Factors Affecting the Preparedness to Care for Patients with Highly Infectious Diseases among Nursing Staff in Long-term Care Hospitals: A Cross-Sectional Descriptive Study

This study aimed to identify factors related to nurses' preparedness to care for patients with highly infectious diseases in long-term care hospitals based on the Theory of Planned Behavior (TPB). Methods: The participants were 226 nurses from 10 long-term care hospitals located in a metropolitan city in Korea. Core components of the TPB, organizational culture for infection control, nursing practice environment, and preparedness to care for patients with highly infectious diseases were measured using a structured online self-report questionnaire. Data were collected from October 25 to December 26, 2021 and were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson's correlation coefficients, and multiple regression. Results: The mean score of preparedness to care for patients with highly infectious diseases was 4.99±1.90 out of 10. The perceived behavioral control (β=.37, p<.001), control beliefs (β=.24, p<.001), attitude toward behavior (β=.18, p=.001), behavioral belief (β=.12, p=.035), and nursing practice environment (β=.12, p=.023) significantly predicted the nursing staff's preparedness to care for these patients (Adj. R2=.62). Conclusion: Theory-based interventions are needed to enhance the confidence of nurses in caring for the patients with highly infectious diseases and to improve their attitude and beliefs regarding positive outcomes in caring for these patients. High quality teamwork and support of resources are necessary to increase the preparedness to care for patients with highly infectious diseases in the nursing practice environment in long-term care hospitals. © 2023 Korean Society of Adult Nursing

Cerebral venous thrombosis after ChAdOx1 nCoV-19 vaccination: a systematic review

OBJECTIVE: To perform a systematic review of case reports or case series regarding thrombosis with thrombocytopenia syndrome (TTS) and cerebral venous thrombosis (CVT) related to ChAdOx1 nCoV-19 vaccination to address the clinical features, laboratory findings, treatment modalities, and prognosis related with CVT. SUBJECTS AND METHODS: We included 64 TTS patients from 19 articles, 6 case series and 13 case reports, in which thrombosis occurred after the first dose of ChAdOx1 nCoV-19 vaccination published up to 30 June 2021 in Embase, ePubs, Medline/PubMed, Scopus, and Web of Science databases. RESULTS: Of the 64 TTS patients, 38 (59.3%) had CVT. Patients with CVT were younger (median 36.5 vs. 52.5 years, p<0.001), had lower fibrinogen levels (130 vs. 245 mg/dL, p=0.008), had more frequent history of intracerebral hemorrhage (ICH), and had higher mortality rate (48.6% vs. 19.2%, p=0.020) than that of patients without CVT. In multivariable analysis, the possibility of presence of CVT was higher in younger age groups [odd ratio (OR): 0.91, 95% confidence interval (CI): (0.86-0.97, p<0.001)] and those with accompanying intracerebral hemorrhage (ICH) (OR: 13.60, 95% CI (1.28-144.12, p=0.045). CONCLUSIONS: Our study demonstrated that CVT related to ChAdOx1 nCoV-19 vaccination was associated with younger age, low levels of fibrinogen, presence of ICH and more frequent mortality compared to those of non-CVT. If TTS occurs after ChAdOx1 nCoV-19 vaccination, the presence of CVT in patients with young age or ICH should be considered.

Cerebral venous thrombosis after ChAdOx1 nCoV-19 vaccination: a systematic review.

OBJECTIVE: To perform a systematic review of case reports or case series regarding thrombosis with thrombocytopenia syndrome (TTS) and cerebral venous thrombosis (CVT) related to ChAdOx1 nCoV-19 vaccination to address the clinical features, laboratory findings, treatment modalities, and prognosis related with CVT. SUBJECTS AND METHODS: We included 64 TTS patients from 19 articles, 6 case series and 13 case reports, in which thrombosis occurred after the first dose of ChAdOx1 nCoV-19 vaccination published up to 30 June 2021 in Embase, ePubs, Medline/PubMed, Scopus, and Web of Science databases. RESULTS: Of the 64 TTS patients, 38 (59.3%) had CVT. Patients with CVT were younger (median 36.5 vs. 52.5 years, p<0.001), had lower fibrinogen levels (130 vs. 245 mg/dL, p=0.008), had more frequent history of intracerebral hemorrhage (ICH), and had higher mortality rate (48.6% vs. 19.2%, p=0.020) than that of patients without CVT. In multivariable analysis, the possibility of presence of CVT was higher in younger age groups [odd ratio (OR): 0.91, 95% confidence interval (CI): (0.86-0.97, p<0.001)] and those with accompanying intracerebral hemorrhage (ICH) (OR: 13.60, 95% CI (1.28-144.12, p=0.045). CONCLUSIONS: Our study demonstrated that CVT related to ChAdOx1 nCoV-19 vaccination was associated with younger age, low levels of fibrinogen, presence of ICH and more frequent mortality compared to those of non-CVT. If TTS occurs after ChAdOx1 nCoV-19 vaccination, the presence of CVT in patients with young age or ICH should be considered.

