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BackgroundBefore SARS-CoV-2 vaccination availability, medical center employees were at high risk of COVID-19. However, risk factors for SARS-CoV-2 infection in medical center employees, both healthcare and non-healthcare workers, are poorly understood.MethodsFrom September-December 2020, free IgG antibody testing was offered to all employees at a large urban medical center. Participants were asked to complete a questionnaire on work and non-work related risk factors for COVID-19 infection.ResultsSARS-CoV-2 seropositivity was found in 4.7%. Seropositivity was associated with close contact with COVID-19 cases with or without the use of adequate personal protective equipment (PPE), (OR 3.1 [95% CI 1.4-6.9] and OR 4.7 [95% CI 2.0-11.0] respectively), never wearing a mask outside of work (OR 10.1 [95% CI 1.9-57]), and Native Hawaiian/Pacific Islander race (OR 6.3 95% CI (1.6-25)].ConclusionsAmong workers in a large urban medical center, SARS-CoV-2 seropositivity was associated with work-related COVID-19 close contacts and low mask use outside of work, suggesting that non-workplace close contacts are also relevant routes of COVID-19 spread among healthcare workers.

PURPOSE OF REVIEW: In this review, we discuss the status of novel radiation shielding and other methods to reduce radiation exposure and its associated health risks within the CCL. RECENT FINDINGS: There are many devices on the market each with its unique advantages and inherent flaws. Several are available for widespread use with promising data, while others still in development. The field of percutaneous transcatheter interventions includes complex procedures often involving significant radiation exposure. Increased radiation exposes the proceduralist and CCL staff to potential harm from both direct effects of radiation but also from the ergonomic consequences of daily use of heavy personal protective equipment. Here we discuss several innovative efforts to reduce both radiation exposure and orthopedic injury within the CCL that are available, leading to a safer daily routine in a lead [apron]-free environment.

BackgroundHundreds of millions of people become infected globally every year while seeking care in health facilities that lack basic needs like infection control measures and personal protective equipment (PPE). We aimed to evaluate the availability of infection control items and PPE in eight low- and middle-income countries and identify disparities in the availability of those items.MethodsIn this study, we combined publicly available nationally representative cross-sectional health system surveys (Service Provision Assessments by the Demographic and Health Survey Programme) conducted in eight countries between 2013 and 2018: Afghanistan, Bangladesh, the Democratic Republic of the Congo, Haiti, Malawi, Nepal, Senegal, and Tanzania. The availability of infection control items was evaluated using a list of six items (a waste receptacle, a sharps container, disinfectant, single-use disposable or auto-disposable syringes, soap and running water, or an alcohol-based hand rub, and guidelines for standard precautions). PPE includes four items: gloves, medical masks, gowns, and eye protection. We considered these items available in a facility if they were observed in general outpatient areas or any service-specific area (i.e. delivery room).ResultsWe analysed data from 7948 health facilities (694 hospitals and 7254 health centres/clinics). Overall, among the infection control items and PPE, most surveyed facilities had high availability of single-use disposable or auto-disposable syringes (91.40%) and latex gloves (92.56%). Of infection control measures, guidelines for infection control were the least available during the survey, with the lowest (6.15%) in Nepal and the highest (68.18%) in Malawi. Of the PPE items, eye protection was the least available during the survey, with the lowest (5.4% in Senegal) and the highest (28.17%) in Haiti. Only 1567 (19.71%) facilities looked to have all the basic infection control materials, and 1023 (12.87%) of the analysed facilities possessed all of the PPE. Within the same country, the availability of items varied more between hospitals and health centres/clinics than between them.ConclusionsAll eight of our study countries experience shortages of the most fundamental standard precaution items to avert infection. Steps must be taken in each of these countries to reduce inadequacies and disparities and enhance efficiency in the conversion of health-system inputs into the facility's availability of standard precaution items for infection control - to curb the risk of infectious disease transmission.

Aim: Quantify disparities and identify correlates and predictors of 'wellness' supplement use among nurses during the first year of the pandemic. Design: Longitudinal secondary analysis of Nurses' Health Studies 2 and 3 and Growing Up Today Study data. Methods: Sample included 36,518 total participants, 12,044 of which were nurses, who completed surveys during the first year of the COVID‐19 pandemic (April 2020 to April 2021). Analyses were conducted in March 2023. Modified Poisson models were used to estimate disparities in 'wellness' supplement use between nurses and non‐healthcare workers and, among nurses only, to quantify associations with workplace‐related predictors (occupational discrimination, PPE access, workplace setting) and psychosocial predictors (depression/anxiety, county‐level COVID‐19 mortality). Models included race/ethnicity, gender identity, age and cohort as covariates. Results: Nurses were significantly more likely to use all types of supplements than non‐healthcare workers. Lacking personal protective equipment and experiencing occupational discrimination were significantly associated with new immune supplement use. Depression increased the risk of using weight loss, energy and immune supplements. Conclusion: Nurses' disproportionate use of 'wellness' supplements during the COVID‐19 pandemic may be related to workplace and psychosocial stressors. Given well‐documented risks of harm from the use of 'wellness' supplements, the use of these products by nurses is of concern. Impact: 'Wellness' supplements promoting weight loss, increased energy, boosted immunity and cleansing of organs are omnipresent in today's health‐focused culture, though their use has been associated with harm. This is of added concern among nurses given their risk of COVID‐19 infection at work. Our study highlighted the risk factors associated with use of these products (lacking PPE and experiencing occupational discrimination). Findings support prior research suggesting a need for greater public health policy and education around the use of 'wellness' supplements. Reporting Method: STROBE guidelines were followed throughout manuscript. Patient or Public Contribution: No patient or public contribution was involved. [ABSTRACT FROM AUTHOR]

Background: We quantified relative and absolute risks of postpartum psychiatric episodes (PPE) following risk factors: Young age, past personal or family history of psychiatric disorders, and genetic liability. Methods: We conducted a register‐based study using the iPSYCH2012 case‐cohort sample. Exposures were personal history of psychiatric episodes prior to childbirth, being a young mother (giving birth before the age of 21.5 years), having a family history of psychiatric disorders, and a high (highest quartile) polygenic score (PGS) for major depression. PPE was defined within 12 months postpartum by prescription of psychotropic medication or in‐ and outpatient contact to a psychiatric facility. We included primiparous women born 1981–1999, giving birth before January 1st, 2016. We conducted Cox regression to calculate hazard ratios (HRs) of PPE, absolute risks were calculated using cumulative incidence functions. Results: We included 8174 primiparous women, and the estimated baseline PPE risk was 6.9% (95% CI 6.0%–7.8%, number of PPE cases: 2169). For young mothers with a personal and family history of psychiatric disorders, the absolute risk of PPE was 21.6% (95% CI 15.9%–27.8%). Adding information on high genetic liability to depression, the risk increased to 29.2% (95% CI 21.3%–38.4%) for PPE. Conclusions: Information on prior personal and family psychiatric episodes as well as age may assist in estimating a personalized risk of PPE. Furthermore, additional information on genetic liability could add even further to this risk assessment. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to develop a novel design method to make personalized masks for the effective prevention of pandemic respiratory infectious disease. Design/methodology/approach: The changes in facial shape during speaking were analyzed using a three-dimensional (3D) scanning technique. In total, 13 anthropometric items were measured, and mask patterns were generated using a parametric pattern design method. Three sizing methods were proposed to reflect not only static but also dynamic body dimensions on the mask patterns. Findings: A significant increase or decrease was observed in 10 out of 13 measurement items. Based on this, four items were selected to be used in the mask pattern design. The nose and cheek areas of a mask were fixed to protect the respiratory tract against viruses. The lower jaw area was deformed to improve the fit. Social implications: This study is expected to provide fundamental data to understand the changes in facial shape during movement. In addition, it is expected that the development of individualized personal protective equipment with movement adaptability will facilitate an effective response to various pandemic respiratory diseases. Originality/value: In order to develop a personal protective equipment (PPE) that has a good fit and can protect against pandemic respiratory infectious diseases, morphological analysis was attempted using 3D facial data. It would be possible to design various products and equipment to be worn on the face by using the method proposed in this study. [ABSTRACT FROM AUTHOR]

