Search

Background: Poor hand hygiene (HH) among health care workers (HCWs) in low-resource healthcare settings has continued to increase the spread of infectious diseases, including COVID-19. The present study aimed to assess the knowledge, attitude, adherence, and barriers to HH practices among HCWs during the COVID-19 pandemic in Nigeria. Methods: The study was an online cross-sectional survey using a tailored questionnaire distributed through chain referral sampling among southern Nigerian HCWs during the first wave of the COVID-19 pandemic (February to August 2020). The primary outcomes were knowledge, attitude, adherence to HH guidelines, and the barriers limiting compliance with the guidelines. Data were analysed using percentage, frequency, mean, standard deviation, one-way ANOVA, and multiple linear regression. The study timeline was from 15 April to 31 July 2020. Results: Four hundred and fifty-four HCWs (236 males and 218 females) participated in the study. The participants had a moderate knowledge of standard HH protocol (mean ± SD) 62.45 ± 10.82%, positive attitude 84.34 ± 11.32%, and high adherence to the standard guidelines 81.21 ± 9.49%. There was no significant difference in knowledge, attitude, and adherence across the healthcare professions. Increasing age (β = 0.186, p < 0.003) and knowledge (β = 0.229, p < 0.001), and decreasing negligence (β = − 0.178, p = 0.004), and forgetfulness (β = − 0.159, p = 0.012) were the significant predictors of effective HH practices. Conclusion: Nigerian HCWs had moderate knowledge, a positive attitude, and adhered to the standard HH practices during the COVID-19 pandemic. However, the major barriers were institutional-based factors such as the inadequate supply of HH items, competing job demands, emergencies, increased workload, and personal characteristics such as age, poor knowledge, negligence, and forgetfulness. We recommend that hospital management provide their staff with adequate HH materials and continued infectious disease training. [ABSTRACT FROM AUTHOR]

Introduction: In Sub-Saharan Africa alone, about 40–65% of Hepatitis B Virus infections among HCWs were a result of percutaneous occupational exposures to contaminated blood and body fluids of patients. Occupational exposure to blood and body fluids among healthcare workers is on the rise in Ghana. However, the relationship between self-reported exposures to blood and body fluids suspected to be contaminated with the hepatitis B virus and actual serological evidence of exposure remains unknown. The aim of the study however was to assess the self-reported exposure to HBV as against the serological evidence of lifetime exposure to HBV and associated factors among Ghanaian HCWs. Methods: The study was a cross-sectional analytical survey that involved 340 HCWs who were recruited using a simple random sampling procedure from six cadres of staff from five districts in Greater Accra. The participants were surveyed using a validated instrument and 5mls of venous blood was aseptically withdrawn for qualitative detection of Anti-HBc. SPSS version 23.0 was used to analyze the data to obtain proportions, odds ratios and their corresponding confidence intervals with the level of significance set at 0.05. Results: The response rate was 94% with Nurses and Doctors in the majority with a mean age of 35.6 ± 7.2. Self-reported exposure to HBV was 63% whereas lifetime exposure to HBV (Anti-HBc) prevalence was 8.2% (95% CI = 5.0-11.0%). Females were 60% less likely to be exposed to HBV (aOR = 0.4; 95% CI = 0.1–0.9) than their male counterparts. HCWs without training in the prevention of blood-borne infections had almost three times higher odds of being exposed to HBV in their lifetime (aOR = 2.6; 95% CI = 1.0-6.4). Conclusions: The findings of this study suggest that self-reported exposure to HBV-contaminated biological materials was high with a corresponding high lifetime exposure to HBV. The female gender was protective of anti-HBc acquisition. Apart from direct interventions for preventing occupational exposures to HBV in the healthcare setting, periodic training of all categories of healthcare workers in infection prevention techniques could significantly reduce exposure to the Hepatitis B virus. [ABSTRACT FROM AUTHOR]

Background: Studies have shown that Omicron breakthrough infections can occur at higher SARS-CoV-2 antibody levels compared to previous variants. Estimating the magnitude of immunological protection induced from COVID-19 vaccination and previous infection remains important due to varying local pandemic dynamics and types of vaccination programmes, particularly among at-risk populations such as health care workers (HCWs). We analysed a follow-up SARS-CoV-2 serological survey of HCWs at a tertiary COVID-19 referral hospital in Germany following the onset of the Omicron variant. Methods: The serological survey was conducted in January 2022, one year after previous surveys in 2020 and the availability of COVID-19 boosters including BNT162b2, ChAdOx1-S, and mRNA-1273. HCWs voluntarily provided blood for serology and completed a comprehensive questionnaire. SARS-CoV-2 serological analyses were performed using an Immunoglobulin G (IgG) enzyme-linked immunosorbent assay (ELISA). Antibody levels were reported according to HCW demographic and occupational characteristics, COVID-19 vaccination and SARS-CoV-2 infection history, and multivariate linear regression was used to evaluate these associations. Results: In January 2022 (following the fourth COVID-19 wave in Germany including the onset of the Omicron variant), 1482/1517 (97.7%) HCWs tested SARS-CoV-2 seropositive, compared to 4.6% in December 2020 (second COVID-19 wave). Approximately 80% had received three COVID-19 vaccine doses and 15% reported a previous laboratory-confirmed SARS-CoV-2 infection. SARS-CoV-2 IgG geometric mean titres ranged from 335 (95% Confidence Intervals [CI]: 258–434) among those vaccinated twice and without previous infection to 2204 (95% CI: 1919–2531) among those vaccinated three times and with previous infection. Heterologous COVID-19 vaccination combinations including a mRNA-1273 booster were significantly associated with the highest IgG antibody levels compared to other schemes. There was an 8-to 10-fold increase in IgG antibody levels among 31 HCWs who reported a SARS-CoV-2 infection in May 2020 to January 2022 after COVID-19 booster vaccination. Conclusions: Our findings demonstrate the importance of ongoing COVID-19 booster vaccination strategies in the context of variants such as Omicron and despite hybrid immunity from previous SARS-CoV-2 infections, particularly for at-risk populations such as HCWs. Where feasible, effective types of booster vaccination, such as mRNA vaccines, and the appropriate timing of administration should be carefully considered. [ABSTRACT FROM AUTHOR]

In this retrospective observational study, we have performed a comparative analysis of the demographic, clinical and epidemiological characteristics of the HCWs affected with SARS-CoV-2 infection during first two waves in India. The overall prevalence of SARS-CoV-2 infection among HCWs was found to be 15.24% (14.20–16.33) and 23.38% (22.14–25.65) during first and second waves respectively. The second wave showed an adjusted odds ratio of 0.04(0.02–0.07) and 2.09(1.49–2.93) for hospitalization and being symptomatic, respectively. We detected significantly higher level of C-reactive protein (CRP) among admitted HCWs during the second wave (5.10 –14.60 mg/dl) as compared to the first wave (2.00 – 2.80 mg/dl). Our study found the relative risk of SARS-CoV-2 reinfection among HCWs during the second wave to be 0.68 [0.57–0.82, p < 0.001)]. Although, the prevalence of SARS CoV-2 infection and risk of being symptomatic was higher during second wave, the risk of hospitalization was less when compared with the first wave. [ABSTRACT FROM AUTHOR]

Background The BCG (Bacillus Calmette-Guérin) vaccine can induce nonspecific protection against unrelated infections. We aimed to test the effect of BCG on absenteeism and health of Danish health care workers (HCWs) during the coronavirus disease 2019 (COVID-19) pandemic. Methods A single-blinded randomized controlled trial included 1221 HCWs from 9 Danish hospitals. Participants were randomized 1:1 to standard dose BCG or placebo. Primary outcome was days of unplanned absenteeism. Main secondary outcomes were incidence of COVID-19, all-cause hospitalization, and infectious disease episodes. Results There was no significant effect of BCG on unplanned absenteeism. Mean number of days absent per 1000 workdays was 20 in the BCG group and 17 in the placebo group (risk ratio, 1.23; 95% credibility interval, 0.98–1.53). BCG had no effect on incidence of COVID-19 or all-cause hospitalization overall. In secondary analyses BCG revaccination was associated with higher COVID-19 incidence (hazard ratio [HR], 2.47; 95% confidence interval [CI], 1.07–5.71), but also reduced risk of hospitalization (HR, 0.28; 95% CI,.09–.86). The incidence of infectious disease episodes was similar between randomization groups (HR, 1.09; 95% CI,.96–1.24). Conclusions In this relatively healthy cohort of HCWs, there was no overall effect of BCG on any of the study outcomes. Clinical Trials Registration NCT0437329 and EU Clinical Trials Register (EudraCT number 2020-001888-90). [ABSTRACT FROM AUTHOR]

