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We assessed depression, anxiety, and stress in healthcare workers (HCWs) in 2023 and the evolution of depression in 2023 compared with 2022. In September–November 2023, 181 HCWs from the Infectious Diseases Hospital, Cluj-Napoca, Romania, completed the Depression, Anxiety, and Stress 21 Scale (DASS-21 R), the Patient Health Questionnaire 9 (PHQ-9), and the Hamilton Anxiety Rating Scale (HAM-A). The prevalence of moderate-to-severe levels was 13.8% for DASS-Depression, 18.8% for DASS-Anxiety, 16.1% for DASS-Stress, 19.9% for PHQ-9, and 18.2% for HAM-A. Moderate-to-severe PHQ-9 depression was significantly lower in the 2023 study group (19.9%, N = 181) compared with 2022 (30.6%, N = 114) (p = 0.04), also within the 2022–2023 follow-up participants (N = 88) (p = 0.03). We did not find significant statistical differences between those infected vs. non-infected, vaccinated vs. non-vaccinated, or working with vs. not working with SARS-CoV-2 infected patients. Males were significantly more stressed (p = 0.02) and anxious (p = 0.03), and physicians in training had the highest prevalence of moderate-to-severe depression (31.6%), followed by physicians (25.6%). In 2023, depression, anxiety, and stress symptoms decreased but remained within a concerning range. By addressing these psychological issues, we may reduce the possibility of medical errors and prevent professional crises in the healthcare system.

Abstract Introduction Child and adolescent mental health is a global priority. In sub-Saharan Africa, despite the high burden, there is a gap in health services for children and adolescents with mental health disorders. To bridge this gap, healthcare workers require a good understanding of child and adolescent mental health, the right attitude, and practices geared to improving child and adolescent mental health. This scoping review examined the knowledge, attitudes, and practices related to child and adolescent mental health among sub-Saharan African healthcare workers. Methods The search was restricted between January 2010, the year when the Mental Health Gap Action Programme guidelines were launched, and April 2024. The review followed the methodological framework proposed by Arksey and O’Malley for conducting scoping reviews. The databases searched included CINHAL, PubMed, Web of Science, PsycINFO, and grey literature databases. Additional articles were identified through cited references of the studies included. A data extraction template was used to retrieve relevant text. A narrative synthesis approach was adopted to explore the relationships within and between the included studies. Results The literature search yielded 4658 studies. Among these, 817 were identified as duplicates, and 3740 were excluded after screening. Only twenty-one articles met the criteria for inclusion in the review. The findings showed that healthcare workers have insufficient knowledge of child and adolescent mental health, hold negative attitudes toward children and adolescents with mental health problems, and exhibit poor practices related to child and adolescent mental health. Conclusion It is crucial to build capacity and improve healthcare workers’ practices, knowledge, and attitudes toward child and adolescent mental health in sub-Saharan Africa. This could lead to better access to mental health services for children and adolescents in the region.

Abstract Background The detrimental mental health effects which emerged from COVID-19 have profoundly affected healthcare workers (HCWs) worldwide. The aim of this study was to investigate the mediating effects of traumatic stress and loneliness on the fears of contracting and dying from COVID-19, and anxiety and depression of HCWs during the pandemic. Methods A cross-sectional online survey was completed by HCWs in a province of Turkey. The Hospital Anxiety Depression Scale, Impact of Events Scale-Revised and numerical rating scales (for fears of COVID-19 and loneliness) were used and a bootstrap approach was used in the analyses with SPSS PROCESS macro software. Results Of the HCWs evaluated, 150 (34.4%) were doctors, with a mean duration of work experience of 10.6 ± 7.5 years. The results indicated that fear of contracting COVID-19 was directly related to anxiety (β = 0.244, p

Abstract Background Healthcare Workers (HCWs) are susceptible to hepatitis B virus (HBV) infection and are advised to receive vaccination. However, vaccination rates remain low in developing countries. There is little data concerning Hepatitis B (HepB) vaccination and information regarding HBV knowledge among HCWs in Cambodia. This study aimed to evaluate the knowledge of HBV infection, HepB vaccine, and vaccination status with its associated factors among HCWs in Cambodia. Methods A Cross-sectional study was conducted among HCWs in Kampot and Kep Provinces, Cambodia, from September to October 2023 using a questionnaire survey. A total of 261 HCWs were recruited from 1,309 individuals working in all 83 health facilities using systematic random sampling methods. Statistical analyses including the χ2-test and multivariate logistic regression were conducted to identify factors associated with vaccination among the participants. Results Among 259 participants, 62.9% showed good knowledge of HBV infection, and 65.6% demonstrated good knowledge of the HepB vaccine. 59.8% of the participants had received the HepB vaccine, while 40.2% remained unvaccinated. Analysis showed that HCWs working at Provincial Health Department/Operational Districts and Provincial Referral Hospital/Referral Hospitals were more likely to be vaccinated compared to those at Health Centers [AOR = 6.5; CI = 1.1–39.5, p = 0.0403; AOR = 2.8, CI = 1.0–7.8, p = 0.0412], respectively. Furthermore, individuals with good knowledge of the HBV infection and vaccine were more likely to receive the vaccine compared to those with inadequate knowledge [AOR = 6.3; CI = 3.3–12.3, p

As the COVID-19 global vaccination campaign was launched in December of 2020, vaccination became mandatory for many healthcare workers (HCWs) worldwide. Large minorities resisted the policy, and the responses of authorities to this resistance led to damaged professional reputations, job losses, and suspension or termination of practice licenses. The joint effect of dismissals, early retirements, career changes, and vaccine injuries disabling some compliant HCWs from adequate performance has exacerbated existing crises within health systems. Nevertheless, leading health authorities have maintained that the benefits of a fully vaccinated healthcare labor force—believed to be protecting health systems, vulnerable patient populations, and even HCWs themselves—achieved through mandates, if necessary, outweigh its potential harms. Informed by critical policy and discourse traditions, we examine the expert literature on vaccine mandates for HCWs. We find that this literature neglects evidence that contradicts official claims about the safety and effectiveness of COVID-19 vaccines, dismisses the science supporting the contextual nature of microbial virulence, miscalculates patient and system-level harms of vaccination policies, and ignores or legitimizes the coercive elements built into their design. We discuss the implications of our findings for the sustainability of health systems, for patient care, and for the well-being of HCWs, and suggest directions for ethical clinical and policy practice.

Objectives The study aimed to assess the mental health and well-being of Lithuanian healthcare workers by gathering demographic information, identifying common stressors affecting the work environment, evaluating mental health, and exploring directions for psychosocial care. Additionally, the research explored the prevalence of considering a career change among respondents. Material and Methods The study included 1618 responders who completed an online survey in December 2021 – January 2022. Participants included in this study: physicians, nurses, residents and other healthcare workers. It evaluated their demographics, most common stressors affecting their work environment and mental health on the Depression, Anxiety and Stress Scale – 21 (DASS-21) scale. Lastly, all responders asked if they had considered changing their occupation to a non-medical job. Univariate analysis was performed using χ2 and Student’s t test, and binary logistic regression evaluated career change predictors. Results Career change was considered by 1081 (66.8%) responders. The main career change predictors were poor working conditions (OR 1.91, p < 0.001), direct contact with patients (OR 1.84, p < 0.001), lack of career perspectives (OR 1.95, p < 0.001), mobbing (OR 1.67, p = 0.001) and exhaustion (OR 1.51, p = 0.005). After evaluating DASS-21 scores, it was found that 23% of respondents had severe and extremely severe depression symptoms, 27.4% severe and extremely severe anxiety, and 21.4% had severe and extremely severe stress levels. Conclusions Lithuanian healthcare workers are in high distress and have poor mental health. They are in need psychosocial assistance to avoid burnout and staff loss. Int J Occup Med Environ Health. 2024;37(3):287–99

Aims: Health indicators provide up-to-date information on the health status of a population. This study aimed to classify the Organization for Economic Co-operation and Development (OECD) countries according to health indicators and assess their status. Methods: The dataset was obtained from the OECD and World Bank databases. The most recent data from 2018 to 2022 were used. The dataset included the number of hospital beds, computed tomography scanners, magnetic resonance imaging (MRI) units, mammography machines, and radiotherapy machines as indicators of health equipment and the number of doctors, nurses, medical graduates, and nursing graduates as indicators of healthcare workers. The classification was performed using latent profile analysis (LPA). Estimated classes were compared using ANOVA or the Kruskal-Wallis test. Results: Three distinct classes were obtained from the models constructed with LPA (Akaike information criteria: 1674.91, Bayesian information criteria: 1726.87, Lo-Mendell-Rubin adjusted likelihood ratio test: p

