scholarly journals Critical care workers have lower seroprevalence of SARS-CoV-2 IgG compared with non-patient facing staff in first wave of COVID19

2020 ◽  
Author(s):  
H.E. Baxendale ◽  
D. Wells ◽  
J. Gronlund ◽  
A. Nadesalingam ◽  
M. Paloniemi ◽  
...  
Keyword(s):  
Health Care ◽  
Critical Care ◽  
Symptom Severity ◽  
Current Approach ◽  
Symptom Reporting ◽  
Care Workers ◽  
Increased Risk ◽  
Significant Difference ◽  
Serological Surveillance ◽  
The Relationship

AbstractWith the first 2020 surge of the COVID-19 pandemic, many health care workers (HCW) were re-deployed to critical care environments to support intensive care teams to look after high numbers of patients with severe COVID-19. There was considerable anxiety of increased risk of COVID19 for staff working in these environments.Using a multiplex platform to assess serum IgG responses to SARS-CoV-2 N, S and RBD proteins, and detailed symptom reporting, we screened over 500 HCW (25% of the total workforce) in a quaternary level hospital to explore the relationship between workplace and evidence of exposure to SARS-CoV-2.Whilst 45% of the cohort reported symptoms that they consider may have represented COVID-19, overall seroprevalence was 14% with anosmia and fever being the most discriminating symptoms for seropositive status. There was a significant difference in seropositive status between staff working in clinical and non-clinical roles (9% patient facing critical care, 15% patient facing non-critical care, 22% nonpatient facing). In the seropositive cohort, symptom severity increased with age for men and not for women. In contrast, there was no relationship between symptom severity and age or sex in the seronegative cohort reporting possible COVID-19 symptoms. Of the 12 staff screened PCR positive (10 symptomatic), 3 showed no evidence of seroconversion in convalescence.ConclusionThe current approach to Personal Protective Equipment (PPE) appears highly effective in protecting staff from patient acquired infection in the critical care environment including protecting staff managing interhospital transfers of COVID-19 patients. The relationship between seroconversion and disease severity in different demographics warrants further investigation. Longitudinally paired virological and serological surveillance, with symptom reporting are urgently required to better understand the role of antibody in the outcome of HCW exposure during subsequent waves of COVID-19 in health care environments.

scholarly journals Risk assessment of acquiring SARS-CoV-2 infection among employees of a tertiary cancer care center

2021 ◽  
Vol 0 ◽  
pp. 1-5
Author(s):  
Sandeep S. Sawakare ◽  
Sandeep P. Tandon ◽  
C. S. Pramesh ◽  
Sudeep Gupta ◽  
Manju Sengar ◽  
...  
Keyword(s):  
Health Care ◽  
Cancer Care ◽  
Care Center ◽  
Healthcare Facility ◽  
Health Care Facilities ◽  
Care Workers ◽  
Increased Risk ◽  
Significant Difference ◽  
Set Up ◽  
Doctors And Nurses

Objectives: Continuation of health-care facilities for non-COVID illness during the SARS-CoV-2 pandemic is mired with apprehension of infection to health care workers (HCWs). The lack of facilities can result in dire outcomes for patients of NCDs such as cancer. The Objective of this paper is to assess the risk of running a healthcare facility during the pandemic. Material and Methods: A retrospective analysis was carried out at a tertiary cancer hospital to understand the quantum of risk to HCWs while providing care to patients of cancer and to SARS-CoV-2 patients, within the same set-up with optimal segregation. Data were collected for 6 weeks during which attendance, exposure, and infection status of doctors and nurses were recorded along with comorbidities. Results: Of 1041 doctors and nurses who attended duties during the study period, 299 worked in dedicated COVID care areas while 742 worked in routine cancer care areas. The proportion of HCWs that developed symptoms or were tested positive for COVID-19 was 3.7% and 3.9%, respectively, with no statistically significant difference between the two. The proportion for the same was found to be 1.2% among the 645 staffs who were on leave. No correlation could be established between pre-existing comorbidities and risk of acquiring infection. Conclusion: Providing COVID care and routine specialty care within the same hospital premises do not put the HCWs at a drastically increased risk of acquiring infection subject to clear demarcation of work areas, screening at gates by trained personnel, regulation of number of hospital visitors, and optimal use of PPEs.

scholarly journals Quantitative Breast Density in Contrast-Enhanced Mammography

2021 ◽  
Vol 10 (15) ◽  
pp. 3309
Author(s):  
Gisella Gennaro ◽  
Melissa L. Hill ◽  
Elisabetta Bezzon ◽  
Francesca Caumo
Keyword(s):  
Breast Density ◽  
Potential Role ◽  
Multiple Correlation Coefficient ◽  
Low Energy ◽  
Coefficient Of Determination ◽  
Contrast Enhanced ◽  
Increased Risk ◽  
Significant Difference ◽  
Automatic Software ◽  
The Relationship