Purpose: Nanotechnology (NT) advancements in personal protective textiles (PPT) or personal protective equipment (PPE) have alleviated spread and transmission of this highly contagious viral disease, and enabled enhancement of PPE, thereby fortifying antiviral behavior. Design/methodology/approach: Review of a series of state of the art research papers on the subject matter. Findings: This paper expounds on novel nanotechnological advancements in polymeric textile composites, emerging applications and fight against COVID-19 pandemic. Research limitations/implications: As a panacea to "public droplet prevention," textiles have proven to be potentially effective as environmental droplet barriers (EDBs). Practical implications: PPT in form of healthcare materials including surgical face masks (SFMs), gloves, goggles, respirators, gowns, uniforms, scrub-suits and other apparels play critical role in hindering the spreading of COVID-19 and other "oral-respiratory droplet contamination" both within and outside hospitals. Social implications: When used as double-layers, textiles display effectiveness as SFMs or surgical-fabrics, which reduces droplet transmission to <10 cm, within circumference of ∼0.3%. Originality/value: NT advancements in textiles through nanoparticles, and sensor integration within textile materials have enhanced versatile sensory capabilities, robotics, flame retardancy, self-cleaning, electrical conductivity, flexibility and comfort, thereby availing it for health, medical, sporting, advanced engineering, pharmaceuticals, aerospace, military, automobile, food and agricultural applications, and more. Therefore, this paper expounds on recently emerging trends in nanotechnological influence in textiles for engineering and fight against COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Recent advancements in the utilization of naturally derived nanocellulose and nanochitin/chitosan have opened new avenues for self‐cleaning and purification applications to address environmental challenges. This review highlights the unique structural properties of bio‐based nanofibers, which are typically rich in hydroxyl groups that enhance their functionality in various industrial sectors. Through appropriate chemical modification, they can perform specific functions facilitated by carboxylic acids or amine groups. We explored the mechanisms by which these materials facilitate oil/water separation, ultrafiltration, and self‐cleaning processes, including the incorporation of inorganic nanoparticles, such as TiO2, to improve hydrophilicity and oleophobicity. Furthermore, this review discusses innovative fabrication techniques, such as spray‐assisted layer‐by‐layer assembly, which enhance the performance of nanofiber‐based coatings. We examined the potential of these materials for diverse applications, including food packaging, wastewater treatment, and personal protective equipment, emphasizing their role in promoting sustainable industrial practices. As the global emphasis on eco‐friendly solutions intensifies, continued research and development of nanocellulose and nanochitin is expected to drive significant advancements in materials science, paving the way for greener technologies. [ABSTRACT FROM AUTHOR]

The capacity to withstand challenges posed by complex environments is crucial for developing advanced high‐performance protective materials with mechanically adjustable nature. By constructing long‐range hierarchical network of shear‐stiffening gel‐carbon nanotube‐cellulose nanofiber (SCC) embedded within epoxy resin (ER), this work engineers a nacre‐inspired variable‐stiffness SCC‐ER composite (SCCE). Lightweight SCC scaffold attenuates falling impact force from 2.23 to 0.46 kN, and reaches 60 °C within 20 s under 1 sun exposure. Additionally, owing to the rigid ER matrix, SCCE exhibits 4.03 GPa elastic modulus, outperforming numerous conventional engineering materials in puncture resistance. Specific energy absorption of nacre‐mimetic SCCE presents 1.91 MJ m−3 while that of random structural SCCE is only 0.50 MJ m−3. More importantly, SCCE features representative photothermal‐induced reversible rigidity whose storage modulus varies from 9.85 MPa at 30 °C to 11.61 kPa at 116 °C under light stimulation. It also presents shape‐programmability, capable of adhering complex structural surfaces for protection. Eventually, SCCE‐based semi‐active adjustable protectors are constructed that leverage contactless photothermal effect to modulate rigidity. 5 mm‐thick smart SCCE‐protectors resist 163.93 m s−1 ballistic impact while 15‐mm commercial kneepads are penetrated at lower speed of 136.98 m s−1. This bio‐inspired semi‐active strategy proposes a promising avenue for enhancing personal protective equipment. [ABSTRACT FROM AUTHOR]

The presence of BTEX (Benzene, Toluene, Ethylbenzene, and Xylene) compounds in beauty salons has raised concerns about potential health risks. This study aimed to measure the levels of BTEX compounds in the air of beauty salons in Lahijan, Iran and assess the associated health risks. Air samples were collected from 15 beauty salons, and the concentrations of BTEX compounds were measured according to 1501 NIOSH standard method. The results showed that the mean concentrations of benzene (20.62 µg/m3), toluene (18.3 µg/m3), ethylbenzene (38.36 µg/m3), and O and P-xylene (27.35, 23.6 µg/m3) were above the recommended levels. The indoor to outdoor ratios for benzene, toluene, ethylbenzene, O and P-xylene were 3.04, 2.36, 3.75, 4.89, and 6.54, respectively. Also, the toluene/benzene (T/B) ratio in indoor and outdoor was 20.9 and 2.68 respectively. Almost half of the technicians (49.12%) reported adverse health effects, including joint pain, itchy eyes and nose, and respiratory allergies. The IARC guideline suggests that there is a potential risk of cancer development for individuals in all salons with LCR values exceeding 10−6, but the HQ index values indicate no non-carcinogenic risk. The findings suggest that beauty salon workers and customers are at risk of developing health problems from exposure to BTEX compounds. Effective risk management strategies, such as proper ventilation, use of personal protective equipment, and substitution of harmful chemicals with safer alternatives, to minimize exposure and protect the health of salon workers and customers recommended. [ABSTRACT FROM AUTHOR]

ObjectivesMethodsResultsConclusionThe level of greenhouse farmers’ personal protection in pesticide use and the possibility of environmental protection through farmers’ willingness to reduce chemical sprayings were assessed in Khuzestan Province, Iran.A survey of 80 active greenhouse vegetable growers was carried out in 2021 with face-to-face interviews. Willingness to reduce chemical sprayings was examined with the theory of planned behavior (TPB) model.Several intoxication symptoms were reported, with the most common symptom of pesticide intoxication being dizziness. Farmers showed unsafe or rather unsafe use of personal protective equipment (PPE) during pesticide handling. The maximum use of PPE pertained to the use of mask, spray clothing, and long-sleeved shirts. On a scale from 1 (= totally disagree) to 5 (= totally agree), the respondents showed negative attitudes towards reducing chemical sprayings (mean = 2.30), rather low levels of subjective norms (mean = 2.67), and rather low levels of perceived behavioral control over reduction of chemical sprayings (mean = 2.76). The TPB variables accounted for 73% of the variance in farmers’ behavioral intention. Overall, farmers’ behavioral intention to reduce chemical sprayings was almost neutral.Increasing knowledge of the adverse effects of pesticides on health is necessary to promote safety behavior of farmers in the greenhouse. [ABSTRACT FROM AUTHOR]

Personal protective equipment (PPE) detection plays a crucial role in ensuring safety in various settings such as factories, hospitals, and disease prevention measures. However, manually checking individuals for proper PPE usage in public can be a challenging task. This paper focuses on the detection of face mask usage and aims to develop a robust system that can identify individuals who are not wearing masks or are not wearing them correctly. Here, we present an enhanced face mask detection method based on YOLOv4. Currently, there is a shortage of a comprehensive and diverse dataset that can be used to accurately evaluate the correct use of masks, mainly due to limited samples of incorrect mask wearing. To address this issue, we propose a pipeline to generate a simulated face mask dataset derived from the original dataset. This approach allows us to enhance the performance of the face mask detection model without requiring additional data samples. Additionally, we introduce a modified face mask detection model called MaskYOLO, which includes improvements in the original YOLOv4 network structure. In the feature extraction network, a global context block is incorporated between the backbone and neck of YOLOv4 to obtain a more comprehensive understanding of the scene. Furthermore, the prediction network incorporates an improved structure to achieve a more efficient network. The effectiveness and accuracy of the proposed method are demonstrated through statistical analyses of the experimental results. Our method outperforms the YOLOv4 baseline by 3.1% in mean Average Precision (mAP). [ABSTRACT FROM AUTHOR]