Abstract Background Evidence-based medicine (EBM) is the combination of the best research evidence with our clinical expertise, specific situations, and the unique values of our patients. It is essential to evaluate the effectiveness of EBM training for healthcare workers (HCWs). Objectives This study aims to assess the impact of EBM training on HCWs’ knowledge, attitude, and practice (KAP) related to EBM. Methods A self-reported online survey was carried out to investigate KAP related to EBM among HCWs at a tertiary hospital in Taizhou, China. HCWs participated in EBM training on 9 and 10 September 2023. The questionnaire survey was conducted to understand KAP related to EBM before and after the training, and to compare and analyze the results before and after the training. The R software (version 4.1.0) was used to analyze data. Results Sixty-four HCWs completed the survey with a response rate of 52.5% (64/122). The overall average scores of KAP related to EBM before training were 55.3, 63.0, and 34.5, respectively, and 56.9, 66.5, and 34.7 were the scores of KAP after training. HCWs’ scores of knowledge (P = 0.033) and attitude (P

Background: Effort–reward imbalance (ERI) refers to the situation where there is a mismatch between the effort that healthcare workers (HCWs) put into their work and the rewards they receive in return. Burnout, on the other hand, is a psychological syndrome characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment. This study aimed to assess the impact of ERI and burnout on the compliance with standard precautions (SPs) among nurses and midwives in Lebanese hospitals under the economic crisis and after the COVID-19 pandemic. Methods: Cross-sectional correlational study, based on self-administered questionnaire data, measuring the compliance with SPs, ERI, and burnout, in addition to the relationship between these factors, was performed among 409 nurses and midwives, working in Lebanese hospitals. Results: ERI was significantly associated with exposure to burnout among nurses and midwives, and burnout was found to be a significant predictor of nurses and midwives’ self-reported adherence with SPs. Conclusions: This study highlights the contribution of ERI and burnout to the chain of infection by decreased adherence to infection control SPs of nurses and midwives.

Abstract Background As an emerging infectious disease with a heterogenous and uncertain transmission pattern, coronavirus disease 2019 (COVID-19) has created a catastrophe in healthcare-associated infections (HAIs) and posed a significant challenge to infection control practices (ICPs) in healthcare settings. While the unique characteristics of psychiatric patients and clinical settings may make the implementation of ICPs difficult, evidence is lacking for compliance with ICPs among healthcare workers (HCWs) in a psychiatric setting during the COVID-19 pandemic. Methods A cross-sectional multi-method study based on participant unobtrusive observation coupled with the completion of a self-administered ICP survey was conducted to assess compliance with ICPs among HCWs in a psychiatric inpatient ward in a regional hospital. An online checklist, called eRub, was used to record the performance of HCWs in hand hygiene (HH) and other essential ICPs. Furthermore, a well-validated questionnaire (i.e., Compliance with Standard Precautions Scale, CSPS) was used to collect the participants’ self-reported ICP compliance for later comparison. Results A total of 2,670 ICP opportunities were observed from January to April 2020. The overall compliance rate was 42.6%. HCWs exhibited satisfactory compliance to the wearing of mask (91.2%) and the handling of clinical waste (87.5%); suboptimal compliance to the handling of sharp objects (67.7%) and linen (72.7%); and poor compliance to HH (3.3%), use of gloves (40.9%), use of personal protective equipment (20%), and disinfection of used surface/area (0.4%). The compliance rates of the nurses and support staff to HH were significantly different (χ2 = 123.25, p

Abstract Background In the initial phase of the SARS-CoV-2 pandemic, masking has been widely accepted in healthcare institutions to mitigate the risk of healthcare-associated infection. Evidence, however, is still scant and the role of masks in preventing healthcare-associated SARS-CoV-2 acquisition remains unclear.We investigated the association of variation in institutional mask policies with healthcare-associated SARS-CoV-2 infections in acute care hospitals in Switzerland during the BA.4/5 2022 wave. Methods SARS-CoV-2 infections in hospitalized patients between June 1 and September 5, 2022, were obtained from the “Hospital-based surveillance of COVID-19 in Switzerland”-database and classified as healthcare- or community-associated based on time of disease onset. Institutions provided information regarding institutional masking policies for healthcare workers and other prevention policies. The percentage of healthcare-associated SARS-CoV-2 infections was calculated per institution and per type of mask policy. The association of healthcare-associated SARS-CoV-2 infections with mask policies was tested using a negative binominal mixed-effect model. Results We included 2’980 SARS-CoV-2 infections from 13 institutions, 444 (15%) were classified as healthcare-associated. Between June 20 and June 30, 2022, six (46%) institutions switched to a more stringent mask policy. The percentage of healthcare-associated infections subsequently declined in institutions with policy switch but not in the others. In particular, the switch from situative masking (standard precautions) to general masking of HCW in contact with patients was followed by a strong reduction of healthcare-associated infections (rate ratio 0.39, 95% CI 0.30–0.49). In contrast, when compared across hospitals, the percentage of health-care associated infections was not related to mask policies. Conclusions Our findings suggest switching to a more stringent mask policy may be beneficial during increases of healthcare-associated SARS-CoV-2 infections at an institutional level.

Infection prevention and control (IPC) standards have a unique role in controlling infection transmission. In Saudi Arabia, every healthcare facility is required to establish an IPC program to identify and reduce the risk of infection acquisition and transmission. This study aimed to estimate adherence to IPC measures after the COVID-19 pandemic among healthcare workers (HCWs) in Najran City, Saudi Arabia. This cross-sectional study was conducted among HCWs in Najran City during the period of May to August 2023. A self-administered questionnaire was given to HCWs consisting of three parts: demographic data, profile of healthcare facility and healthcare professional regarding infection control, and questionnaire to assess the adherence of HCWs regarding infection control measures. The study recruited 580 HCWs, of whom 57.6% were males, and 46.6% were aged between 31 and 40 years. The overall mean adherence score was 103.2±9.71 out of 150 points. Accordingly, 88.4% were classified as having moderate adherence, 10.2% were good, and only 1.4% were classified as having poor adherence. Some of the factors associated with increased adherence to IPC measures, include being female, being a nurse, being a practitioner, working in the hospital emergency department, and having a recognized antimicrobial stewardship program team/unit at a healthcare facility. There was satisfactory adherence among HCWs regarding infection prevention and control measures. Being a female, a nurse, a practitioner, working in a hospital emergency department, being a staff of a non-MOH (Ministry of Health) hospital, and having a recognized antimicrobial stewardship program team/unit were identified as significant predictors of increased adherence. IPC measures can be optimized by setting up institutional IPC teams, necessary PPE, and periodic provision of IPC training.

Shira Ramot,1 Orna Tal1– 3 1Department of Management, Health Systems Management Program, Bar Ilan University, Ramat Gan, Israel; 2Shamir Medical Center (Assaf Harofeh), Zerifin, Israel; 3ICET - Israeli Center for Emerging Technologies, Zerifin, IsraelCorrespondence: Shira Ramot, Email ramotsh@gmail.comBackground and Objective: While there is a substantial amount of research on risk perception, there has been less focus on the way medical technologies are perceived by experts as opposed to lay individuals. We investigated the factors that may influence the risk perception of healthcare workers (HCWs) and the general public regarding 3 distinct medical technologies: magnetic resonance imaging (MRI), laser-assisted in situ keratomileusis (LASIK) and the Covid-19 vaccine.Methods: A cross-sectional study conducted in 2021 among 2 populations: HCWs employed at a general public hospital and a sample of outpatients and individuals who are not medical professionals. The participants completed an electronic questionnaire.Results: In total, 739 respondents were included: 197 HCWs (26.7%) and 542 members of the public (73.3%). Most of the respondents (89.4%) reported being vaccinated against Covid-19, 43.8% had previously undergone an MRI but 90% had not undergone LASIK. Overall, all 3 technologies assessed in the study were rated by the respondents as having a high benefit and low risk. HCWs and the public showed statistically significant differences in perceived risk towards MRI and LASIK, as well as in some of the risk perception characteristics of each technology. In contrast, no differences in risk perception towards the Covid-19 vaccine were found between HCWs and the public. Both study populations showed a significant negative correlation between trust in the MoH and the perceived risk towards MRI and the Covid-19 vaccine. Both study populations regarded information provided by medical sources as the most reliable for decision-making.Conclusion: The perceptions and concerns towards medical technologies influence individuals’ behavior and acceptance of technologies. They are also essential for risk communication. The study contributes to the understanding of attitudes towards various medical technologies, including risk perception, risk characteristics, trust and sources of information pertaining to each of the technologies, by examining the differences between HCWs and the general public.Keywords: healthcare workers, medical technologies, risk perception. trust, information source