Contrast-enhanced mammography (CEM) demonstrates a potential role in personalized screening models, in particular for women at increased risk and women with dense breasts. In this study, volumetric breast density (VBD) measured in CEM images was compared with VBD obtained from digital mammography (DM) or tomosynthesis (DBT) images. A total of 150 women who underwent CEM between March 2019 and December 2020, having at least a DM/DBT study performed before/after CEM, were included. Low-energy CEM (LE-CEM) and DM/DBT images were processed with automatic software to obtain the VBD. VBDs from the paired datasets were compared by Wilcoxon tests. A multivariate regression model was applied to analyze the relationship between VBD differences and multiple independent variables certainly or potentially affecting VBD. Median VBD was comparable for LE-CEM and DM/DBT (12.73% vs. 12.39%), not evidencing any statistically significant difference (p = 0.5855). VBD differences between LE-CEM and DM were associated with significant differences of glandular volume, breast thickness, compression force and pressure, contact area, and nipple-to-posterior-edge distance, i.e., variables reflecting differences in breast positioning (coefficient of determination 0.6023; multiple correlation coefficient 0.7761). Volumetric breast density was obtained from low-energy contrast-enhanced spectral mammography and was not significantly different from volumetric breast density measured from standard mammograms.

scholarly journals Measuring the Quality of Rural-Based, Government Health Care Workers in Nepal

2010 ◽  
Author(s):  
Stephen Knoble ◽  
Anil Pandit ◽  
Bibek Koirala ◽  
Laxmi Ghimire
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Clinical Training ◽  
Health Workers ◽  
Clinical Skills ◽  
Clinical Teacher ◽  
Government Health ◽  
Care Workers ◽  
Key Skills ◽  
Significant Difference

A representative, cross-sectional clinical skills assessment of 163 mid-level, rural-based, government health care workers was conducted in four districts of Nepal in June 2007. All Health Assistants and Auxiliary Healthcare Workers within the target districts were scored using checklists of standardized key skills in clinical encounters with model patients or clinical models. Participant scores were reported as a mean percentage in adult medicine 28(%), pediatric medicine 56(%), maternity medicine 35(%), orthopedic medicine 45(%), clinical procedures 59(%), and management 46(%). This was measured against the government’s 60(%) standard on clinical skills. There was little significant difference between categories of health workers by district of posting or years of experience. There was a minor difference in skills by level of facility - workers in higher level facilities scored better across the domains. Reasons for poor performance in clinical skills were attributed to a lack of clinical in-service training programs, training only focusing on prevention and public health, and poor on-sight supervision. Poor pre-service schooling factors included heavy theory concentration in pathophysiology and inadequate clinical exposure opportunities. Recommendations for the improvement of clinical skills and decision-making include the institution of in-service competency-based training with a high emphasis on real patient exposure. Pre-service recommendations include implementation of a national certification program and an expansion of the current government clinical training sites and clinical teacher development programs.

scholarly journals Incidence of COVID-19 infection amongst the high risk versus low risk health care workers: an audit from a tertiary cancer care centre

2021 ◽  
Vol 8 (7) ◽  
pp. 3474
Author(s):  
Nitin Shetty ◽  
Nivedita Chakrabarty ◽  
Amit Joshi ◽  
Amar Patil ◽  
Suyash Kulkarni ◽  
...  
Keyword(s):  
Health Care ◽  
High Risk ◽  
Health Care Workers ◽  
Cancer Care ◽  
Low Risk ◽  
Care Centre ◽  
Protective Measures ◽  
Care Workers ◽  
Significant Difference ◽  
Treatment Research

Background: Theoretically, health care workers (HCW) are at increased risk of getting infected with COVID-19 compared to the general population. Limited data exists regarding the actual incidence of COVID-19 infection amongst the high risk and low risk HCW of the same hospital. We present an audit from our tertiary cancer care centre comparing the COVID-19 infection rate between the high risk and low risk HCW, all of whom had been provided with adequate protective measures and health education.Methods: This is a retrospective observational study from 01 April 2020 to 30 September 2020, in which all the 970 HCW of Advanced Centre for Treatment, Research and Education in Cancer were divided into high risk and low risk groups. High risk HCW included all the medical and non-medical staff directly involved with the care of COVID-19 patients, and rest were low risk HCW. Adequate protective measures and classes for infection prevention were provided to all the HCW. We calculated the incidence of COVID-19 infection in both these groups based on the positive real time-polymerase chain reaction (RT-PCR) result and also looked for any significant difference in incidence between these two groups.Results: The incidence of COVID-19 infection amongst the high risk HCW was 13% and that of low risk HCW was 14%.Conclusions: We found no significant difference in COVID-19 infection between the high risk and low risk HCW. Thus, along with protective measures, behavior modifications induced by working in high risk areas, prevented the high risk HCW from getting increased COVID-19 infection compared to the low risk HCW.

