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Aim This study was conducted to investigate the relationship between nurses' fear of COVID-19, professional commitment and medical error tendency. Methods This study was use correlational research design with 312 nurses in January-April 2021. Data were collected online using a demographic characteristics questionnaire, the Fear of COVID-19 Scale (FCV-19S), the Professional Commitment Scale (PCS), and the Scale of Tendency to Medical Errors (STME). The study was approved by ethics committee. Number, mean, and standard deviation were used for sociodemographic variables. Participants' FCV-19S, PCS, and STME scores were calculated. The correlations between scale scores were determined using Pearson's correlation coefficient and Spearman correlation analysis. Results Participants had a mean FCV-19S, PCS, and STME score of 19±8.17, 72.21±13.58, and 4.58±0.51, respectively. FCV-19S scores were weakly and positively correlated with PCS overall score (r=0.200, p<0.001), ‘'willingness to make an effort (r=0.273, p<0.001)'' and ‘'belief in goals and values (r=0.115, p=0.043)'' subscale scores. FCV-19S scores were weakly and positively correlated with STME "communication (r=0.119, p=0.036)” subscale score. Conclusion Nurses who feared more about COVID-19 were found to have higher professional commitment, greater willingness to make an effort, and stronger belief in goals and values. Nurses who feared more COVID-19 were less likely to make communication-related medical errors. © 2023 Kamuzu University of Health Sciences and the Medical Association of Malawi.
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COVID-19 , Hip Fractures , Pandemics , Aged , Aged, 80 and over , Emergency Service, Hospital , Female , Hip Fractures/epidemiology , Humans , MaleABSTRACT
BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects humans' lower respiratory tracts and causes coronavirus disease-2019 (COVID-19). Neutralizing antibodies is one of the adaptive immune system responses that can reduce SARS-CoV-2 infection. This study aimed to develop a SARS-CoV-2 neutralization assay system using pseudo-lentivirus. METHODS: The plasmid used for pseudo-lentivirus production was characterized using restriction analysis. The gene encoding for SARS-CoV-2 spike protein was confirmed using sequencing. The transfection pseudolentivirus optimal condition was determined by choosing the transfection reagents and adding centrifugation step. Optimal pseudo-lentivirus infection was analysed using fluorescent assay and luciferase assay. The optimal condition of pseudo-lentivirus infection was determined by the target cell type and the number of pseudo-lentiviruses used for neutralization test. SARS-CoV-2 pseudo-lentivirus was used to detect neutralizing antibodies from serum samples. RESULTS: The plasmid used for pseudo-lentivirus production was characterized and confirmed to have no mutations. Lipofectamine 2000 reagent generated pseudolentivirus with a higher ability to infect target cells, as indicated by a percentage green fluorescent protein (GFP) of 12.68%. Pseudo-lentivirus centrifuged obtained more stable results in luciferase expression. Optimal pseudo-lentivirus infection conditions were obtained using puromycinselected HEK 293T-ACE2 cells as target cells. The number of pseudo-lentiviruses used in the neutralization assay system was multiplicity of infection (MOI) 0.075. Serum A samples with a 1:10 dilution had the highest neutralizing antibody activity. CONCLUSION: This study shows that SARS-CoV-2 neutralization assay system using pseudo-lentivirus successfully detected neutralizing antibodies in human serum, which were indicated by a decrease in the percentage of pseudo-lentivirus infections. © 2023 The Prodia Education and Research Institute