Background: Elastomeric half-mask respirators (EHMR) reduce health care workers’ exposure to airborne hazards including bioaerosols but have primarily been used in the industrial setting. Purpose: To assess health care workers’ perceptions, attitudes, and experiences wearing EHMRs in a clinical environment. Methods: Employees within a single health care system who wore the EHMR continuously during their shift completed an investigator developed survey. Descriptive statistics and thematic analysis were used. Results: Of the 8273 EHMR “fit-tested” eligible employees, 1478 met inclusion criteria and participated. Respondents reported that they felt well protected with the EHMR and confident in their care and maintenance of the EHMR. Although skin changes developed, they were primarily managed by adjusting the straps. Clarity of communication was a concern across all respondents and disciplines. Conclusions: The EHMR was preferred over reusing the N95 although clarity in communication was challenging. [ABSTRACT FROM AUTHOR]

Background: Violence against health care workers (HCWs) is a multifaceted issue entwined with broader social, cultural, and economic contexts. While it is a global phenomenon, in crisis settings, HCWs are exposed to exceptionally high rates of violence. We hypothesize that the implementation of a training on de-escalation of violence and of a code of conduct informed through participatory citizen science research would reduce the incidence and severity of episodes of violence in primary healthcare settings of rural Democratic Republic of Congo (DRC) and large hospitals in Baghdad, Iraq. Methods: In an initial formative research phase, the study will use a transdisciplinary citizen science approach to inform the re-adaptation of a violence de-escalation training for HCWs and the content of a code of conduct for both HCWs and clients. Qualitative and citizen science methods will explore motivations, causes, and contributing factors that lead to violence against HCWs. Preliminary findings will inform participatory meetings aimed at co-developing local rules of conduct through in-depth discussion and input from various stakeholders, followed by a validation and legitimization process. The effectiveness of the two interventions will be evaluated through a stepped-wedge randomized-cluster trial (SW-RCT) design with 11 arms, measuring the frequency and severity of violence, as well as secondary outcomes such as post-traumatic stress disorder (PTSD), job burnout, empathy, or HCWs' quality of life at various points in time, alongside a cost-effectiveness study comparing the two strategies. Discussion: Violence against HCWs is a global issue, and it can be particularly severe in humanitarian contexts. However, there is limited evidence on effective and affordable approaches to address this problem. Understanding the context of community distrust and motivation for violence against HCWs will be critical for developing effective, tailored, and culturally appropriate responses, including a training on violence de-escalation and a community behavioral change approach to increase public trust in HCWs. This study aims therefore to compare the effectiveness and cost-effectiveness of different interventions to reduce violence against HCWs in two post-crisis settings, providing valuable evidence for future efforts to address this issue. Trial registration: ClinicalTrial.gov Identifier NCT05419687. Prospectively registered on June 15, 2022. [ABSTRACT FROM AUTHOR]

The primary objective of the RisCoin study was to investigate the interplay of genetic, metabolic, and lifestyle factors as well as stress levels on influencing the humoral immune response after at least two COVID-19 vaccinations, primarily with mRNAs, and the risk of SARS-CoV-2 breakthrough infections during follow-up. Here, we describe the study design, procedures, and study population. RisCoin is a prospective, monocentric, longitudinal, observational cohort study. Between October and December 2021, 4515 participants with at least two COVID-19 vaccinations, primarily BNT162b2 and mRNA-1273, were enrolled at the LMU University Hospital of Munich, thereof > 4000 healthcare workers (HCW), 180 patients with inflammatory bowel disease under immunosuppression, and 119 patients with mental disorders. At enrollment, blood and saliva samples were collected to measure anti-SARS-CoV-2 antibodies, their neutralizing capacity against Omicron-BA.1, stress markers, metabolomics, and genetics. To ensure the confidential handling of sensitive data of study participants, we developed a data protection concept and a mobile application for two-way communication. The application allowed continuous data reporting, including breakthrough infections by the participants, despite irreversible anonymization. Up to 1500 participants attended follow-up visits every two to six months after enrollment. The study gathered comprehensive data and bio-samples of a large representative HCW cohort and two patient groups allowing analyses of complex interactions. Our data protection concept combined with the mobile application proves the feasibility of longitudinal assessment of anonymized participants. Our concept may serve as a blueprint for other studies handling sensitive data on HCW. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The COVID-19 pandemic is one of the disasters that has caused the highest number of healthcare worker (HCW) deaths recently. The aim of this study is to determine the anxiety levels of HCWs who are actively working during the COVID-19 pandemic. MATERIAL AND METHODS: The study was conducted online with 177 HCWs (127 doctors, 31 nurses, 15 paramedics, and 4 health technicians) due to the pandemic. Beck Anxiety Inventory (BAI) was used for anxiety levels. RESULTS: Anxiety levels of HCWs were found to be 48% 'minimal', 23.7% 'mild', 17.5% 'moderate' and 10.7% 'severe'. The mean BAI score of other HCWs was higher than the mean BAI score of doctors (15.94 ± 12.776 vs 9.53 ± 8.868). The highest level of anxiety was found in nurses (19.64 ± 13.370), (p < 0.001). The mean BAI score of female HCWs was found higher than the mean BAI of male HCWs (14.07 ± 10.899 vs 7.61 ± 8.681) and the mean BAI score of HCWs without children was found to be higher than the mean BAI score of those with children (13.77 ± 11.713 vs 9.66 ± 9.260). The mean BAI score of HCWs who live with their relatives over 65 years of age or live with a relative with a chronic disease was found to be higher than the others (14.11 ± 9.752 vs 10.44 ± 9.752), (p < 0.05). CONCLUSIONS: During the COVID-19 epidemic, which has caused the highest number of HCW deaths in recent years, it has been determined that both the BAI score and anxiety levels of HCWs are high. Anxiety levels of nurses, women, those who do not have children, those who live with their relatives over 65 years of age, and those who live with chronic patients were found to be higher than the others. [ABSTRACT FROM AUTHOR]

Since the beginning of the COVID-19 pandemic in 2020, healthcare workers (HCW) have been leading the charge in combating it, in spite of being disproportionately affected by the disease compared to the general population. This study describes the measures instituted at the largest maternity center in the United Arab Emirates during the pandemic to mitigate the risk of HCW contracting COVID-19, as well as the effectiveness of those measures. The incidence of COVID-19 amongst healthcare workers at the facility was compared to that in the general population over a 13-month period from February 2021 to February 2022. Data on population testing was obtained from the database maintained by the regional testing lab, while HCW testing data was obtained from the occupational health department at the hospital. The incidence of COVID-19 in HCWs and the general population was compared using summary statistics and charts. Several mitigation measures were instituted to protect HCW during the pandemic including patient traffic management, adequate provision of personal protective equipment, staff vaccination campaigns, infrastructure enhancement, workforce planning, and structured occupational health policies. During the study period the overall positivity rate in the general population was 5.78% (83,005/1.4 million tests) and that for staff was 1.19% (401/33,228 tests). The peaks and troughs on staff turning positive for COVID-19 coincided with peaks and troughs of the pandemic in the general population. The hospital instituted effective mitigation measures in protecting the staff and keeping COVID-19 rates well below the ones encountered in the general population. [ABSTRACT FROM AUTHOR]

Background: Health-care-associated infection (HCAI) is one of the most important and pervasive problems in the medical field. When the healthcare system first began, maintaining clean hands was thought to play a critical part in reducing hospital acquired illnesses. It has become more important for healthcare professionals to practice good hand hygiene at the outset of the Covid pandemic. Methods: - A cross-sectional observational research conducted at Teerthanker Mahaveer Medical College & Research Center Hospital in Moradabad by using a convenience sequential sampling method 360 professionals were enrolled then divided into 3 groups for comparison and assess knowledge, attitude, practices (behavior) the WHO knowledge questionnaire, attitude and self-perceived practices via Likert scale. Results: Of the 360 participants were involved in the study, we found that majority (doctors-60.4%, nurses-70.8%, ward staff-74.8%) had received knowledge on hand hygiene in last three years but the overall most participants had positive attitude of the respondents towards hand hygiene and more than 70 % of participants considered it as an essential part of their role during practice but still practices lagged situationally. Conclusion: We concluded that there is lacunae in training leading to differences in attitude and practices when compared to knowledge of the health care worker even after a pandemic. Laying importance on the training of staff of all strata. [ABSTRACT FROM AUTHOR]