scholarly journals A-31 Association Between Cognitive Activity and Recovery Outcomes in College Students Following Concussion

2020 ◽  
Vol 35 (5) ◽  
pp. 627-627
Author(s):  
K M Petit ◽  
A J Zynda ◽  
M Anderson ◽  
C P Tomczyk ◽  
T Covassin
Keyword(s):  
College Students ◽  
Symptom Severity ◽  
Recovery Time ◽  
Cognitive Activity ◽  
Symptom Reporting ◽  
Future Research ◽  
Symptom Scale ◽  
Post Injury ◽  
Medical Clearance ◽  
The Relationship

Abstract Objective To evaluate the relationship between self-reported cognitive activity and recovery outcomes (symptom reporting, recovery time) in college students following concussion. Method Cognitive activity was defined as self-reported minutes spent in class and studying during the first 5 days following concussion. Self-reported symptoms were reported at day 5 post-injury using the Post-Concussion Symptom Scale (PCSS). The PCSS evaluates 22 symptoms on a 7-point Likert Scale from 0 (none) to 6 (severe). Recovery time was defined as total days from injury to unrestricted medical clearance. Separate Spearman’s rank correlations assessed the relationship between total cognitive activity (minutes in class and studying) and recovery outcomes (symptom total (22), symptom severity (132), and recovery time). Alpha level set a priori at 0.05. Results Twenty-one participants (14 female, 7 male, 19.5 ± 1.3 years) averaged a total of 653[IQR = 348] minutes of cognitive activity during the first 5 days after concussion (334[IQR = 149] minutes in class, 273[IQR = 313] minutes studying). Five days after injury, participants self-reported 3[IQR = 8] total symptoms yielding a severity of 4[IQR = 12]. Participants took 15 [IQR = 8] days to reach unrestricted medical clearance. No associations were found between total cognitive load and any post-concussion recovery outcomes (symptom total: Rs = −.299, p = .19; symptom severity: Rs = −.230, p = .32; recovery time: Rs = −.041, p = .86). Conclusions Preliminary analyses suggest that concussed college students can be encouraged to gradually return to normal levels of cognitive activity, as it may not be associated with future symptom reporting or recovery time. Future research is needed to assess specific cognitive activities immediately influence on post-concussion symptom reporting.

scholarly journals Relationship of Migraine and Body Mass Index (BMI)

2016 ◽  
Vol 6 (2) ◽  
pp. 80-87
Author(s):  
Mohammed Momenuzzaman Khan ◽  
Md Nazmul Huda ◽  
Manabendra Bhattacharjee ◽  
Md Jalal Uddin ◽  
Mustofa Kamal Uddin Khan
Keyword(s):  
Social Life ◽  
Overweight And Obesity ◽  
Control Group ◽  
P Value ◽  
Case Group ◽  
Increased Risk ◽  
Significant Difference ◽  
Associated Symptoms ◽  
Migraine Group ◽  
The Relationship

