Reverse Transcription-Quantitative real-time PCR (RT-qPCR) Assay for the Rapid Enumeration of Live Candida auris from the Healthcare Environment

Ongoing healthcare-associated outbreaks of multidrug-resistant yeast Candida auris have prompted the development of several rapid DNA-based molecular diagnostic tests. These tests do not distinguish between live and dead C. auris cells, limiting their use for environmental surveillance and containment efforts. We addressed this critical gap by developing a reverse transcription (RT)-quantitative real-time PCR (RT-qPCR) assay to detect live C. auris in healthcare environments rapidly. This assay targeted the internal transcribed spacer 2 (ITS2) ribosomal gene by obtaining pure RNA followed by reverse transcription (ITS2 cDNA) and qPCR. ITS2 cDNA was not detectable in bleach-killed cells but detectable in heat- and ethanol-killed C. auris cells. The assay was highly sensitive, with the detection limit of ten colony-forming units (CFU) per RT-qPCR reaction. Validation studies yielded positive Ct values from sponge matrix samples spiked with 10 2 to 10 5 CFU of live C. auris while dead (bleach-killed) C. auris (10 5 /ml) or other live Candida species (10 5 /ml) had no cycle threshold (Ct) values. Finally, 33 environmental samples positive for C. auris DNA but negative by culture were all negative by RT-qPCR assay, confirming the concordance between culture and the PCR assay. The RT-qPCR assay appears highly reproducible, robust, and specific for detecting live C. auris from environmental samples. Candida auris RT-qPCR assay could be an invaluable tool in surveillance efforts to control the spread of live C. auris in healthcare environments.

Interior Environments in Long-Term Care Units From the Theory of Supportive Design

Aim: This study was designed to examine how residents in long-term care (LTC) units perceive their living environment based on the theory of supportive design. Background: Healthcare environments may cause a significant level of stress mainly due to patients’ lack of familiarity with such environments and patients’ poor health conditions. According to the theory, the healthcare environments providing a sense of control, social support, and positive distraction can promote wellness. This study was designed to learn how LTC residents perceive their current living environments. Method: This study collected data through qualitative interviews. A total of 48 residents living in two LTC units were asked the three interior environments they liked and they wanted to improve. Only the residents who lived in the current space for 1 month and communicate without any cognitive disabilities were able to participate. Most residents were female and lived in a private room. Results: The participants’ responses indicated the importance of perceived control, social support, and positive distraction in the environment. The most frequently mentioned interior environment that the residents liked was “window and view,” followed by “pictures and photos” and “TV,” while they wanted “bigger room and space,” followed by “improved privacy” and “more options for food.” In addition to the three elements, the participants considered other elements as important for them which can benefit the participants. Conclusion: More studies must be carried out to expand the theory, so that it can be applied to future studies with inclusive perspectives.

Firewall Best Practices for Securing Smart Healthcare Environment: A Review

Smart healthcare environments are growing at a rapid pace due to the services and benefits offered to healthcare practitioners and to patients. At the same time, smart healthcare environments are becoming increasingly complex environments where a plethora of devices are linked with each other, to deliver services to patients, and they require special security measures to protect the privacy and integrity of user data. Moreover, these environments are exposed to various kinds of security risks, threats, and attacks. Firewalls are considered as the first line of defense for securing smart healthcare networks and addressing the challenges mentioned above. Firewalls are applied at different levels in networks, and range from conventional server-based to cloud-based firewalls. However, the selection and implementation of a proper firewall to get the maximum benefit is a challenging task. Therefore, understanding firewall types, the services offered, and analyzing underlying vulnerabilities are important design considerations that need addressing before implementing a firewall in a smart healthcare environment. The paper provides a comprehensive review and best practices of firewall types, with offered benefits and drawbacks, which may help to define a comprehensive set of policies for smart healthcare devices and environments.