Background & Objective: Opioids remain the mainstay of management of postoperative pain, despite a number of associated side effects and a chance of habituation or even addiction. This study aimed to look at the knowledge and attitudes of Health Care Professionals (HCPs) towards opioid use as the both of these directly impact management of post-operative pain in surgical patients. Methodology: A questionnaire like the one used in a Taiwan study by Luo Ping Ger et al. was administered. A total of seventeen questions were used to evaluate knowledge and attitudes towards opioid use using a 5-point Likert scale ranging from Strongly agree to strongly disagree. The questionnaire was administered to HCPs at various levels who were involved in the treatment of the orthopedic patients. Results: The paucity of knowledge about opioids and the methods of administration leads to poor attitudes regarding opioid prescribing, administration, and side effect profile. This would, in turn, lead to general noncompliance by nursing staff regarding administration of the drug. Also, it was determined in the survey that a notable percentage of HCPs may not know what to do if there was a side effect related to opioid administration, as there was a general lack of knowledge about how to recognize and precautionary measures to be instituted. Conclusion: Most health care professionals had a positive attitude regarding respiratory depression and opioids; however, this was not seen with the other side effects such as abdominal distension, nausea and vomiting, and constipation where negative attitudes were expressed by the senior nursing staff. This may be attributed to lack of continuous medical training regarding pain management on the ward. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Working through the COVID-19 pandemic has exposed Health Care Workers to physical and psychological risks that can result in a broad range of mental health problems, including burnout. The aim of the present study was to investigate factors affecting burnout in Iranian Health Care Workers during the COVID-19 pandemic. Identifying the principal factors affecting burnout will assist efforts to prepare for, and, prevent harm, to staff participating in future healthcare emergencies. MATERIAL AND METHODS: A systematic review of scientific literature using the PRISMA guideline was completed, and included literature published from January 2020 until December 2021. The articles related to burnout in Iranian Health Care Workers during COVID-19 were obtained through Google Scholar, SID, Magiran Scopus, PubMed, and Web of Science databases using related keywords. Thematic analysis was used to analyze the obtained data. RESULTS: 203 articles were identified through an initial search and finally, 14 studies were entered into the analysis. Based on the literature review, the principal factors affecting burnout were divided into 2 main themes and 4 subthemes. The themes included human factors, and organizational factors, and the subthemes included individual characteristics, psychosocial factors, occupational conditions, and training. CONCLUSIONS: Individual and psychosocial characteristics have important effects on burnout among Health Care Workers and this can cause negative flow-on effects on the quality of life of these workers, and the quality of medical services. The prevalence of burnout is relatively higher among medical practitioners and nurses, and it is important to enhance coping resources and health education activities that support the resilience of these clinicians in the challenging and stressful context of a pandemic. [ABSTRACT FROM AUTHOR]

(1) Influenza causes a significant health and socio-economic burden every year, and health personnel (HP) are at higher risk of exposure to respiratory pathogens than the general population. (2) The study's purpose was to describe and compare influenza vaccine uptake and its prognostic factors among Medical Doctors (MDs) and Non-Medical Health Personnel (NMHP) vs. Non-HP (NHP). We analyzed 2014–2018 data (n = 105,608) from the Italian Behavioral Risk Factor Surveillance System PASSI that, since 2008, has been collecting health-related information continuously in sampled adults. (3) MDs and NMHP represented, respectively, 1.1% and 4.6% of the sample. Among HP, 22.8% (CI 19.8–26.1%) of MDs and 8.5% (CI 7.5–9.5%) of NMHP reported to have been vaccinated vs. 6.3% (CI 6.1–6.5%) in NHP. This difference is confirmed in the three categories (MDs, NMHP, NHP), even more across age groups: in 18–34 yy, respectively, 9.9%, 4.4%, 3.4% vs. 28.4%, 13.9%, 10.6% in 50–64 yy. PASSI surveillance shows an increasing influenza vaccination uptake over time, especially among MDs (22.2% in 2014 vs. 30.5% in 2018). (4) Despite such an increase, especially among younger HP, influenza vaccination uptake is low. Even more under pandemic scenarios, these figures represent key information to address effective strategies for disease prevention and health promotion. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) poses a significant occupational risk factor to health care workers (HCWs). As in previous events, this occupational risk amplifies and compounds the adverse impact of the pandemic. We conducted a narrative review summarizing risk factors associated with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) transmission in HCWs. We searched for original observational studies (including case-control, cross-sectional, prospective and retrospective cohorts) using PubMed, Scopus, and Google Scholar. A total of 22 articles were reviewed, including eligible English articles published between April 2020 and May 2022. Job category, work environment, personal protective equipment (PPE) noncompliance, lack of PPE awareness and training, unvaccinated status, and competing community and household exposures were identified as risk factors for SARS-CoV-2 transmission among HCWs. Effective measures to protect HCWs from SARS-CoV-2 need to account for the identified occupational risk factors. Identifying and understanding COVID-19 risk factors among HCWs must be considered a public health priority for policy makers to mitigate occupational and community transmission in current and future epidemics. [ABSTRACT FROM AUTHOR]

Copyright of Saudi Medical Journal is the property of Saudi Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: bacterial carriage by health care workers (HCWs) is a major risk factor for transmission of healthcare-associated infections (HAIs). Often, these pathogens are multiple drug resistant (MDR) and are transmitted from hospital environments. We aimed to study the carriage of pathogenic bacteria among HCWs at a tertiary care hospital in Uganda. Methods: a cross-sectional study was done at Naguru Regional Referral Hospital from June 2017 to August 2017. Five finger imprints of both hands-on blood and MacConkey agar were done. We assessed pathogenic bacterial carriage by HCWs and characterized drug sensitivity and relatedness of these isolates. Genotyping of extended-spectrum beta-lactamase (ESBL) and Methicillin-resistant Staphylococcus aureus (MRSA) positive isolates was done to determine intrahospital transmission. A survey of the hospital's IPC de program was done. Results: one hundred and eight (108) HCWs were enrolled. Carriage of pathogenic bacteria was highest in surgical and emergency wards at 36% and 35.6% respectively, pvalue of 0.00. The proportion of microbial carriage was highest among nurses 16 (34.8%) followed by medical officers 11 (23.9%). Among the isolated pathogenic bacteria, 25 (36.2%) were Grampositive and 44 (63.8%) were Gram-negative. Fifty percent of Staphylococcus aureus were methicillinresistant, and one isolate was vancomycinresistant. Fifty-four percent (54.6%) of HCWs had never been trained on moments of hand hygiene, only 44.4% recognized the presence of an IPC program in the hospital and 49% were not aware of problems associated with poor IPC practices. Conclusion: this study demonstrated that hands of HCWs at Naguru Regional Referral Hospital were colonized with pathogenic bacteria with varying prevalence, some with multidrug-resistant strains including MRSA and ESBL. [ABSTRACT FROM AUTHOR]

Background: Psychological distress has been frequently observed in frontline healthcare workers under stress during the coronavirus disease 2019 (COVID-19) epidemic; however, it is unclear if there are differences in the stress and symptoms experienced by staff members who work exclusively in a COVID-19 ward and support staff temporarily deployed to a COVID-19 ward. The present study investigated psychosocial stress specific to the care for patients with COVID-19 and psychological distress among ward staff working exclusively with COVID-19 and temporary support staff. Methods: The participants were full-time nurses and doctors working in COVID-19 wards or the ICU who provided face-to-face care to patients with COVID-19 during the COVID-19 outbreak in February of 2021. The data of 67 staff members (21 exclusively working with Covid-19 patients (group A) and 46 in the temporary support group (group B)) was available for study. Psychosocial stress specific to healthcare professionals during this COVID-19 outbreak (Tokyo Metropolitan Distress Scale for Pandemic [TMDP]) and general psychological distress (K6) were assessed. Results: The K6 score was significantly lower in group B than in group A (p =.006), but no significant difference was found in the total score of TMDP or its subscales. Positive correlations were found between TMDP and K6 for group B (p =.011), as was the number of days of care on TMDP-social (rs =.456, p =.001). Conclusion: Even though support staff members experienced lower psychological distress than staff working exclusively with COVID-19, COVID-19-related psychosocial stress specific to HCWs was comparable. The support staff also presented psychological distress associated with psychosocial stress specific to healthcare professionals during this COVID-19 outbreak, and the COVID-19-related social stress was enhanced as the number of working days increased. Our results show that all staff, not only those working exclusively with COVID-19 patients but also other support staff should be provided with care focusing on COVID-19-related psychosocial occupational stress. [ABSTRACT FROM AUTHOR]

Background: The crisis in human resources for health is observed worldwide, particularly in sub-Saharan Africa. Many studies have demonstrated the importance of human resources for health as a major pillar for the proper functioning of the health system, especially in fragile and conflict-affected contexts such as DR Congo. However, the aspects relating to human resources profile in relation to the level of performance of the health districts in a particular context of conflicts and multiform crises have not yet been described. Objective: This study aims to describe the profile of staff working in rural health districts in a context of crisis and conflicts. Methods: A cross-sectional study was carried out from May 15, 2017 to May 30, 2019 on 1090 health care workers (HCW) exhaustively chosen from four health districts in Eastern Democratic Republic of Congo (Idjwi, Katana, Mulungu and Walungu). Data were collected using a survey questionnaire. The Chi2 test was used for comparison of proportions and the Kruskal–Wallis test for medians. As measures of association, we calculated the odds ratios (OR) along with their 95% confidence interval. The α-error cut-off was set at 5%. Results: In all the health districts the number of medical doctors was very insufficient with an average of 0.35 medical doctors per 10,000 inhabitants. However, the number of nurses was sufficient, with an average of 3 nurses per 5000 inhabitants; the nursing / medical staff (47%) were less represented than the administrative staff (53%). The median (Min–Max) age of all HCW was 46 (20–84) years and 32% of them were female. This was the same for the registration of staff in the civil service (obtaining a registration number). The mechanism of remuneration and payment of benefits, although a national responsibility, also suffered more in unstable districts. Twenty-one percent of the HCW had a monthly income of 151USD and above in the stable district; 9.2% in the intermediate and 0.9% in the unstable districts. Ninety-six percent of HCW do not receive Government' salary and 64% of them do not receive the Government bonus. Conclusion: The context of instability compromises the performance of the health system by depriving it of competent personnel. This is the consequence of the weakening of the mechanisms for implementing the practices and policies related to its management. DR Congo authorities should develop incentive mechanisms to motivate young and trained HCW to work in unstable and intermediate health districts by improving their living and working conditions. [ABSTRACT FROM AUTHOR]