Background: Migraine is an important cause of headache and headache-related disabilities. It increases loss of working time, causes inability to carry out daily activities and disruption of family and social life. The pathophysiology of migraine is still poorly understood. On the other hand, the prevalence of obesity is constantly increasing worldwide. The consequence of overweight and obesity includes increased risk of diabetes mellitus, dyslipidemia, hypertension, cardiovascular disease and cancer.Objectives: This study was performed to assess the relationship between BMI and migraine by finding out the relationship between migraine frequency and duration in different BMI groups, comparing the socio-demographic variables in migraine and non-migraine patients and to find out the migraine related co-morbidities.Materials and Methods: This observational case-control study was conducted on 100 subjects aged 12–50 years in the Neurology Outpatient Department, Mymensingh Medical College Hospital, Mymensingh in the period of January 2011 to December 2012. Out of total subjects fifty migraine patients were selected as cases and fifty nonmigraineurs as controls. Subjects were then categorized in three groups based on BMI: <23, 23 to 25 and >25. Collected data were compiled and appropriate analyses were done by using computer based software, Statistical Package for Social Sciences (SPSS) version 16.0. For statistical analysis one way ANOVA tests were done for comparing means of quantitative data and Chi-square tests were done for qualitative data. A p value <0.05 was considered statistically significant.Results: In this study, majority (>95%) of the study subjects were between 10 and 35 years of age. Mean age of case group was found 25.55 ± 5.87 and that of control was 25.53 ± 4.22 years. Case group contained 10 (20%) males and 40 (80%) females whereas control group had 14 (28%) males and 36 (72%) females. Number of female cases and controls were higher than that of male. In control group 30 (60%) were unmarried and 20 (40%) were married. There was no significant difference in the financial condition between case and control groups. Students and housewives occupied the largest number of study subjects who were unemployed. Regarding residence, rural and urban patients were equal in case group and in control group 29 (58%) were urban and 21 (42%) rural. Mean duration of headache was 8.9 ± 7.5, 5.8 ± 6.7, 9.6 ± 14.3 years in different BMI groups (<23, 23–25, >25 respectively) in case group and 4.6 ± 5.3, 4.4 ± 3.4, 3.4 ± 1.4 years in control group respectively. There was significant difference in quality of headache. In migrainous group 58.6% in BMI <23, 30% in BMI 23–25, 36.4% in BMI >25 noted their headache as throbbing, in contrast most of the nonmigrainous described them as dull in nature. Mean frequency of headache per month was significantly higher in migraine group compared to non-migraine group (p=0.02). Regarding associated symptoms, nausea, vomiting, photophobia and phonophobia were observed significantly higher in migraine patients in BMI <23 group. Odd ratios (ORs) for vomiting, photophobia and phonophobia with 95% confidence interval (CI) were 23.385 (2.752–97.739), 16.500 (3.060– 88.971) and 13.000 (2.922–57.846) respectively. Smoking was found significantly higher in nonmigrainous group than migraine group in case of BMI <23.Conclusion: From the result of present study it can be concluded that there is statistically no significant relation of BMI with frequency of headache, but some relationship were observed for associated symptoms of migraine with low BMI.J Enam Med Col 2016; 6(2): 80-87

Telehealth policy: Looking for global complementarity

2002 ◽  
Vol 8 (3_suppl) ◽  
pp. 55-57 ◽  
Author(s):  
Richard E Scott ◽  
M Faruq U Chowdhury ◽  
Sunil Varghese
Keyword(s):  
Health Care ◽  
Current Approach ◽  
Policy Makers ◽  
Policy Issues ◽  
Regulatory Constraints ◽  
Care Workers ◽  
Political Boundaries ◽  
Global Health Care ◽  
Health Institutions ◽  
Daunting Challenge

summary Telehealth is gaining acceptance as a tool for bridging the local and global health-care divides. However, integrating telehealth into existing health infrastructures presents a daunting challenge for governments, policy makers, telehealth advocates and health-care workers. The development of specific inter-jurisdictional telehealth policies will significantly improve the ability to meet this challenge. In the policy context, one ‘success’ is the increasing number of jurisdictions addressing policy issues. However, policy decisions have largely been taken in isolation, within individual health institutions, regions, provinces/states or countries. This represents a failure of the current approach. Telehealth, by its very nature, has the ability to transgress existing geo-political boundaries. As a consequence, policy in any single jurisdiction may hamper or even cripple the ability of telehealth to fulfil its potential. Commonality-or at least complementarity-of approach to telehealth policy must be encouraged. To achieve this, it is essential to understand the current or anticipated regulatory constraints that may affect telehealth. We have begun a preliminary study of country-specific policy issues.

scholarly journals PREVALENCE OF LATENT TB INFECTION AMONG HEALTH CARE WORKERS, ALJAZEERA STATE TB CENTERS, SUDAN

2020 ◽  
Vol 5 (12) ◽  
pp. 465-470
Author(s):  
Juhaina Abdulraiem AL Mosharaf ◽  
Adam Abdalla Mater
Keyword(s):  
Health Care ◽  
Skin Test ◽  
Health Care Workers ◽  
Latent Tuberculosis ◽  
Health Care Facilities ◽  
Control Measures ◽  
Treatment Center ◽  
Infection Control Measures ◽  
Care Workers ◽  
Increased Risk

Health care workers (HCW) are at increased risk of latent tuberculosis infection (LTBI) from occupational exposure to Mycobacterium tuberculosis. The objective was to determine the prevalence and risk factors for LTBI among primary HCW in Aljazeera state Sudan. We conducted an analytical study, among HCW in TB treatment center using a structured questionnaire and an evaluated for LTBI using the tuberculin skin test among 367 HCW, the LTBI prevalence was 35.7%. (64.5%), We found that the following factors associated with LTBI in HCW were in age group 30-40 years was 63% ,75.2% of the participants didn't do the skin test for TB, and the high risk among the  lab technician represented 41.2%. Our study recommended implementation of sound TB infection control measures in all health care facilities with patients suspected of having infectious.

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