The use of personal protection equipment does not negatively affect paramedics’ attention and dexterity: a prospective triple-cross over randomized controlled non-inferiority trial

Background The COVID-19 pandemic led to widespread use of personal protection equipment (PPE), including filtering face piece (FFP) masks, throughout the world. PPE. Previous studies indicate that PPE impairs neurocognitive performance in healthcare workers. Concerns for personnel safety have led to special recommendations regarding basic life support (BLS) in patients with a potential SARS-CoV-2 infection, including the use of PPE. Established instruments are available to assess attention and dexterity in BLS settings, respectively. We aimed to evaluate the influence of PPE with different types of FFP masks on these two neuropsychological components of EMS personnel during BLS. Methods This was a randomized controlled non-inferiority triple-crossover study. Teams of paramedics completed three 12-min long BLS scenarios on a manikin after having climbed three flights of stairs with equipment, each in three experimental conditions: (a) without pandemic PPE, (b) with PPE including a FFP2 mask with an expiration valve and (c) with PPE including an FFP2 mask without an expiration valve. The teams and intervention sequences were randomized. We measured the shift in concentration performance using the d2 test and dexterity using the nine-hole peg test (NHPT). We compared results between the three conditions. For the primary outcome, the non-inferiority margin was set at 20 points. Results Forty-eight paramedics participated. Concentration performance was significantly better after each scenario, with no differences noted between groups: d2 shift control versus with valve − 8.3 (95% CI − 19.4 to 2.7) points; control versus without valve − 8.5 (− 19.7 to 2.7) points; with valve versus without valve 0.1 (− 11.1 to 11.3) points. Similar results were found for the NHPT: + 0.3 (− 0.7 to 1.4), − 0.4 (− 1.4 to 0.7), 0.7 (− 0.4 to 1.8) s respectively. Conclusion Attention increases when performing BLS. Attention and dexterity are not inferior when wearing PPE, including FFP2 masks. PPE should be used on a low-threshold basis.

COVID-19 pandemic, challenges, and opportunities in Northern Uganda; Community overview and perspectives: A qualitative study using informant interviews.

Background Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2), a virus that causes COVID-19, has overwhelmingly interrupted human activities worldwide, especially in the low-to-middle income countries. Not much is reported about exclusive challenges and opportunities presented by the COVID-19 pandemic in some remote communities in Africa. Objective The objective of this study was to assess the community’s views and perspectives on the challenges and opportunities of the COVID-19 pandemic in Northern Uganda. Methods We interviewed 36 participants (age range, 28-63 years), including health workers, civil servants, members of civil society, security forces, politicians, and staff of local government administration who were members of COVID-19 district task forces in Northern Uganda using qualitative study methods between August and September 2021. The initial selection of participants was purposeful, but the snowballing technique was later used to select others. The interview questions were pre-tested among health workers and laypersons who were not part of the main study. Participants described how the COVID-19 pandemic presented challenges and opportunities, and the experience could be used to strengthen community resolves to control the pandemic and any other in the future. A local IRB approved this study. Data were analyzed using thematic analysis. Results The current study findings revealed challenges but many opportunities during the COVID-19 pandemic in this community, including loss of lives and livelihoods, increased poverty, lack of personal protection equipment, uncertainties, stress, and anxiety among health workers in the community. However, it also offered opportunities for quality family time, increased engagement, sensitization, and mobilization of communities for health, improved general security of persons and property, increased budgets and logistics for government departments, reduced incidences of diarrheal diseases and road traffic accidents, increased incomes for task force members, and more interactions among members during task force meetings. Conclusion Although the COVID-19 pandemic presented enormous challenges to low-to-middle-income countries, there are opportunities in some communities that are worth mentioning. Information obtained in this study has practical lessons that disease control experts could use to develop strategies to organize communities better and conduct disease surveillance activities for the COVID-19 pandemic and others.

Design and validation of a tool to assess the safety principles of working with nanomaterials in nanotechnology laboratories

Introduction: The unique properties of nanomaterials, in addition to their applications in science and technology, can be a threat to human health and the environment. Exposure to these materials may occur in workplaces or research laboratories. It can be said that about half of people with occupational exposure to nanomaterials work in academic environments and laboratories. So, the present study was conducted to design and validate a tool to investigate the principles of working safely with nanomaterials in research laboratories. Materials & Methods: The tool was designed using reports, instructions and articles related to " Methods of working safely with nanomaterials". The validity of the tool was assessed using Lawshe method by calculating CVI and CVR. The reliability of the instrument was evaluated using Cronbach's alpha coefficient and kappa coefficient. Results: The tool was designed in 5 sections: "General Information", "Transportation and Storage of Nanomaterials", "Engineering Controls", "Administrative Controls" and "Personal Protection Equipment". After validation, 5 items did not get the necessary points to stay in the tool and were removed. The Cronbach's alpha value for each section of the tool was more than 0.80, indicating that the was "appropriate". Conclusion: According to the results, it seems that the tool studied in this study is compatible for the designed purpose and is ready to be used as a questionnaire or checklist.