Introduction: During the Coronavirus Disease 2019 (COVID-19) pandemic in India, two vaccinees were predominantly administered to prevent the spread of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The first vaccine introduced in India was ChAdOx1-nCOV (Covishield), followed by BBV-152 (Covaxin). In the first phase, Healthcare Workers (HCW) were prioritised for vaccination, given their crucial role in the healthcare system. Aim: To assess the antibody response post Covishield vaccination at specific time intervals in HCWs and to determine the correlation of antibody response with age, gender, co-morbidities and blood group. Materials and Methods: This prospective study was conducted at Dr. Balasaheb Vikhe Patil Rural Medical College, Pravara Institute of Medical Sciences, Loni, Maharashtra, India, over a duration of six months from January 2021 to June 2021. A total of 110 vaccinated HCWs who volunteered were included in this study. SARS-CoV-2 antibodies at specific time intervals were assessed using Ortho Clinical Diagnostic’s VITROS 3600 based on the principle of Chemiluminescent Immunosorbent Assay (CLIA). Assessment of anti-SARS-CoV-2 total and IgG antibodies was performed at 15 days, one month, one and a half months, two months, three months, and four months postfirst dose of vaccination, or in other words, 15 days and one month after the 1st dose, and 15 days, one month, two months, and three months post second dose of vaccination. For analysis, Pearson’s correlation and a regression model were performed using GraphPad Prism 8.0.2 version. Results: Fifteen days post second dose, 110 HCWs (100%) and 109 (99.09%) HCWs turned seropositive for total antibodies and IgG antibodies, respectively. It was observed that the majority of participants (33, 30.27%) with peak IgG levels in the medium range were from the age group of 31-40 years. Overall, there was a negative correlation between age and IgG antibody levels for peak IgG values (r-value=-0.224, p-value=0.019). The peak values were achieved in the majority of participants 15 days post second dose (53.6%). The difference in antibody levels based on gender was not significant (Chi-square value=3.387, p-value=0.184). No significant difference in SARS-CoV-2 IgG levels was observed between participants with co-morbidities and those without co-morbidities. Participants who developed SARS-CoV-2 infection during the study period exhibited robust antibody responses after vaccination. Conclusion: These findings help elucidate Covishield vaccine-specific antibody responses in vaccinees of different age groups, genders, blood groups, and with co-morbid conditions. The vaccine has substantially reduced the burden of disease by preventing serious illness in vaccinated HCWs during the second wave of the COVID-19 pandemic.

Healthcare-associated infections present a challenge to healthcare systems, particularly critical care units. Hand hygiene emerges as a crucial element in infection control, acting as a vital link between healthcare workers, patients, and pathogens. Positive attitudes, motivated by a genuine concern for patient safety, are recognized as major predictors of hand hygiene compliance among healthcare workers. This study aims to assess the attitudes of ICU staff toward hand hygiene and identify factors that influence these attitudes. A cross-sectional survey of intensive care unit staff in seven large Saudi hospitals was conducted using an anonymous, self-reporting questionnaire to examine the attitudes of ICU personnel about hand hygiene and determine the factors that impact these attitudes. A regression analysis was used to determine the determinants of hand hygiene attitudes. Of the 600 respondents, 93% rated their hand hygiene knowledge as good, and 71% received hand hygiene training from their hospital. Most respondents (78%) had previously experienced healthcare-associated infections. The majority reported a favorable overall attitude toward hand hygiene (M = 4.15, SD = 0.85). Attitudes toward hand hygiene were significantly associated with perceived knowledge (β = 0.32, p < 0.001), prior hand hygiene training (β = 0.13, p < 0.05), and years of experience (β = − 0.10, p < 0.05). Healthcare workers in the ICU have a generally positive attitude toward hand hygiene. Such attitudes were correlated with hand hygiene knowledge, prior training, and job experience. The study’s findings can help to inform health promotion initiatives and campaigns aimed at achieving long-term improvements in hand hygiene behaviors. [ABSTRACT FROM AUTHOR]

Background: Hospital infections with SARS-CoV-2 continued during the initial waves of the pandemic worldwide. So far, Data on the dynamics of these infections and the economic burden of outbreaks are rare. Methods: We retrospectively analysed SARS-CoV-2 infections in patients, hospital employees and nosocomial infections resulting in outbreaks in two hospitals of a secondary care hospital network in Germany during the initial 3 pandemic waves (03/2020–06/2021). In addition to hospital infections, we evaluated infection prevention strategies and the economic burden of hospital outbreaks. Results: A total of 396 patients with SARS-CoV-2 infection were hospitalized in both hospitals. The risk factors for severe disease and death increased with age, male sex and a CRB-65 score > 0. The most frequent symptom was dyspnoea (30.1%). Sixty-five patients died, most of whom were in the 2nd wave. A total of 182 (12.5%) hospital employees were infected, 63 (34.6%) of whom were involved in outbreaks. An occupational risk of infection during outbreaks was particularly common among nurses and HCWs working on regular wards. Eleven hospital outbreaks led to high economic impact on both hospitals through the loss of manpower as result of infected employees, temporary locked wards, blocked beds, a reduced number of total hospitalized patients and increased personnel costs. Conclusion: Continuously adaptation of infection prevention strategies is a valuable tool to keep hospitals safe places for patients and employees. We do need more analyses of the different pandemic waves and applied infection prevention strategies to learn from weak points. Trial registration: This research was conducted in accordance with the Declaration of Helsinki and national standards. The study protocol was approved by the relevant ethics committee of the Chamber of Physicians Westphalia-Lippe and University of Münster (no. 2021–475-f-S). The study was registered on 25th August 2021 at the German Clinical Trials Register (DRKS00025865). [ABSTRACT FROM AUTHOR]

Background: China has made remarkable achievements in tuberculosis (TB) prevention and control, but it still takes long way to achieve the End TB goal especially in underdeveloped Southwest China. TB healthcare workers (HCWs) are core forces in TB prevention and control but often face job burnout. This study aimed to explore the burden and associated factors of job burnout among TB HCWs in Southwest China. Methods: This cross-sectional study used both survey questionnaires and semi-structured interviews, to assess job burnout among TB HCWs based on Malasch Model and explore the associated factors based on Herzberg's two-factor theory (different hygiene and motivation factors). Quantitative data analysis adopts multiple linear regression to in SPSS 22.0, and qualitative data were analyzed through a framework approach. Results: A total of 1140 TB HCWs were included in questionnaire surveys. The overall job burnout rates of TB HCWs in Centers for Disease Control and Prevention (CDC), designated hospitals and Primary Health Care (PHC) sectors were 55%, 70.1% and 67.5%, respectively. TB HCWs in CDC who scored lower in interpersonal factors had a higher risk of depersonalization (DP) [B(95%CI): -0.89 (-1.71 to -0.80)]. TB HCWs in designated hospitals who scored lower in doctor-patient relationship factors [B (95%CI): 6.63 (-12.06 to -1.20)] were more likely to have emotional exhaustion (EE). TB HCWs who were less satisfied with training, supervision and assessment in PHC sectors [B(95%CI): 0.65 (0.03 to 1.26)] had less personal accomplishment (PA). Interviews with nine TB HCWs showed that poor environment could lead to high infection and heavy workload could lead to work pressure among TB HCWs in Chongqing. It is also found that performance assessment and management of TB HCWs, communication and cooperation and so on are related to job burnout. Conclusions: TB HCWs had different levels of job burnout in CDC, designated hospitals, and PHC sectors of Chongqing, which were affected by different hygiene and motivation factors. Governments, organizations and individuals should take cooperative measures such as strengthening communication to deal with job burnout among TB HCWs. [ABSTRACT FROM AUTHOR]

In addition to having some of the worst health outcomes in the region, Haiti faces a political and economic crisis. The most recent humanitarian crisis includes an increase in homicides and kidnappings in the capital Port-au-Prince. This study is a cross-sectional, mixed methods online survey of health workers and medical students in Port-au-Prince from May 20 – September 15, 2023. It provides evidence of the kidnapping risk healthcare workers face and shares the perspective of a medical community operating in a challenging context to provide a continuity of care under the threat of violence. The survey of Haitian health workers and students show a significant risk of kidnapping with 44% of respondents reporting that they had a colleague kidnapped in the previous 2 years. 5 of the 249 respondents had been kidnapped and all were young, female health workers. 74% of health workers and students surveyed reported they plan to continue their profession abroad. Although teletraining was viewed as a positive opportunity to continue training cadres of medical professionals, health workers shared numerous limitations present for the expansion of telemedicine in the Haitian context. In addition to describing the experience of the Haitian healthcare professional during this crisis and documenting barriers to teletraining and telemedicine, this survey documents design considerations for mobile phone surveys with healthcare providers working in areas affected by conflict. [ABSTRACT FROM AUTHOR]