Personal protective equipment (PPE) is worn in a range of industrial environments by women and men alike. However, the majority of PPE is designed around male anthropometrics and the impacts of this on women are largely undocumented. Reflexive thematic analysis was used to develop themes from in-depth interviews with 30 women working in diverse roles in industrial environments, around their experiences of wearing PPE. Four themes developed: ‘There's nothing here for me’; ‘Collateral damage’; ‘Organisational culture and the burden of responsibility’; and ‘Personally protective women’. The findings significantly expand upon previous literature concerning: the reduced range of PPE available for women when compared with men; considerable fit and comfort issues; and physical, day-to-day and health-related consequences. This work evidences the increased PPE-related burden on women, and demonstrates fundamental links between women wearing ill-fitting or inappropriate PPE and their reduced sense of belonging, confidence and morale. [ABSTRACT FROM AUTHOR]

Background: The agricultural sector is vital for food production, economic stability, and environmental sustainability. However, it also poses significant occupational health and safety challenges due to factors such as heavy machinery usage, exposure to chemicals, and challenging environmental conditions. Method: This cross-sectional study involved 366 farmers affiliated with the Yozgat Chamber of Agriculture in Turkey. Data on demographic characteristics, occupational factors, and work accidents were collected with interview technique between May and August 2023. While descriptive data were expressed as categories with numbers and percentages, chi-square analysis was used to compare the obtained answers with the status of having or not having a work accident. Binary logistic regression analysis was used to estimate the effect of independent variables on the probability of having a work accident. Results: The study revealed that 33.0% of farmers experienced work accidents in the last year. Most accidents occurred during work shifts (28.8%) and in the fall season (34.8%). Factors contributing to accidents included lack of personal protective equipment (51.5%) and transportation-related issues (36.4%). Logistic regression analysis indicated that working more than 8 h daily, working 5 days or more per week, and using bus/minibus transportation significantly increased the likelihood of experiencing work accidents. Conclusion: Findings underscore the importance of implementing effective occupational health and safety measures, including proper training, provision of personal protective equipment, and improving transportation safety. Addressing these issues can enhance the well-being of agricultural workers and contribute to a safer working environment in the sector. [ABSTRACT FROM AUTHOR]

Purpose: Healthcare workers (HCWs) wearing personal protective equipment (PPE) experience physiological strain that can impair motor and psychological functions, potentially affecting patient care. We assessed the effects of heat exposure on maximal strength and risk-taking behavior among PPE-wearing HCWs and the efficacy of ice slurry to alleviate adverse effects. Methods: Seventeen HCWS completed two experimental trials in a crossover design, consuming 5 g·kg−1 of body mass of ambient drink (AMB) or ice slurry (ICE) before donning PPE and undergoing 2 h of simulated decontamination exercise (wet-bulb globe temperature (WBGT): 25.9° C ± 0.8°C, PPE microenvironment WBGT: 29.1°C ± 2.1°C). Body core temperature (Tc), heart rate (HR), chest skin temperature (Tsk), ratings of perceived exertion (RPE), thermal sensation (RTS), maximal voluntary contraction (MVC), risk-taking behavior (balloon analogue risk-taking task (BART)), and salivary cortisol were assessed. Results: Predrinking to postdrinking ΔTc was greater in ICE (−0.2°C ± 0.1°C) than AMB (−0.0°C ± 0.1°C, P = 0.003). Post-drinking RTS was lower in ICE (2.7 ± 1.2) than AMB (4.1 ± 0.4, P < 0.001). ICE and AMB had similar Tc and HR (both P > 0.05), but Tsk was lower in ICE than AMB (P = 0.049). A lower MVC (30.3 ± 6.7 vs 27.4 ± 4.9 kg, P = 0.001) and higher BART-adjusted total pump count (472 ± 170 vs 615 ± 174 pumps, P = 0.017) was observed pretrial to posttrial in AMB but absent in ICE (both P > 0.05). Salivary cortisol was similar between trials (P = 0.42). Conclusions: Heat-exposed PPE-wearing HCWs had impaired maximal strength and elevated risk-taking behavior. This may increase the risk of avoidable workplace accidents that can jeopardize HCWs and patient care. Ice slurry ingestion alleviated these heat-related impairments, suggesting its potential as an ergogenic aid. [ABSTRACT FROM AUTHOR]

This research examines the incorporation of CuO and TiO2 nanoparticles into polypropylene or cotton fabrics to develop reusable personal protective equipment. Different preparation methods are applied to anchor the nanoparticles and avoid leaching. The composition and preparation of fabrics are verified by scanning electron microscopy and X-ray diffraction. Optical properties are assessed by diffuse reflectance spectroscopy and photoluminescence. The results show that for a low ratio of CuO to TiO2, the optical properties improve, reducing bandgap energy and the electron-hole pair recombination rate. Photodegradation of methylene blue increases by 22.8% in polypropylene fabrics and up to 350% in cotton fabrics. In conclusion, photoactivity in polypropylene fabrics is 23.7 times higher than in cotton fabrics, since the preparation method controls the loading of active species [ABSTRACT FROM AUTHOR]

Global shortages of critical equipment and supplies induced by COVID-19 forced countries to rapidly build and ramp up their indigenous testing and production capacities. However, the many ways in which institutional and organizational change occurred has not been sufficiently captured. Building domestic capacity requires the leveraging and repurposing of existing domestic scientific and technological capabilities, coupled with intensified global outreach to new and existing partners and suppliers. Using the framework of institutional variety, this paper looks at two facets of the UK's COVID emergency industrial response: (1) building its laboratory testing capabilities and (2) for increasing production of personal protective equipment; assessing the institutional capacities and relations that were leveraged in this regard. It uses these findings together with observations of 'innovation processes under emergency conditions' and the potential uses of a 'critical equipment policy' to sharpen some of the recommendations made in the UK's post-COVID Research and Development Roadmap. [ABSTRACT FROM AUTHOR]

Hazardous chemicals are transported on rail and road networks. In the case of accidental spillage or terror attack, civilian and military first responders must approach the scene equipped with appropriate personal protective equipment. The plausible manufacturing of chemical protective polymer material, from photocatalyst anatase titanium dioxide (TiO2) doped low-density polyethylene (LDPE), for cost-effective durable lightweight protective garments against toxic chemicals such as 2-chloroethyl ethyl sulphide (CEES) was investigated. The photocatalytic effects on the physico-chemical properties, before and after ultraviolet (UV) light exposure were evaluated. TiO2 (0, 5, 10, 15% wt) doped LDPE films were extruded and characterized by SEM-EDX, TEM, tensile tester, DSC-TGA and permeation studies before and after exposure to UV light, respectively. Results revealed that tensile strength and thermal analysis showed an increasing shift, whilst CEES permeation times responded oppositely with a significant decrease from 127 min to 84 min due to the degradation of the polymer matrix for neat LDPE, before and after UV exposure. The TiO2-doped films showed an increasing shift in results obtained for physical properties as the doping concentration increased, before and after UV exposure. Relating to chemical properties, the trend was the inverse of the physical properties. The 15% TiO2-doped film showed improved permeation times only when the photocatalytic TiO2 was activated. However, 5% TiO2-doped film exceptionally maintained better permeation times before and after UV exposure demonstrating better resistance against CEES permeation. [ABSTRACT FROM AUTHOR]

Background: The use of appropriate personal protective equipment (PPE) in healthcare settings is a very important factor of infection control activities to prevent transmission of infection. In this study, we aimed to develop a non-face-to-face method that can reduce transmission of infection and an educational method that allows self-learning and self-training, and verify the effectiveness of a donning and doffing PPE education using video debriefing on third-year nursing students in clinical train. Methods: The researcher assigned groups through random sampling using a random number table from the list of research subjects who agreed to participate. Therefore, 35 subjects in the experimental group with an education on donning and doffing PPE using video debriefing and 34 subjects in the control group with video-based training (VBT) were participated in April 2023 at a university in Incheon, South Korea. The evaluation phase involved verifying effects of the education on observer evaluation donningand doffing PPE performance and self-evaluation donningand doffing PPE performance. Satisfaction with the education also assessed immediately after intervention by the experimental group. Results: The experimental group had significantly higher scores for observer evaluationdonning (t = 7.84, p <.001) and observer evaluation doffing (t = 6.52, p <.001) PPE performances than the control group. However, there was no significant difference in self-evaluation donning (t = 0.98, p <.330) or doffing PPE performance (t = 0.17, p <.869) between the two groups. In the experimental group that applied video debriefing, learning satisfaction was 4.33 ± 0.82 points out of 5 points. Conclusions: The education on donning and doffing PPE applying video debriefing was effective. If the education developed in this study is used as a self-learning method to improve the infection control capacity necessary to respond to a disaster crisis caused by infectious diseases, it is considered to be useful for preventing the transmission of infectious diseases in the future. [ABSTRACT FROM AUTHOR]

