-Bündel basiert auf mehrere Maßnahmen: einer Reorientierung, einer Verbesserung der Schlafhygiene, einer frühen Mobilisation, einer Optimierung des Tag-Nachts-Rhythmus. Die Einbeziehung der Angehörigen haben ebenso einen positiven Einfluss auf das Delir. Diskussion: Die Ergebnisse zeigen, dass nicht-pharmakologische Maßnahmen, den Verlauf eines Delirs verändern können. Summary Background: Delirium is one of the most common comorbidities that can occur in the intensive care setting. The incidence of delirium at 15-90%. Delirium can have a negative impact on clinical outcome. Likewise, the treatment of delirium is associated with a higher nursing workload. Therefore, it is even more important to act preventively with non-pharmacological measures to avoid sedation by pharmacological measures. For this reason, nursing activities should be oriented toward the recognition, reduction and elimination of delirium. Aim: The aim of this bachelor thesis is to show, based on scientific literature, what influence non-pharmacological interventions have on the development of delirium and on the presence of delirium. The thesis also aims to show how important it is to recognise delirium at an early stage in order to be able to take non-pharmacological measures as quickly as possible. Method: Using a systematic literature search of the Academic Search Elite, CINAHL, and PubMed databases, 13 studies were singled out, tabulated, synthesized, and critically appraised. Results: In summary, adequate non-pharmacological measures are one of the most effective ways to prevent delirium and avoid extensive complications. The best prophylaxis according to the studies is to combine several non-pharmacological measures, also called ABCDE bundle. This ABCDE bundle is based on several measures: reorientation, improvement of sleep hygiene, early mobilization, optimization of the day-night rhythm. The involvement of relatives also has a positive influence on delirium. Discussion: The results show that nonpharmacologic interventions, can alter the course of delirium.

Einleitung: Das Delirium ist ein hirnorganisches Syndrom, das mit einer Vielzahl von Beschwerden einhergeht. Das Phänomen Delirium ist eine der häufigsten Komplikationen bei Patient*innen, die auf der Intensivstation behandelt werden.Es betrifft bis zu 50 % der stationär behandelten Personen über 65 Jahre. Obwohl das Krankheitsbild weit verbreitet ist, werden 55 % bis 80 % der Fälle nicht diagnostiziert und bleiben vom Pflege- und medizinischen Personal unbemerkt. Im Zuge dessen ist eine frühzeitige Diagnose und Behandlung entscheidend für eine optimale Versorgung. Methodik: Im Rahmen einer systematischen Literaturrecherche in den Datenbanken PubMed, CINAHL, Thieme Connect und der Internetsuchmaschine Google Scholar wurden dreizehn Studien ausgewählt, tabellarisch erfasst, zusammengefasst und einer kritischen Bewertung unterzogen Ergebnisse: Die multifaktorielle Ätiologie verdeutlicht die Notwendigkeit einer raschen mulltiprofessionellen Beurteilung, unter anderem durch den Einsatz eines gültigen Assessemntesinstruments, einer körperlichen Untersuchung und der Einbeziehung der Familie, um frühzeitig mit nicht-pharmakologischen Maßnahmen zu beginnen. Schlussfolgerung: Zur Durchführung von diversen Pflegemaßnahmen ist ein hohes Maß an fachlicher Kompetenz des diplomierten Gesundheits- und Krankenpflegepersonals von zentraler Bedeutung. Dementsprechend wird im Rahmen der Ausbildung empfohlen, das Wissen über das Syndrom Delir zu vertiefen. Delirium is a brain-organic syndrome associated with a variety of complaints. The phenomenon of delirium is one of the most common complications in patients treated in the intensive care unit, affecting up to 50% of hospitalized individuals over the age of 65. Although delirium is common, 55% to 80% of cases are undiagnosed and go unnoticed by nursing and medical staff. Therefore, early diagnosis and treatment is critical to ensure optimal care. Methodology: Within the context of a systematic literature search in the PubMed and CINAHL databases, 13 studies were selected, tabulated, summarized, and subjected to a critical evaluation Results: The multifactorial etiology highlights the need for rapid mulltiprofessional assessment, including the use of a valid instrument, physical examination, and family involvement to begin nonpharmacologic interventions early. Conclusion: In order to carry out nursing measures, a high level of professional competence on the part of certified health care and nursing staff is of central importance. Accordingly, as part of the training, it is recommended to deepen the knowledge of the syndrome delir