Background: Psychological resilience facilitates adaptation in stressful environments and is an important personal characteristic that enables workers to navigate occupational challenges. Few studies have evaluated the factors associated with psychological resilience in healthcare workers. Objectives: To determine the prevalence and factors associated with psychological resilience in a group of South African medical doctors and ambulance personnel. Materials and methods: This analytical cross-sectional study used secondary data obtained from two studies conducted among healthcare workers in 2019 and 2022. Self-reported factors associated with resilience, as measured by the Connor-Davidson Resilience Scale-10 (CD-RISC-10), were evaluated. R statistical software was used for analysing the data and performing statistical tests. Results: A total of 647 healthcare workers were included in the study, of which 259 were doctors and 388 were ambulance personnel. Resilience scores were low overall (27.6 ± 6.6) but higher for ambulance personnel (28.0 ± 6.9) than for doctors (27.1 ± 6.0) (p = 0.006). Female gender (OR 1.94, 95%CI 1.03–3.72, p = 0.043), job category (OR 6.94 95%CI 1.22–60.50, p = 0.044) and overtime work (OR 13.88, 95%CI 1.61–368.00, p = 0.044) significantly increased the odds of low resilience for doctors. Conversely, salary (OR 0.13, 95%CI 0.02–0.64, p = 0.024) and current smoking status (OR 0.16, 95%CI 0.02–0.66, p = 0.027) significantly reduced the odds of low resilience amongst doctors. In addition, only previous alcohol use significantly reduced the odds of low resilience for ambulance personnel (OR 0.44, 95%CI 0.20–0.94, p = 0.038) and overall sample (OR 0.52, 95%CI 0.29–0.91, p = 0.024). Conclusions: Resilience was relatively low in this group of South African healthcare workers. The strong association between low resilience and individual and workplace factors provides avenues for early intervention and building resilience among healthcare workers. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study is to compare the efficacy of mind–body practices (MBPs) and multiple psychological methods, and identify the optimal method for relieving work-related stress among healthcare workers (HCWs) by network meta-analysis (NMA). Methods: We applied six electronic databases, namely PubMed, Web of Science, Embase, PsycINFO, Cochrane, and Chinese National Knowledge Infrastructure to identify relevant RCTs from inception to September 16, 2023, and implemented a search strategy based on the PICOS principles. Data selection, extraction, and analysis of bias were carried out independently and in duplicate by separate researchers. State 16.0 was used to conduct NMA for comparing the effectiveness of various therapies. Results: We identified 23 studies including MBPs and three different psychological therapies, namely mindfulness-related therapy (MRT), psychoeducational therapy (PT), and comprehensive therapy (CT), which were divided into eleven specific techniques, namely yoga, meditation techniques (MT), Qigong, muscle relaxation(MR), biofeedback therapy (BT), mindfulness-based interventions (MBIs), modified mindfulness-based stress reduction (MBSR-M), mindfulness-based interventions combined with others (MBIs-C), mindfulness-based awareness(MBA), PT and CT. Our NMA results of MBPs and three psychological therapies showed MBPs (SMD = -0.90, CrI:-1.26, -0.05, SUCRA = 99%) were effective for occupational stress in HCWs, followed by MRT(SMD = -0.48, CrI:-0.87, -0.08, SUCRA = 66.5%). NMA results of eleven specific techniques showed yoga (SMD = 1.36, CrI:0.91, 1.81, SUCRA = 97.5%) was the most effective technique in relieving the stress of HCWs, followed by MR (SMD = 1.36, CrI:0.91, 1.81, SUCRA = 87.3%). Conclusions: Our study suggested MBPs may be the most effective intervention to improve the occupational stress of HCWs. Furthermore, yoga is likely to be the most optimal of MBPs. Hospital managers should attach importance to yoga in addressing occupational stress among medical workers. Key Points: • Previous studies have identified that various psychological methods can improve the occupational stress of healthcare workers (HCWs). Mind-body practices (MBPs) integrating physical exercise with mind-based practice have been proven to be a clear strategy to relieve stress and facilitate adaptation to extreme environments for HCWs in recent years. However, few studies have compared the efficacy of MBPs with that of psychological methods. In addition, it is unclear which specific method is optimal for stress reduction among HCWs. • Network meta-analysis (NMA) can provide complete insights into the clinical efficacy of different methods and is regarded as the highest level of evidence in the intervention guidelines. Thus, this study aims to compare the efficacy of MBPs and psychological interventions and identify the optimal method for relieving work-related stress in HCWs using NMA. • Our NMA indicates MBPs are more effective than other psychological interventions for occupational stress among HCWs. The best intervention among MBPs is yoga, followed by MR. Therefore, hospital managers should attach importance to yoga in workplace wellness programs. Researches targeting suitable yoga training plan for medical workers need to be explored. [ABSTRACT FROM AUTHOR]

Introduction: In the COVID-19 era, burnout is a major occupational hazard among healthcare workers. This scoping review intended to investigate the pertinent literature concerning COVID-19 burnout among healthcare workers (HCWs) and the measures to prevent and reduce HCW burnout during the COVID-19 pandemic. Methods: The databases CINAHL, PubMed, ScienceDirect, and Scopus were systematically searched and screened for relevant papers. Additionally, manual searching was employed to supplement the electronic database results. The researchers examined 21 publications to answer the research question, "What have been the measures to prevent and reduce healthcare worker burnout during the COVID-19 pandemic?" The PRISMA 2020 checklist was used to guide the reporting of this scoping review. Results: It was found that to diminish healthcare workers' burnout, it is vital to use multilevel, evidence-based approaches. These interventions may include increasing awareness of the risks and preparing for potential occupational stress and burnout; promoting mindfulness and self-care practices to enhance mental well-being; enhancing organizational policies and procedures to address burnout among healthcare workers; and ensuring the availability of optimal mental health services, including the use of digital technologies to address workplace stress and facilitate mental health interventions. Conclusion: The interventions to prevent and reduce HCW burnout during the COVID-19 pandemic include supporting HCWs individually, improving work environments, and addressing health system factors contributing to burnout complemented by interventions aimed at enhancing work culture. [ABSTRACT FROM AUTHOR]

Background: Children's health is a global public health priority and a determinant of development and sustainability. Its effective delivery and further improvements require constant and dedicated research on children, especially by child healthcare workers (HCWs). Studies have shown a high involvement of child HCWs from developed countries in child health research, with an under-representation from the global south in authorship and leadership in international collaborations. To our knowledge, there is very little literature on challenges faced by child HCWs in Malawi in conducting child health research. We sought to explore the lived experiences of child HCWs at Kamuzu Central Hospital (KCH) in Malawi by examining their perceptions of child health research and assessing the availability of child health research opportunities. Methods: From July 2023 to August 2023, we conducted five key informant interviews with purposively sampled policymakers and 20 in-depth interviews with child HCWs at KCH. The interviews were conducted in English, audio-recorded, and transcribed verbatim. We utilised interpretative phenomenological analysis by reviewing initial transcripts for familiarity, generating codes manually, and refining them into broader themes through comparisons and iterative processes. Results: The analysis revealed three main themes on perceptions of child HCWs at KCH in child health research. These are (i) perceived motivation and challenges for engaging in child health research, (ii) perceptions of resource availability and research opportunities at KCH, and (iii) perceptions of gaps in research training and participation among child HCWs. Conclusions: Our study has uncovered critical factors influencing the low participation of child HCWs in child health research at KCH. Lack of collaboration, limited financial opportunities, and non-research-based training were the key barriers to participation in child health research among child HCWs at KCH. We advocate for the inclusion of child HCWs at all stages of collaborative health research, transparency on funding opportunities for child health research, and inclusion of research in the training of HCWs. These initiatives can strengthen the participation of child HCWs in child health research and ultimately enhance child health outcomes in Malawi. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic deeply affected healthcare workers, although the impact may have differed according to different workplace contexts. The aim of this current research was to compare the psychopathology presented by hospital versus nursing home healthcare workers during the COVID-19 pandemic and to analyse the predictive role of purpose in life and moral courage in the appearance of psychopathology. This was an observational, cross-sectional study carried out on a sample of 108 healthcare workers, 54 each from a hospital or nursing homes, who were recruited during the 5 and 6th waves of the COVID-19 pandemic in Spain. Various self-reported scales were used to assess anxiety, depression, acute/post-traumatic stress disorder, drug and alcohol abuse, burnout, purpose in life, and moral courage. Compared to the hospital healthcare workers, nursing home healthcare workers had higher scores and a higher prevalence of anxiety (74.1% vs. 42%), depression (40.7% vs. 14.8%), and post-traumatic stress disorder (55.6% vs. 25.9). In the overall sample, purpose in life was a protective factor against psychopathology (OR = 0.54) and burnout (OR = 0.48); moral courage was a protective factor against depression (OR = 0.47) and acute stress (OR = 0.45); and exposure of family/friends to SARS-CoV-2 was a risk factor for acute stress (OR = 2.24), post-traumatic stress disorder (OR = 1.33), and higher burnout depersonalisation subscale scores (OR = 1.84). In conclusion, the increased presence of psychopathology in nursing home healthcare workers may be influenced by workplace and occupational contexts, personal factors such as exposure of family/friends to SARS-CoV-2, or internal dimensions such as purpose in life and moral courage. This knowledge could be useful for understanding how a future epidemic or pandemic might affect the mental health of healthcare workers in different labour contexts. [ABSTRACT FROM AUTHOR]