A Critical Analysis of Legal and Policy Responses to the COVID-19 Pandemic and its Long-term Impacts in Taiwan

The COVID-19 pandemic has dramatically impacted public health and economic and social stability worldwide since the WHO’s Public Health Emergency of International Concerns declaration in early March 2020. The COVID-19 virus was first discovered in December 2019 in Wuhan city, China, and eventually resulted in the global pandemic, of which the cumulative cases have reached 181,367,824 at the time of writing. Taiwan encountered severe public health threats because of the frequent travelers as many as 10 million who commuted annually between mainland China and Taiwan. Recognizing the imminent threats arising from an intensive flow of people from mainland China due to the lockdown policy adopted by the Chinese government, Taiwan has adopted strict border control, sophisticated contact tracing and monitoring measures, and most importantly the securing of sufficient Personal Protection Equipment supply for citizens to prevent community spread. Taiwan’s quick and precise COVID-19 response at the early stage of containing the virus has been proven very successful since the outbreak of the COVID-19 global pandemic in late February 2020. Taiwan is now struggling to fight the recent outbreak for lacking sufficient vaccines and testing capacities and shall learn from other country’s experience for countermeasures against a massive epidemic. This article aims to explore the key elements for the early success of containing the COVID-19 virus, including the comprehensive legal framework for preventing infectious disease, highly trained public health officials and governance system, and citizen self-awareness. The article then discusses the potential legal controversies and their long-term impacts on Taiwan. Finally, this article provides the concluding observation and suggestions for fighting massive infectious diseases.

PREVALENCE OF INJURIES AMONG WASTE PICKERS. A CASE STUDY IN NIGERIA

Waste picking might provide, in low-income countries, a livelihood for many individuals representing an important survival strategy. However, during their activities, waste pickers are at risk of encountering harmful waste, which could cause injuries and other infectious diseases. This paper investigates the occurrences of injury among waste pickers and the methods they use to treat the injuries in Bauchi city, Northeastern Nigeria. A total of 322 waste pickers were randomly selected across 80 waste pickers’ middlemen shops. Data was obtained through questionnaire and interview. Based on the data presented, 1474 frequencies of injuries were reported among 247 waste pickers. Age, education and working experience are significant parameters to the prevalence of injuries among waste pickers, and the incidence of injuries increased with the decrease in those parameters. The study shows that most of the waste pickers experienced injuries, most of whom do not attend clinic when injury occurs; instead, they used salt, ash, sand, hydraulic, kerosene, battery acid, among others, to treat their wounds. Cuts and pierces are good entry points for bacteria and viruses, which can eventually spread to the general public infectious diseases, such as Hepatitis, Cholera and Lassa fever. Provision of Personal Protection Equipment (PPE), a labor rights policy, immunization and the launch of an awareness campaign are among the recommendations made by this study.

Healthcare Resource Utilization and Healthcare Costs of COVID-19 Patients in A Tertiary Care Public Hospital: A Retrospective Cohort Study in Thailand

Objective: Health care costs (HCCs) are a significant concern in developing countries. The authors investigated the healthcare resource utilization (HCRU) and HCCs for patients with COVID-19 based on disease severity and infection site. Materials and Methods: The authors reviewed data from the electronic medical records of COVID-19 patients admitted to the present study hospital between January 2020 and April 2020. The authors used comorbidities and patient characteristics as covariates. Analyses were conducted using simple linear regression and generalized linear regression models with a log-link and gamma distribution. Results: Two hundred two patients had confirmed SARS-CoV-2 infection. Total costs per patient were 6,626 USD (756 to 45,586). Personal protection equipment costs were the most significant cost for COVID-19 patients with a mean of 3,778 USD. The mean treatment cost per patient was 326 USD. Patients with severe symptoms and lower respiratory tract infection (LRI) had a higher cost and resource utilization value before and after adjusting for covariates. Conclusion: COVID-19 patients with severe symptoms and LRI had higher HCRU. Length of stay, severity of symptoms, and LRI were associated with higher cost of treatment. Keywords: SARS-CoV-2; COVID-19; Healthcare resource utilization; Healthcare costs; Thailand

