Back and neck problems as well as disadvantageous ergonomic behavior patterns in university students: Concomitants of the pandemic?

Background: As a part of the coronavirus disease 2019 (COVID-19) lockdown measures, universities converted courses to digital formats, leading to remote studying. It is unclear how these measures affect university students in terms of musculoskeletal problems (i.e., neck and back pain), e.g., by non-ergonomically equipped home offices or reduced physical activity. Material(s) and Method(s): Students from Osnabruck University weresurveyed via fully standardized online questionnaires from early March to mid-April 2022 (6 weeks) about neck and back problems, movement behavior in home offices, and personal information. Result(s): Of 447 students who clicked on the link, 378 students (80.4% female, mean age: 24.1 +/- 4.2 years) answered the questionnaire (response rate: 84.6%). 299 (79.1%) students suffered from neck pain and 294 (77.8%) from back pain during the pandemic. 206 (54.4%) students generally used ergonomic furniture, 83 (22.0%) used ergonomic sitting furniture, 57 (15.1%) used a standing desk, and 212 (56.1%) used aids for a more comfortable use of laptops in home office. 203 (53.7%) students took movement breaks in home office, 207 (54.8%) worked out regularly, and 65 (17.2%) moved regularly in the fresh air. Conclusion(s): The present study found a high rate of neck and back pain amongst university students. Measures are needed to prevent neck and back pain in this group, considering that increased physical activity and enhanced home office equipment might be beneficial.Copyright © 2022 Elsevier GmbH

The Impact of the COVID-19 Pandemic on a Dedicated Vascular Emergency Clinic.

BACKGROUND: Vascular Emergency Clinics (VEC) improve patient outcomes in chronic limb-threatening ischemia (CLTI). They provide a "1 stop" open access policy, whereby "suspicion of CLTI" by a healthcare professional or patient leads to a direct review. We assessed the resilience of the outpatient VEC model to the first year of the coronavirus disease (COVID-19) pandemic. METHODS: A retrospective review of a prospectively maintained database of all patients assessed in our VEC for lower limb pathologies between March 2020 and April 2021 was performed. This was cross-referenced to national and loco-regional Governmental COVID-19 data. Individuals with CLTI were further analysed to determine Peripheral Arterial Disease-Quality Improvement Framework compliance. RESULTS: Seven hundred and ninety one patients attended for 1,084 assessments (Male n = 484, 61%; Age 72.5 ± standard deviation 12.2 years; White British n = 645, 81.7%). In total, 322 patients were diagnosed with CLTI (40.7%). A total of 188 individuals (58.6%) underwent a first revascularization strategy (Endovascular n = 128, 39.8%; Hybrid n = 41, 12.7%; Open surgery n = 19, 5.9%; Conservative n = 134, 41.6%). Major lower limb amputation rate was 10.9% (n = 35) and mortality rate was 25.8% (n = 83) at 12 months of follow-up. Median referral to assessment time was 3 days (interquartile range: 1-5). For the nonadmitted patient with CLTI, the median assessment to intervention was 8 days (interquartile range: 6-15) and median referral to intervention time of 11 days (11-18). CONCLUSIONS: The VEC model has demonstrated strong resilience to the COVID-19 pandemic with rapid treatment timelines maintained for patients with CLTI.

Acceptance of skin products in healthcare workers: an empirical investigation.

BACKGROUND: Healthcare workers (HCWs) are at high risk of developing hand eczema (HE). This can be exacerbated by hygiene measures related to the coronavirus disease (COVID-19). Using mild skin cleansers and emollients or moisturizers is central in the prevention of HE-especially with increased COVID-19 hygiene regimes. AIMS: This study aimed to assess parameters important for the acceptance of a skincare concept in HCWs. METHODS: In this proof-of-concept user trial, HCWs were provided ad libitum with hand wash oil and hand cream during the 6-month period, when occupationally acquired COVID-19 infections among HCWs were peaking in Germany and then surveyed about acceptance of the products using questionnaires. RESULTS: Of 135 HCWs, 115 (85%) responded. Skin tolerance of the hand wash oil and the hand cream was rated very good by 63% and 52% of the 115 participants, respectively. Of the 115 participants, 58% and 57% were very satisfied with the hand wash oil and the hand cream, respectively. CONCLUSIONS: Acceptance of skin cleansing and skincare products in HCWs seems influenced by parameters such as self-assessed skin tolerance and self-reported overall satisfaction. It must be assumed that products are only used as recommended if they are well-accepted. Employers might survey employees about acceptance of products using the parameters identified to adjust concepts if necessary to sustainably contribute to the prevention of HE.

Interaction between gut microbiota and COVID-19 and its vaccines.

The whole world has been continuously afflicted by the coronavirus disease 2019 (COVID-19) pandemic for the past 3 years. Many countries have tried many methods to control this virus infection with varying successes and failures. The gut microbiota is a biosystem spanning the entire length of the digestive tract and playing important roles in health and disease. It is much affected by COVID-19. In return it also substantially impacts infection. In particular, the gut microbiota has established a bidirectional interaction with the COVID-19 vaccines, enhancing or reducing vaccine efficacy by virtue of its varying components. Conversely, COVID-19 vaccines also make a substantial impact on the gut microbiota, re-ducing its overall population and biodiversity. It is hoped that by exploring and harnessing this bidirectional interaction we may break new ground and develop new methods to prevent and treat this formidable virus infection.