Personalisation and choice in psychiatric spaces Nachricht eingeben

In Europe psychiatric wards tend to be highly institutionalised settings, often lacking essential psychosocially-supportive elements which promote health, wellbeing and social interaction of patients and staff. This happens in the name of increased safety and anti-ligature standards or as a result of neglect and stigma often resulting from reduced opportunities of patients to actively participate in the decision making of their lives, the conditions of hospitalisation and the quality of their environments. Research on healthcare environments shows a profound impact of the built environment on therapeutic outcomes. While many recommendations derived from these studies, such as views to nature or single bedrooms, are difficult to implement in existing facilities, everyday objects potentially pose a powerful yet easily implementable resource for increasing therapeutic effects of the built environment. In this presentation we are going to briefly describe the hierarchies of psychiatric care affordances, as they derive from the SCP model –S stands for Safety and security, C for competence and P for personalisation and choice– that is a model especially developed for interpreting and evaluating psychiatric environments in relation to these principles. Then we are going to explore further the idea of personalisation and choice, its relationship with the psychosocial model of psychiatric rehabilitation and bring some implemented, practical examples of how this has been implemented in psychiatric settings across Europe and beyond. The aspects of co-design will be highlighted, as a key element of achieving personalisation and valorisation. This will help the audience come, who can be either from healthcare, policy or management backgrounds on the same page with members of the audience who come from a built environment background with concepts of institutionalisation vs ecopsychosocial concepts in relation to the built environment of the psychiatric wards.

A Provably Secure Authentication and Key Agreement Protocol in Cloud-Based Smart Healthcare Environments

The wide applications of the Internet of Things and cloud computing technologies have driven the development of many industries. With the improvement of living standards, health has become the top priority of people’s attention. The emergence of the wireless body area network (WBAN) enables people to master their physical condition all the time and make it more convenient for patients and doctors to communicate with each other. Doctors can provide real-time online treatment with cloud-based smart healthcare environments for patients. In this process, patients, health records, and doctors need to maintain security and privacy. Recently, Kumari et al. proposed a secure framework for the smart medical system. However, we found that their framework cannot provide the anonymity of patients and doctors, data confidentiality, and patient unlinkability and also is subject to impersonation attacks and desynchronization attacks. In order to ensure the security and privacy of patients and doctors, we propose an authentication and key exchange protocol in cloud-based smart healthcare environments. Formal and informal security analyses, as well as performance analysis, demonstrated that our protocol is suitable for these environments.

Wandering Eyes: Using Gaze-Tracking Method to Capture Eye Fixations in Unfamiliar Healthcare Environments

Objective: This study aims to investigate the elements of wayfinding in indoor complex healthcare environments. Background: The study replicates Ghamari and Pati’s 2018 study to identify the environmental attributes that attract eye fixation during wayfinding by objectively tracking eye movements and fixation as healthy subjects navigate through a complex, unfamiliar indoor healthcare setting. The study addressed what do people look at while navigating in unfamiliar healthcare environments? What are the relative time periods of eye fixations on different visual environmental elements of the healthcare-designed environments? And what role do visual environmental attributes in healthcare facilities, such as configuration, color, art, directories, maps, furniture, and so on, play during the wayfinding process. Method: Twenty-four adults in different genders and various age groups participated in this study and navigated five routes with different degrees of difficulty. The sequence of the destinations in this study was randomized. The data were collected by tracking gaze fixations while human subjects navigated an indoor complex healthcare environment. Results: The findings show that identifying signs (29.1%), informative signs (20.8%), and architectural features (11.3%) constituted the most frequent elements attracting gaze, substantially more than the other classes of information. Four types of signage (identifying signs, informative signs, directional, and safety/regulatory signs) were accounted for 62.3% of the total gaze fixation time. Conclusions: The comparison of the ordered list based on frequencies and time of eye fixations on various elements developed in Ghamari and Pati’s study shows a vast degree of similarities.