Introduction/Objectives: A culture of joy in the workplace supports well-being, but less is known about the effect of a shared experience on well-being and burnout in a health care setting. This pilot study investigated personal well-being and occupational burnout among primary care staff who participated in a 3-month virtual book club. Methods: In December 2021, health care workers from a primary care practice were invited to participate in a 3-month virtual book club. Participants were emailed a preintervention survey with questions regarding well-being and burnout, the pandemic's influence on emotional health, and demographic information. The book club met virtually every month from January 2022 through March 2022. After the March 2022 book club meeting, a paired postintervention survey was sent to participants with additional questions regarding their participation in the book club. Well-being and burnout were measured with the 11-point Well-Being Index, and the pandemic's influence on emotional health was assessed with the 64-point Pandemic Emotional Impact Scale. Results: Of 12 book club participants, 9 participants (6 physicians and 3 nurses) completed surveys before and after the intervention. Postintervention improvement in the median score of the Pandemic Emotional Impact Scale was significant (7 points, P =.04). Although Well-Being Index results uniformly favored improved well-being after book club participation, the median improvement of 1 point was not significant (P =.69). Conclusions: Social connection through a virtual workplace activity such as a book club may contribute to well-being and may decrease occupational burnout. [ABSTRACT FROM AUTHOR]

Improved sleep hygiene is postulated to be protective against burnout. Previous studies assessing a potential association between poor sleep quality and burnout showed incongruent results. To investigate the relationship between sleep quality and burnout. Setting and Participants: A survey was conducted in a large health care cluster in Singapore and included health care staff from different professions (N = 4777). The Maslach Burnout Inventory – Human Services Survey was used to measure burnout across 3 sub-scales: Emotional Exhaustion, Depersonalization and Personal Accomplishment, while the Pittsburgh Sleep Quality Index (PSQI) was used to gauge the participants' sleep quality. Multi-variable general linear model ANOVA was used for correlation analysis. There is a strong correlation between sleep quality and all 3 burnout sub-scales. PSQI is associated with Emotional Exhaustion (F value = 90.65, P-value <.0001), Depersonalization (F value = 49.46, P-value <.0001) and Personal Accomplishment (F value = 12.29, P-value <.0001). PSQI shows a significant linear upward trend with Emotional Exhaustion (linear contrast = 957.06, P-value <.0001) and with Depersonalization (linear contrast = 521.92, P-value <.0001). With Personal Accomplishment, PSQI shows a significant linear downward trend (linear contrast = 123.61, P-value <.0001). Poor sleep quality is progressively and linearly associated with burnout and its 3 sub-scales. Future studies that evaluate interventions which improve sleep quality among health care workers may be useful in reducing burnout and improving patient care. • This is the largest survey on sleep quality and burnout in Southeast Asia, thus far on health care workers. • Burnout has 3 sub-scales: Emotional Exhaustion, Depersonalization and Personal Accomplishment. • Poor sleep quality is progressively and linearly associated with all 3 burnout sub-scales. • Future studies on interventions to improve sleep quality and burnout among health care workers may help decrease burnout. [ABSTRACT FROM AUTHOR]

[Display omitted] • Depressive symptoms predicted lower antibody titers after COVID-19 vaccination. • Body temperature as a side effect was a positive predictor for antibody responses. • Alcohol intake could be a negative factor for antibody responses of COVID-19 vaccine. • Poor health check-up results were related to lower antibody titers after vaccination. • Longer duration from second dose to blood sampling resulted in weaker antibody responses. Although factors associated with the antibody response to the BNT162b2 mRNA COVID-19 vaccine have been reported, psychological factors have not been examined. Depression or anxiety may affect vaccine reactions because these factors influence immune responses. This study aimed to determine whether psychological status at the time of vaccination predicts antibody responses. A prospective observational study of the BNT162b2 mRNA COVID-19 vaccine response was carried out among individuals attending for an annual health check-up. Participants included 78 volunteers out of 80 hospital workers in Nagoya, Japan. No participants had been infected with COVID-19 and all gave written informed consent to participate in the study. Blood samples were obtained approximately 28 days after the second dose of the vaccine, and antibody titers of the SARS-CoV-2 spike protein were determined using the SARS-CoV-2 IgG II Quant assay. Participants completed the Japanese version of the hospital anxiety and depression scale (HADS) questionnaire, one day before both vaccinations. Participants also recorded any adverse reactions, such as body temperature and other side effects, every day for two weeks after each dose. The relationships between antibody titers and the predictive factors were analyzed using multiple linear regression analysis, with the antibody titers as the dependent variables, followed by univariate analysis. Multiple linear regression analysis revealed that no or excessive alcohol intake (p = 0.039), poor results from a health check-up (p = 0.011), a longer duration between the second dose and blood collection (p = 0.039), and increased degree of depressive symptoms (p = 0.041) were significant negative predictors of antibody titers, while body temperature one day after the second dose as a significant positive predictor of antibody titers (p < 0.0005). We identified that depressive symptoms just before the second dose of the BNT162b2 mRNA COVID-19 were an independent negative predictor of antibody responses, in addition to other factors. Our results highlight the importance of mental health at the time of vaccination to achieve the higher antibody responses necessary to acquire humoral immunity. [ABSTRACT FROM AUTHOR]

Background: Covid-19 has been declared a global pandemic by WHO. Health Care Workers (HCWs) being the front -line warriors have been most exposed to the SARS-CoV-2 virus. Vaccine hesitancy against Covid-19 has been seen among HCWs. The main aim of the research was to find the hesitancy rates of vaccine among HCWs and the pulling and pushing factors to get vaccinated. Methods: A descriptive cross-sectional study was conducted on HCWs. Questionnaires on Google forms were sent to all participants through their WhatsApp number and data was analysed through SPSS version 23.0. Results: Out of 81 HCWs selected, 51.9% (n=42) were initially hesitant when the vaccine was first introduced. The main pulling factor initially to get vaccinated was to shield loved ones, 38.75% (n=31) and 46.2 % (n=37) of them received a booster dose of vaccine mainly due to employment requirements. Out of the total, 19.75% (n=16) are still hesitant even after vaccination and the most common pushing factors were fear of the side effects and inadequatel y tested vaccines. Conclusion: Though the majority of the HCWs got vaccinated, vaccine hesitancy is still present among the HCWs and the major reason is uncertainty about the side effects it could cause in the long term. [ABSTRACT FROM AUTHOR]

Monkeypox is a zoonotic infection that causes painful or pruritic dermatologic lesions on the face, trunk, limbs, genitals, and mucosal surfaces. Monkeypox cases increased exponentially in 2022, prompting the World Health Organization and the United States Department of Health and Human Services to proclaim it a public health emergency. The role of community health nurses towards monkeypox prevention and control in transmission. We searched various databases like World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), American Nurses Association (ANA), EMBASE, Web of Science, CINAHL, PubMed, and Cochrane databases were comprehensively searched. This review article focuses on the monkeypox pandemic, the transmission of the infection, vaccination and the role of healthcare workers. The healthcare role is crucial in preventing and promoting the monkeypox pandemic. These results can be consolidated when policymakers plan to increase the implementation of the healthcare worker in the face of monkeypox and future global threats. [ABSTRACT FROM AUTHOR]

The uptake of non-EPI vaccines, such as influenza and pneumonia vaccines, are very low in China compared to other countries. In China, immunization services are provided by dedicated vaccination service providers (VSPs), and their recommendation is the key to improve vaccine uptake. This study explores VSP recommendation practices for non-EPI vaccines from a socio-ecological perspective. A mixed-methods study, combining a questionnaire survey and key informant interviews, was conducted in Anhui, Shaanxi, and Guangdong provinces. 555 VSPs completed the valid questionnaire, and 49 VSPs participated in in-depth interviews. Among the surveyed VSPs, 51.54% stated that they always or often recommended non-EPI vaccines in work, and the remaining half reported that they sometimes or never recommended non-EPI vaccines. Most VSPs interviewed communicated about non-EPI vaccines with the public in an informed style, not a presumptive one, and provided the public with all the decision-making latitude. The infrequent recommendation of non-EPI vaccines was widely prevalent among Chinese VSPs regardless of their individual characteristics, and was mainly driven by the interpersonal relationship, institutional arrangement, and public policy. Firstly, the VSPs were concerned about conflicts arising from the recommendation of self-paid vaccines and the risk of adverse reactions following vaccination. Secondly, high workloads left them insufficient time to communicate about non-EPI vaccines. Thirdly, there was no performance assessment or financial incentive for VSPs to recommend non-EPI vaccination, and their main responsibility was around EPI vaccination. Therefore, multi-level socio-ecological systems around non-EPI vaccination should be improved to optimize the communication between VSPs and the public, which include a better system of legal redress to resolve potential misunderstandings between the VSPs and the public, more effective workload management through whole-process health information system and strengthening public health workforce, and the introduction of performance assessment and appropriate incentives on non-EPI vaccination. [ABSTRACT FROM AUTHOR]

