Methods for Evaluating the Protective Activity of Intravenous Immunoglobulins for Neonatal Pathogens: Entanglement or Encouragement?

Reducing neonatal mortality is a goal common among health care workers. However, the means by which to achieve this goal may engender debate and cause confusion. It is inherently attractive to consider human immunoglobulin prepared for intravenous use as an adjunct to therapy for neonatal sepsis, especially in those preterm infants who have the highest incidence and mortality. Before we embark on difficult and costly clinical trials to determine the efficacy of intravenous immunoglobulin (IVIG) as adjunctive therapy, however, two hurdles must be surmounted. Commercial preparations of IVIG must be proved to be safe in neonates and there must be the promise that their benefit will outweigh both risk and cost.

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Attitudes of Parents and Health Care Workers to Major Surgery for High-Risk Preterm Infants

The Journal of Pediatrics ◽

10.1016/j.jpeds.2016.06.071 ◽

2016 ◽

Vol 177 ◽

pp. 78-83.e3 ◽

Cited By ~ 1

Author(s):

Hugh Simon Lam ◽

Tony Sit ◽

Chi Lok Chau ◽

Yuk Him Tam ◽

Hon Ming Cheung ◽

...

Keyword(s):

Health Care ◽

High Risk ◽

Preterm Infants ◽

Health Care Workers ◽

Major Surgery ◽

Care Workers

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SARS-CoV-2 and Health Care Worker Protection in Low-Risk Settings: a Review of Modes of Transmission and a Novel Airborne Model Involving Inhalable Particles

Clinical Microbiology Reviews ◽

10.1128/cmr.00184-20 ◽

2020 ◽

Vol 34 (1) ◽

Cited By ~ 1

Author(s):

X. Sophie Zhang ◽

Caroline Duchaine

Keyword(s):

Health Care ◽

Clinical Trials ◽

Health Care Workers ◽

Personal Protective Equipment ◽

Low Risk ◽

Protective Equipment ◽

Long Distance ◽

Airborne Transmission ◽

Inhalable Particles ◽

Care Workers

SUMMARY Since the beginning of the COVID-19 pandemic, there has been intense debate over SARS-CoV-2’s mode of transmission and appropriate personal protective equipment for health care workers in low-risk settings. The objective of this review is to identify and appraise the available evidence (clinical trials and laboratory studies on masks and respirators, epidemiological studies, and air sampling studies), clarify key concepts and necessary conditions for airborne transmission, and shed light on knowledge gaps in the field. We find that, except for aerosol-generating procedures, the overall data in support of airborne transmission—taken in its traditional definition (long-distance and respirable aerosols)—are weak, based predominantly on indirect and experimental rather than clinical or epidemiological evidence. Consequently, we propose a revised and broader definition of “airborne,” going beyond the current droplet and aerosol dichotomy and involving short-range inhalable particles, supported by data targeting the nose as the main viral receptor site. This new model better explains clinical observations, especially in the context of close and prolonged contacts between health care workers and patients, and reconciles seemingly contradictory data in the SARS-CoV-2 literature. The model also carries important implications for personal protective equipment and environmental controls, such as ventilation, in health care settings. However, further studies, especially clinical trials, are needed to complete the picture.

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Elimination of Staphylococcus aureus Nasal Carriage in Health Care Workers: Analysis of Six Clinical Trials with Calcium Mupirocin Ointment

Clinical Infectious Diseases ◽

10.1093/clinids/17.3.466 ◽

1993 ◽

Vol 17 (3) ◽

pp. 466-474 ◽

Cited By ~ 113

Author(s):

B. N. Doebbeling ◽

D. L. Breneman ◽

H. C. Neu ◽

R. Aly ◽

B. G. Yangco ◽

...

Keyword(s):

Health Care ◽

Staphylococcus Aureus ◽

Clinical Trials ◽

Health Care Workers ◽

Nasal Carriage ◽

Care Workers ◽

Mupirocin Ointment

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Health Care Workers’ Reasons for Choosing Between Two Different COVID-19 Prophylaxis Trials in an Acute Pandemic Context: Single-Center Questionnaire Study

Journal of Medical Internet Research ◽

10.2196/23441 ◽

2021 ◽

Vol 23 (2) ◽

pp. e23441

Author(s):

Alberto M Borobia ◽

Irene García-García ◽

Lucía Díaz-García ◽

Amelia Rodríguez-Mariblanca ◽

Lucía Martínez de Soto ◽

...