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The increasing emergence of infectious diseases like COVID-19 has created an urgent need for filtration/purification materials coupled with multifunctional features such as mechanical integrity, excellent airflow/filtration, and antibacterial/antimicrobial properties. Polymer membranes and metal-organic frameworks (MOFs) have demonstrated high effectiveness in air filtration and purification. MOF nanoparticles have been introduced into electrospun polymer nanofibrous membranes through embedding or postsolution growth. However, the derived hybrids are still facing the issue of (1) limited MOF exposure, which leads to low efficacy;and (2) uncontrollable growth, which leads to pore blocking and low breathability. In this work, we customized an electrospray-on-electrospinning in situ process to dynamically integrate MOF nanoparticles into a robust and elastic continuous nanofibrous membrane for advanced properties including high mechanical strength and flexibility, excellent breathability, particle filtration, and good antimicrobial performance. Biodegradable polylactic acid was reinforced by the poly(hydroxybutyrate)-di-poly(DLA-CL)x copolymer (PHBR) and used as an electrospinning matrix, while MOF nanoparticles were simultaneously electrically sprayed onto the nanofibers with easily controllable MOF loading. The MOF nanoparticles were homogeneously deposited onto nanofibers without clogging the pores in the membrane. The collision of PLA and MOF under the wet status during electrospinning and the hydrogen bonding through C=O and N-H bonds strengthen the affinity between PLA nanofibers and MOF nanoparticles. Because of these factors, the MOF-incorporated PLA/PHBR nanofibrous membrane achieved over 95% particle filtration efficiency with enhanced mechanical properties while maintaining high breathability. Meanwhile, it exhibits excellent photocatalytic antibacterial performance, which is necessary to kill microbes. The electrospray-on-electrospinning in situ process provides an efficient and straightforward way to hybridize one-dimensional (1D) or two-dimensional (2D) nanomaterials into a continuous nanofibrous membrane with strong interaction and controllable loading. Upon integrating proper functionalities from the materials, the obtained hybrids are able to achieve multifunctionalities for various applications.
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Lateral flow immunoassay (LFIA) is one of the most common analytical platforms for point-of-care testing (POCT), which is capable of large-scale primary screening and home self-testing of infectious diseases. However, the sensitivity of conventional AuNPs-based LFIA is relatively low and more prone to false negatives. Herein, we report a novel LFIA based on gold-core-silver-shell bimetallic nanoparticles (Au4-ATP@Ag NPs) emitting Surface-enhanced Raman scatting (SERS) and Photothermal (PT) effect, named SERS/PT-based dual-modal LFIA (SERS/PT-dmLFIA), for the antigen detection of infectious diseases pathogens, which displayed an excellent performance. For influenza A virus (IAV), influenza B virus (IBV), and Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) N protein detection, the limit of detections (LoD) with Raman as signal were 31.25, 93.75, and 31.25 pg mL-1 respectively, and the LoDs with temperature difference (∆T) as signal were as low as 15.63, 187.5, and 15.63 pg mL-1 respectively, which were over 4-fold more sensitive than visual-based LFIA. The proposed SERS/PT-dmLFIA was used for detecting virus antigen in pharyngeal swabs and showed ideal coincidence rate of over 95% compared to the commercialized assays. In addition, we explored the development of multiplex SERS/PT-dmLFIA that can detect IAV, IBV, and SARS-CoV-2 antigens simultaneously without cross reactivity. Overall, the SERS/PT-dmLFIA for antigen detection not only exhibits high sensitivity, accuracy and specificity, but also have characteristics of rapidity and simplicity, which holds high potential for rapid diagnosis of infectious diseases in laboratory testing, mass screening, and home self-testing. © 2023 Elsevier B.V.