In this case study we describe how Sydney Local Health District (SLHD) Disability Inclusion and Advice Service (DIAS) provided support to disability group homes during the COVID-19 Delta and Omicron waves. The study provides insights into group home providers' experience of supports implemented by SLHD and other stakeholders. A mixed method approach was undertaken that included analysing data from a database and electronic medical records and a survey of disability group home managers. DIAS developed a range of processes to support prevention, outbreak preparedness and response. This included developing a Disability Shared Living COVID-19 Pathway, engaging with group home providers through a fortnightly Community of Practice, assisting with improving vaccination status and procuring personal protective equipment. During an outbreak DIAS provided a 24 h, 7 days per week on call support, coordinated outbreak management team meetings and collaborated with several internal and external stakeholders. SLHD infection prevention and control nurses were recruited to undertake a process of reviewing outbreak management plans and providing support during an outbreak. Most disability providers (86%) reported that they felt very prepared to manage outbreaks at the time of the survey (August 2022) compared with the pre-Delta wave, for which 36% reported feeling 'not prepared'. The proportion who rated the support from the stakeholders as very supportive/supportive was as follows: SLHD (100%), NSW Health (64%), National Disability Insurance Agency (50%) and National Disability Insurance Scheme Quality & Safeguards Commission (37%). Our case study provides insights into the support that LHDs can provide to disability homes in response to future outbreaks. What is known about the topic? People with a disability (PWD) are at higher risk of morbidity and mortality following COVID-19 infection but little is known about how PWD were supported during the COVID-19 pandemic. What does this paper add? Describes one local health district (LHD's) approach to prevent, manage and minimise COVID-19 outbreaks in disability group homes along with insights from the disability group home managers on their experience of support provided by the LHD and other stakeholders. What are the implications for practitioners? Awareness of effective strategies supporting PWD that could be replicated in health organisations. [ABSTRACT FROM AUTHOR]

ObjectivesMethodsResultsConclusionThis study examined the factors affecting the use of personal protective equipment (PPE) among US agriculture producers, specifically focusing on chemical, respiratory, and hearing protection. The primary goals were to identify demographic and farm-related factors linked to lower PPE usage and to explore the associations between PPE use and self-reported injuries or diseases in this occupational context.We developed generalized multilevel multinomial logistic regressions for the agricultural safety and health survey data from 2018 and 2020. Our models aimed to explore associations between PPE use, covariates, and their impact on skin diseases, hearing loss, and respiratory diseases. The hierarchical structure of the data was accommodated by designating the survey year as the level-3 variable and the state of residence as the level-2 variable, further delineating the nested structure of the respondents. We proposed using Adaptive Quadrature methods to approximate marginal maximum likelihood function, along with Gauss-Hermite quadrature weights when estimating fixed-effects and random effects in the proposed models. Missing data in this hierarchical structure were addressed through a multiple imputation method.Our findings revealed older age is associated with lower PPE usage across all types. Males exhibited higher PPE use, particularly for chemical (OR: 1.26, 95% CI: 1.08, 1.47) and respiratory protection (OR: 1.33, 95% CI: 1.18, 1.52). Producers on grain-only farms showed increased chemical PPE use (OR: 1.26, 95% CI: 1.10, 1.43) compared to those on livestock-only farms. Additionally, individuals spending 0%–24% of their worktime on the farm/ranch demonstrated lower PPE use than those who spent more time engaged in farm-related activities.The study underscores the importance of addressing low PPE usage among agriculture producers. Interventions tailored to specific groups, such as female producers, livestock-only farms, older-aged producers, and part-time producers, can effectively improve PPE use. By identifying these high-risk groups, interventions can be better adapted and targeted to enhance the adoption of PPE, subsequently reducing the risk of health hazards in the agriculture sector. [ABSTRACT FROM AUTHOR]

Purpose: This paper explores how frontline nurses experienced the onset of the coronavirus disease (COVID‐19) pandemic to provide appropriate care during a global health crisis. Design and Methods: A qualitative descriptive phenomenological study. The sample consisted of 13 frontline nurses from Turkey, working in intensive care units, inpatient clinics and emergency unit. Data were collected online through face‐to‐face interviews based on a semi‐structured interview guide. Data were analysed using thematic analysis. Findings: Nurses experienced certain difficulties in the continuous use of protective personal equipment, communication both with patients and colleagues, administrative processes. Besides, they experienced exhaustion, reduced job satisfaction and certain physical complaints. Conclusions: Hospital administrators and health policy makers should effectively manage human and hospital resources effectively and solve nurses' problems in times of crisis, such as pandemics. Clinical Relevance: Understanding the challenges faced by frontline nurses during the onset of the COVID‐19 pandemic may help healthcare practitioners and policy makers to implement targeted interventions, support mechanisms and resource allocation strategies that enhance the well‐being of frontline nurses and optimise patient care delivery during health crises. [ABSTRACT FROM AUTHOR]

The Coronavirus Disease 2019 (COVID-19) has caused massive losses for the global economy. Scholars have used different methods to study the transmission mode and influencing factors of the virus to find effective methods to provide people with a healthy built environment. However, these studies arrived at different or even contradictory conclusions. This review presents the main research methodologies utilized in this field, summarizes the main investigation methods, and critically discusses their related conclusions. Data statistical analysis, sample collection, simulation models, and replication transmission scenarios are the main research methods. The summarized conclusion for prevention from all reviewed papers are: adequate ventilation and proper location of return air vents, proper use of personal protective equipment, as well as the reasonable and strict enforcement of policies are the main methods for reducing the transmission. Recommendations including standardized databases, causation clarification, rigorous experiment design, improved simulation accuracy and verification are provided. [ABSTRACT FROM AUTHOR]

Purpose: There have been over 40 descriptions of the common developmental variants of the accessory ossicles of the feet. Although predominantly asymptomatic, they sometimes may be linked to painful conditions. One of the most common accessory ossicles in the foot is the accessory navicular bone (AN), located on the medial side of the foot. Our research provides a first meta-analysis on this topic that establishes its frequency by contrasting 39 studies from across the globe. Methods: Up to February 2024, PubMed and Embase databases were thoroughly searched for research on the AN. Eligible data regarding AN prevalence was extracted. This study strictly adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: A total of 39 studies, 11,015 patients, and 36,837 feet were analyzed in our study. The pooled prevalence estimate (PPE) of AN was found to be 17.5% (95%CI: 11.5–25.7) and 12.6% (95%CI: 10.1–15.5) in patients and feet analyses, respectively. Accessory navicular occurred bilaterally in 50.0% of patients, with similar distribution in gender-based groups (21.1% of males and 22.0% of females were confirmed with AN). Accessory navicular was most prevalent in the East Asian population (38.4%) and least prevalent in North Americans (8.0%). No significant differences in AN prevalence were found when comparing different imaging modalities (X-ray and cadaver dissection). Conclusion: Accessory navicular is a common finding in imaging studies. Its prevalence depends on the population covered by the study but is not affected by the patient's gender or the imaging modality utilized for AN assessment. [ABSTRACT FROM AUTHOR]

Personal protective equipment (PPE) plays a crucial role in safeguarding the well-being of workers on construction sites by mitigating the risk of accidents and incidents. Nevertheless, incidents stemming from a lack of awareness regarding PPE usage persist. To enhance the oversight of construction laborers for accident prevention, most current approaches involve overseeing the availability and correct utilization of PPE using intricate data processing techniques. However, these methods encounter challenges related to their applicability and capacity for universal implementation. This study presents the hybridization of seahorse optimization (SHO) algorithm with the YOLOv5 model to ultimate detection accuracy. First, an improved YOLO network is constructed through scale and loss function enhancement. Second, the SHO is utilized to tune the parameters of the improved YOLOv5. A data set with 4535 construction work images was collected for training, validation and testing the hybrid SHO-YOLOv5 model. Experimental results supported by statistical tests show that the SHO-YOLOv5 is a capable method for detecting automatically the PPE with a precision value of 0.74, recall value of 0.65 and F1 score of 0.68. The SHO-YOLOv5 surpasses the benchmarked models like YOLOv8, YOLOv5, Faster-R-CNN MobilenetV3, and Faster-R-CNN Resnet50. Therefore, the proposed hybrid approach is a promising tool to support the project managers in the task of safety inspection. [ABSTRACT FROM AUTHOR]