In the pediatric population, acute respiratory tract infections (RTIs) are the most common reason for seeking professional help from a physician or a pharmacist. Alleviation of symptoms is the only therapeutic measure in viral RTIs and is an adjunct to antibiotic therapy in bacterial RTIs. This article discusses pharmacologic and non- pharmacologic options for treating nasal congestion, cough, fever and sore throat in RTIs and clinical evidence on their efficacy and safety in the pediatric population. In general, clinical studies conducted in children for most of these drug groups are few or nonexistent, making it difficult to create evidence-based recommendations. Nasal decongestants, cough suppressants, mucolytics, expectorants, antipyretics/analgesics and sore throat local preparations are available in suitable pharmaceutical forms and strengths for the certain age. As many of them are over-the-counter (OTC) preparations, it is necessary to strictly take into account the age of the child in whom they may be used and dose properly. Multicomponent preparations carry the risk of taking unnecessary medications and of their side effects. The use of multiple OTC medicines is associated with the risk of an overdose of a component that may be present in different preparations. Appropriate non-pharmacological measures (e.g. oral hydration, nasal saline application or irrigation, honey) may be helpful and should be used whenever possible due to their safety. U pedijatrijskoj populaciji, akutne infekcije respiratornog trakta (IRT) su najčešći razlog traženja stručne pomoći od lekara ili farmaceuta. Ublažavanje simptoma je jedina terapijska mera kod virusnih i dodatak je antibiotskoj terapiji kod bakterijskih IRT. Ovaj članak govori o farmakološkim i nefarmakološkim opcijama za lečenje nazalne kongestije, kašlja, povišene telesne temperature i upale grla kod IRT i kliničkim dokazima o njihovoj efikasnosti i bezbednosti u pedijatrijskoj populaciji. Uopšteno govoreći, kliničke studije sprovedene kod dece za većinu ovih grupa lekova su malobrojne ili ih uopšte nema, što otežava pripremu preporuka zasnovanih na dokazima. Dostupni su nazalni dekongestivi, antitusici, mukolitici, ekspektoransi, antipiretici/analgetici i lokalni preparati za ublažavanje simptoma upale grla, u odgovarajućim farmaceutskim oblicima i jačinama za određeni uzrast. Kako se mnogi od njih izdaju bez lekarskog recepta (OTC), potrebno je striktno voditi računa o uzrastu deteta u kome se smeju koristiti i pravilnom doziranju. Višekomponentni preparati nose rizik od primene nepotrebnih lekova i njihovih neželjenih efekata. Primena više OTC lekova nosi rizik od predoziranja komponente koja može biti sastojak različitih preparata. Odgovarajuće nefarmakološke mere (npr. oralna hidratacija, primena fiziološkog rastvora u nos ili ispiranje nosa, med) mogu biti od pomoći i treba ih koristiti kad god je to moguće zbog njihove bezbednosti.