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The subscription of digital services has increased due to the COVID-19 pandemic. However, this was not the same for digital news subscription which remained low. Therefore, this study looks to study the factors that influence the resistance to digital news subscription during the COVID-19 pandemic. In order to achieve this, the Innovation Resistance Theory was applied. Data was collected through an online survey that yielded 199 responses. Based on the results of the data analysis, two out of the five barriers were revealed to have insignificant relationships with resistance. With that said, value barrier, risk barrier, and image barrier were established as significant facilitators of resistance. Several insights were then proposed to news media companies. Moreover, this study fills the theoretical gap of comprehending the antecedents of resistance on digital news during the COVID-19 pandemic. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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Patient adherence to treatment is vital for treatment success as poor adherence can lead to disease worsening. Our study aims to investigate how well moderate-to-severe asthma patients adhere to biologics and other asthma treatments, and to determine any differences in their adherence to these treatments. The Ipsos Syndicated Severe Asthma Patient Community is an online qualitative study which gathered perceptions from 223 patients with moderate-to-severe asthma in France, Germany, Italy, Spain, UK, Canada and Japan in October 2021. Patients chose to participate and are screened to reflect moderate-to-severe asthma patients taking a range of asthma therapies. Among 133 moderate-to-severe asthma patient participants who are currently receiving a biologic treatment in our study, 11% missed at least 1 dose of their biologic treatment in the last 6 months. Of the 110 sampled biologic users reported also taking other asthma treatments, 23% missed at least 1 dose of their non-biologic treatment in the last month. As for patient participants who are not on any biologics (n=88), 41% recorded at least 1 missing dose in the last month. 'Forgetfulness' and 'interruptions to daily routines' were the top 2 reasons cited by sampled patients for missing their treatments. One biologic user participant skipped his injection due to COVID-19 vaccination;5 nonbiologic user participants reported missed doses as they felt too unwell to take their medication. Moderate-to-severe asthma patients in our study showed better adherence to their biologic treatments compared to non-biologic users. This suggests that using biologics improves patient adherence to treatment;however, further investigation using comparator cohort is warranted.
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The 2019 Novel Coronavirus Pandemic has severely challenged the continuity of post-secondary education around the world. Online learning platforms have been put to the test, in a context where student engagement will not occur as a simple matter of course. To identify the factors supporting online learning under pandemic conditions, a questionnaire based on the Unified Theory of Acceptance and Use of Technology was adapted and administered to a sample of 704 Chinese university students. Structural equation modelling was applied to the resulting data, to identify the most relevant theoretical components. Effort expectancy, social influence, and information quality all significantly predicted both students' performance expectancies and the overall adoption of their university's Moodle-based system. Performance expectancy mediated the effects of effort expectancy, social influence, and information quality on symbolic adoption. Internet speed and reliability had no clear impact on adoption, and neither did gender. The direct impact of information quality on symbolic adoption represents a particularly robust and relatively novel result;one that is not usually examined by comparable research. As outlined, this is one of three key factors that have predicted online learning engagement, and the viability of educational continuity, during the Coronavirus pandemic. The same factors can be leveraged through user-focused development and implementation, to help ensure tertiary education continuity during a range of crises © The Author(s) 2022
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The increasing emergence of infectious diseases like COVID-19 has created an urgent need for filtration/purification materials coupled with multifunctional features such as mechanical integrity, excellent airflow/filtration, and antibacterial/antimicrobial properties. Polymer membranes and metal-organic frameworks (MOFs) have demonstrated high effectiveness in air filtration and purification. MOF nanoparticles have been introduced into electrospun polymer nanofibrous membranes through embedding or postsolution growth. However, the derived hybrids are still facing the issue of (1) limited MOF exposure, which leads to low efficacy;and (2) uncontrollable growth, which leads to pore blocking and low breathability. In this work, we customized an electrospray-on-electrospinning in situ process to dynamically integrate MOF nanoparticles into a robust and elastic continuous nanofibrous membrane for advanced properties including high mechanical strength and flexibility, excellent breathability, particle filtration, and good antimicrobial performance. Biodegradable polylactic acid was reinforced by the poly(hydroxybutyrate)-di-poly(DLA-CL)x copolymer (PHBR) and used as an electrospinning matrix, while MOF nanoparticles were simultaneously electrically sprayed onto the nanofibers with easily controllable MOF loading. The MOF nanoparticles were homogeneously deposited onto nanofibers without clogging the pores in the membrane. The collision of PLA and MOF under the wet status during electrospinning and the hydrogen bonding through C═O and N-H bonds strengthen the affinity between PLA nanofibers and MOF nanoparticles. Because of these factors, the MOF-incorporated PLA/PHBR nanofibrous membrane achieved over 95% particle filtration efficiency with enhanced mechanical properties while maintaining high breathability. Meanwhile, it exhibits excellent photocatalytic antibacterial performance, which is necessary to kill microbes. The electrospray-on-electrospinning in situ process provides an efficient and straightforward way to hybridize one-dimensional (1D) or two-dimensional (2D) nanomaterials into a continuous nanofibrous membrane with strong interaction and controllable loading. Upon integrating proper functionalities from the materials, the obtained hybrids are able to achieve multifunctionalities for various applications. © 2023 American Chemical Society.