Aim: To find whether an emergent airborne infection is more likely to spread among healthcare workers (HCW) based on data of SARS-CoV-2 and whether the number of new cases of such airborne viral disease can be predicted using a method traditionally used in weather forecasting called Autoregressive Fractionally Integrated Moving Average (ARFIMA). Methods: We analyzed SARS-CoV-2 spread among HCWs based on outpatient nasopharyngeal swabs for real-time polymerase chain reaction (RT-PCR) tests and compared it to non-HCW in the first and the second wave of the pandemic. We also generated an ARFIMA model based on weekly case numbers from February 2020 to April 2021 and tested it on data from May to July 2021. Results: Our analysis of 8998 tests in the 15 months period showed a rapid rise in positive RT-PCR tests among HCWs during the first wave of pandemic. In the second wave, however, positive patients were more commonly non-HCWs. The ARFIMA model showed a long-memory pattern for SARS-CoV-2 (seven months) and predicted future new cases with an average error of ± 1.9 cases per week. Conclusion: Our data indicate that the virus rapidly spread among HCWs during the first wave of the pandemic. Review of published literature showed that this was the case in multiple other areas as well. We therefore suggest strict policies early in the emergence of a new infection to protect HCWs and prevent spreading to the general public. The ARFIMA model can be a valuable forecasting tool to predict the number of new cases in advance and assist in efficient planning. [ABSTRACT FROM AUTHOR]

The term, "aerosol-generating procedures" (AGPs), was proposed during the prior SARS-CoV-1 epidemic in order to maximise healthcare worker and patient protection. The concept of AGPs has since expanded to include routine therapeutic processes such as various modes of oxygen delivery and non-invasive ventilation modalities. Evidence gained during the SARS-CoV-2 pandemic has brought into question the concept of AGPs with regard to intubation, airway management, non-invasive ventilation and high flow nasal oxygen delivery. Although encounters where these procedures occur may still be associated with increased risk of infectious transmission, this is a function of the clinical context and not because the procedure itself is aerosol-generating. [ABSTRACT FROM AUTHOR]

Occupational skin-related problems include dermatoses caused by agents in the working environment. For health care workers, these occupational dermatoses could be due to usage of Personal Protective Equipment (PPE), such as gloves, masks, goggles, and other protective equipment. These PPE contribute to both allergic and irritant contact dermatitis. This review summarized the skin damage after PPE usage and hand hygiene protocol. Recommendations should be established to prevent these occupational dermatoses from PPE usage. [ABSTRACT FROM AUTHOR]

Background: Health care workers (HCWs) represent a vulnerable population during epidemic periods. Our cohort study aimed to estimate the risk of infection and associated factors among HCWs during the first wave of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) in Madagascar. Methods: A prospective cohort study was carried out in three hospitals that oversaw the first cases of COVID‐19. Monthly ELISA‐based serological tests were conducted, and nasopharyngeal swabs were collected in the case of symptoms linked to COVID‐19 for RT–PCR analysis. Survival analyses were used to determine factors associated with SARS‐CoV‐2 infection. Results: The study lasted 7 months from May 2020. We included 122 HCWs, 61.5% of whom were women. The median age was 31.9 years (IQR: 26.4–42.3). In total, 42 (34.4%) had SARS‐CoV‐2 infections, of which 20 were asymptomatic (47.6%). The incidence of SARS‐CoV‐2 infection was 9.3% (95% CI [6.5–13.2]) person‐months. Sixty‐five HCWs presented symptoms, of which 19 were positive by RT–PCR. When adjusted for exposure to deceased cases, infection was more frequent in HCWs younger than 30 years of age (RR = 4.9, 95% CI [1.4–17.2]). Conclusion: Our results indicate a high incidence of infection with SARS‐CoV‐2 among HCWs, with a high proportion of asymptomatic cases. Young HCWs are more likely to be at risk than others. Greater awareness among young people is necessary to reduce the threat of infection among HCWs. [ABSTRACT FROM AUTHOR]

Background The pandemic of the 21st century Coronavirus disease 19 (COVID 19) caused by severe acute respiratory syndrome came with a very high infectivity. Personal protective equipment (PPE) prevent the health care workers from droplet and contact transmission of virus while they are treating COVID 19 patients. Due to the frequent use of protective devices and frequent hand hygiene among healthcare workers during this pandemic came a second mini pandemic-Pandemic of occupational dermatitis. Materials and Methods A cross-sectional type of observational study was conducted. A google questionnaire was circulated on social media to the healthcare workers. The responses were recorded in Google Sheets and transferred to Microsoft Excel. The statistical analysis was done using data editor, S PSS Version 20. Results The study included 124 doctors, 54 nurses, 20 wardboys, 10 technicians and 10 in other health care workers.13.9% had the allergic predisposition The most common type of dermatoses seen in HCW was hand dermatitis (56.9%, 124/218) followed by facial acne(39.4%.86/218) and sweat dermatitis (38.5%, 84/218). The most common cause of hand dermatis was use of gloves (latex and non latex) in 82.2 % (102/124) and sanitizers in 63.7% (79/124), soap in 21.7% (27/124). Conclusion There is need to make the health care workers aware about the proper and correct use of PPE in order to prevent and decrease the occupational dermatosis in due to personal protective equiments use in COVID-19. [ABSTRACT FROM AUTHOR]

To describe the training of healthcare workers (HCW) in nasopharyngeal swabbing during the COVID 19 pandemic. Study design: Retrospective study. Setting: Tertiary care teaching hospital. Subjects and methods: One hundred and seventy eight health care workers were trained from May 2020 to January 2021. Three modules were designed to train the health care workers in the technique of obtaining a nasopharyngeal swab specimen.Training consisted of an instructional video on how to perform nasopharyngeal swabs and live demonstration followed by hands-on supervised training. The trainees included 30 doctors, 101 nurses, 31 respiratory therapists, 3 physiotherapists, 9 interns and 4 lab technicians. There were 39 male and 139 female trainees. After attending all 3 modules of training, they were confident and efficient in taking a non-traumatic nasopharyngeal swab. Good knowledge and adequate training is key to a good nasopharyngeal sampling for SARS CoV-2 testing. [ABSTRACT FROM AUTHOR]

Background: Health care workers (HCWs) are at high risk of COVID-19 infection; therefore, screening is recommended for early detection and management to break the chain of transmission. Globally, multiple strategies have been utilized for the screening of HCWs. This article reports and evaluates an active surveillance and screening strategy for severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) among HCWs following work or nonwork exposures in Brunei Darussalam to prevent health care–associated COVID-19 transmission. Methods: In March 2020, the Ministry of Health through the Occupational Health Division adopted an active screening strategy for symptomatic and asymptomatic HCWs, which involved symptom screening, risk assessment, SARS-COV-2 testing, and management following work/nonwork exposure and recent overseas travel, and those with influenza-like illness (ILI) symptoms. Screening frequency was based on the HCWs' symptoms and exposure, with the intent to evaluate all possible sources of exposure. Findings: As of December 31, 2020, 821 HCWs were screened, of which 632 (77%) had ILI symptoms and 14 (1.7%) had high-risk occupational exposure. Reverse transcription polymerase chain reaction (RT-PCR) swab testing was carried out on 577 (70.3%) HCWs, with the highest proportion of swabs done on doctors (85.1%; p <.01) due to their workplace exposure (34.3%) and overseas travel (38.7%). Conclusion: By July 2021, Brunei Darussalam had recorded zero cases of COVID-19 among HCWs from occupational exposure. Our strategy of active screening for SARS-COV-2 RT-PCR testing since early in the outbreak has proven to be successful, in combination with infection control practices and public health measures, in the prevention of occupational transmission, thereby facilitating early return to work for HCWs with low-risk exposure and without symptoms. [ABSTRACT FROM AUTHOR]