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Einleitung: Werden Schmerzen bei Neugeborenen und Säuglingen nicht behandelt, kann das langfristige Folgen auf die Entwicklung des Kindes haben. Ein optimales und schnelles Schmerzmanagement ist daher unerlässlich. Nichtmedikamentöse Maßnahmen ermöglichen dabei eine oft kostengünstige und wirksame Schmerzreduzierung. Nebenwirkungen von einer pharmakologischen Therapie werden dabei meist gänzlich verhindert. Diese Arbeit soll dabei die verschiedenen nichtmedikamentösen Maßnahmen und ihre Wirkungsweisen darstellen und somit eine einfachere und bessere Implementierung in die Pflegepraxis ermöglichen. Methodik: Es wurde eine systematische Literaturrecherche zwischen Dezember 2019 und März 2020 durchgeführt. Dabei wurde nach den Phasen von Kleibel & Mayer gearbeitet, um einen strukturellen Aufbau zu gewährleisten. Diese Suche wurde mithilfe von fachgerechten Datenbanken, Suchbegriffen und Ein- und Ausschlusskriterien eingegrenzt. Ausgewählte Studien wurden anschließend noch anhand der Bewertungskriterien nach Brandenburg, Panfil und Mayer beurteilt. Insgesamt konnten dadurch 13 Studien identifiziert werden, die zur Beantwortung der Forschungsfrage dieser Arbeit führten. Ergebnisse: Um eine zentrale Aussage zu ermöglichen, wurden die Ergebnisse aus den insgesamt 13 Studien synthetisiert. Dabei wurde herausgefunden, dass nichtmedikamentöse Maßnahmen effektiv darin sind, die Schmerzen von Neugeborenen und Säuglingen zu reduzieren. Sie wirken sich sowohl auf den Schmerzscore als auch auf verschiedene Parameter positiv aus und bilden daher eine sichere und schnelle Methode. Schlussfolgerungen: Die Methoden, die in dieser Arbeit beschrieben wurden, sind meist kostengünstig, schnell einsetzbar und können den Schmerz dieser Patientengruppe deutlich reduzieren. Wichtig für die Pflege ist hierbei, dass diese Maßnahmen auch in der Praxis eingesetzt werden. Dies sollte durch beispielsweise Weiterbildungen gewährleistet werden. Introduction: There can be long-term consequences on a child’s development if pain in newborns and infants is left untreated. Therefore, an optimal and quick pain management is essential. Non-pharmacological measures allow an inexpensive, quick and effective pain relief. Side effects of pharmacological therapy are often completely prevented. The intent of this work is to present the different non-pharmacological methods and their mechanism to enable an easier and better implementation into nursing practice. Methodology: A systematic literature search was conducted between December 2019 and March 2020. To ensure a structured basis the phases of Kleibel & Mayer were used. With the help of professional databases, search terms and inclusion and exclusion criteria the search was narrowed down. The selected studies were then evaluated using the assessment criteria of Brandenburg, Panfil and Mayer. In total, 13 studies were identified that led to the answer to the thesis of this work. Results: The results of the 13 studies were synthesized in order to form a crucial statement. It was found that non-pharmacological measures are effective in reducing pain in newborns and infants. They have a positive effect on both the pain score and various parameters and therefore form a safe and quick method for pain relief. Conclusion: The methods described in this work are mostly inexpensive, can be used quickly and can significantly reduce the pain of this patient group. It is important that these measures are used in clinical practice. This should be accomplished with further training.

Background Treatment adherence play important roles in blood pressure control leading to reduction in morbidity and mortality. This study therefore assessed adherence to pharmacological and non-pharmacological therapies among ambulatory hypertensive patients. Reasons for treatment non-adherence, and association between adherence and blood pressure were also investigated. Methods Cross-sectional questionnaire-guided interview and retrospective review of medical records of 605-patients from two-tertiary healthcare institutions in Sokoto, Northwestern Nigeria. Nine-item modified Morisky adherence scale was used to assess medication adherence. Overall adherence score to lifestyle modifications was obtained from the total scores from 4-domains of non-pharmacological measures including cigarette smoking and alcohol cessation, salt-restriction and exercise. Patient-specific adherence education was provided at contact to resolve the knowledge gap(s). Clinical-parameters were retrieved at contact and subsequent 2-months appointment. Descriptive statistics, Chi-square and Student’s t-test were used for analysis at p Results Fifty-four (8.9%) patients were adherent to medications. Forgetfulness (404; 35.2%) was the most common reason for medication non-adherence. Use of buddy/companion reminder (605, 30.2%) top the list of adherence education. Overall adherence to lifestyle modifications was 36(6.0%). Mean systolic blood pressure (SBP) at contact was 149.6 ± 22.5 versus 134.2 ± 15.8 mmHg at 2-months with a 10% reduction. There were significant associations in baseline SBP for patients with or without adherence to medication, cigarette smoking cessation, and exercise (p Conclusions Overall adherence to antihypertensive medications and lifestyle modifications is suboptimal, underscoring the need for continuous patient-specific adherence education to ensure better therapeutic outcomes.

Background The objective of the study was to investigate the effectiveness of non-pharmacological interventions in preventing cases of influenza requiring hospitalization. Methods We performed a multicenter case-control study in 36 hospitals, in 2010 in Spain. Hospitalized influenza cases confirmed by reverse-transcription polymerase chain reaction and three matched controls (two hospital and one community control) per case were selected. The use of non-pharmacological measures seven days before the onset of symptoms (frequency of hand washing, use of alcohol-based hand sanitizers and handwashing after touching contaminated surfaces) was collected. Results We studied 813 cases hospitalized for influenza and 2274 controls. The frequency of hand washing 5-10 times (adjusted odds ratio [aOR] = 0.65) and > 10 times (aOR = 0.59) and handwashing after contact with contaminated surfaces (aOR = 0.65) were protective factors and were dose-responsive (p, Highlights ► There is a dose-response relationship between hand washing and a lower risk of influenza requiring hospitalization ► We recommend hand washing at least 5 times a day ► Alcohol-based hand sanitizers were associated with marginal benefits.