TECHNOLOGY INTEGRATION OBSERVATIONAL DATA: GENERATING NEW KNOWLEDGE FASTER

Users can query population health trends, compare like patients for trends in appropriate treatment, and potentially perform patient-level research. [...]David Kaelber, MD, a pediatric and internal medicine physician and researcher at MetroHealth, a multihospital system in Cleveland, Ohio, was concerned that in March and April 2020, fewer patients were coming to the emergency room for life-threatening illnesses like stroke. Human subjects research must be approved by ethics committees/institutional Review Boards (IRBs) and follow strictly enforced standards.

Adverse skin reactions caused by masks in healthcare workers during the COVID-19 pandemic: an empirical investigation in a Lower Saxonian maximum-care hospital

Introduction: In order to contain the coronavirus disease 2019 (COVID-19) pandemic, strict hygiene measures have been introduced for healthcare workers (HCW). An increase in the occurrence of skin changes in the facial area due to the wearing of masks has already been shown for the private sector. For professional collectives, there is a lack of data. This paper aims at evaluating and quantifying the occurrence of skin changes in the facial area associated with wearing a mask in HCW. Methods: In November 2021, a written survey was conducted in HCW working in a Lower Saxonian maximum-care hospital using fully standardized questionnaires. Results: 192 HCW participated. The average daily wearing time of a mask in the collective (n = 192) adds up to 0.6 +/- 1.7 hours before the pandemic and to 9.0 +/- 1.9 hours during the pandemic. 10.9% of the 192 participants stated that they had suffered from skin changes in the facial area before the introduction of the COVID-19-associated hygiene measures and 80.7% of the 192 participants stated that they had suffered from skin changes in the facial area - which can be attributed to wearing a mask according to self-assessment - since the introduction of the COVID-19-associated hygiene measures. Discussion: Not only a surge in the daily mask wearing time, but also a substantial increase in the occurrence of skin changes in the facial area that are associated with wearing a mask in HCW can be traced back to COVID-19-associated hygiene measures. The need for information about preventive measures indicates that the increased occurrence of skin changes in the facial area is perceived as burdensome by HCW. Conclusion: Since no decline of COVID-19-associated hygiene measures is to be expected in the foreseeable future, HCW should be provided with information on the prevention of skin changes in the facial area. In (occupational) dermatological practice, the use of adequate, individualized skin cleansing and skin care concepts is advisable. Comprehensive primary preventive content can be included in health education training measures - also in the sense of an e-learning/e-health concept.

What do COVID-19-associated hygiene measures mean for the skin health of healthcare workers? Results of a controlled, prospective intervention study

Introduction: More than 100,000 occupational COVID-19 infections in healthcare workers (HCW) were reported in Germany from 12/2020 to 6/2021. Hygiene measures were consequently tightened further. We investigated the impact of current hygiene measures on the incidence of hand eczema (HE) and the effect of prevention measures during the above-mentioned period. Materials and Methods: 302 nurses from two hospitals were recruited for a controlled intervention study. The intervention group (IG, n=135) underwent a two-part intervention (online health education course and provision of a skin cleansing and skin care product ad libitum). The control group (CG, n=167) received no intervention. The skin condition of the hands was assessed by a dermatologist at baseline (T0) and after 6 months (T2) using the Osnabrueck Hand Eczema Severity Index (OHSI). Results: The drop-out rate was 16.9% at T2. New HE developed in none of the 115 participants of the IG but in 12 (8.8%) of the 136 participants of the CG. With the same baseline score (1.5 points in both groups at T0), the OHSI showed statistically significantly better values in the IG than in the CG at T2 (0.6 points vs. 2.1 points, p<.001). Conclusions: The intervention did not only contribute to maintenance but even to improvement of the skin condition. A decrease in hygiene measures is not to be expected in the foreseeable future. The use of the intervention concept in the context of the prevention of occupational HE among HCW seems reasonable. Skin protection and skin care recommendations of the online health education course can also be adapted for other high-risk occupations.

Incidence of occupational contact dermatitis in healthcare workers: a systematic review.

Healthcare workers (HCWs) can be considered at an increased risk of developing occupational contact dermatitis (OCD) due to repetitive hand washing with soaps and disinfectants and extended use of gloves for many hours during the day. The aim of this study was to summarize the incidence of OCD in HCWs. We searched the databases PubMed/MEDLINE (1980-present), EMBASE (1980-present) and Cochrane Library (1992-present) through May 2020 using the search term 'incidence of contact dermatitis in HCWs' according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Overall, 16 studies (six cohorts; 10 register-based) with follow-up periods between 1987 and 2013 fulfilled the inclusion criteria. The incidence of OCD reported in studies using registers of occupational diseases ranged from 0.6 to 6.7 per 10 000 person-years. The cohort studies reported incidence from 15.9 to 780.0 per 10 000 person-years; the incidence was higher in studies which included apprentice nurses. A higher incidence was also observed amongst dental practitioners, particularly dental technicians and nurses, compared to other HCWs. Studies reporting incidence data are very scarce and results differed by study design, type of contact dermatitis and investigated HCWs. Our study highlighted the dearth of high-quality data on the incidence of OCD and the possible underestimation of disease burden. Prospective cohort studies with harmonized designs, especially exposure assessment and outcome ascertainment, are required to provide more accurate, valid and recent estimates of the incidence of OCD. A high incidence amongst specific occupational groups suggests the need to undertake intervention studies with a focus on prevention, particularly during pandemics such as COVID-19.