Comprehensive assessment of the active/passive seismic stability of shallow tunnel faces is an urgent and complex task. This work establishes a promising three-dimensional (3D) approach using upper-bound limit analysis to evaluate the active and passive seismic stability of shallow shield tunnel faces. The outcrop failure model and inside failure model are provided for active failure analysis. To capture the spatiotemporal variations of seismic loading, the pseudodynamic approach is employed to assess the limit active and passive support pressures. Comparisons with published studies and numerical simulations demonstrate that the proposed 3D approach greatly improves existing 2D results for limit active and passive support pressures. A detailed investigation is then conducted to analyze the effects of pseudodynamic parameters, surface surcharge, and buried depth on face stability of shallow tunnels. Finally, the proposed approach is further tested by conducting the seismic face stability analysis of Changsha Metro 2 tunnel based on actual seismic response. The results indicate that the surface surcharge has a greater influence on limit passive support pressure than limit active support pressure, and increasing of buried depth leads to a larger safety range of limit support pressure. Practical Applications: Active and passive face failure of shallow tunnels under earthquakes can endanger the safety of tunnels and ground surfaces, leading to severe casualties and property losses. Determination of limit support pressures under seismic forces is a critical task in shield tunnel construction. This work establishes an approach to assess 3D active and passive seismic stability of shallow shield tunnel faces. Time–space variations of seismic loading are incorporated to accurately determine limit active and passive support pressures using pseudodynamic approach. Effects of seismic parameters, surface surcharge, and buried depth on face stability of shallow tunnels are then presented and discussed. Finally, the proposed approach is tested by conducting the seismic face stability analysis of Changsha Metro 2 tunnel based on actual seismic response. The results indicate that surface surcharge has a greater influence on limit passive support pressure compared with limit active support pressure, and increasing buried depth leads to a larger safety range of limit support pressure. The proposed approach determines a safety range of limit support pressures more accurately for shallow shield tunnels during earthquakes. [ABSTRACT FROM AUTHOR]

This study aims to clarify the mechanism of slurry support and its effect at different stages of slurry infiltration in shield construction. The analysis of various expressions of slurry support throughout the entire excavation cycle is based on the theories of slurry infiltration effects and the cutting action of the cutters. Furthermore, the limit support pressure calculation method at the tunnel face is modified considering the slurry support mechanism observed during different slurry infiltration stages. Some of the main conclusions drawn are as follows. (1) When slurry deep infiltration occurs, the main form of slurry support is the seepage force acting on the soil skeleton. At this stage, the limit support pressure from the filter cake model will not be sufficient to meet the tunnel face stability requirements. (2) The effectiveness of slurry support is influenced by both the slurry infiltration state and the cutting action of the cutterhead. Slurry infiltration and shield tunneling together create a quasi-static equilibrium state, in which slurry support is effective only when the infiltration velocity corresponding to this state is greater than the critical velocity. (3) And the influence of shield tunneling parameters on the slurry support mechanism is significant. Compared with the cutter's penetration degree, the cutter's rotational speed has a more pronounced effect on the conversion rate of slurry support pressure at the shield tunnel face. [ABSTRACT FROM AUTHOR]

The limit support pressure significantly influences the stability of the shield tunnel face and deformation control during tunneling. Current research predominantly focuses on soils under dried or saturated conditions. However, unsaturated soils, which are more commonly encountered in engineering practice and widely distributed, have not been as extensively studied. Based on limit equilibrium theory, a modified analytical wedge-prism model is proposed in this paper to predict the limit support pressure acting on the shallow shield tunnel face in unsaturated sandy soil where the soil arching effect is considered. Taking advantage of finite-element software ABAQUS (version 2021), a series of numerical trapdoor tests are conducted first to study the failure behavior of unsaturated sandy soil. Then, by combining the rotation trajectory of major principal stress with the shear strength theory of unsaturated soil, the loosening earth pressure solution above the shallow trapdoor can be derived analytically. The limit support pressure can be finally obtained through a force equilibrium analysis of the wedge body. The accuracy of the proposed model is validated by comparing the calculated results with current model tests and numerical simulations. Parameter analysis results reveal that both the loosening earth pressure and limit support pressure initially decrease and then increase with the rising degree of soil saturation. A critical saturation point is identified where the loosening earth pressure and the limit support pressure reach their minimum values, attributed to the full development of the soil arching effect. [ABSTRACT FROM AUTHOR]

Background: Construction workers are exposed to risks that differ markedly from general industry related to occupational health and safety. Objectives: • To study the morbidity profile of construction workers. • To assess the socio-demographic profile of construction workers • To assess working conditions and facilities available at construction site. • To know the usage of personal protective equipment (PPE) among construction workers. Methodology: An observational, descriptive cross-sectional study conducted by Department of Community Medicine, Andhra Medical College, Visakhapatnam among 305 construction workers. All male and female construction workers aged above 14 years who were available at the construction site. After obtaining permission from the Institutional Ethics Committee, and Informed written consent data was collected. Data analysis was done by using SPSS software. Results: In the present study the current morbidity among the study population was 46.9%. The most common morbidity among construction workers was musculoskeletal problems (34.1%), followed by respiratory disorders (30.5%), gastrointestinal problems (23.6%), skin problems (21.6%), and central nervous system problems (22.6%). About 40.7% of the study participants were using personal protective equipment. Conclusion: Health education for workers is required to create awareness regarding workplace problems and the correct usage of Personal Protective equipment. [ABSTRACT FROM AUTHOR]

Reasonable support force is crucial for the stability of the excavation face in sandy pebble tunnels. By utilizing the existing failure mode of the logarithmic spiral curve, this study combined the collapse arch model with the limit analysis method to establish a failure model for the excavation face in sandy pebble tunnels. A calculation method for the ultimate supporting force applicable to the excavation face of sandy pebble tunnels was also proposed. Then, the theoretical analysis presented in this paper was compared with numerical simulation and existing theories to determine the failure areas under different internal friction angles and cohesion values. Finally, the excavation face stability of a shield tunnel in Beijing was analyzed using theoretical analysis and numerical simulation methods. The results showed that the analytical solution proposed in this paper was in good agreement with the limit supporting force derived from existing research, with convenient and accurate calculations. The limit supporting force decreased nonlinearly with the increase of the internal friction angle, and was more sensitive to changes in the friction angle when the angle was small. The limit supporting force decreased approximately linearly with the increase in cohesion. When the burial depth was small, it had a more significant impact on the limit supporting force. When the C / D ratio exceeded 1. 0, the increase of the burial depth of the tunnel had no obvious effect on the limit supporting force, and the friction angle had a very significant effect on the failure area. With the increase of internal friction angle, the failure area decreased significantly. Cohesion had little impact on the failure area, i. e., the size of the energy dissipation surface remained nearly unchanged under different cohesion values. For the shield tunnel in Beijing, the calculation based on the limit analysis method optimized the collapse range and shape, making the failure mode more reasonable while increasing the failure range, achieving excellent engineering application results. [ABSTRACT FROM AUTHOR]