Objective: To examine the effects of household preparedness on perceptions of workplace preparedness during a pandemic among all employees at the US Department of Veterans Affairs (VA) medical facilities. Methods: The VA Preparedness Survey (October–December 2018, Los Angeles, CA) used a stratified simple random, web-based survey. Multivariate statistical analyses examined the effect of household preparedness on perceptions of workforce preparedness during a pandemic: institutional readiness; desire for additional training; and understanding their role and its importance. Results: VA employees totaling 4026 participated. For a pandemic, 55% were confident in their VA medical facility's ability to respond, 63% would like additional training, 49% understood their role during a response, and 68% reported their role as important. Only 23% reported being "well prepared" at home during major disasters. After controlling for study-relevant factors, household preparedness was positively associated with perceptions of workforce preparedness during a pandemic. Conclusions: Efforts to increase household preparedness for health care employees could bolster workforce preparedness during pandemics. Organizations should consider robust policies and strategies, such as flexible work arrangements, in order to mitigate factors that may serve as barriers to household preparedness. [ABSTRACT FROM AUTHOR]

Background: Health literacy (HL) is an important public health goal but also crucial in individuals providing medical care. During the pandemic, COVID-19–related HL of health professionals (HPs) has gained momentum; it helps to minimize the risk of self-infection, on the one hand, and to protect patients and relatives from infection, on the other. However, comprehensive information about the levels of individual pandemic-related HL in HPs is scarce. Objective: In this paper, we aimed at describing the extent of existing research on HL (concept) conducted in HPs (population) in the COVID-19 pandemic (context). The review intends to map the literature on HL in HPs, thereby highlighting research gaps. Methods: This scoping review was conducted using the methodology of Khalil et al (2016). This involved an electronic search of PubMed (MEDLINE) and PsycInfo and a hand search. The included studies were iteratively examined to find items representing the four HL dimensions of access, understand, critically appraise, and apply COVID-19–related health information. Results: The search yielded a total of 3875 references. Only 7 (1.4%) of the 489 included studies explicitly stated to have addressed HL; 2 (0.4%) studies attempted to develop an instrument measuring COVID-19–related HL in HPs; 6 (1.2%) studies included an HL measure in an observational survey design. Of the remainder, the vast majority used a cross-sectional design. The dimensions access and understand were frequently examined, but few studies looked at the dimensions critical appraisal or apply. Very few studies reported an intervention aiming to improve a COVID-19–related HL outcome. Conclusions: High levels of COVID-19–related HL among HPs are necessary to ensure not only safe practice with necessary protection of HPs, their patients, and relatives, but also successful care delivery and subsequently improved health outcomes in the long term. To advance our understanding of how high COVID-19–related HL manifests itself in HPs, how it relates to health outcomes, and how it can be improved, more research is necessary. [ABSTRACT FROM AUTHOR]

Aim: We aim to describe the relationship between job satisfaction and compare levels of resilience among out‐of‐hospital emergency medical service professionals. Background: The study of the impact of the working environment on health professionals has raised great interest. Job‐related variables and resilience can be a protective factor against stressful and demanding events at work. Methods: A cross‐sectional survey comprising sociodemographic and job‐related variables was conducted among 406 workers (doctors, nurses, psychologists, and ambulance technicians) from the out‐of‐hospital emergency medical system in Spain. Resilience was self‐reported using the Connor‐Davidson Resilience Scale. Results: Nursing professionals were less resilient compared with ambulance technicians (score difference 1.709, p =.008). As age increased, resilience was lower (r = −.118). Professionals with higher resilience scores were more satisfied in their work (OR = 1.06, 95% CI: 1.02–1.11), and professionals with higher psychological strength, gained from working with other colleagues, also showed greater job satisfaction (OR = 5.47, 95% CI: 2.55–11.73). Conclusion: There was a positive association between resilience, job satisfaction and collaborative work. Professionals with greater psychological strength, gained from working with other colleagues, also showed higher levels of job satisfaction. Implications for Nursing Management: Managers can use these results to influence the work environment to enhance job satisfaction and hence improve the resilience of the out‐of‐hospital emergency health care professionals. [ABSTRACT FROM AUTHOR]

Background: Despite measures to reduce the spread of COVID-19 in the world, it is increasing day by day. Countries that implement good prevention strategies are less likely to be infected with COVID-19 than those that do not. Therefore, the aim of this study was to assess knowledge, attitude, and preventive practices toward COVID-19 early in the outbreak among health workers in Northern Ethiopia. Methods: A health facility-based cross-sectional study was conducted among health professionals working in public health centers and hospitals from April to May 2020. A simple random sampling technique was employed to select study respondents. Data were entered in Epi-info 7.1 and exported to SPSS version 20.00 for analysis. Simple descriptive summary statistics were done. Binary logistic regression was used to evaluate the factors of the principal defense practice. Results: A total of 403 health workers were included in the study making a response rate of 96%. Of these, 79% and 87.9% of health care workers had good knowledge and a good attitude and 64.3% of health care practitioners had good practice in preventing COVID-19. Approximately 92.0% said that COVID-19 has no specific treatment and vaccine, while 54.8% of health care workers did not use the necessary personal protective equipment at all times. We found that being female [AOR 2.43, 95% CI (1.50–3.94)], work experience of 2–5 years [AOR 2.44, 95% CI (1.10–5.39)], news media as a source of information [AOR 7.11, 95% CI (3.07–16.49)], social media as a source of information [AOR 4.59, 95% CI (2.15–9.84)], and governmental website as a source of information [AOR 4.21, 95% CI (2.15–8.27)] were reported as protective factors, and being single marital status [AOR 0.15, 95% CI (0.03–0.75)] was reported as a risk factor toward the prevention of COVID-19. Conclusion: Most health workers scored good knowledge and attitude; nevertheless, a significant proportion of health workers had poor practice toward the prevention of COVID-19, including the use of PPE. Additionally, some groups of health professional had poor practices of implementing the public health measures, thus necessitating a call targeted at them to improve the prevention and control of COVID-19. [ABSTRACT FROM AUTHOR]

Background: Health care workers (HCWs) are more likely to get latent tuberculosis infection (LTBI) because of the direct contact they may have with patients and carriers. Therefore, this study aimed to assess the prevalence of LTBI in HCWs. Materials and Methods: In the present study, we searched from 1st 2010 to the end of 2021 in various databases such as; PubMed, Scopus, Web of sciences, and Google Scholar for studies presented LTBI in HCWS. After applying inclusion and exclusion criteria and quality assessment, obtained data were analyzed by Comprehensive Meta-analysis (CMV) software. Results: In total, 22 studies met the eligibility criteria to include in the present systematic review and metaanalysis. The combined prevalence of LTBI was reported by 25.9% (95% CI: 19.3-33.7). No publication bias was seen among studies included based on Eger's regression test (p=0.04). Conclusion: Our study showed a high prevalence of LTBI in HCWs. Therefore, periodical screening of HCWs with Suitable tests is essential to prevent this high prevalence. According to the results of this systematic review and meta-analysis, the rate of LTBI in Iranian HCWs is high. Therefore, periodical screening and diagnostic tests such as TST are necessary for the timely diagnosis and treatment of these individuals to prevent changing LTBI to an active form of tuberculosis. [ABSTRACT FROM AUTHOR]

Aim: To investigate impact of Yoga and Music Intervention on anxiety, stress, and depression levels of health care workers during the COVID-19 outbreak. Methods: This study was conducted to assess psychological responses of 240 healthcare workers during COVID-19 outbreak. We used Yoga and Music Intervention in normal and abnormal subjects based on Depression Anxiety and Stress Scale-42 (DASS-42). Results: Of all 209 participants, 105 (50.23%) had symptoms of depression (35.88%), anxiety (40.19), and stress (34.92%) alone or in combination. The data suggest that there is significant improvement in test scores after intervention. Majority of persons with abnormal score exhibited improved DASS-42 score on combined interventions of Yoga and music compared to control group. Even subjects without abnormalities on DASS-42 score also showed improved DASS-42 scores in intervention (n = 52) group compared to nonintervention (n = 52) group. Conclusions: Our findings highlighted the significance of easily available, simple, inexpensive, safe nonpharmacological interventions like Yoga and Music therapy to overcome stress, anxiety, and depression in present times. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic and its associated vaccine have highlighted vaccine hesitancy among healthcare workers (HCWs). Vaccine hesitancy among this group existed prior to the pandemic and particularly centered around influenza vaccination. Being a physician, having more advanced education, and previous vaccination habits are frequently associated with vaccine acceptance. The relationship between age and caring for patients on COVID-19 vaccination is unclear, with studies providing opposing results. Reasons for hesitancy include concerns about safety and efficacy, mistrust of government and institutions, waiting for more data, and feeling that personal rights are being infringed upon. Many of these reasons reflect previous attitudes about influenza vaccination as well as political beliefs and views of personal autonomy. Finally, several interventions to encourage vaccination have been studied, including education programs and non-monetary incentives with the most effective studies using a combination of methods. [ABSTRACT FROM AUTHOR]