Meaningful work and life: challenges faced by acute- and critical-care nurses

Objectives: The severity of the COVID-19 epidemic in 2021 in Taiwan doubled the workload of first-line acute- and critical-care nurses and increased their risk of infection. This study explored such nurses' work and personal lives to help hospitals develop auxiliary measures. Methods: This qualitative study interviewed fifteen nurses working in acute- and critical-care units. Results: Three themes were regarding the meaning of the nurses' work during the pandemic were identified: (a) keeping life stable, (b) fulfilling duties, and (c) recognizing self-worth. Four themes regarding the meaning of the nurses' personal lives were identified: (a) caring for families, (b) the impermanence of life and death, (c) doing good, and (d) seizing the day. Conclusions: During the pandemic, the nurses faced challenges at with a positive attitude, which helped them find meaning in their lives. In the limited life course, he left behind a great historical track of defending the health of the Chinese people. This study provides insight into the professional and personal lives of nurses in acute- and critical-care units during the pandemic in Taiwan, and the findings can help policymakers plan for future pandemics. © 2022 Chinese Public Health Association of Taiwan. All rights reserved.

Design and Evaluation of Noncontact Elevator Control Mode and User Interface

In response to the global coronavirus disease 2019 (COVID-19) pandemic, the use of short-term confined spaces has attracted widespread attention, and elevators have become a major pathway for pathogens. This study uses video recognition technology to develop a contactless elevator operating system, which can be operated by hand gestures of the user. This design can solve current elevator usage problems by integrating human and spatial aspects into the control mode and user interface. By observing and analyzing operational interfaces and behaviors in current hospital elevators, specifications for the new interface were developed. A video motion recognition sensory system was applied to formulate the design and planning principles of the noncontact elevator. Gesture images were combined with simulations to create experimental tasks, in which users were timed and interviewed to evaluate the acceptability and efficiency of the designed interface. The results of this study show that the planning and design of noncontact elevator control modes and user interfaces are advantageous, intuitive, and easy to learn. The control interface of the elevator was displayed in an electronic panel using colors, shapes, and sizes to show operational information, enabling a quick search and high learnability. © MYU K.K.

COVID-19 susceptibility and clinical outcomes in autoimmune inflammatory rheumatic diseases (AIRDs): a systematic review and meta-analysis.

OBJECTIVE: This meta-analysis aims to assess the susceptibility to and clinical outcomes of COVID-19 in autoimmune inflammatory rheumatic disease (AIRD) and following AIRD drug use. MATERIALS AND METHODS: We included observational and case-controlled studies assessing susceptibility and clinical outcomes of COVID-19 in patients with AIRD as well as the clinical outcomes of COVID-19 with or without use of steroids and conventional synthetic disease-modifying antirheumatic drugs (csDMARDs). RESULTS: Meta-analysis including three studies showed that patients with AIRD are not more susceptible to COVID-19 compared to patients without AIRD or the general population (OR: 1.11, 95% CI: 0.58 to 2.14). Incidence of severe outcomes of COVID-19 (OR: 1.34, 95% CI: 0.76 to 2.35) and COVID-19 related death (OR: 1.21, 95% CI: 0.68 to 2.16) also did not show significant difference. The clinical outcomes of COVID-19 among AIRD patients with and without csDMARD or steroid showed that both use of steroid (OR: 1.69, 95% CI: 0.96 to 2.98) or csDMARD (OR: 1.35, 95% CI: 0.63 to 3.08) had no effect on clinical outcomes of COVID-19. CONCLUSIONS: AIRD does not increase susceptibility to COVID-19, not affecting the clinical outcome of COVID-19. Similarly, the use of steroids or csDMARDs for AIRD does not worsen the clinical outcome.

Clinical characteristics and treatments of multi-system inflammatory syndrome in children: a systematic review.