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Background: Healthcare-associated infections are infections that patients acquire during hospitalization or while receiving healthcare in other facilities. They represent the most frequent negative outcome in healthcare, can be entirely prevented, and pose a burden in terms of financial and human costs. With the development of new AI and ML algorithms, hospitals could develop new and automated surveillance and prevention models for HAIs, leading to improved patient safety. The aim of this review is to systematically retrieve, collect, and summarize all available information on the application and impact of AI in HAI surveillance and/or prevention. Methods: We conducted a systematic review of the literature using PubMed and Scopus to find articles related to the implementation of artificial intelligence in the surveillance and/or prevention of HAIs. Results: We identified a total of 218 articles, of which only 35 were included in the review. Most studies were conducted in the US (n = 10, 28.6%) and China (n = 5; 14.3%) and were published between 2021 and 2023 (26 articles, 74.3%) with an increasing trend over time. Most focused on the development of ML algorithms for the identification/prevention of surgical site infections (n = 18; 51%), followed by HAIs in general (n = 9; 26%), hospital-acquired urinary tract infections (n = 5; 9%), and healthcare-associated pneumonia (n = 3; 9%). Only one study focused on the proper use of personal protective equipment (PPE) and included healthcare workers as the study population. Overall, the trend indicates that several AI/ML models can effectively assist clinicians in everyday decisions, by identifying HAIs early or preventing them through personalized risk factors with good performance. However, only a few studies have reported an actual implementation of these models, which proved highly successful. In one case, manual workload was reduced by nearly 85%, while another study observed a decrease in the local hospital's HAI incidence from 1.31% to 0.58%. Conclusions: AI has significant potential to improve the prevention, diagnosis, and management of healthcare-associated infections, offering benefits such as increased accuracy, reduced workloads, and cost savings. Although some AI applications have already been tested and validated, adoption in healthcare is hindered by barriers such as high implementation costs, technological limitations, and resistance from healthcare workers. Overcoming these challenges could allow AI to be more widely and cost-effectively integrated, ultimately improving patient care and infection management. [ABSTRACT FROM AUTHOR]

Background/Objectives: The previous literature has identified increased work-related stress among healthcare workers (HCWs) during the COVID-19 pandemic. This study analyzes work-related perceived stress experienced by therapists during the COVID-19 pandemic in Germany to identify potential for supporting this crucial group of HCWs in future health crises. Methods: Survey data on stress, measured through the Perceived Stress Scale 4, among HCWs (therapists n = 612, nurses n = 501, and doctors n = 461) were analyzed using descriptive statistics, and data from four semi-structured interviews and seven focus group discussions with therapists were analyzed using thematic content analysis. Data were collected from March to September 2022. Results: Therapists reported similar stress levels to other HCWs, with the reporting of perceived stress differing between work contexts. Eight stressors were identified through the thematic analysis: (1) concerns about maintaining the quality of care, (2) uncertainty about the future, (3) workload, (4) interactions with colleagues and patients, (5) PPE, (6) the risk of infection, (7) insufficient information flow, and (8) the lack of public and political recognition. Conclusions: This study emphasizes the distinct challenges that therapists experienced during the COVID-19 pandemic. By identifying the factors that contributed to the stress experienced, the study can inform targeted support strategies which can enhance therapists' work, ultimately contributing to sustaining essential healthcare services during public health crises. [ABSTRACT FROM AUTHOR]

HIV care services have been interrupted by the COVID-19 pandemic in many states in the U.S. including South Carolina (SC). However, many HIV care facilities demonstrated organizational resilience (i.e., the ability to maintain needed health services amid rapidly changing circumstances) by addressing challenges to maintaining care during the pandemic. This study, therefore, aims to identify key facilitators for organizational resilience among AIDS Services Organizations (ASOs) in SC. In-depth interviews were conducted among 11 leaders, from 8 ASOs, across SC during the summer of 2020. The interviews were recorded after receiving proper consent and then transcribed. Utilizing a codebook based upon the interview guide, a thematic analysis approach was utilized to analyze the data. All data management and analysis were conducted in NVivo 11.0. Our findings demonstrate several facilitators of organizational resilience, including (1) accurate and timely crisis information dissemination; (2) clear and preemptive protocols; (3) effective healthcare system policies, management, and leadership; (4) prioritization of staff psychological wellbeing; (5) stable access to personal protective equipment (PPE); (6) adequate and flexible funding; and (7) infrastructure that supports telehealth. Given the facilitators of organizational resilience among ASOs in SC during the COVID-19 pandemic, it is recommended that organizations implement and maintain coordinated and informed responses based upon preemptive protocols and emerging needs. ASO funders are encouraged to allow a flexibility in spending. The lessons learned from the participating leaders enable ASOs to develop and strengthen their organizational resilience and experience fewer disruptions in the future. [ABSTRACT FROM AUTHOR]

Objective: To characterize the experience of people with epilepsy and aligned healthcare workers (HCWs) during the first 18 months of the COVID‐19 pandemic and compare experiences in high‐income countries (HICs) with non‐HICs. Methods: Separate surveys for people with epilepsy and HCWs were distributed online in April 2020. Responses were collected to September 2021. Data were collected for COVID‐19 infections, the effect of COVID‐related restrictions, access to specialist help for epilepsy (people with epilepsy), and the impact of the pandemic on work productivity (HCWs). The frequency of responses for non‐HICs and HICs were compared using non‐parametric Chi‐square tests. Results: Two thousand one hundred and five individuals with epilepsy from 53 countries and 392 HCWs from 26 countries provided data. The same proportion of people with epilepsy in non‐HICs and HICs reported COVID‐19 infection (7%). Those in HICs were more likely to report that COVID‐19 measures had affected their health (32% vs. 23%; p < 0.001). There was no difference between non‐HICs and HICs in the proportion who reported difficulty in obtaining help for epilepsy. HCWs in non‐HICs were more likely to report COVID‐19 infection than those in HICs (18% vs 6%; p = 0.001) and that their clinical work had been affected by concerns about contracting COVID‐19, lack of personal protective equipment, and the impact of the pandemic on mental health (all p < 0.001). Compared to pre‐pandemic practices, there was a significant shift to remote consultations in both non‐HICs and HICs (p < 0.001). Significance: While the frequency of COVID‐19 infection was relatively low in these data from early in the pandemic, our findings suggest broader health consequences and an increased psychosocial burden, particularly among HCWs in non‐HICs. Planning for future pandemics should prioritize mental healthcare alongside ensuring access to essential epilepsy services and expanding and enhancing access to remote consultations. Plain Language Summary: We asked people with epilepsy about the effects of COVID‐19 on their health and healthcare. We wanted to compare responses from people in high‐income countries and other countries. We found that people in high‐income countries and other countries had similar levels of difficulty in getting help for their epilepsy. People in high‐income countries were more likely to say that their general health had been affected. Healthcare workers in non‐high‐income settings were more likely to have contracted COVID‐19 and have the care they deliver affected by the pandemic. Across all settings, COVID‐19 associated with a large shift to remote consultations. [ABSTRACT FROM AUTHOR]

This scoping review aimed to identify and summarise evidence on the comfort and functional performance of police officer personal protective equipment (PPE). The Arksey and O'Malley (2005) five-stage framework for scoping reviews was followed. PubMed, CINAHL, Scopus, and Web of Science were searched, and 35 articles were included in the review. The findings show that increased police PPE mass increases heart rate, metabolic energy expenditure, and perceived exertion in response to exercise. Unisex armour designs cause increased discomfort for females with larger bra sizes. PPE reduces joint-specific range of motion, with the design and location impairing movement more than mass. Jumping and sprinting performance is decreased with heavy PPE but unaffected by lighter protection, while agility is compromised with most forms of protection. Future research is needed on the fit and function of PPE for specialist police units, such as mounted police, along with further investigations on how fit can affect functional performance. PRACTITIONER SUMMARY: This paper identifies and reviews existing evidence on the comfort and functional performance of police officer personal protective equipment (PPE). This is significant because it summarises and categorises key concepts that underpin research in this area, whilst highlighting gaps in the current knowledge and areas for future research. [ABSTRACT FROM AUTHOR]

The recent pandemic has shown that protecting the general population from hazardous substances or pathogens can be a challenging and urgent task. The key element to adequate protection is appropriately sized, well-fitted and sufficiently distributed personal protective equipment (PPE). While these conditions are followed for adult PPE wearers, they are less considered when it comes to protecting subadults. In this study, the assessment of the fit and design improvements of a 3D-printed facial half mask for subadult wearers (4–18 years) is designed. The target population was represented by 1137 subadults, aged 4.06–18.94 years, for whom 3D face models were acquired. The half mask tested, which was originally provided in one subadult size, did not fit appropriately the target population. This finding prompted the creation of four size categories using the age-dependent distribution of the centroid size calculated from 7 facial landmarks. For each size category, a modified half-mask virtual design was created, including resizing and reshaping, and fit was evaluated visually and numerically using averaged and random 3D face representatives. Practitioner summary: The reason for this study was to describe procedures which led to design improvement of an existing half-mask and provide respiratory protection for subadults. To address this, fit was assessed using an innovative metric approach. Four sizes were then created based on centroid size, resulting in improved fit and design. Abbreviations: CH: cheilion landmark; CS: centroid size; EX: exocanthion landmark; GN: gnathion landmark; N: nasion landmark; PPE: personal protective equipment; PR: pronasale landmark; RPE: respiratory protective equipment HIGHLIGHTS: 3D human face dataset was used for modifying and validating protective equipment for subadults To ensure optimal protection for subadults, four size categories were proposed based on 3D face landmarks and centroid size Modified half-mask design fit was validated virtually using a visual and numerical approach [ABSTRACT FROM AUTHOR]