Background: Familiarity is a concept often used in literature but is not well defined or understood. As a key concept in rural nursing theory, the conceptual understanding of familiarity is currently incomplete. The findings from this scoping review will inform a concept analysis using Walker and Avant's method and to identify and define the missing key components of familiarity. Objective: The objective of this scoping review is to examine and analyze what is known in the existing literature about the concept of familiarity. Methods: The Joanna Briggs Institute scoping review framework guided the identification of literature published from 2016 to 2022 on familiarity. Following the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) reporting standard, the familiarity scoping review is registered on Open Science Framework (registration digital object identifier: 10.17605/OSF.IO/ZB8VF). A total of 8 databases, including PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature) Plus with full text, APA PsychInfo, Communication Source, EBSCO MegaFILE, Medline, Nursing & Allied Health Database, and ScienceDirect, will be searched for 22 search terms. Covidence software will be used to manage the scoping review with each citation independently reviewed by 2 research team members for eligibility. Eligibility will be determined using a 2-level process. Each title and abstract will be screened for eligibility; for citations deemed eligible, a full-text article review will be conducted. The scoping review is expected to locate a large body of literature, and eligibility criteria will be refined during the title and abstract screening process. In addition, reference list scanning will be performed to locate relevant literature. Results: Familiarity data will be collected beginning October 2021 with anticipated completion in March 2022. Dissemination of findings will occur through scholarly presentations and in rural-focused and nursing publications in 2022 or 2023. The findings from this review will further the understanding of familiarity and how it affects rural life and nursing practice. Conclusions: This review will support a full understanding and add clarity to the concept of familiarity as a component of rural life. These new insights will advance the understanding of how familiarity influences rural health care practice. The concept analysis will provide theoretical support for rural nursing theory and promote an understanding of the interrelationships of rural concepts. [ABSTRACT FROM AUTHOR]

Background: The 2019 coronavirus (COVID-19) pandemic placed unprecedented strains on the U.S. health care system, putting health care workers (HCWs) at increased risk for experiencing moral injury (MI). Moral resilience (MR), the ability to preserve or restore integrity, has been proposed as a resource to mitigate the detrimental effects of MI among HCWs. Objectives: The objectives of this study were to investigate the prevalence of MI among HCWs, to identify the relationship among factors that predict MI, and to determine whether MR can act as buffer against it. Design: Web-based exploratory survey. Setting/Subjects: HCWs from a research network in the U.S. mid-Atlantic region. Measurements: Survey items included: our outcome, Moral Injury Symptoms Scale–Health Professional (MISS-HP), and predictors including demographics, items derived from the Rushton Moral Resilience Scale (RMRS), and ethical concerns index (ECI). Results: Sixty-five percent of 595 respondents provided COVID-19 care. The overall prevalence of clinically significant MI in HCWs was 32.4%; nurses reporting the highest occurrence. Higher scores on each of the ECI items were significantly positively associated with higher MI symptoms (p < 0.05). MI among HCWs was significantly related to the following: MR score, ECI score, religious affiliation, and having ≥20 years in their profession. MR was a moderator of the effect of years of experience on MI. Conclusions: HCWs are experiencing MI during the pandemic. MR offers a promising individual resource to buffer the detrimental impact of MI. Further research is needed to understand how to cultivate MR, reduce ECI, and understand other systems level factors to prevent MI symptoms in U.S. HCWs. [ABSTRACT FROM AUTHOR]

Purpose: Seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a cohort of health care workers (HCWs) in our tertiary health care set-up and determine the association of seroconversion with demographic characteristics, level of exposure, job responsibilities, and clinical symptoms of HCWs exposed to COVID-19 patients. Method: An observational cross-sectional epidemiological study was conducted in the Department of Microbiology, ESI-Postgraduate Institute of Medical Science and Research (PGIMSR), Kolkata. The study population was hospital staff who deliver care and services to patients Result: A total of 242 HCWs participated in this cross-sectional study. Among the study population, 161 (66.5%) were male, and 81 (33.5%) were females, and the median age was 43 years. Of all, 22.7% were physicians, 22.3% nurses, 15.7% lab technician. A total of 16 HCWs had reported having diabetes mellitus, 7 chronic lung diseases, and 4 cardiac diseases. Out of 242 participants, 30 (12.4%) HCWs were found to be anti-SARS-CoV-2 IgG antibody positive after 4 months of duty in COVID hospital. Seropositivity rate was more among the age group 18–44 years (76.7%) and doctors (33.3%) than other disciplines. Around 31.4% (76/242) of them had high-risk exposure with either COVID patients or samples, and 18.4% became seropositive. A total of 59.1% HCWs gave the history of known or suspected contact with COVID patients in the household, and 14.7% turned seropositive. A total of 84.8% of those participants, who attended in-house training on infection control practices, remained seronegative. Conclusion: In conclusion, the cross-sectional serology study in a tertiary care hospital in Kolkata revealed 30 (12.4%) HCWs had positive serology responses to SARS-CoV-2 out of 242 participants. Though there was an infection control policy and practice in the hospital to prevent the disease transmission, high-risk exposure and presence of comorbidities were definite risk factors for acquiring disease in our study. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has been declared a public health emergency of international concern, causing excessive anxiety among health care workers. Additionally, publication bias and low-quality publications have become widespread, which can result in the dissemination of unreliable information. A meta-analysis was performed for this study with the following two aims: (1) to examine the prevalence of anxiety among health care workers and determine whether it has increased owing to the COVID-19 pandemic and (2) to investigate whether there has been an increase in publication bias. Methods: All relevant studies published between 2015 and 2020 were searched in electronic databases (namely Web of Science, PubMed, Embase, PsycInfo, PsyArXiv, and medRxiv). The heterogeneity of the studies was assessed using the I 2 statistic. The effect size (prevalence rate of anxiety) and 95% CI for each study were also calculated. We used moderator analysis to test for the effect of the COVID-19 pandemic on health care workers' anxiety levels and to detect publication bias in COVID-19 studies. We assessed publication bias using funnel plots and Egger's regression. Results: A total of 122 studies with 118,025 participants met the inclusion criteria. Eighty-eight articles (75,066 participants) were related to COVID-19, 13 articles (9,222 participants) were unrelated to COVID-19 (i.e., articles related to other outbreaks, which were excluded), and 21 preprints (33,737 participants) were related to COVID-19. The pooled meta-analysis prevalence was 33.6% (95% CI [30.5-36.8]; 95% PI [6.5-76.3]). Moderator analysis revealed no significant differences between articles related to COVID-19 and those unrelated to COVID-19 (p = 0.824). Moreover, no significant differences were found between articles and preprints related to COVID-19 (p = 0.843). Significant heterogeneity was observed in each subgroup. An Egger's test revealed publication bias in both articles and preprints related to COVID-19 (p < 0.001). Conclusions: Determining whether the anxiety state of health care workers is altered by the COVID-19 pandemic is currently difficult. However, there is evidence that their anxiety levels may always be high, which suggests that more attention should be paid to their mental health. Furthermore, we found a substantial publication bias; however, the quality of the studies was relatively stable and reliable. [ABSTRACT FROM AUTHOR]

Background: The mRNA-based vaccine BNT162b2 of BioNTech/Pfizer has shown high efficacy against SARS-CoV-2 infection and a severe course of the COVID-19 disease. However, little is known about the long-term durability of the induced immune response resulting from the vaccination. Methods: In a longitudinal observational study in employees at a German hospital we compared the humoral and cellular immune response in 184 participants after two doses of the BioNTech/Pfizer vaccine (BNT162b2) with a mid-term follow-up after 9 months. Anti-SARS-CoV-2 binding antibodies were determined using both a quantitative and a semi-quantitative assay. For a qualitative assessment of the humoral immune response, we additionally measured neutralizing antibodies. Cellular immune response was evaluated by measuring Interferon-gamma release after stimulating blood-cells with SARS-CoV-2 specific peptides using a commercial assay. Results: In the first analysis, a 100% humoral response rate was described after two doses of BNT162b2 vaccine with a mean antibody ratio of 8.01 ± 1.00. 9 months after the second dose of BNT162b2, serological testing showed a significant decreased mean antibody ratio of 3.84 ± 1.69 (p < 0.001). Neutralizing antibodies were still detectable in 96% of all participants, showing an average binding inhibition value of 68.20% ± 18.87%. Older age (p < 0.001) and obesity (p = 0.01) had a negative effect on the antibody persistence. SARS-CoV-2 specific cellular immune response was proven in 75% of individuals (mean Interferon-gamma release: 579.68 mlU/ml ± 705.56 mlU/ml). Conclusion: Our data shows a declining immune response 9 months after the second dose of BNT162b2, supporting the potentially beneficial effect of booster vaccinations, the negative effect of obesity and age stresses the need of booster doses especially in these groups. [ABSTRACT FROM AUTHOR]