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INTRODUCTION: The COVID-19 pandemic has reached a phase where many have been infected at least once. Healthcare workers were not spared from being infected. This study aimed to determine the period prevalence of COVID-19 among the paediatric healthcare workers in Negeri Sembilan as the country transitioned into an endemic phase of the pandemic. Additionally, we investigate potential sociodemographic and occupational characteristics associated with SARS-CoV-2 infection among healthcare workers. MATERIALS AND METHODS: A cross-sectional study was conducted among the healthcare workers in the paediatric department at three public specialist hospitals in Negeri Sembilan between 15 and 21 April 2022. Data were collected through a self-administered questionnaire. RESULTS: Out of the 504 eligible healthcare workers, 493 participated in this study (response rate 97.8%). The overall prevalence of COVID-19 (11 March 2020-15 April 2022) among healthcare workers was 50.9%. The majority (80.1%) were infected during the Omicron wave two months before the survey. Household contacts accounted for 35.9% of infection sources. The proportion of non-doctors in the COVID-19-infected group was significantly higher compared to the non-infected group (74.1% vs 64.0%, p=0.016). The COVID-19-infected group had a higher proportion of schoolgoing children (44.6% vs 30.6%, p=0.001) and children who attended pre-school/sent to the babysitter (49.0% vs 24.4%, p<0.001). There were no significant differences between infection rates among the healthcare workers working in the tertiary hospital and the district hospitals. There were also no significant differences in the proportion of COVID-19- infected doctors and nurses when analysed by seniority. CONCLUSION: Our study provided an estimate on the prevalence of COVID-19 among paediatric healthcare workers in Negeri Sembilan and the factors associated with infection, which captures the extent and magnitude of this pandemic on the state's paediatric department. Most infections resulted from household contact, with a higher proportion of infected healthcare workers having young children.
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COVID-19 , Humans , Child , Child, Preschool , COVID-19/epidemiology , Cross-Sectional Studies , Prevalence , SARS-CoV-2 , Pandemics , Health PersonnelABSTRACT
Background: The COVID-19 pandemic profoundly impacted healthcare services globally. This in turn, expedited digitalization in its response to new norms. Technological means were heavily explored in healthcare delivery especially in patient management and treatment. Implementation of telemedicine on outpatient clinic was ideal amongst closely monitored patients such as those with heart failure. Heart failure patients were ideal candidates for such delivery services as means of communication were already established prior to patient enrolment. Objective(s): To study the impact of telemedicine on heart failure hospital admissions and mortality among the heart failure frequent flyer programme patients. Methodology: This is a retrospective observational study involving adaptation of outpatient care delivery through telemedicine on Hospital Tengku Ampuan Rahimah heart failure frequent flyer program patients. Incapability of physical healthcare services delivery prompted diverse forms of communication between patients and healthcare providers. The communications were performed using social media platforms such as WhatsApp or virtual platforms such as Google Meet. Communication between patients from the heart failure clinic and the Heart Failure team with morbidity and mortality were analysed. Result(s): Our study consisted of 38 patients, with a male majority at 88%. More than half of our cohort utilized various platforms for the adopted outpatient management. Approximately 30% of our cohort had virtual assessment with more than half favouring Google Meet. WhatsApp message exchanges were commonly seen with a mean of 2.5 messages per patient. A total of eight deaths were documented among our cohort. The cause of death was attributed to Non-ST Elevation Myocardial Infarction, Ruptured Aortic Abdominal Aneurysm, Septicaemia and COVID-19 infection. Correlation by Phi and Cramer's V between patients' communication and outcome of mortality showed significance at p value <0.05. Apart from that, there was no documented hospital readmission for decompensated congestive heart failure on surviving patients. Conclusion(s): Virtual assessment via telemedicine in heart failure patients are challenging but highly effective if done right. In addition, rapid transformation and adoption of telemedicine utilizing all forms of communication between primary care provider and patients showed an immense role in morbidity and mortality reduction. Copyright © 2022