Background: Digital health technologies such as sensor systems are intended to support healthcare staff in providing adequate patient care. In the Department of Palliative Medicine (University Medical Center Freiburg), we developed and implemented a noninvasive, bed-based sensor system in a pilot study. The aim was to detect distress in patients who were no longer able to express themselves by monitoring heart and respiratory rates, vocalizations, and movement measurements. The sensor system was intended to supplement standard care, which generally cannot guarantee constant monitoring. As there is a lack of data on how healthcare professionals experience such a techno-digital innovation, the aim of this study was to explore how the multiprofessional palliative care team who piloted the sensor system perceived its potential benefits and limitations, and how they experienced the broader context of healthcare technology and research in palliative care. Methods: We conducted a qualitative interview study with 20 members of the palliative care team and analyzed the recorded, verbatim transcribed interviews using qualitative content analysis. Results: The sensor system was described as easy to use and as helpful support for patients, care staff, and relatives, especially against the backdrop of demographic change. However, it could not replace human interpretation of stress and subsequent treatment decisions: this remained the expertise of the nursing staff. A potential reduction in personnel was expected to be a risk of a digital monitoring system. The special conditions of research and digital health technologies in an end-of-life context also became clear. Specifically, healthcare staff were open to health technologies if they benefited the patient and were compatible with professional nursing and/or palliative care attitudes. Additionally, a patient-protective attitude and possible interprofessional differences in priorities and the resulting challenges for the team became apparent. Conclusions: A potential digital solution for distress monitoring was considered useful by palliative care practitioners. However, interprofessional differences and compatibility with existing palliative care practices need to be considered before implementing such a system. To increase user acceptability, the perspectives of healthcare professionals should be included in the implementation of technological innovations in palliative care. [ABSTRACT FROM AUTHOR]

Introduction: Public safety personnel (PSP) are at increased risk for posttraumatic stress injuries (PTSI). Before Operational Stress (BOS) is a mental health program for PSP with preliminary support mitigating PTSI. The current study compared the effectiveness of delivering BOS in-person by a registered clinician (i.e., Intensive) to virtually delivery by a trained clinician (i.e., Classroom). Methods: Canadian PSP completed the Intensive (n = 118; 61.9% male) or Classroom (n = 149; 50.3% male) program, with self-report surveys at pre-, post-, 1 month, and 4 months follow-ups. Results: Multilevel modelling evidenced comparable reductions in anxiety (p < 0.05, ES = 0.21) and emotional regulation difficulties (ps < 0.05, ESs = 0.20, 0.25) over time with no significant difference between modalities. Participants discussed benefits of the delivery modality they received. Discussion: The results support virtual delivery of the BOS program (Classroom) as an accessible mental health training option for PSP, producing effects comparable to in-person delivery by clinicians. [ABSTRACT FROM AUTHOR]

Objective: This study investigated how protective factors, stress, and anxiety levels affected the resilience of healthcare workers (HCWs) during the COVID-19 pandemic. Specific aims included examining whether HCW resilience levels varied significantly according to demographic variables. Methods: A total of 303 HCWs from two training and research hospitals completed the survey. The Protective Factors for Resilience Scale (PFRS), The Stress and Anxiety to Viral Epidemics–9 Items Scale, and Brief Resilience Scale were used as data collection tools. Confirmatory factor analysis, reliability analyses, construct validity analysis, discriminant validity analysis, structural equation modeling, t-test and ANOVA were conducted respectively. Results: Only the impact of the individual sub-factor of PFRS on the resilience level of HCWs was positive and significant (b=.847, t= 8.670, p<.001); stress and anxiety levels of HCWs to viral epidemics on their resilience level were both insignificant (b= .039, t=-.468, p=.640; b= .095, t=1.073, p=.283). The resilience level of HCWs who were male (M=4.53, SD=.55), married (M=4.50, SD=.55), had high school graduates (M=4.87, SD=.27), had 31 years and above experience (M=5.00, SD=.00), had children (M=4.54, SD=. 53), and exercised 2-3 days a week (M=4.54, SD=.46) had significantly higher levels of resilience. Conclusion: This study pointed out that individual protective factors (such as healthy skills and abilities) positively affect the resilience of HCWs and play a crucial for the mental health of HCWs. HCWs who were male, married, low educated, more experienced, had children and doing sports 2-3 days a week had significantly higher resilience. [ABSTRACT FROM AUTHOR]

Objective To analyze risk factors for occupational blood-borne exposures among healthcare workers, providing a basis for timely and targeted interventions to prevent occupational blood-borne exposure. Methods The study included 103 healthcare workers who reported occupational blood-borne exposures from January 2016 to June 2023 at a tertiary hospital in Hulunbuir as the exposure group and 625 healthcare workers from the same shifts who did not experience occupational exposures as the control group. Relevant information was collected for all subjects. Random Forest algorithms and multivariate logistic regression analysis were used to construct predictive models for occupational blood-borne exposure among healthcare workers. Results Among the 103 blood-borne exposure cases, the main exposure site was the hand in 89 cases (86.41%); the main mode of exposure was sharp force injury in 83 cases (80.58%); and the predominant exposure source was hepatitis B virus (HBV) in 65 cases (63.11%). Sixty-five cases (63.11%) were reported immediately after exposure, while 24 cases (23.30%) were reported within 12 hours. Logistic regression analysis revealed that compared to healthcare workers aged 30 years or more, likelihood of occupational blood-borne exposure increased to 4.142 times for those under 30 years (P < 0.05) ; compared with 5 or more years, the likelihood of occupational blood-borne exposure increased to 1.696 times for healthcare workers with less than 5 years of service (P < 0.05) the likelihood of occupational blood-borne exposure increased to 5.989 times for junior-title healthcare workers compared to intermediate and higher- level titles (P < 0.05); healthcare workers who attended occupational protection training only once per year were up to 1.864 times more likely to have occupational blood-borne exposure compared to those who participated multiple times annually (P < 0.05); the likelihood of occupational blood-borne exposure increased to 2.205 times for healthcare workers in the departmental categories of emergency, critical care, and operating room compared to those in other departments (P < 0.05). The Random Forest algorithm identified the top 6 influential factors in order of importance as professional title, age, years of work experience, annual training frequency of occupational protection, occupation type, and education level. The Random Forest predictive model demonstrated higher accuracy, precision, recall, and FI score (the reconciled mean of precision and recall) compared to the logistic regression model. The area under the receiver operating characteristic curve (AUC) for the Random Forest model was 0.829 (P < 0.001) which was also higher than that of the logistic regression model of 0.818 (P < 0.001). Conclusions The Random Forest model showed superior predictive performance for occupational blood-borne exposures, while the logistic regression model provided more intuitive analytical results. The combined use of both models can further enhance prediction accuracy. Enhanced training should be provided for high-risk groups, including younger healthcare workers, those with less work experience, and those with lower professional titles. Standardized measures should be implemented to prevent blood-borne exposure among healthcare workers. [ABSTRACT FROM AUTHOR]

Introduction: Employees working in shifts are exposed to many threats affecting their health, quality of life and safety at work. Those who perform their work only at night are particularly vulnerable. The purpose of the review is to identify risks to the health, quality of life and sleep of shift health workers. Method: A systematic review (SR) was used in the analysis. Electronic databases were searched. The search was limited to the latest studies published in the last five years: 2019–2023. Results: Finally, 36 articles were included in the review. Most authors have shown a link between sleep disturbance or its quality and shift work/night work. Moreover, a three-shift schedule was the most significant factor for poorer subjective sleep quality when compared to other work schedules. Furthermore, many authors have shown a link between shift/night work and health problems, which include cardiometabolic risk, glucose intolerance, breast cancer and immune vulnerability. Conclusions: The research results clearly show a significant impact of night work on the increased risk of sleep disorders and health disturbance. Healthcare workers should be aware of the risks associated with night work in order to take measures preventing sleep/health problems. Shift/night workers should have the opportunity to be screened for disorders linked with their work. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to explore the perspective of healthcare workers on the resources they need to provide quality rehabilitation for people recovering from coronavirus disease 2019 (COVID-19) infection. Methods: A descriptive qualitative approach using reflexive thematic analysis was employed. Focus groups and interviews were performed with nine healthcare workers (one intensive care unit physiotherapist, one respiratory therapist and seven occupational therapists) with experience treating patients recovering from COVID-19 infection within hospital and in the community. Verbatim transcripts were coded and analysed for themes. Results: Healthcare workers perceive an urgent need for resources about recovery from COVID-19 infection to support quality care. They particularly want detailed guidance about potential trajectories of recovery, and what should be expected over time for people with long COVID. Many observed that this group of patients had higher oxygen requirement and experienced slower recovery than others with serious respiratory conditions. Supports for quality care do exist but were not perceived as sufficient by participants. They want any new resources developed to be accessible, quick to access and targeted to specific healthcare worker roles and services settings. Participants identified several barriers to accessing practice supports, including the time poor nature of health care and financial costs to both patients and healthcare workers. Conclusion: Healthcare workers perceive an urgent need for the development of resources to support quality rehabilitation for people recovering from COVID-19 infection, to support best outcomes for this group of patients. Any resources developed must consider identified barriers to their access and use to maximise their impact. What is known about the topic? Workforce development needs related to the management of people recovering from coronavirus disease 2019 (COVID-19) are relatively unknown, due to the novelty of the virus and sustained pressure on the healthcare system due to the pandemic. What does this paper add? The paper identifies resource gaps and potential improvements from the clinician perspective. It also emphasises the urgent need for tailored, multidisciplinary resources and workforce capacity building. What are the implications for practitioners? Access to accessible updated resources and continuing professional development is critical for allied health clinicians in the evolving field of COVID-19 rehabilitation. [ABSTRACT FROM AUTHOR]

