FEELING VS BEING CONNECTED: DIFFERENTIATING LONELINESS AND ISOLATION IN NEAR- AND CENTENARIANS

While gerotranscendence theories postulate that older adults tend to orient themselves toward solitude, activity theories highlight the importance of continuing social and meaningful engagement for well-being across lifespan. The distinction between loneliness and social isolation is particularly observable in older adults of advanced age who are often facing accelerated decline in physical and functional health, therefore restricting their opportunities to interact with others. This has been particularly disturbing during the previous two years under COVID. This study utilized data from the 2nd Hong Kong Centenarian Study which interviewed 120 family caregivers of older adults aged 95 or above in 2021–2022 when the city experienced almost an entire year of the outbreak. Using family or friend proxy information as well as caregiver ratings of whether older adults expressed feelings of social isolation and loneliness, we found that 10.7% of older adults reported high levels of loneliness and isolation;26.7% feeling low in both;11.5% were isolated but not lonely, and 38.2% were lonely but not isolated. Loneliness ratings were more strongly associated with psychological well-being (Patient Health Questionnaire-4), autonomy, happiness, perceived usefulness, worries, and death anxiety than did isolation, with the latter negatively correlated with optimism. Participants rated in the low isolation/loneliness group were least (death) anxious than the other three groups. Our findings underscore the divergence of isolation and loneliness for adults of advanced age and call for psychological support for oldest-old adults who continue to face social isolation, especially when society gradually recovers from COVID.

A New Model of Teaching Simulation Based Neonatal Resuscitation during Covid-19 Outbreak in Hong Kong

Aims To establish an innovative web-based COVID adapted Neonatal Resuscitation Workshop (CaNRW) which provides regular Simulation Based Education in neonatal resuscitation to meet service need and training demand and at the same time satisfy strict infection control measures imposed on classroom simulation based training in a regional hospital with delivery of 6000 per annum during COVID-19 outbreak in Hong Kong since 2021. Methods A CaNRW was developed with the Multi-Disciplinary Simulation and Skills Centre (MDSSC) in January 21. It consists of a 1-hour lecture delivered in YouTube;a 1- hour video on skills recommended by Neonatal Resuscitation Program of American Academy of Pediatrics and a real time birth related drill performed at MDSSC- Pict 1. All trainees participate it online except those involved in the drill. All providers can join the drill and debriefing online simultaneously. Upon competition, they were asked to complete an evaluation. Results Total 113 providers consisting of pediatric and emergency department residents, neonatal nurses and midwives joined three CaNRW in 2021. Providers didn't report difficulties in viewing the program through electronic devices. Program facilitators felt more comfortable in executing this CaNRW. Seventy-three evaluations were analyzed. The providers reported this CaNRW was useful with high level of satisfaction (Score:4.41/5). They strongly recommended it to colleagues (Score:8.53/10). Nurses and midwives were granted continuous nursing education credits (figure 1). Conclusion Our data data shows that this web-based innovative CaNRW is feasible and well accepted by trainees. It provides regular neonatal resuscitation training and satisfies strict infection control measures imposed on classroom simulation based training amidst of COVID outbreak in a regional hospital in Hong Kong since 2021. Both neonatal nurses and midwives gained training credits to fulfill their continuous professional education. Therefore, this mode of web-based CaNRW worth promoting and should be made available to more trainees and departments in hospitals where strict infection control measures for classroom teaching is in place amidst of COVID- 19 Outbreak.. (Figure Presented).