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Objectives: The aim of this study was to determine the level of post-traumatic stress disorder (PTSD) and internalized stig-ma among healthcare workers caring for patients with coronavirus 2019 (COVID-19) during the height of the pandemic.Methods: The data of this descriptive, cross-sectional study were collected online using a personal information form and the Post-Traumatic Stress Disorder Checklist for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (PCL-DSM-5).Results: The mean PCL-DSM-5 score of the healthcare professionals evaluated was 38.143 +/- 17.30765. When asked about their perception of stigma related to COVID-19, half of those who tested positive for COVID-19 concealed the diagnosis from neighbors and family, 91% of the participants felt the need to isolate themselves when potentially symptomatic, 60% stated that other people were trying to avoid them, and 66% reported symptoms of COVID-19.Conclusion: Healthcare professionals who experienced possible symptoms of COVID-19 and chose to isolate them-selves and those who felt that others were trying to stay away from them experienced more symptoms of PTSD. Our findings indicated that many healthcare workers who cared for patients with COVID-19 reported signs of internalized stigma and PTSD. These findings and other literature reports emphasize the need to provide healthcare professionals with appropriate emotional support in order to ensure employee welfare, retention, and quality care.
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Background: The Singapore General Hospital COVID-19 Virtual Ward is a "hospital at home” (HaH) programme for the supervised home recovery of higher-acuity COVID-19 patients from the hospital and the community. Objective: To describe how an existing HaH programme was redesigned so that COVID-19 patients could be remotely monitored at home and report the outcomes of the first 100 patients in this Virtual Ward. Methods: Patients received an admission package comprising instructions and equipment for home monitoring, and uploaded their parameters into a clinical dashboard via a secure messaging app. Medical staff conducted video or telephone consultations daily. Patients were discharged according to time-based criteria, although some required SARS-CoV-2 PCR testing, which were conducted at home by a third-party medical provider. De-identified data of the first 100 patients were analysed by demographic details, indication for enrolment into the Virtual Ward, and the need for subsequent inpatient readmission. Results: Of the first 100 patients admitted into the Virtual Ward, 58 were female, mean age was 63.1 years old (23–95 years), and 76 were fully vaccinated. There were 77 hospital referrals and 23 community referrals. The number of days of inpatient hospitalisation avoided was 717 days (average of 7.9 days per patient). Three hospital referrals (3.9%) were readmitted, while seven community referrals (30.4%) required subsequent hospitalisation. Conclusion: The Virtual Ward programme demonstrates that selected COVID-19 patient can safely recover at home with remote medical support and monitoring, thereby expanding hospital capacity.
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Objective: To describe the functional outcomes of post COVID-19 patients after inpatient rehabilitation and determine if patients who underwent adjunct daily robotic therapy with Andago had better functional outcomes than those who did not and if patients who were frail had worse functional outcomes than those who were pre-frail or not frail. Design: Retrospective study of COVID-19 patients transferred for acute inpatient rehabilitation from 1 November 2021 to 31 December 2021. Results: Post COVID-19 patients who underwent inpatient rehabilitation had an improvement in the Functional Independence Measure (FIM) (median 109 vs 82), Functional Ambulation Category(FAC) (median 3 vs 2), distance walked with physiotherapist (mean 143.5 vs 18.7 m), and the Hospital Anxiety and Depression Scale(HADS) (mean 4.5 vs 7.8) from baseline. Robotic therapy may be associated with a shorter rehabilitation medicine length of stay (median 13 vs 19.5 days) and a higher FIM efficiency (mean 2.3 vs 1.2). Patients with a higher frailty score may have a slower 10 Meter Walk Test (10MWT) speed at discharge (Spearman's rho −0.542). Conclusion: Post COVID-19 patients benefit from inpatient rehabilitation with a comprehensive rehabilitation program, and adjunct robotic therapy may be offered to further improve functional outcomes. Frailty may also be considered when establishing rehabilitation goals, as meaningful functional gains can still be achieved.