Keyword(s):

Health Care ◽

Clinical Trials ◽

Health Care Workers ◽

Adverse Reactions ◽

Primary Reason ◽

Initial Screening ◽

Web Based ◽

Care Workers ◽

Survey Participation ◽

News Bulletin

Background In April 2020, two independent clinical trials to assess SARS-CoV-2 prophylaxis strategies among health care workers were initiated at our hospital: MeCOVID (melatonin vs placebo) and EPICOS (tenofovir disoproxil/emtricitabine vs hydroxychloroquine vs combination therapy vs placebo). Objective This study aimed to evaluate the reasons why health care workers chose to participate in the MeCOVID and EPICOS trials, as well as why they chose one over the other. Methods Both trials were offered to health care workers through an internal news bulletin. After an initial screening visit, all subjects were asked to respond to a web-based survey. Results In the first month, 206 health care workers were screened and 160 were randomized. The survey participation was high at 73.3%. Health care workers cited “to contribute to scientific knowledge” (n=80, 53.0%), followed by “to avoid SARS-CoV-2 infection” (n=33, 21.9%) and “the interest to be tested for SARS-CoV-2” (n=28, 18.5%), as their primary reasons to participate in the trials. We observed significant differences in the expected personal benefits across physicians and nurses (P=.01). The vast majority of volunteers (n=202, 98.0%) selected the MeCOVID trial, their primary reason being their concern regarding adverse reactions to treatments in the EPICOS trial (n=102, 69.4%). Conclusions Health care workers’ reasons to participate in prophylaxis trials in an acute pandemic context appear to be driven largely by their desire to contribute to science and to gain health benefits. Safety outweighed efficacy when choosing between the two clinical trials.

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Smoking cessation interventions on health-care workers: a systematic review and meta-analysis

PeerJ ◽

10.7717/peerj.9396 ◽

2020 ◽

Vol 8 ◽

pp. e9396

Author(s):

Giuseppe La Torre ◽

Generosa Tiberio ◽

Alessandro Sindoni ◽

Barbara Dorelli ◽

Vittoria Cammalleri

Keyword(s):

Systematic Review ◽

Health Care ◽

Clinical Trials ◽

Smoking Cessation ◽

Cohort Studies ◽

Success Rate ◽

Health Care Workers ◽

Meta Analysis ◽

Cross Sectional ◽

Care Workers

Objective The authors carried out a systematic review and a meta-analysis on smoking cessation interventions on health -care workers to clarify the state of the art interventions and to identify the best one. Materials and Methods This review was registered with PROSPERO: CRD42019130117. The databases PubMed, Scopus, Web of Science and CINAHL were searched until December 2018. Quality of all studies included in the systematic review was assessed according to the Newcastle-Ottawa Scale (NOS) on cohort or cross-sectional studies and to the Cochrane Risk of Bias Tool for Randomized Controlled Trials. Meta-analysis and meta-regression analyses were also carried out for cohort studies (quasi-experimental or a before-after studies design) and clinical trials. Results Twenty–four studies have been included in the analysis: four before-after, 13 cross-sectional, three quasi-experimental studies and four clinical trials. Articles were heterogeneous (P for homogeneity <0.01), but they have all shown positive results since they reached the goal of smoking cessation among health-care workers, even if with different proportions. Meta-analysis was performed on 10 studies (six cohort studies and four clinical trials), showing a 21% of success rate from the application of smoking cessation interventions, either pharmacological or behavioral ones. The resulted pooled RR (Risk Ratio) was 1.21 (95% CI [1.06–1.38]), being 24% of success rate from clinical trials (pooled RR 1.244; 95% CI [1.099–1.407]) and 19% of success rate from cohort studies (pooled RR 1.192; 0.996–1.426). However, two studies have confidence intervals which include unity and one study has a wide confidence interval; as a consequence, the meta-analysis for its results depends heavily on one single study. Meta-regression analysis revealed that results were influenced by the number of participants. Conclusion Both policy and pharmaceutical interventions can obtain positive results in quitting smoking among health-care workers. However, as shown by our review, combination approaches can produce better results in terms of cessation percentages and smoking abstinence.

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