AbstractThe COVID-19 pandemic had an unprecedented impact on the well-being of individuals working in the healthcare sector. Though many studies exist that focus on physician and nurse well-being, few have specifically identified stressors that affect professionals working within the end-of-life interdisciplinary team. The primary objective of this study was to expand research on moral distress and clinician well-being to include healthcare professionals working with patients with chronic and life-limiting illnesses during the COVID-19 pandemic. A survey approach was used with 110 professionals working within one hospital network’s palliative and hospice team to identify key indicators of moral distress (using the MMD-HP scale) and professional well-being during the pandemic. Quantitative and qualitative analysis was completed to determine themes related to moral distress and professional well-being. Numerous themes were identified, including the importance of caseload, general support, team support, management, and professional flexibility. Additional end-of-life themes were identified, including the impact of death, lack of personal protective equipment, fear of transmitting the virus, COVID disbelief, and the inability of clinicians and/or family to be with patients in person. From the experience participants had during COVID-19, four areas of change were identified: professional resilience, management/ethics support, professional development, and physical and emotional safety. [ABSTRACT FROM AUTHOR]

Background: Evidence suggests that semi-facial respirators provide protection against contamination in high-risk environments, although the COVID-19 pandemic called for greater protection and viral inactivation capacity. Thus, the aim of this study was to investigate the efficacy of a novel semi-facial respirator containing chitosan nanoparticles, compared with a conventional N95 respirator on the incidence of laboratory-confirmed SARS-CoV-2 in healthcare professionals. The secondary outcomes were influenza infection, usability and comfort. Methods: Randomized controlled trial within a large public hospital (reference for COVID-19 patients) carried out between March 2021 and June 2023. We included 230 healthcare professionals exposed to SARS-Cov-2 and influenza, working in emergency departments, hospital wards, and intensive care units. Participants were assessed at baseline, after 10 days, and 21 days of follow-up. Researchers, participants, and outcome assessors were blinded to the allocated groups. Outcomes were analyzed by bivariate and multivariate comparisons using logistic regression. Crude (cOR) and adjusted odds ratios (aOR) were estimated, followed by 95% confidence intervals (CIs 95%). We adopted intention-to-treat (ITT) and complete-case (CC) analyses. Results: Baseline characteristics were considered homogeneous between groups, and usability and comfort were reported as excellent in both groups. Non-significant differences were found for all outcomes, both in the ITT and CC analyses. The incidence of COVID-19 and influenza were, respectively, cOR: 0.96 [CI95%: 0.21–4.42] and cOR: 1.25 [CI95%: 0.34–4.62]; and aOR: 1.08 [CI95%: 0.21–5.47] and aOR: 1.11 [CI95%: 0.17–7.01]. Conclusions: We found that the incidence of SARS-Cov-2 and influenza infections were similar between the new respirator compared to the conventional respirator. Furthermore, we observed that usability and comfort were similar and considered excellent for both respirators. Trial registration: Clinicaltrials.gov (NCT04490200, 29/07/2020). [ABSTRACT FROM AUTHOR]

Building on qualitative interviews, this article brings into view how New Delhi university students organized improvised forms of Covid relief during the Delta coronavirus wave in the spring of 2021. Responding to a lack of care due to state negligence and a breakdown of public and private healthcare infrastructure, students coordinated access to crucial resources such as masks, other personal protective equipment and even oxygen through the use of social media, existing social networks, and practices developed in earlier moments of organizing. Using the lenses of improvisation, rehearsal and repair, this article documents how students improvised informal Covid relief. Conceptually, the article offers the framework of transposition to look at how improvisational capacity in a social network was shifted from one crisis to the next. [ABSTRACT FROM AUTHOR]

Highlights Highly filled polymer fibers offer huge promise for radiation protection safety and wear comfort of personal protective equipment (PPE) in radiation environments. However, it usually sacrifices mechanical properties that directly related to practical usability. Here, as high as 75 wt% PbWO4 (PWO) particles have been filled in polyvinyl alcohol (PVA) fiber via tailoring their size and shape for enhanced γ‐rays shielding and good mechanical properties. Clearly shown that 0 dimensional (0‐D) PWO exhibits better dispersion and compatibility between the interfaces than 1‐D PWO in highly filled PVA fibers. In addition, 70 wt% 0‐D PWO/PVA fibers display better mechanical properties than 70 wt% 1‐D PWO/PVA fibers. Note that 75 wt% 0‐D PWO/PVA fibers show 1.02 cN/dtex of tensile strength. However, 75 wt% 1‐D PWO/PVA fibers fail to be fabricated smoothly. Importantly, the overlapped fabrics with 75 wt% 0‐D PWO/PVA fibers display 43.05% of γ‐ray shielding (105 keV) meanwhile it offers good air and water vapor permeability for wear comfort. The superior γ‐ray shielding ascribes the polymer fibers with the higher filling in comparison with its counterpart, which provides a practical means to design radiation protection safety and wear comfort of articles. This work breaks the upper limit of filling in polymer fibers Filler structure can weigh the integrated properties of polymer fibers. 0‐D PWO particles promote interfacial compatibility in highly filled fibers. Radiation protection safety and wear comfort of articles tend to be designed. [ABSTRACT FROM AUTHOR]

Infection prevention and control (IPC) is essential in nursing practice to safeguard patient health and reduce healthcare-associated infections. This article explores IPC strategies, including hand hygiene, the use of personal protective equipment, environmental cleaning, safe injection practices, and antimicrobial stewardship. It discusses the implementation challenges and solutions, such as ensuring compliance through education, monitoring and strong leadership. IPC measures are crucial in preventing infections such as catheter-associated urinary tract infections, central line-associated bloodstream infections, surgical site infections, and ventilator-associated pneumonia. By integrating personalised IPC strategies into nursing practice, healthcare providers can significantly improve infection control outcomes and enhance overall patient safety and quality of care. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Methods and Results Conclusion Backyard production systems (BPS) represent an interface of contact between people, domestic and wild animals. Studies conducted in Chile during the last decade have provided extensive evidence of influenza A virus (IAV) circulation in backyard poultry and swine. The aim of this study was to investigate exposure practices of humans to animal‐origin IAV within backyards.Backyard farmers and household members of a total of 101 BPS in the proximity of wetlands located throughout Chile were interviewed between 2021 and 2022. Data were collected on the nature of human–animal contacts through participation in productive activities conducted within backyards, which was used to estimate participants' exposure risk to animal‐origin IAV. Additionally, RT‐qPCR and serologic IAV active surveillance was carried out in backyard animals. Multilinear regression was used to identify factors associated with exposure risk. Overall, IAV prevalence was 10.1% (95% CI: 4.7%–15.5%) and seroprevalence was 43.5% (95% CI: 29.7%–54.2%), both at the BPS level. Of 180 interviewees, 86% reported participating regularly in poultry or swine exposure activities within the backyard. A greater participation of male participants was observed when evaluating swine exposure activities, while female participation was greater for some activities related to poultry handling. Handwashing was a very extended hygiene practice; however, the use of personal protective equipment was uncommon. Different factors related to participants, households and backyards were associated with an increased exposure risk of participants to animal‐origin IAV: (i) older age, (ii) less years of education, (iii) no off‐farm work, (iv) greater backyard production value and (v) greater household consumption of backyard products.These results indicate the circulation of IAV in BPS and the frequent human–animal contact at this interface, highlighting the need for awareness campaigns and educational programmes aimed at backyard farmers on prevention and biosecurity measures in the management of backyard animals. [ABSTRACT FROM AUTHOR]