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Background. Patients admitted to the hospital with SARS-CoV-2 infection are often treated with antibacterial agents in addition to antivirals, although bacterial coinfection in this population is uncommon. Overuse of unnecessary antibiotics can lead to suboptimal outcomes, including increased bacterial resistance, adverse events, and costs. Our Antimicrobial Stewardship (AS) Program routinely provides recommendations for appropriate therapy based on molecular/microbiologic tests, clinical findings, and procalcitonin (PCT). PCT can assist in differentiating bacterial from viral respiratory infections, and can be useful in the decision to discontinue antibiotic therapy if viral monomicrobial infection is suspected. The purpose of our quality improvement project was to review the appropriateness of antibiotics utilized for patients admitted with SARS-CoV-2 and to promote optimal patient care and AS at our institution. Methods. We performed a retrospective review of SARS-CoV-2 patients from our institution's COVID-19 registry for patients hospitalized from March 2020-April 2021. We compared patients with PCT < 0.25 ng/mL to those with PCT > 0.25 ng/mL and assessed differences in patient characteristics and disease presentation, including: age, gender, WBC, serum creatinine, culture results, disease severity, patient location, duration of antibiotics, length of stay, 30 day readmission and mortality. Characteristics were compared using descriptive statistics and appropriate inferential statistics. Results. Shown in Table 1. If prescribed antibiotics, median duration of antibiotic therapy was significantly reduced in the PCT < 0.25 group vs. the PCT > 0.25 group (2 days vs. 4.1 days). Median WBC, SOFA score, serum creatinine, and length of stay were significantly lower in the PCT < 0.25 group compared to the PCT > 0.25 group. Severity adjusted models showed significantly decreased duration and overall likelihood of antibiotic use for PCT < 0.25 vs. PCT > 0.25. 30 day readmission and 30 day mortality were significantly lower in the PCT < 0.25 group vs. the PCT > 0.25 group. Conclusion. Antibiotic utilization was reduced in patients admitted with SARS-CoV-2 infection and PCT < 0.25, and if prescribed antibiotics, duration was significantly shorter vs. those in the PCT > 0.25 group.
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The digital transformation movement persuaded many pharma companies towards greater adoption of digital marketing and e-commerce. This was accelerated even more by the COVID-19 crisis. Therefore, this study aims to explore the general perception and attitude of consumers in Malaysia regarding the use of online shopping and digital marketing tactics for OTC drugs. Thirteen in-depth interviews were conducted between September and November 2020. A thematic content analysis approach was used to analyse the qualitative data. Key themes emerging from the interviews included: (1) general perception of OTC drug consumers regarding digital marketing;(2) attitude of consumers towards the purchase of OTC drugs;(3) factors affecting OTC drug consumer behaviour;and (4) perception of consumers towards online advertisements for OTC drugs. The majority of the study participants believe that digital marketing has a direct or indirect impact on their purchasing decisions as OTC consumers. Although most rely mainly on offline purchases for OTC products, they have shown a willingness to increase their adoption of online purchasing methods, particularly in the aftermath of the COVID-19 outbreak. These findings can be useful to public and private healthcare managers on a practical level.