This paper describes a process evaluation of a 'wise' intervention that took place in six acute care units in two medical-surgical teaching hospitals in the United States during 2016–2017. 'Wise' interventions are short, inexpensive interventions that depend on triggering specific psychological mechanisms to achieve behaviour change. This study sought to increase the hand hygiene compliance (HHC) rates before entering a patient's room among nurses. The intervention centred on the use of threat to professional identity to prompt improved HHC. Through questionnaires administered to intervention participants and the implementation facilitator, together with independent observation of intervention delivery, we examined whether the steps in the Theory of Change occurred as expected. We found that aspects of the implementation—including mode of delivery, use of incentives, and how nurses were recruited and complied with the intervention—affected reach and likely effectiveness. While components of the intervention's mechanisms of impact—such as the element of surprise—were successful, they ultimately did not translate into performance of the target behaviour. Performance was also not affected by use of an implementation intention as repeated performance of HHC over years of being a nurse has likely already established well-ingrained practices. Context did have an effect; the safety culture of the units, the involvement of the Nurse Managers, the level of accountability for HHC in each unit, and the hospitals themselves all influenced levels of engagement. These conclusions should have implications for those interested in the applicability of 'wise' interventions and those seeking to improve HHC in hospitals. [ABSTRACT FROM AUTHOR]

Objective: This cross-sectional-survey-based study aimed to investigate the severity of side-effects from Coronavirus disease (COVID-19) mRNA (Pfizer, Moderna), viral vector DNA (Oxford-AstraZeneca, J&J/Janssen), inactivated virus (Sinopharm, Sinovac), and other vaccines among healthcare workers (HCWs) in Saudi Arabia, focusing on their impact on work attendance. Methods: A total of 894 HCWs residing in Saudi Arabia participated in this study from March 2023 to May 2023. Participants completed an online questionnaire assessing demographic information, vaccination status, comorbidities, vaccine side-effects, and missed work information after vaccination. Descriptive statistics and chi-square tests were used for data analysis. Results: The majority of participants were female (83.7%) and aged 25–34 years (42.8%). Most participants were predominantly vaccinated with mRNA vaccines. Common side-effects included pain at the injection site, fatigue, fever, and chills. However, no significant association was found between vaccine type, side-effects, and work absenteeism. While demographic factors such as age and healthcare profession did not influence work absenteeism, variations were observed among different racial groups. Conclusion: COVID-19 vaccination among HCWs in Saudi Arabia is associated with common side-effects, but their impact on work attendance is not significant. Understanding these implications can inform strategies to support the healthcare workforce and mitigate the impact on patient care and staffing during the ongoing COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

The emergence of SARS-CoV-2 in 2019 led to a global pandemic with a significant impact on healthcare systems. Healthcare workers were particularly vulnerable due to frequent contact with COVID-19 patients. Despite vaccination, they remained at higher risk as the vaccines provided limited protection against infection with viral variants, like Delta or Omicron BA.1 and BA.5. Three years after the onset of the pandemic, we evaluated SARS-CoV-2 infection frequencies among healthcare workers with varying levels of patient contact: high-risk (frequent COVID-19 patient contact), intermediate-risk (non-COVID-19 patient contact), and low-risk (no patient contact). We assessed their cellular and humoral immune responses based on their vaccination status and number of prior infections. SARS-CoV-2-specific antibodies were measured by immunoglobulin ELISA, and neutralizing antibody titers were determined against the viral variants D614G, Delta, and Omicron BA.1 and BA.5. Cellular immune responses were analyzed using an interferon-γ ELISpot. Notably, three years into the pandemic, healthcare workers in daily contact with COVID-19 patients did not have higher infection rates compared to healthcare workers with non-COVID-19 patient contact or no patient contact. Immune responses were similar across all groups, highlighting the effectiveness of vaccination and current hygiene standards in preventing virus transmission from patients to staff. [ABSTRACT FROM AUTHOR]

This study surveyed Asian American healthcare workers to examine the impact of discrimination on workplace stress during the COVID-19 pandemic. Workplace stress was measured by utilizing the Perceived Stress Scale (PSS-10), and discrimination experienced by healthcare workers was measured using the Everyday Discrimination Scale. This research reported several key findings. Healthcare workers who were not married at the time of the survey experienced the most discrimination, followed by those who worked less than five years. Those who were married experienced the least discrimination. Healthcare workers with less than five years of work experience felt the most workplace stress, followed by those who were not married, while those who were married experienced the least workplace stress. Healthcare workers who experienced greater discrimination also reported higher workplace stress. As hypothesized, workplace discrimination emerged as the most influential predictor of Asian HCWs' workplace stress during the pandemic. Feeling safe at work and being married contributed to less workplace stress among healthcare workers during the pandemic. These factors explained 25.6% of the variance in workplace stress among healthcare workers during the pandemic. [ABSTRACT FROM AUTHOR]

This study explores the role of inflammation and oxidative stress, hallmarks of COVID-19, in accelerating cellular biological aging. We investigated early molecular markers—DNA methylation age (DNAmAge) and telomere length (TL)—in blood leukocytes, nasal cells (NCs), and induced sputum (IS) one year post-infection in pauci- and asymptomatic healthcare workers (HCWs) infected during the first pandemic wave (February–May 2020), compared to COPD patients, model for "aged lung". Data from questionnaires, Work Ability Index (WAI), blood analyses, autonomic cardiac balance assessments, heart rate variability (HRV), and pulmonary function tests were collected. Elevated leukocyte DNAmAge significantly correlated with advancing age, male sex, daytime work, and an aged phenotype characterized by chronic diseases, elevated LDL and glycemia levels, medications affecting HRV, and declines in lung function, WAI, lymphocyte count, hemoglobin levels, and HRV (p < 0.05). Increasing age, LDL levels, job positions involving intensive patient contact, and higher leukocyte counts collectively contributed to shortened leukocyte TL (p < 0.05). Notably, HCWs exhibited accelerated biological aging in IS cells compared to both blood leukocytes (p ≤ 0.05) and NCs (p < 0.001) and were biologically older than COPD patients (p < 0.05). These findings suggest the need to monitor aging in pauci- and asymptomatic COVID-19 survivors, who represent the majority of the general population. [ABSTRACT FROM AUTHOR]

Background: The underlying mechanisms of post-COVID syndrome (PCS) are still not fully understood. While pre-existing conditions have been described as a risk factor for severe PCS in the general population, data specific to different occupational groups in this context is lacking. This study aimed to investigate the impact of pre-existing conditions on severe post-COVID syndrome among the occupational group of healthcare and social services employees. Methods: Baseline data from a longitudinal, observational study were analysed. In February 2021, health workers who had a COVID-19 infection in 2020 were surveyed about sequelae of the infection. Factors influencing severe PCS with at least one persistent symptom categorised as severe were subjected to a multivariate logistic regression analysis. Results: Of a total of 2,053 participants, 21.5% had severe PCS. Underlying respiratory (OR 1.94; CI 1.44–2.61), cardiovascular (OR 1.35; CI 1.04–1.77) and urogenital (OR 1.79; CI 1.10–2.91) disease were risk factors for severe PCS overall. Respiratory and mental illnesses had a statistically significant impact on persistent fatigue/exhaustion, concentration/memory difficulties and shortness of breath categorised as severe. Urogenital disease was associated with severe fatigue/exhaustion. Other significant risk factors for severe PCS were female sex, smoking, physical exercise and hospitalisation due to COVID-19 infection. Conclusion: Workers in healthcare and social services with pre-existing conditions may face a higher risk of developing severe PCS. Additional analyses performed as part of the longitudinal study will show if and how this result changes over time. [ABSTRACT FROM AUTHOR]