OBJECTIVE: Multisystem inflammatory syndrome in children (MIS-C) can occur in association with coronavirus disease 2019 (COVID-19). It is not easy to differentiate MIS-C from severe COVID-19 or Kawasaki disease based on symptoms. The aim of this study was to describe the clinical and laboratory characteristics of MIS-C. PATIENTS AND METHODS: We searched PubMed/Medline for case series and reports of MIS-C published until June 20, 2020. From a total of nine articles involving 45 cases, various clinical and laboratory data were extracted. Each target case was evaluated by using different diagnostic criteria. RESULTS: The average age at onset of MIS-C was 8.6 years. In 80% of cases, the age of patients ranged from 5 to 15 years. Fever (100%) and shock (82%) were the most common presenting symptoms. Sixty percent of cases met the diagnostic criteria for typical or atypical Kawasaki disease. Biomarkers indicative of inflammation, coagulopathy, or cardiac injury were characteristically elevated as follows: ferritin (mean: 1,061 ng/mL), CRP (217 mg/L), ESR (69 mm/hr), IL-6 (214.8 pg/mL), TNFα (63.4 pg/mL), D-dimer (3,220 ng/mL), PT (15.5 s), troponin I (1,006 ng/L), and BNP (12,150 pg/mL). Intravenous immunoglobulin was administered in all target cases, and inotropic agents were commonly used as well. No case of death was observed. CONCLUSIONS: This study demonstrated that MIS-C is a serious condition that presents with fever, rash, as well as cardiovascular and gastrointestinal symptoms. Although it is challenging to differentiate MIS-C from Kawasaki disease or severe COVID-19, initiation of appropriate treatments through early diagnosis is warranted.

Few-Shot Learning Approach for COVID-19 Detection from X-Ray Images

The end of 2019 and the beginning of 2020 were accompanied by an exponential spread of COVID-19 infection (a viral disease). This later led to a pandemic situation all over the planet. Such a rapid infection of people with the virus (SARS-CoV-2) from each other was caused by the fact that the symptoms of this disease are very similar to ordinary ARVI (acute respiratory viral infection). This in turn complicates the identification of a patient with a new virus. In order to isolate and contain the further spread of the virus, effective and rapid methods are needed to identify patients at an early stage. In our research work, we propose to use the few-shot method. This method is effective with a small amount of input data, training with few-shot is aimed at creating accurate machine learning models with less training data. Since the size of the input data is a factor determining the cost of resources (such as time costs), it is possible to reduce the cost of data analysis by using few-shot learning. The obtained results include the highest accuracy of 97.7% for 10 shots of COVID-19 X-ray images, which implies the effectiveness of the proposed approach. Notably, it was discovered that the accuracy of the approach directly correlates with the number of COVID-19 samples used for training. © 2021 IEEE.

Deep Neural Network Classification Models for COVID-19 Detection in X-ray Images

At the beginning of 2020 new COVID-19 infection became a global pandemic, and society needed an efficient method to detect infected people. To handle the spread of infection testing systems were developed. But due to the fact that they take a lot of time and are not available to everyone, alternative methods of early screening have become an urgent need. In our paper, we propose to use convolutional neural networks (CNN) to detect coronavirus infection on X-ray images. We have collected 9 of the most popular datasets containing x-ray images of patients infected with COVID-19 or pneumonia and classified on most common CNN models: ResNet50, VGG-16, Alexnet, Inception-v3, and InceptionResNet-v2. Based on results we obtained it was possible to generate a heat map that indicates areas containing features that distinguish infected patients most effectively. Also, 2D T-SNE images were created to provide a lower dimensional overview of the data distribution among 2 classes representing infected scans vs normal scans. In our experiments, the InceptionResNet-v2 model showed best test result and the average prediction value reached 95.1%, which is a very promising accuracy for classifying healthy and infected patients. © 2021 IEEE.

COVID-19 classification based on CNNs models in CT image datasets

The COVID-19 coronavirus pandemic was a global challenge to the whole society and at the same time created a unique situation for the development of science, scientific communication and open access to scientific information. At the beginning of 2019 the world has faced a pandemic of Covid-19 coronavirus. The coronavirus impacted dramatically lives of majority people around the globe. Deep learning methods allow automatic classification of the coronavirus disease from the computer tomography (CT) scans of the lung. In our work we test several popular convolutional neural network (CNN) models to classify slices of the CT scans. In this study we indicate that the VGG-19 model gives the best classification accuracy among the other tested models such as DenseNet201, MobileNetV2, Xception, VGG-16 and ResNet50v2. In particular, the model achieves the accuracy of 99.08% for CovidX CT Dataset and 98.44% for SARS-CoV-2 CT dataset and 92.30% for UCSD COVID-CT dataset. Additionally, our results include 3D heatmaps that explain classification results for each individual model, showing regions of the lung affected by the coronavirus. © 2021 IEEE.