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Background/Purpose: As a result of the COVID-19 pandemic, changes in data collection methods have been introduced in research to ensure continuity despite physical distancing and lockdown restrictions. Our objective was to compare differences in physical and mental health of older adults participating in falls research using data collection methods pre-covid-19 pandemic (face-to-face) and during the pandemic (hybrid). Method(s): Individuals aged 60 years and over with at least one fall in the past 12 months, and controls with no history of falls in the past 12 months were recruited. Pre-pandemic, individuals were interviewed face-to-face exclusively, those interviews after the start of the pandemic were conducted virtually with physical assessments conducted face-to-face to minimize physical contact. Cognitive status, physical performance, psychological status, quality of life, physical activity, and social participation were measured. Result(s): Of the 145 participants of similar socio-demographic backgrounds, 69 were interviewed face-to-face, while 76 were assessed using a hybrid method. Differences were observed in presence of fall characteristics, with fewer fallers seeing a doctor and more fallers attending the emergency department after the start of the pandemic. After adjustment for baseline differences, participants interviewed using hybrid status had lower depression scores (OR (95%CI)=0.29(0.14-0.61)) and stress scores (OR(95%CI)=0.33(0.15-0.72)), but greater fear of falling (OR(95%CI)=2.16(1.04-4.48)) and reduced social participation (OR(95%CI)=2.64(1.20-5.79)). Conclusion(s): Alterations in data collection methods to overcome pandemic restrictions should take into consideration potential differences in individuals who agree to participate as well as the influence of major life events on the psychological status of participants. Copyright © 2022, Full Universe Integrated Marketing Limited. All rights reserved.
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In 2020, COVID-19 swept across the globe. To reduce the social harms caused by this public health event, nonprofit organizations (NPOs) cooperated with medical enterprises to produce reserves of emergency medical supplies. In practice, this cooperation was challenged by the different goals of NPOs and medical enterprises and the asymmetry of information between these parties. Enterprises are prone to irregularities or speculative behaviors that can result in insufficient production capacity during public health events, which increase disaster risks. Based on the principal–agent relationship of NPOs and enterprises, this study analyzed a game model between NPOs and enterprises under information asymmetry;constructed an incentive model for reserve emergency medical supply production capacity;and solved the optimal reward and punishment coefficients of NPOs, optimal effort level of enterprises, and benefits of disaster reduction. The study also verified the validity of the model using numerical examples and a sensitivity analysis. In taking up the findings of the study, this paper discusses the effects of several important exogenous variables on the optimal decision strategies of NPOs and enterprises and offers management-related insights for NPOs. © 2022 by the authors.
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Introduction: Logbooks are now ubiquitous in medical practice, aiding in provision of evidence of competency for training progression and revalidation processes. The Faculty of Intensive Care Medicine (FICM) recommends all practitioners keep a logbook, but does not mandate a particular one. During COVID19, redeployment from other specialties into ICU has meant many training opportunities have been difficult to evidence.1,2 Logbooks provide an evidence base for documenting educational experiences, identifying opportunities and learning from good practice.3 Objectives: The NorthWest Intensive Care Unit Logbook (NW ICU Logbook) provides a digital, spread-sheet based, easy-to-use, mobile-compatible personal logbook for ICU practitioners of all grades. Originally created for personal use, it has been made available for free for all. We used analytical software to track its use and spread so as to better understand the desire for such logbooks. Methods: Google Analytics were built into the logbook download website to track views and downloads. Data is collected anonymously and provides evidence of its appeal. Extrapolation of its spread suggests an increased focused on governance within global ICM. Prospective, real-time data is continuously collected regarding website traffic, number of downloads, geographical and device data. This provides a rich source of anonymised data to better understand the use of a product. Already, many businesses use such software, but this method is still relatively new within medicine. Results: The logbook has been downloaded over 3000 times from over 30 countries. Although interest is heavily centred in the UK, hotspots of downloads have also occurred in India, Egypt and Middle East. This is likely due to existing links and partnerships between hospitals. The logbook has been responsive to change, and several versions have been created based on feedback from users. The global appeal suggests an increased focus on educational governance and therefore presents many opportunities for further data collection and understanding of educational capacity and quality. Furthermore, expansion of the dataset may enable better understanding of human resources for health, caseload and global critical care trends. Conclusion: There continues to be an interest for an easyto-use and fit-for-purpose logbook for ICU practitioners. This logbook may form a template for further development. For example, an app would allow anonymised big data to be collected which can provide an evidence-base for regional variation in educational opportunities and achievements. Also, the global interest already shown may allow anonymised data which can add to evidence regarding human resources for health in low resource settings, further contributing to the understanding and advancing larger global health agendas within acute and emergency care.4 This provides a powerful opportunity for organisations to collect data for further research.