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of health workers should be immediately initiated with attention to reduction of stigma, ensuring an adequate support system such as personal protective equipments, and family support for those with history of mental health problems.

The study findings revealed a considerate proportion of anxiety, depression and insomnia symptoms among health workers during the early phase of the pandemic in Nepal. Health workers facing stigma, those with history of medication for mental health problems, and those reporting inadequate precautionary measures in their workplace were more at risk of developing mental health outcomes. A focus on improving mental wellbeing of health workers should be immediately initiated with attention to reduction of stigma, ensuring an adequate support system such as personal protective equipments, and family support for those with history of mental health problems.

Healthcare managers, in comparison with other healthcare professionals, have an increased likelihood of experiencing technostress at work. Since knowledge about the causes and severity of technostress and about the strategies healthcare managers use to handle it is limited, the aim of this study was to describe their experience of technostress and the actions they employ to address it.

An explorative design based on the critical incident technique was used. In total, 20 healthcare managers (10 women, 10 men) from four hospitals in two county councils in Swedenwere purposively selected according to professional background, hierarchical management position, control span, time in the management position, and sex. Semi-structured interviews with regard to critical incidents and actions taken to handle technostress were conducted.

Healthcare managers' experiences of technostress (n = 279) were categorised related to three main areas. These involved 'negative aspects of digital communication' (e.g. high worklesources. All these features, along with consideration of healthcare managers' job demands and resources in general, should be incorporated into actions monitored by healthcare organisations to improve or maintain a sustainable digitalised environment for healthcare managers.

Regional Ethics Board in Linköping #2017/597-31. Registered 20 March 2018. URL not available.

Regional Ethics Board in Linköping #2017/597-31. Registered 20 March 2018. URL not available.

A recent editorial urged those working in global mental health to "change the conversation" on coronavirus disease (Covid-19) by putting more focus on the needs of people with severe mental health conditions. UPSIDES (Using Peer Support In Developing Empowering mental health Services) is a six-country consortium carrying out implementation research on peer support for people with severe mental health conditions in high- (Germany, Israel), lower middle- (India) and low-income (Tanzania, Uganda) settings. This commentary briefly outlines some of the key challenges faced by UPSIDES sites in low- and middle-income countries as a result of Covid-19, sharing early lessons that may also apply to other services seeking to address the needs of people with severe mental health conditions in similar contexts.

The key take-away from experiences in India, Tanzania and Uganda is that inequalities in terms of access to mobile technologies, as well as to secure employment and benefits, put peer support workers in particu mental health will need to redouble their efforts not only to make up for lost time and help individuals cope with the added stressors of Covid-19 in their communities, but also to regain lost ground in mental health care reform and in broader conversations about mental health in low-resource settings.

In environments where mental health care was already heavily medicalized and mostly limited to medications issued by psychiatric institutions, Covid-19 threatens burgeoning efforts to pursue a more holistic and person-centered model of care for people with severe mental health conditions. As countries emerge from lockdown, those working in global mental health will need to redouble their efforts not only to make up for lost time and help individuals cope with the added stressors of Covid-19 in their communities, but also to regain lost ground in mental health care reform and in broader conversations about mental health in low-resource settings.

The aim of this study was to adapt the instrument and evaluate the psychometric properties of the Swedish version of the Swallowing Quality of Care questionnaire (S-SWAL-CARE) in patients with oropharyngeal dysphagia.

Translation and adaptation of the original SWAL-CARE into Swedish was performed according to established international guidelines. Field testing was performed using 100 patients with oropharyngeal dysphagia due to multiple reasons such as head and neck cancer and neurologic/neuromuscular disease, who had undergone swallowing evaluation within 6months prior to the study. learn more The patients answered the S-SWAL-CARE, the Quality from the Patient's Perspective (QPP) and the Swallowing Quality of Life (SWAL-QOL). Test-retest was performed in 20% of the participants. The reliability and validity of the S-SWAL-CARE were assessed by Pearson correlation coefficient and Cronbach's alpha as well as convergent and discriminative validity, respectively.

The field testing of the S-SWAL-CARE resulted in sufficient reliability, with Cronbach's alpha values exceeding 0.90 for all domains. All items correlated strongly to their own domain, with weaker correlations to the other domains, indicating proper scale structure. Results also indicate sufficient convergent and discriminant validity when tested for association to the QPP domains and the SWAL-QOL Total score. The test-retest reliability of the S-SWAL-CARE demonstrated sufficient intraclass correlation coefficient (ICC) for the General advice domain (0.73) and Clinical advice domain (0.82). The ICC for the Patient satisfaction domain was lower (0.44).

The S-SWAL-CARE can be considered a reliable and valid tool to assess the dysphagia-related quality of care in a mixed Swedish dysphagia patient population.

The S-SWAL-CARE can be considered a reliable and valid tool to assess the dysphagia-related quality of care in a mixed Swedish dysphagia patient population.