A COVID-Adapted Neonatal Resuscitation Workshop for Teaching Neonatal Resuscitation - A Regional Hospital's Experience

Background: A good and effect iveneonatal resuscitation training (NRT) program is important for retaining skills and achieving good outcome. A stimulation based Neonatal Resuscitation Workshop (NRW) has been held quarterly for Paediatric, Obstetric and Emergency Department trainees since 2011. The NRW was suspended since July 20 due to COVID-19 pandemic. A web-based COVID-adapted NRW (CaNRW) was developed in January 21 to achieve the objectives of providing NRT and abiding infection control measures. Methods: A CaNRW was developed with the Multi- Disciplinary Simulation and Skills Centre (MDSSC), Queen Elizabeth Hospital in January 21. It consists of a 1- hour lecture delivered in YouTube;a 1- hour video on skills and a birth related drill performed at MDSSC. All trainees participate it online except those involved in the drill. Trainees can join the drill and debriefing online simultaneously. Upon competition, they were asked to complete an evaluation. Results: Total 113 trainees joined three CaNRW in 21. Trainees didn't report difficulties in viewing. Facilitators felt more comfortable in executing this CaNRW. Seventythree evaluations were analysed. Trainees reported this CaNRW was useful with high level of satisfaction (Score: 4.41/5). Trainees strongly recommended it to their colleagues (Score: 8.53/10). Nurses and midwives were granted Continuous Nursing Education and PEM credits respectively. Conclusions: This innovative web-based CaNRW provides a simple and structured model for NRT during COVID-19 pandemic. Trainees welcomed and enjoyed it. Thus, this CaNRW is worth promoting and should be made available to more trainees and departments. More studies should be performed to testify its clinical values.

Development, Implementation, and Evaluation of a Clinical Practice Guideline for Care of Preterm Infants Receiving Non-Invasive Ventilation: A Before and After Study

Background: Nowadays, noninvasive ventilation is the mainstay of the ventilation strategy in the neonatal intensive care units (NICUs) and most of infants, especially preterm infants, having respiratory problems, are provided noninvasive ventilation (NIV) upon their demands. Nevertheless, complication of NIV device-related pressure injury was common, the incidence of nasal injury ranged from 20% to 60%. Limited studies were found evaluating the nursing care of preterm infants receiving NIV. Aims: This study aimed to develop an evidence-based clinical practice guideline for preterm infants receiving NIV, implement the guideline in a NICU of a regional hospital, and evaluate infant outcomes including comfort, incidence of NIV device-related pressure injury. Besides, improvement on nurse's knowledge and practice for caring infants under NIV were assessed. Study Design and Methods: The Iowa Model-Revised was adopted as the theoretical framework to guide the study process. A multidisciplinary workgroup consists of eight stakeholders in NICU was formed for the process and acted as the champions for the new practice. A before and after study design was adopted and included the preimplementation and post-implementation phases. An integrative review was conducted to identify relevant studies from eight electronic databases before the study. All eligible studies were appraised using the Johns Hopkins University's evidence appraisal tool. Neonatal Pain, Agitation and Sedation Scale (N-PASS) for pain assessment and two self-developed NIV care bundle knowledge test and audit tool were used for the study. Results: Due to the COVID-19 pandemic in 2020, the study was extended for a month and ended in January 2021. A total of 74 infants in Pre-implementation phase (before group) and 67 infants in Post-implementation phase (after group) were recruited. Logistic regression model was used to compare the incidence of pressure injury between groups after adjusted for all substantial covariates in the study. Infants in after group had an 84% decreased odds of acquiring pressure injury (adjusted OR=0.149, 95% CI 0.045-0.495, p=0.002). Infant's comfort level whilst receiving NIV was not determined in the study as the after group having a significantly lesser mean time (p<0.001) in calm state but lower N-PASS score. Regarding nurse participants, 71 nurses received the training programme on NIV care bundle, and overall nurses' knowledge level improved immediately (adjusted p<0.001) and at 12 weeks after the programme. Three audits were conducted to evaluate nurses' practice, nurses' compliance rate to the care bundle significantly improved at 12 (p<0.001) and 24 weeks (p<0.001) in comparison with baseline compliance rate in the pre-implementation phase. However, nurses' knowledge retention at 12-week and compliance rate at 24-week after the training programme declined. Conclusion: The evidence-based clinical practice guideline aims to promote comfort and prevent injury in infants receiving NIV, and outcomes of the infants depend on vigilant nursing care and compliance to this clinical practice guideline. Declining of nurse's knowledge level and practice compliance found in the study indicates the needs of continuous education and audit on the practice to sustain the service quality and patient's safety.