• 100% humoral response rate in participants after 2 doses of BNT162b2 vaccine. • No difference in antibody ratio after one dose BNT162b2 or Vaxzevria and previous PCR-confirmed infection. • Smoking showed a negative effect on the antibody response (p = 0.006) Following a year of development, several vaccines have been approved to contain the global COVID-19 pandemic. Real world comparative data on immune response following vaccination or natural infection are rare. We conducted a longitudinal observational study in employees at a secondary care hospital affected by the COVID-19 pandemic. Comparisons were made about the presence of anti-SARS-CoV-2 immunglobulin G (IgG) antibody ratio after natural infection, or vaccination with one or two doses of BioNTech/Pfizer (BNT162b2), or one dose of AstraZenca (Vaxzevria) vaccine. We found a 100% humoral response rate in participants after 2 doses of BNT162b2 vaccine. The antibody ratio in participants with one dose BNT162b2 and Vaxzevria did not differ significantly to those with previous PCR-confirmed infection, whereas this was significantly lower in comparison to two doses of BioNTech/Pfizer. We could not identify a correlation with previous comorbidities, obesity or age within this study. Smoking showed a negative effect on the antibody response (p = 0.006) Our data provide an overview about humoral immune response after natural SARS-CoV-2 infection or following vaccination, and supports the usage of booster vaccinations, especially in patients after a natural SARS-CoV-2 infection. [ABSTRACT FROM AUTHOR]

BACKGROUND: COVID-19 has caused a pandemic during 2019-2020 that has resulted in illnesses ranging from the usual flu to serious respiratory problems, even leading to mortality. Recent literature has suggested that the health (psychological) impact of quarantine is wide-ranging, substantial, and can be long-lasting. OBJECTIVES: The purpose of this study was to assess the mental health status (psychological distress) of those who experienced quarantine and their compliance with quarantine during the outbreak of COVID-19 among health care professionals. MATERIALS AND METHODS: The study included 217 health care staff (doctors and nurses) working in COVID-19 outpatient and wards, sent on quarantine at home or state-run facilities. The psychological impact was assessed using the Kessler Psychological Distress Scale (K10). Categorical data were presented as percentages (%), and the Chi-square test was used to determine the association, with a P < 0.05 considered statistically significant. RESULTS: Out of 217 participants, only 206 gave their consent to be part of the study, and only 10.2% (21/206) of quarantined subjects were compliant with all protective measures. It has a significant association with the participant's understanding of all the rationale for quarantine and with the Kessler Psychological Distress Scale (P < 0.05). The mean score obtained on Kessler Psychological Distress Scale (K10) subjects was 18.91 ± 5.16, whereas 63 subjects out of 206 (30.6%) had a score of 20 or more. CONCLUSION: Given the developing situation with the coronavirus, policymakers urgently need evidence synthesis to produce guidance for the public. Thus, the outcomes of this study will definitely help authorities, administrators, and policymakers to put quarantine measures in a better way. [ABSTRACT FROM AUTHOR]

Background: The health care workers'(HCWs) are working 24/7 in managing devastating pandemic Corona virus disease19(COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) as front liner which leads them to be at highest risk for contacting infection. In Bangladesh, being a lower middle-income country and densely populated, the burden is much more on HCWs. Methods: We did a cross-sectional study with an aim to identify the prevalence, risk factors, and outcomes of SARS-CoV-2 infection among the HCWs in a COVID-19 dedicated tertiary care hospital. Statistical analysis was done in SPSS version-26. Multivariate regression analysis was done to evaluate risk factors responsible for COVID-19 infection and the severity of the COVID-19 disease. We expressed odds ratio with 95% CI, and considered the p-value of <0.05 as significant in the two-tailed test. Results: A total of 864 HCWs had participated with mean age of 34.16 ± 6.77 and 426 (49.31%) males. Among them 143 (16.55%) were tested RT-PCR positive for SARS-COV-2. Bronchial asthma/COPD and Hypertension were the most common co-morbidities with 23 (16.08%) for each. About 102 (71.33%) of the RT-PCR positive HCWs became symptomatic. Fever, cough and myalgia were the most common symptoms 84(82.35%), 67(65.69%) and 52(50.98%) respectively. Multivariate regression analysis revealed hypertension, gout, and working in the COVID-19 confirmed ward had a significant odds ratio for getting infected with SARS-CoV-2 [95% CI, p-value 1.91 (1.08 - 3.41), 0.027; 5.85 (1.33 - 25.74), 0.020; and 1.83 (1.10 - 3.03), 0.019]. Bronchial asthma/COPD and gout found to be risk factors for moderate to severe COVID-19 disease [95% CI, p-value 3.04 (1.01 - 9.21), 0.049 and 23.38 (3.42 - 159.72), 0.001]. Hospitalization rate was 12(85.7%), and 3(100%) and median hospital stays were 11 (5.5 - 15), and 20 (7 - 30) days for moderate and severe diseases respectively. Outcome was uneventful without any ICU admission and death. Conclusion: HCWs working in the COVID-19 confirmed ward are at increased risk of infection with SARS-COV-2. Some co-morbidities like hypertension and gout are important risk factors for contacting SARS-COV-2 infection. Bronchial asthma/COPD and gout favors disease severity. [ABSTRACT FROM AUTHOR]

Background: The present study aimed to investigate the one-year prevalence of SARSCoV- 2, common comorbidities and demographic information among negative- and positive rRT-PCR in health care workers (HCW), hospitalized and outpatients. Also, the association between SARS-CoV-2 cycle threshold (Ct) and the outcomes of patients were analyzed in Babol, northern Iran. Methods: This large retrospective cross-sectional study was performed between March 2020 and March 2021. The records of 19232 hospitalized, outpatients and HCW suspected to COVID-19 were collected from teaching hospitals in the North of Iran. Results: Out of the 19232 suspected to COVID-19 patients, 7251 (37.7%) had a positive rRT-PCR result; 652 (9%), 4599 (63.4%) and 2000 (27.6%) of those were categorized as HCW, hospitalized and outpatients, respectively. Moreover, between the hospitalized and the outpatient group, 10.2 and 0.8% cases died, whereas no death cases were reported in the HCW. Furthermore, it seems that death rate was significantly different between the three groups of Ct value, the highest mortality in those with Ct between 21 and 30 (group B=7.6%) and the lowest in the group with the highest Ct (between 31 and 40 = 5.5%) (p<0.001). Conclusion: In summary, 37.7% of cases were positive for SARS-CoV-2; of which, 63.4, 27.6 and 9% were hospitalized, outpatients and HCW, respectively. With regard to the mortality rate in hospitalized patients and the significant association with Ct under 20 and 30, it seems that the early detection and the initial quantification of SARS-CoV-2 in the first week of the conflict and therapeutic considerations to reduce the relative load can reduce the mortality rate. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B virus (HBV) infection is a serious public health issue around the world. Health care workers (HCWs) are at high risk of HBV infection because they have direct contact with HBV infected blood and body fluids in their work. Objective: The purpose of this study was to evaluate the knowledge, attitude, and practice (KAP) of HCWs towards hepatitis B infection in Kabul, Afghanistan. Methods: This cross-sectional study was conducted on 502 HCWs, between November 2018 and January 2019 by a simple random sampling method. The data was collected through a self-administered structured questionnaire. Using this questionnaire, demographic characteristics and KAP of HCWs was assessed. In addition, descriptive and inferential analyses was conducted on the collected data using SPSS 16 (SPSS Inc., Chicago, IL, USA). Results: The overall KAP scores of HCWs were found to be 86.58%, 34.73%, and 61.22%, respectively. Most of the participants correctly recognized the HBV infection. Among the participants, only 77.45% had undergone screening for HBV, and 56.37% had received HBV vaccine (p < 0.0001). Moreover, only 6.77% had completed the three doses of vaccination for HBV. Among the HCWs, the group with higher education level had better knowledge than the group with lower education level. However, the attitude of most of the participants towards HBV prevention was found to be inadequate (53.98%). Conclusion: This study shows that HCWs in Kabul, Afghanistan are at high risk of HBV infection due to low vaccination coverage and inadequate infection control. Therefore, we strongly encourage providing an accessible and compulsory vaccination program for all HCWs to improve their attitude and awareness towards HBV infection and to achieve effective infection control. [ABSTRACT FROM AUTHOR]

Background: Health care workers are often affected by burnout, resulting in reduced personal well-being and professional functioning. Although emotional exhaustion is considered a core component of burnout, little is known about the dynamics of emotions and their relation to burnout. We used network analysis to investigate the correlation between the density of a negative emotion network, a marker for emotional rigidity in person-specific networks, and burnout severity. Methods: Using an ecological momentary assessment design, the intensity of negative emotions of forty-three health care workers and medical students was assessed five times per day (between 6 am and 8 pm) for 17 days. Burnout symptoms were assessed at the end of the study period with the Maslach Burnout Inventory. Multilevel vector autoregressive models were computed to calculate network density of subject-specific temporal networks. The one-sided correlation between network density and burnout severity was assessed. The study protocol and analytic plan were registered prior to the data collection. Results: We found a medium-sized correlation between the negative emotion network density and burnout severity at the end of the study period r(45) =.32, 95% CI =.09–1.0, p =.014). Conclusions: The strength of the temporal interplay of negative emotions is associated with burnout, highlighting the importance of emotions and emotional exhaustion in reaction to occupational-related distress in health care workers. Moreover, our findings align with previous investigations of emotion network density and impaired psychological functioning, demonstrating the utility of conceptualizing the dynamics of emotions as a network. [ABSTRACT FROM AUTHOR]