Objective: Healthcare workers (HCWs) were considered a population at risk for developing psychiatric symptoms during the COVID-19 pandemic, such as anxiety, depression, and post-traumatic stress disorder (PTSD). Peritraumatic distress is associated with post-traumatic psychopathological symptoms; however, little is known about how it may affect functioning. The study aimed at evaluating the level of peritraumatic distress in a sample of HCWs during the first wave of the COVID-19 pandemic and at examining the relationship between peritraumatic distress, mental health symptoms, and functioning impairment. Methods: A sample of 554 frontline HCWs were consecutively enrolled in major university hospitals and community services in Italy. The PDI, IES-R, PHQ-9, and GAD-7 were used to assess peritraumatic distress, symptoms of PTSD, depression, and anxiety, respectively, and the WSAS to investigate functioning impairment. PDI scores were higher among females, community services, physicians, and nurses. Furthermore, the PDI correlated significantly with the GAD-7, PHQ-9, IES-R, and WSAS. Results: In a mediation analysis, the direct effect of PDI on WSAS and the indirect effects through the PHQ-9 and IES-R were statistically significant (P < .001). Conclusion: Peritraumatic distress reported by HCWs was associated with symptoms of PTSD, depression, and anxiety, but the association with reduced functioning may be only partially mediated through symptoms of depression and PTSD. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) is a global health problem that has put a tremendous amount of pressure on healthcare systems worldwide. This pressure has taken its toll on hospitals, administrators and healthcare workers. Prevention and management are the best ways of fighting against COVID-19. This article focused on healthcare workers' and hospital administrators' experiences with the pandemic. This study adopted a qualitative phenomenological design to draw on hospital administrators' and healthcare workers' first-hand experience of the pandemic. Most participants stated that the pandemic took a physical and psychosocial toll on them. They noted that although they experienced some challenges, the pandemic brought with it opportunities as well. They remarked that they needed psychosocial support. Five main themes and fourteen subthemes were developed based on the interviews: 'access', 'appreciating things', 'fight against COVID-19', 'a physically and emotionally challenging time' and 'times of need'. The pandemic has taken its toll on all healthcare systems around the world. It has been a never-before-seen challenge for all departments of hospitals. Leaders, healthcare organisations and healthcare workers have worked relentlessly to keep the pandemic under control. However, tackling the pandemic is not only their responsibility. It is evident that the public should also have a certain awareness to support the state and healthcare workers in their struggle against the pandemic. [ABSTRACT FROM AUTHOR]

Background: It has been suggested that the Human Papillomavirus (HPV) vaccine and screening tests for HPV are necessary to prevent HPV infection. However, low rates of HPV vaccination have been reported in developing countries. The objectives of this study are to assess healthcare workers' Knowledge, Attitude, and Practice (KAP) about HPV and its vaccine in Saudi Arabia. Methods: A cross-sectional study was conducted in Khobar city among a representative sample of the Khobar network of healthcare professionals (n=542). A self-administered questionnaire was employed for data gathering. It consisted of four main parts: socio-demographic characteristics, assessing knowledge regarding cervical cancer, HPV, and HPV vaccines (12 closedended questions), assessing attitude towards the HPV vaccine (8 close-ended questions), and assessing practice/behaviour concerning the HPV vaccine (7 close-ended questions). Results: A total of 223 healthcare workers were included in the study. Almost half (50.2%) of them were females. Their age ranged between 23 years and 60 years, with a mean Standard Deviation (SD) of 38.0 years ± 9.2 years. Overall, 42.9% of the participants expressed inadequate knowledge about cancer cervix, human papillomavirus, and its vaccine. Participants who attended any training activity in cancer cervix prevention and screening were less likely than their peers to express inadequate knowledge (Adjusted odds ratio "aOR"=0.30; 95% confidence interval "CI": 0.16-0.51, p<0.001). Bachelor holders and those with higher education were less likely than those with intermediate diplomas to express inadequate knowledge (aOR=0.54; 95% CI: 0.29-0.94, p=0.048 and aOR=0.09; 95% CI: 0.03-0.26, p<0.001, respectively). The majority (82.1%) expressed a positive attitude toward cervical cancer and the HPV vaccine. With each year of increase in the participant's age, the likelihood of negative attitude towards cancer cervix and HPV vaccine decreased by 15% (aOR=0.85; 95% CI: 0.80-0.91), p<0.001). History of being ever vaccinated for HPV was reported by 55.2% of the participants. Females are significantly more susceptible to being unvaccinated for HPV (aOR=8.06; 95% CI: 4.17-15.57, p<0.001). Participants who attended any training activity in cancer cervix prevention and screening were at 74% lower risk for being not vaccinated for HPV than those who did not participate in such courses (aOR=0.27; 95% CI: 0.14-0.53, p<0.001). Conclusion: There is an overall adequate knowledge about cancer cervix, HPV and its vaccine, positive attitude towards HPV vaccine, and promising practice of HPV vaccine up taking and recommendation to girls aged 16 years-21 years among healthcare workers. However, improving knowledge, attitude, and training of healthcare workers regarding the HPV vaccine are highly needed to overcome HPV infection and cancer cervix epidemics. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the change in diet quality in addition to dietary adherence to the planetary health diet during night shifts in healthcare workers. This observational follow-up study involved 450 healthcare workers working night shifts (327 females, 123 males). A survey form requesting sociodemographic information (gender, age, marital status), job title, sleeping duration during the night shift, 24 h dietary records for pre-night-shift, during night shift, and post-night-shift, and anthropometric measurements (body weight and height) was applied. The scores of the Planetary Health Diet Index (PHDI) and the Healthy Eating Index 2020 (HEI-2020) were calculated according to the dietary records. The total HEI-2020 and PHDI scores decreased significantly (p < 0.05) during the night shift (44.0 ± 8.8 and 48.3 ± 13.2, respectively) compared to pre-night-shift (46.1 ± 9.2 and 51.9 ± 13.4, respectively) and increased post-night-shift (44.7 ± 9.9 and 50.6 ± 14.9, respectively), with no statistically significant difference between pre- and post-night-shift. There was a significant main effect of night shift working on total PHDI (F(896, 2) = 8.208, p < 0.001, ηp2 = 0.018) and HEI-2020 scores (F(894, 2) = 6.277, p = 0.002, ηp2 = 0.014). Despite healthcare workers' knowledge of health factors, night shifts lead to poor dietary choices. To improve diet quality and sustainability, it is crucial to enhance access to healthy food options in their work environment. [ABSTRACT FROM AUTHOR]

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Objective: This cross-sectional and descriptive study was conducted to evaluate the attitudes of healthcare workers towards the safe use of needle-stick and sharp medical instruments. Methods: The study was conducted cross-sectionally on 248 healthcare workers. Data were collected face-to-face using the "Healthcare Worker Identification Form" and the "Healthcare Workers' Attitude Scale Towards Safe Use of Needle-Stick and Sharp Medical Instruments". Results: The total score and cognitive and affective subscale mean scores of the Attitudes Toward Safe Use of Needle-Stick and Sharp Medical Instruments Scale were statistically significantly higher in women than in men (p<0.05). The mean scores of healthcare workers who were having night shift were lower than those who were not having night shift (p<0.05). According to the results of linear regression analysis, gender, educational status, occupation, and exposure to injury were determined as factors independently affecting attitudes towards safe use of needle-stick and sharp medical instruments (p<0.05). Conclusion: In this study, it was found that the attitudes of male healthcare workers, those who were having night shift, those who experienced sharps injuries, midwives and health officers towards safe use of needle-stick and sharp medical instruments were low. In line with these results, it is recommended to organize in-service training programs for the prevention of sharps injuries, to pay attention to standard prevention practices and to actively use the reporting system, taking into account the personal (gender) and professional characteristics of healthcare workers (occupation, having a needle-stick and sharp injury, postgraduate education status, having night shift, etc.). [ABSTRACT FROM AUTHOR]

Purpose: To explore occupational and non-occupational risk and protective factors for the coronavirus disease 2019 (COVID-19) in healthcare workers (HCWs). Methods: Serum specimens and questionnaire data were obtained between October 7 and December 16, 2021 from COVID-19-vaccinated HCWs at a quaternary care hospital in Munich, Germany, and were analyzed in the RisCoin Study. Results: Of 3,696 participants evaluated, 6.6% have had COVID-19 at least once. Multivariate logistic regression analysis identified working in patient care occupations (7.3% had COVID-19, 95% CI 6.4–8.3, Pr = 0.0002), especially as nurses, to be a potential occupation-related COVID-19 risk factor. Non-occupational factors significantly associated with high rates of the disease were contacts to COVID-19 cases in the community (12.8% had COVID-19, 95% CI 10.3–15.8, Pr < 0.0001), being obese (9.9% had COVID-19, 95% CI 7.1–13.5, Pr = 0.0014), and frequent traveling abroad (9.4% had COVID-19, 95% CI 7.1–12.3, Pr = 0.0088). On the contrary, receiving the basic COVID-19 immunization early during the pandemic (5.9% had COVID-19, 95% CI 5.1–6.8, Pr < 0.0001), regular smoking (3.6% had COVID-19, 95% CI 2.1–6.0, Pr = 0.0088), living with the elderly (3.0% had COVID-19, 95% CI 1.0–8.0, Pr = 0.0475), and frequent consumption of ready-to-eat meals (2.6% had COVID-19, 95% CI 1.1–5.4, Pr = 0.0045) were non-occupational factors potentially protecting study participants against COVID-19. Conclusion: The newly discovered associations between the living situation, traveling as well as dietary habits and altered COVID-19 risk can potentially help refine containment measures and, furthermore, contribute to new mechanistic insights that may aid the protection of risk groups and vulnerable individuals. [ABSTRACT FROM AUTHOR]