Material Extrusion-Based Additive Manufacturing of Poly(Lactic Acid) Antibacterial Filaments—A Case Study of Antimicrobial Properties

In the era of the coronavirus pandemic, one of the most demanding areas was the supply of healthcare systems in essential Personal Protection Equipment (PPE), including face-shields and hands-free door openers. This need, impossible to fill by traditional manufacturing methods, was met by implementing of such emerging technologies as additive manufacturing (AM/3D printing). In this article, Poly(lactic acid) (PLA) filaments for Fused filament fabrication (FFF) technology in the context of the antibacterial properties of finished products were analyzed. The methodology included 2D radiography and scanning electron microscopy (SEM) analysis to determine the presence of antimicrobial additives in the material and their impact on such hospital pathogens as Staphylococcus aureus, Pseudomonas aeruginosa, and Clostridium difficile. The results show that not all tested materials displayed the expected antimicrobial properties after processing in FFF technology. The results showed that in the case of specific species of bacteria, the FFF samples, produced using the declared antibacterial materials, may even stimulate the microbial growth. The novelty of the results relies on methodological approach exceeding scope of ISO 22196 standard and is based on tests with three different species of bacteria in two types of media simulating common body fluids that can be found on frequently touched, nosocomial surfaces. The data presented in this article is of pivotal meaning taking under consideration the increasing interest in application of such products in the clinical setting.

Prevalence of SARS-CoV-2 infection among COVID-19 RT-PCR laboratory workers in Bangladesh

BackgroundHealth care workers (HCWs) at the frontline are confronting a substantial risk of infection during the coronavirus disease 2019 (COVID-19) pandemic. This emerging virus created specific hazards to researchers and laboratory staff in a clinical setting, underlined by rapid and extensive worldwide transmission. This study aimed to investigate the prevalence of SARS-CoV-2 infection among COVID-19 RT-PCR laboratory health workers in Bangladesh.Materials & MethodsThis retrospective study was conducted between October 2 to December 2, 2020. A total of 508 participants, including doctors, scientific officers, medical technologists, and cleaners working in several COVID-19 RT-PCR laboratories, were included in this study. Data were collected from each participant using a semi-structured questionnaire prepared in the format of an anonymous Google form. All participants provided informed consent. The Ethical clearance was obtained from the Institutional Ethics Review Committee of Shaheed Suhrawardy Medical College, Dhaka, Bangladesh. All statistical analyses were performed using SPSS (Statistical Package for the Social Sciences) version 25.0 software (SPSS, Inc).ResultsOut of the 508 participants, 295 tested positive for SARS CoV-2 RT-PCR. Among the positive cases, 202 were men, 93 were women, with the median age of 30 years. The most positive cases were medical technologists (53.22%) followed by doctors (28.8%). Out of the 271 symptomatic positive cases, the most typical symptoms were fever (78.5%), fatigue (70%), loss of smell and taste (65%), cough (64%), and others. Hypertension, obesity, and diabetes were found in 8.8%, 8.8%, and 7.1% positive cases. A + blood group was present in 37% of the positive cases, followed by the B+ blood group (27%) and O+ blood group (25%). Inadequate supply of personal protection equipment (PPE), absence of negative pressure ventilation, laboratory contamination, and no training on molecular test methods were found in 13.8%, 67.8%, 44.7%, and 40.6% of positive cases, respectively.ConclusionEvaluating the infection status of laboratory health workers is crucial for drawing attention from the public, providing practical suggestions for government agencies, and increasing protective measures for laboratory health workers.

Mental Health Consequences of SARS-CoV-2 Pandemic on Long-Term Care Facility Social Care Provider in Poland

During the pandemic long-term care facilities (LTCF) social health providers constantly remain in a dilemma between loyalty to people with dementia and concerns for their own families. All of these factors could contribute to the mental burden, burnout, and increased chance of depression, anxiety and post-traumatic symptoms. In our study we aimed to provide a window on psychopathological consequences (somatic symptoms, anxiety and insomnia, social dysfunction, and depression) associated with the exposure of LTCF employees to the risk of the SARS-CoV-2 contagion in Poland. Moreover, we investigated if institutional factors, such as personal protection equipment availability, safety guidelines or access to psychiatric and psychological support at the workplace, contribute to the decrease of psychological distress of the LTCF personnel. The results can serve as ready-made guidelines for mitigating the SARS-CoV-2 impact on dementia care and constitute the basis for further analysis of long-term consequences of this precedential situation.