A new easy protocol to functionalize the middle layer of commercial surgical face masks (FMs) with Zn and Cu oxides is proposed in order to obtain antibacterial personal protective equipment. Zinc and copper oxides were synthesized embedded in a polydopamine (PDA) shell as potential antibacterial agents; they were analyzed by XRD and TEM, revealing, in all the cases, the formation of metal oxide nanoparticles (NPs). PDA is a natural polymer appreciated for its simple and rapid synthesis, biocompatibility, and high functionalization; it is used in this work as an organic matrix that, in addition to stabilizing NPs, also acts as a diluent in the functionalization step, decreasing the metal loading on the polypropylene (PP) surface. The functionalized middle layers of the FMs were characterized by SEM, XRD, FTIR, and TXRF and tested in their bacterial-growth-inhibiting effect against Klebsiella pneumoniae and Staphylococcus aureus. Among all functionalizing agents, Cu2O-doped-ZnO NPs enclosed in PDA shell, prepared by an ultrasound-assisted method, showed the best antibacterial effect, even at low metal loading, without changing the hydrophobicity of the FM. This approach offers a sustainable solution by prolonging FM lifespan and reducing material waste. [ABSTRACT FROM AUTHOR]

Background: Primary health-care workers (PHWs) managed increased workloads and pressure during the COVID-19 pandemic. This study conducted a national survey examining burnout among PHWs at the end of the COVID-19 pandemic, and identifies related factors. By doing so, it addresses the gap in understanding the burnout situation among PHWs at a national level, taking into account urban-rural disparities. Methods: We conducted a nationwide cross-sectional survey of PHWs in China from May to October 2022, covering 31 provinces. The MBI-HSS was used to measure overall burnout and emotional exhaustion (EE), depersonalization (DP), and reduced personal accomplishment (PA). We used multivariable logistic regression to identify risk factors, and subgroup analyses to identify differences between rural and urban areas. Results: 3769 PHWs from 44 primary health-care institutions completed the survey. Overall, 16.6% reported overall burnout, and the prevalence of EE, DP, and reduced PA was 29.7%, 28.0%, and 62.9%, respectively. The prevalence of overall burnout (17.6% vs. 13.7%, P = 0.004) and EE (31.5% vs. 24.8%, P < 0.001) was higher in urban than rural areas (AOR = 1.285; 95%CI, 1.021–1.617). Job satisfaction was a protective factor against burnout in both settings. The protective factors of overall burnout, EE and DP vary between urban and rural areas. Conclusions: The Mental Health Status Questionnaire-Short Form (MSQ-SF) score functioned as a protective factor against burnout across both rural and urban locales, highlighting the intrinsic link between job satisfaction and burnout. Other influencing factors differed between urban and rural areas, so interventions should be tailored to local conditions. Rural married PHWs experienced the lower prevalence of burnout indicates the support structure may play a significant role. In urban settings, it is recommended to strategically pre-emptively stock essential supplies like PPE. [ABSTRACT FROM AUTHOR]

Objectives. Research literature has not given much evaluation to why the proposed noise control actions in workplaces are not being implemented. There are views of the different personnel groups in the workplace and the reasons why the possibilities for solutions have not been examined. Methods. The companies under study were a welding machine shop, an assembly plant, a heavy steel company and an art glass factory. Noise management was approached by combining the perspectives of technology, acoustics and occupational safety with the examination of sociocultural factors at the workplace level. Results. Noise was not well represented in occupational safety practices. The productivity aspect was strongly emphasized. The use of personal protective equipment created the illusion that everything possible has been done and noise controlled. Conclusion. The study developed a model in which experts in the field of acoustics and sociocultural researchers together evaluated the state and development needs of noise abatement. The results of the project show that successful noise control solutions require a process involving all staff in the workplace. [ABSTRACT FROM AUTHOR]

Introduction In light of the COVID-19 (Coronovirus Disease 2019) pandemic, the use of personal protective equipment has become essential to reduce viral transmission and maintain public health. Viruses, particularly human coronavirus and influenza, pose significant challenges because of their various transmission routes. UMF Corporation's innovation, Micrillon, aims to address these challenges by creating durable, antiviral technology for textiles without harmful chemicals, reducing viral transmission risks. Materials and Methods The study followed ISO Standard 18184:2019, testing Micrillon textiles against Human Coronavirus OC43 and H1N1 Influenza A virus using MDCK and HCT-8 cell lines. Cell propagation, viral application, TCID50 (Median Tissue Culture Infectious Dose) testing, and maintenance protocols were rigorously implemented to assess antiviral efficacy. Results Micrillon gloves, fabrics, and fibers exhibited high antiviral efficacy against both viruses across various contact times. Gloves demonstrated exceptional antiviral activity against H1N1 (99.88%) and OC43 (99.67%) at 120 minutes. Rolled fabrics showed strong efficacy against H1N1 (99.42% at 30 minutes) and OC43 (>97%) at all time points. Bundled fibers displayed substantial efficacy against H1N1 (99.17% at 120 minutes) and OC43 (>98%) at all time points. Conclusions The study demonstrates that Micrillon technology effectively inhibits viral activity, particularly in gloves, fabrics, and fibers. The innovation not only shows high antiviral efficacy against both Human Coronavirus and Influenza but also promises a reusable, sustainable solution, mitigating environmental impact and reducing the use of harmful chemicals in personal protective equipment. The technology holds promise for widespread use in health care and hospitality, offering a layer of protection while being environmentally conscious. Further development of such technologies can significantly reduce infection risks while minimizing environmental harm. [ABSTRACT FROM AUTHOR]

Patients with high-consequence infectious diseases (HCIDs) require high-quality care by specially trained staff in a high-level isolation unit (HLIU) that follows strict infection prevention and control (IPC) measures. Caring for patients with (suspected) HCID is challenging, mainly because of the strict personal protective equipment (PPE) and IPC protocols healthcare workers (HCW) must adhere to for protection. The Radboud University Medical Center, located in Nijmegen, the Netherlands, has been a dedicated HLIU facility since 2008. A newly built HLIU opened in May 2022, and encouraged us to review the existing PPE selection, IPC protocols, and HCID training program to improve safety and comfort for HCWs working in the HLIU. Based on a systematic search through (inter)national HCID PPE guidelines and semistructured interviews with end users, we selected an improved, more comfortable set of PPE. Additionally, we developed a more concise and easier-to-use patient care process flow and implemented a new teaching strategy. The new way of working was tested in October 2022 when the first 2 patients with suspected HCID were admitted to our unit. We used surveys to evaluate the experiences of HCWs involved in this care to further improve the workflow of the unit. When optimizing safety and comfort for HCWs, it is important to consider (inter)national guidelines as well as user preferences. By systematically evaluating recent experiences of patient admission to the HLIU and then adjusting protocols and training, we can ensure that the quality of provided healthcare and the safety of HCWs working in the HLIU remains high. [ABSTRACT FROM AUTHOR]

Objective: This study assessed the incidence and risk factors of latent tuberculosis infection (LTBI) among healthcare workers (HCWs) in a tertiary healthcare institution in Central Anatolia. Materials and Methods: A prospective study was conducted. From January 1 to June 30, 2024, HCWs who visited the personnel follow-up outpatient clinic were diagnosed with LTBI based on tuberculin skin test results. Demographic data, occupation, workplace and duration of employment, and risk factors for tuberculosis exposure inside and outside the workplace were compared between HCWs with and without LTBI. Results: A total of 101 HCWs participated in the study. LTBI was detected in 19 HCWs (19%). The median age of healthcare workers was 36 years, with the majority being nurses (40%) and university graduates (60%). There were no differences between LTBI and non-LTBI groups in terms of demographic data, occupational, and non-occupational tuberculosis contact risks. Examination of chest X-ray findings revealed that HCWs with LTBI had more abnormal findings, with a statistically significant difference in the rate of calcification (p=0.003). Among HCWs with LTBI, the use rate of filtering facepiece (FFP-3) masks when in contact with suspected or confirmed tuberculosis patients was lower (31% and 45%). Conclusion: This study identified latent tuberculosis in one out of every five healthcare workers. Routine examination and periodic chest X-rays for HCWs are crucial for predicting latent tuberculosis. Healthcare workers should be educated on the correct use of personal protective equipment. [ABSTRACT FROM AUTHOR]