Trauma mitigation for the workforce: A conceptual framework applied in COVID-19 pandemic conditions

The sudden and protracted emergency stemming from the coronavirus disease-2019 (COVID-19) pandemic presents potential exposures, or exacerbations, of psychological trauma to workforces. Organizationally significant traumatic stress warrants the trauma-informed attention of emergency managers wishing to protect the well-being of responders and prevent performance breakdowns. This study focuses on interventions that can be applied at the organizational level without the need for specially trained clinicians. We first provide a rapid review of design principles intended to provide safe, ethical, and efficacious interventions that utilize informational and social learning principles. Next, we present a conceptual framework, drawing from the disaster management and clinical trauma evidence base, targeted to build proactive workplace programs for trauma mitigation. Duty of care and shared responsibility are discussed as a way to balance obligations and burdens of operating in milieus characterized by psychological trauma. Assuming that clinically significant trauma is handled by established systems of mental healthcare, the five case studies in this study demonstrate how empirical findings support program elements to address subclinical trauma in emergency managers and responders across sectors. © 2022 Weston Medical Publishing. All rights reserved.

Averting an Outbreak of SARS-CoV-2 in a University Residence Hall through Wastewater Surveillance.

A wastewater surveillance program targeting a university residence hall was implemented during the spring semester 2021 as a proactive measure to avoid an outbreak of COVID-19 on campus. Over a period of 7 weeks from early February through late March 2021, wastewater originating from the residence hall was collected as grab samples 3 times per week. During this time, there was no detection of SARS-CoV-2 by reverse transcriptase quantitative PCR (RT-qPCR) in the residence hall wastewater stream. Aiming to obtain a sample more representative of the residence hall community, a decision was made to use passive samplers beginning in late March onwards. Adopting a Moore swab approach, SARS-CoV-2 was detected in wastewater samples just 2 days after passive samplers were deployed. These samples also tested positive for the B.1.1.7 (Alpha) variant of concern (VOC) using RT-qPCR. The positive result triggered a public health case-finding response, including a mobile testing unit deployed to the residence hall the following day, with testing of nearly 200 students and staff, which identified two laboratory-confirmed cases of Alpha variant COVID-19. These individuals were relocated to a separate quarantine facility, averting an outbreak on campus. Aggregating wastewater and clinical data, the campus wastewater surveillance program has yielded the first estimates of fecal shedding rates of the Alpha VOC of SARS-CoV-2 in individuals from a nonclinical setting. IMPORTANCE Among early adopters of wastewater monitoring for SARS-CoV-2 have been colleges and universities throughout North America, many of whom are using this approach to monitor congregate living facilities for early evidence of COVID-19 infection as an integral component of campus screening programs. Yet, while there have been numerous examples where wastewater monitoring on a university campus has detected evidence for infection among community members, there are few examples where this monitoring triggered a public health response that may have averted an actual outbreak. This report details a wastewater-testing program targeting a residence hall on a university campus during spring 2021, when there was mounting concern globally over the emergence of SARS-CoV-2 variants of concern, reported to be more transmissible than the wild-type Wuhan strain. In this communication, we present a clear example of how wastewater monitoring resulted in actionable responses by university administration and public health, which averted an outbreak of COVID-19 on a university campus.

Influencing Factors of Residential Well-Being Under COVID-19

Due to the changes of lifestyles brought by COVID-19, people have spent most of their time in residential communities for the past about one year, which makes people pay more attention to their psychological feelings and emotional needs in their living environments. This study aimed to explore the relationship between multiple influencing factors and residential well-being under COVID-19. By collecting 172 valid online questionnaires, this study explored the aspects of the residential community which would cause more attention after experiencing COVID-19. Based on previous research, the paper analysed the influence of six environmental factors and five emotional factors on residential well-being by SPSS and discussed the reasons for the differences between the results of correlation analysis and attitude analysis. The results of the study contribute to propose strategies for the transformation of residential communities to improve people’s residential well-being when facing an epidemic in the future. © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG.