Personal protective equipment simulation training is associated with lower COVID-19 infection among healthcare workers

ABSTRACT Objective To describe the personal protective equipment training strategies during the beginning of the pandemic and to investigate the association between training and COVID-19 infection among healthcare workers. Methods This cross-sectional study conducted between March and May 2020 included 7,142 healthcare professionals who were eligible for both online and face-to-face simulation-based training on personal protective equipment use. Simulation training attendance was assessed by reviewing the attendance list, and the COVID-19 sick leave records recovered from the institutional RT-PCR database used to grant sick leave. The association between personal protective equipment training and COVID-19 was investigated using logistic regression, adjusted for sociodemographic and occupational characteristics. Results The mean age was 36.9 years (± 8.3), and 72.6% of participants were female. A total of 5,502 (77.0%) professionals were trained: 3,012 (54.7%) through online training, 691 (12.6%) through face-to-face training, and 1,799 (32.7%) through both strategies. During the study period, 584 (8.2%) COVID-19 cases were diagnosed among these professionals. The number of positive RT-PCR tests was 180 (11.0%) for untrained professionals, 245 (8.1%) for those trained only online, 35 (5.1%) for those trained face-to-face, and 124 (6.9%) for those trained with both strategies (p<0.001). Participants who received face-to-face training had a 0.43 lower risk of contracting COVID-19. Conclusion Personal protective equipment training decreased the odds of COVID-19 among healthcare professionals, with face-to-face simulation-based training being most effective.

Enabling Elements for the Implementation of Community Health Promoter Led Interventions: A Literature Review / Elementos Habilitadores para la Implementación de Intervenciones Dirigidas por Promotores de Salud Comunitaria: Una Revisión de la Literatura

ABSTRACT: This research seeks to present Community Lay Advisor interventions as a health promoting strategy that have appeared in the international literature, in order to highlight these enabling elements in the intervention's implementation and establish a comparison among the aspects addressed in the analyzed experiences and the "Schoolbased Oral Health Promoters Program" at the Universidad de La Frontera in Temuco, Chile. A comprehensive scoping review was held between February and March 2018, with searches performed in both the academic and grey literature. Peer-reviewed scientific papers were found using the interdisciplinary database Scopus (including MEDLINE) and EBSCOhost, while grey literature and media sources were extracted from the Google and Google Scholar search engines, supplemented with a visit to the EPES foundation in Chile and an analysis of the reference lists for the selected articles. 369 articles were identified, of which 23 met eligibility criteria for this review. Based on the analysis of the experiences, some facilitators were found more pertinent when achieving the goals concerning the intervention's design, implementation and assessment. This paper makes recommendations for the design and execution of peer-led health promotion interventions in order to increase its effectiveness and success rate.

RESUMEN: Esta investigación busca presentar las intervenciones del Community Lay Advisor como una estrategia de promoción de la salud que ha aparecido en la literatura internacional, para resaltar estos elementos habilitadores en la implementación de la intervención y establecer una comparación entre los aspectos abordados en las experiencias analizadas y el "Programa de Promotores de Salud Bucal en las Escuelas" de la Universidad de La Frontera, en Temuco, Chile. Entre febrero y marzo de 2018 se llevó a cabo una revisión exhaustiva del alcance, con búsquedas realizadas tanto en la literatura académica como en la gris. Se encontraron artículos científicos revisados por pares utilizando la base de datos interdisciplinaria Scopus (incluyendo MEDLINE) y EBSCOhost, mientras que la literatura gris y las fuentes de medios se extrajeron de los motores de búsqueda Google y Google Scholar, complementados con una visita a la fundación EPES en Chile y un análisis de las listas de referencias de los artículos seleccionados. Se identificaron 369 artículos, de los cuales 23 cumplieron con los criterios de elegibilidad para esta revisión. Sobre la base del análisis de las experiencias, algunos facilitadores resultaron más pertinentes al alcanzar los objetivos relacionados con el diseño, la implementación y la evaluación de la intervención. Este documento hace recomendaciones para el diseño y la ejecución de intervenciones de promoción de la salud dirigidas por pares para aumentar su eficacia y su tasa de éxito.

Prevalência e características das feridas em pessoas idosas residentes na comunidade / Prevalencia y características de las lesiones en personas mayores que viven en la comunidade / Prevalence and characteristics of lesions in elderly people living in the community

RESUMO Objetivo Descrever o perfil e as características de idosos com restrição de mobilidade, residentes na comunidade e com presença de lesões de pele. Método Estudo exploratório e descritivo, parte do Estudo SABE – Saúde Bem-estar e Envelhecimento que avaliou a presença de lesões de pele em uma amostra probabilística de idosos residentes no município de São Paulo segundo aspectos sociodemográficos, biomarcadores sanguíneos, condições de saúde e utilização de serviços. A análise utilizou o teste de qui-quadrado com correção de Rao-Scott para amostras complexas com nível de significância de 5%. Resultados No ano de 2010, 20,7% dos idosos com restrição de mobilidade apresentavam lesões na pele em decorrência desse problema. Os locais mais frequentes foram região sacral para ambos os sexos, escapular para mulheres e trocanteriana para homens. Idade mais avançada, multimorbidade e comprometimento funcional foram mais prevalentes entre os idosos com feridas, assim como a maior frequência de cuidado requerido. A disfuncionalidade familiar mostrou-se associada à maior sobrecarga do cuidador que pode refletir na qualidade do cuidado prestado. Observou-se que esses idosos que são prioritários para a atenção domiciliar não a recebem adequadamente. Conclusão A prevalência de lesões de pele em idosos com restrição de mobilidade na comunidade é baixa, no entanto requerem atenção diferenciada e essa não está sendo adequadamente oferecida. A reorganização das políticas e serviços assistenciais mostra-se essencial.

RESUMEN Objetivo Describir el perfil y las características de las personas mayores con limitaciones de movilidad, residentes en la comunidad y con la presencia de lesiones en la piel. Método Un estudio exploratorio y descriptivo, parte del Estudio SABE – Salud, Bienestar y Envejecimiento para evaluar la presencia de lesiones en la piel en una muestra probabilística de personas mayores que viven en la ciudad de São Paulo por características sociodemográficas, biomarcadores sanguíneos, condiciones de salud y uso de los servicios. El análisis utilizó la prueba de chi cuadrado con corrección de Rao-Scott para muestras complejas con nivel de significación de 5%. Resultados En 2010, el 20,7% de los viejos con limitaciones de movilidad tenía lesiones en la piel debido a esto. Los sitios más comunes fueron la región sacra para ambos sexos, escapular para mujeres y del trocánter para hombres. Edad avanzada, multimorbidades y deterioro funcional fueron más frecuentes entre las personas mayores con heridas, así como una mayor necesidad de atencíon. La disfunción familiar se asoció con una mayor carga de los cuidadores que pueden afectar a la calidad de la atención prestada. Se observó que estas personas mayores que son prioritarios para la atención domiciliaria no la reciben correctamente. Conclusión La prevalencia de lesiones de la piel en personas mayores con limitaciones de movilidad en la comunidad es baja, sin embargo, requieren una atención especial y esa no se está proporcionando adecuadamente. Una reorganización de las políticas y servicios de bienestar es esencial.

ABSTRACT Objective To describe the profile and the characteristics of elderly people with mobility restrictions who are residents in the community and have skin lesions. Method This was an exploratory and descriptive study that was part of the Health, Welfare and Ageing (SABE) study which assessed the presence of skin lesions in a probabilistic sample of elderly people living in the city of São Paulo in relation to factors such as socio-demographic issues, blood biomarkers, health conditions and the use of services. The analysis used the chi-square test with the Rao-Scott correction for complex samples, with a level of significance of 5%. Results In 2010, 20.7% of elderly people with restricted mobility had skin lesions due to this problem. The most common sites of these lesions were the sacral region for both sexes, the scapular region for women and the trochanteric region for men. Older age, multimorbidity and functional impairment were more prevalent among the elderly people with lesions, as well as greater levels of care that were required. Family dysfunction was associated with higher burdens on caregivers, which may affect the quality of care provided. It was observed that elderly people who are priorities for home care do not receive such care adequately. Conclusion The prevalence of skin lesions in the elderly with mobility restrictions living in the community was low; however, these elderly people require special attention, which is not currently being adequately provided. The reorganization of policies and care services appears to be essential.