A study of job insecurity and life satisfaction in COVID-19: the multilevel moderating effect of perceived control and work-life balance programs

Background: The effect of COVID-19 on the manufacturing industry in China has resulted in increased employee psychological pressure and job insecurity. This study uses a theoretical model to identify the links between job insecurity and life satisfaction, and further explores the multilevel moderating effect underlying these links. Methods: Based on the conservation of resources theory, a hierarchical linear model is utilized to test the relationships among cross-level variables. The data comprises 528 valid questionnaires from 43 manufacturing companies in China. Results: The research results show that both perceived control (individual level) and work life balance programs (organizational level) positively moderate the relationship between job insecurity and life satisfaction. Conclusions: This study contributes toward identifying the effect of employees' psychological status and job insecurity on life satisfaction, and further confirms two different level moderators that alleviate the negative relationship between job insecurity and life satisfaction. Whether different genders have an effect on perception of life satisfaction is also considered, and the results show that men perceive significantly greater life satisfaction than women. Finally, based on the research findings, practical and theoretical implications are proposed.

Adverse reactions to coronavirus disease 2019 vaccines in children and adolescents

The incidence of coronavirus diseases 2019 (COVID-19), including severe cases, has been increasing in both children and adolescents with the spread of the delta variant. COVID-19 vaccines have been identified to be effective in the prevention of COVID-19 transmission in children and adolescents and keeping schools open. However, adverse reactions associated with COVID-19 vaccination in children and adolescents contribute to parents' hesitation to proceed with vaccination, especially due to serious, albeit rare, reactions. The results from COVID-19 vaccine clinical trials on the safety and efficacy of COVID-19 vaccines in children and adolescents are promising in terms of their effects on COVID-19 infection prevention. In the present study, we summarize the adverse reactions of COVID-19 vaccines in children and adolescents, based on the clinical trials, mainly including Pfizer-BioNTech and Moderna COVID-19 vaccines. In the Pfizer-BioNTech COVID-19 clinical trials, the most common local adverse reaction was pain at the injection site in 74.1%-86%, depending on age, and the most common systemic adverse reaction was fatigue, followed by headache, myalgia, diarrhea, and fever with differences in the distribution according to age. There was no severe adverse reaction related to any COVID-19 vaccine in children and adolescents during the study period. In the mass vaccination program of COVID-19 in children and adolescent, myocarditis has rarely been diagnosed after COVID-19 vaccination, which most commonly occurred in boys after the second dose. Currently, Pfizer-BioNTech COVID-19 vaccines can be safely recommended in children and adolescents for the prevention of COVID-19 infection and the reduction in COVID-19 severity.

Deriving Design Requirements and Conceptual Scenarios of Temporary Negative Pressure Isolation Wards for Infectious Diseases

Background Recently, the demand for isolation rooms has rapidly increased with the spread of infectious diseases such as COVID-19. Previous studies investigated temporary isolation wards to resolve the shortage of beds. Most of the studies, however, focused on construction methods and the capability of equipment instead of experiential aspects such as medical activities and life in quarantine. This article presents design requirements and the associated example design cases based on the identified needs of medical and facility staff from a participatory design workshop. Methods A participatory design workshop was conducted with 21 medical and facility staff in a hospital specializing in infectious diseases. Two workshop sessions including MACRO-level design for overall configurations and MICRO-level design for room layouts were conducted to participants. The collected data was analyzed to derive design requirements for temporary isolation wards. To verify the relevance and applicability of the derived design requirements, we asked four designers to develop conceptual designs of new isolation wards based on the card-type design aid, which includes the details of the requirements. Results From the design workshop, five design requirements were derived: supporting the communication between the inside and outside of an isolation ward;preventing contact with the infection source;relieving emotional anxiety;relieving medical staffs’ work burden;and securing an appropriate hospital environment. During the conceptual design process using the design aids, designers created animated conceptual scenarios for isolation wards (information system using QR codes, serving robots for delivery, trash bin discharging wastes in safety, digital window, and plugin facility module). Conclusions The design requirements can be applied for new medical service design projects, which should consider experiential aspects in addition to the physical and spatial aspects in context of temporary isolation ward design. The example scenarios would be beneficial for further exploration of a new product, system, and service design for infectious diseases while considering the experiences beyond the physical configuration. © 2021. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License org/licenses/bync/ 3.0/), which permits unrestricted educational provided the original work is properly cited. All Rights Reserved.

Factors that affect the performance of covid-19 infection management administration in general hospitals

Background: This study aimed to provide basic data for the development of COVID-19 infection management educational programs by confirming the factors that affect the performance of COVID-19 infection management administration in general hospitals. Method: Data was collected from administrative staff at 192 general hospitals by means of a structuralized questionnaire, and SPSS Ver. 21.0 software was used for data analysis. Conclusion: The extent of knowledge and execution of COVID-19 infection management processes by administrative staff in general hospitals was positively correlated with the extent of educational demand for COVID-19 infection management, with explanatory power of 16.7%. It is necessary to include factors including COVID-19 transmission route, transmission prevention, and staff safety in COVID-19 infection management educational program administration. In addition, it is essential also to performance COVID-19 infection management education.