Purpose: Anti SARS-CoV-2 vaccination initially showed high effectiveness in preventing COVID-19. However, after the surge of variants of concern, the effectiveness dropped. Several studies investigated if this was related to the decrease of the humoral response over time; however, this issue is still unclear. The aim of this study was to understand whether SARS-CoV-2 anti-S IgG levels can be used to predict breakthrough infection risk and define the timing for further booster doses administration. Method: Within the framework of the ORCHESTRA Project, over 20,000 health workers from 11 European centers were enrolled since December 2020. We performed two Cox proportional hazards survival analyses regarding pre-Omicron (from January to July 2021) and Omicron (December 2021–May 2022) periods. The serological response was classified as high (above the 75th percentile), medium (25th-75th), or low (< 25th). Results: Seventy-four (0.33%) and 2122 (20%) health workers were infected during the first and second periods, respectively. Both Cox analyses showed that having high anti-S titer was linked to a significantly lower risk of infection as compared to having medium serological response [HR of high vs medium anti-S titer = 0.27 (95% CI 0.11–0.66) during the first phase, HR = 0.76 (95% CI 0.62–0.93) during the second phase]. Conclusion: Vaccine effectiveness wanes significantly after new variants surge, making anti-S titer unsuitable to predict optimal timing for further booster dose administration. Studies on other immunological indicators, such as cellular immunity, are therefore needed to better understand the mechanisms and duration of protection against breakthrough infection risk. [ABSTRACT FROM AUTHOR]

Purpose: Despite substantial vaccination progress, persistent measles outbreaks challenge global elimination efforts, particularly within healthcare settings. In this paper, we critically review the factors contributing to measles outbreak and effective control measures for nosocomial transmission of measles. Methods: We systematically searched electronic databases for articles up to 17th May, 2023. This was performed by two independent reviewers, with any disagreements resolved by a third reviewer. We also searched governmental and international health agencies for relevant studies. Results: Forty relevant articles were systematically reviewed, revealing key factors fuelling measles outbreak in healthcare settings, including high transmissibility capability; high intensity exposure; delayed care; failure to use protective equipment and implement control measures; vaccine failure; unclear immunisation history and lack of registries; and lacking recommendation on healthcare workers' (HCWs) measles vaccination. To combat these challenges, successful control strategies were identified which include early notification of outbreak and contact tracing; triaging all cases and setting up dedicated isolation unit; strengthening protective equipment use and physical measures; improving case detection; determining immunity status of HCWs; establishing policy for measles vaccination for HCWs; management of exposed personnel; and developing a pre-incident response plan. Conclusion: A coordinated and comprehensive approach is essential to promptly identify and manage measles cases within healthcare settings, necessitating multifactorial strategies tailored to individual settings. These findings provide a valuable foundation for refining strategies to achieve and maintain measles elimination status in healthcare environments. [ABSTRACT FROM AUTHOR]

Background/Aim: Low back pain (LBP) is a highly prevalent pathology affecting more than half of our population. The lumbar region inherently possesses a complex structure; therefore, dozens of causes for the clinical presentation of acute/chronic pain are present. We focused on the impact of hamstring shortness on LBP in healthcare workers/professionals who need to keep medical records and perform invasive procedures while traveling overwhelming distances in relatively small workplaces. Methods: Our research was designed as a cross-sectional study and was conducted at Beykent University Hospital from March to April 2022. Sixty-two otherwise healthy healthcare workers/professionals aged 25-45 (both male and female) volunteered. Two equal groups with and without LBP were created. Oswestry disability index, Roland-Morris score, Quebec LBP questionnaire, Visual Analog Scale (VAS), active/passive knee extension, sit and reach, and forward bending tests were performed in each group. The collected data were statistically analyzed (confidence interval [CI]=20%; P<0.05). Results: Active/passive knee extension, sit and reach, and toe touch tests were significantly related to Roland-Morris, Quebec, and Oswestry Disability Index questionnaires; thus hamstring muscle shortness was significantly related to chronic low back pain (P<0.05). Short hamstring muscle length could accurately reflect the lower test scores obtained by the female participants. Conclusion: Hamstring muscle shortness could explain a significant proportion of low back pain in healthcare professionals. [ABSTRACT FROM AUTHOR]

Copyright of Viral Hepatitis Journal / Viral Hepatit Dergisi is the property of Galenos Yayinevi Tic. LTD. STI 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.)

Background: The recent Marburg virus outbreaks in Equatorial Guinea and Tanzania in March 2023 have sparked fears about potential worldwide spread. Thus, assessing healthcare workers’ (HCW) knowledge of the disease is critical, particularly in India, where the healthcare system is underfunded and understaffed and already has an immense burden of infectious illnesses. Methods: We carried out a cross-sectional web-based survey among 300 healthcare workers including doctors, nurses, and pharmacists. The Google survey form was circulated online via email. To recruit participants, a convenience sample technique was utilized. Descriptive and logistic regression was applied to analyse data. Results: 50.9% were aware of Marburg virus disease, and 60.5% had a favourable attitude towards Marburg virus disease (MARVD) control and prevention. Bleeding was cited as the most common clinical symptom of MARVD by 53.3% of participants. Regarding the mode of transmission, 51.6% were aware of how MARVD is spread. Almost all HCWs (99%) claimed they would accept an approved vaccine for themselves, however, the readiness to receive experimental treatments was less certain. The logistic regression model showed gender [female—OR: 2.8 (1.75 to 3.5), p = 0.001] and job roles [pharmacist—OR: 4.1 (2.9 to 7.2), P < 0.001] as predictors of poor KAP about MARVD. Conclusion: Although there was a high degree of awareness about MARVD, there were notable knowledge gaps and differences in attitudes among healthcare professionals. This underlines the importance of customized training programs for each group to increase healthcare workers’ knowledge of MARVD. [ABSTRACT FROM AUTHOR]

Copyright of Clinical Neuroscience / Ideggyógyászati Szemle is the property of LifeTime Media Kft. 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: Child and adolescent mental health is a global priority. In sub-Saharan Africa, despite the high burden, there is a gap in health services for children and adolescents with mental health disorders. To bridge this gap, healthcare workers require a good understanding of child and adolescent mental health, the right attitude, and practices geared to improving child and adolescent mental health. This scoping review examined the knowledge, attitudes, and practices related to child and adolescent mental health among sub-Saharan African healthcare workers. Methods: The search was restricted between January 2010, the year when the Mental Health Gap Action Programme guidelines were launched, and April 2024. The review followed the methodological framework proposed by Arksey and O'Malley for conducting scoping reviews. The databases searched included CINHAL, PubMed, Web of Science, PsycINFO, and grey literature databases. Additional articles were identified through cited references of the studies included. A data extraction template was used to retrieve relevant text. A narrative synthesis approach was adopted to explore the relationships within and between the included studies. Results: The literature search yielded 4658 studies. Among these, 817 were identified as duplicates, and 3740 were excluded after screening. Only twenty-one articles met the criteria for inclusion in the review. The findings showed that healthcare workers have insufficient knowledge of child and adolescent mental health, hold negative attitudes toward children and adolescents with mental health problems, and exhibit poor practices related to child and adolescent mental health. Conclusion: It is crucial to build capacity and improve healthcare workers' practices, knowledge, and attitudes toward child and adolescent mental health in sub-Saharan Africa. This could lead to better access to mental health services for children and adolescents in the region. [ABSTRACT FROM AUTHOR]

Introduction: Burnout is a syndrome characterised by physical, emotional and mental exhaustion that results from a long period of involvement in an overwhelming work condition. It is prevalent among frontline workers. This study aimed to identify the prevalence of burnout among primary healthcare workers in the district of Manjung, Perak and determine the factors associated with burnout. Methods: This cross-sectional study was conducted among healthcare workers in seven health clinics located in the district from August to September 2022. The self-administered validated Malay version of the Copenhagen Burnout Inventory and the Malay version of the Multidimensional Scale of Perceived Social Support were used. These instruments consisted of 31 questions rated on a 5-point Likert scale. The scores were then summed up to determine the burnout level. Data were analysed using SPSS version 20. Simple logistic regression analysis was performed. Thereafter, multiple logistic regression analysis was conducted to determine the factors associated with burnout. Results: A total of 224 participants were included. Among them, 61.6% were nurses; 21.4%, doctors; and 17.0%, assistant medical officers. The prevalence of personal burnout was 31.3%; work-related burnout, 16.5%; and patient-related burnout, 5.4%. The factors associated with burnout were the highest educational level, financial difficulties and low perceived social support from friends and significant others. Conclusion: Healthcare workers in Manjung health clinics have a higher prevalence of personal burnout than work- and patient-related burnout. The findings of this study provide early insights and guidance for possible interventions. [ABSTRACT FROM AUTHOR]