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Background The study explores the challenges and threats young doctors in Pakistan working frontline toward the pandemic face, and how it translates into their personal and social lives. Methods Thirteen resident doctors working frontline with COVID-19 cases were approached and interviewed in-depth until the point of data saturation. Interpretative phenomenological analysis was used as a method for analysis. Results Four themes emerged in the analysis: pandemic anxiety, organizational lack of readiness for change, impact on interpersonal relationships, and commitment to service. Young doctors experienced psychological distress, and emotional vulnerability due to the challenges and concerns faced by them in the wake of COVID-19. Shortage and excessive reuse of personal protective equipment, direct exposure to the disease, concern for personal safety, fear and apprehension of being a probable disease carrier for families, physical distancing from loved ones, long working hours, and increased organizational responsibility altered the quality of life for doctors working frontline toward pandemic in COVID wards. Doctors who received appreciation and support by families reported improved filial bonds. Conclusion The adverse effect on psychological health, personal and social life, and increased professional demands have been some of the major challenges and threats faced by young doctors working frontline toward the pandemic. However, unconditional love and support from family and community has proven to reduce pandemic anxiety among doctors. Furthermore, the sense of compassion and the satisfaction in service to community has kept doctors devoted to fight against pandemic 2020.

BACKGROUND: Seamless and safe discharge of children from hospital requires successful collaboration with community pharmacists, for whom pediatrics is often a small part of their practice. OBJECTIVES: The purpose of this study was to understand community pharmacists' comfort level and confidence in providing care for children. METHODS: We conducted a self-administered online survey of community pharmacists in Ontario, Canada. Respondents rated their comfort and confidence on a scale of 1 to 7 in each of 3 scenarios: oral morphine, prednisone, and amoxicillin. We also evaluated the relationship between participants' comfort level and demographics. RESULTS: We included 622 responses (377 completed and 245 partially completed surveys). A total of 182 participants (48%) were female, 271 participants (72%) had children of their own, and they had practiced pharmacy for a median (interquartile range) of 19 (5–28) years. The percentage of respondents who were comfortable (5–7 on a 7-point scale) with filling the prescriptions as written was 64% for morphine, 58% for prednisone, and 61% for amoxicillin and was not different among the scenarios. Having children was associated with increased comfort (p = 0.02), whereas other demographic variables were not. Compared to the amoxicillin scenario, pharmacists reported being significantly more likely to choose another course of action for prednisone (p = 0.01) but not for morphine (p = 0.25). Although 428 pharmacists (70%) agreed that they maintained adequate knowledge of pediatric topics, 558 (91%) were interested in more education. CONCLUSIONS: Variability exists in the confidence and comfort levels of community pharmacists when dealing with children, and many are not comfortable with the common prescriptions in this survey.

IntroductionMillions of children in low resource settings are at high risk of poor development due to factors such as under nutrition, inadequate stimulation and maternal depression. Evidence-based interventions to address these risk factors exist, but often as a separate and overlapping package. The current study aims to evaluate the effectiveness of a common elements-based intervention to improve mother–infant interaction at 12 months post-partum.Method and analysisA two-arm, single-blinded, individual randomised controlled trial is being carried out in the community settings of the rural subdistrict of Gujar Khan in Rawalpindi, Pakistan. 250 pregnant women in third trimester with distress (Self-Reporting Questionnaire, cut-off score >9) have been randomised on 1:1 allocation ratio into intervention (n=125) and treatment-as-usual arms (n=125). The participants in the intervention arm will receive 15 individual sessions of intervention on a monthly basis by non-specialist facilitators. The intervention involves components of early stimulation, learning through play, responsive feeding, guided discovery using pictures, behavioural activation and problem solving. The primary outcome is caregiver–infant interaction at 12 months postpartum. The secondary outcomes include maternal psychological well-being, quality of life, social support and empowerment. Infant secondary outcomes include growth, nutrition and development. The data will be collected at baseline, 6 and 12 months postpartum. A qualitative process evaluation will be conducted to inform the feasibility of intervention delivery.EthicsEthics approval for the present study was obtained from the Human Development Research Foundation Institutional Review Board, Islamabad Pakistan.DisseminationIf proven effective, the study will contribute to scale-up care for maternal and child mental health in low resource settings, globally. The findings of the present study will be published in peer-reviewed journals and presented at conferences and community forums.Trial registration numberNCT04252807.