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1.
Microorganisms ; 10(4):8, 2022.
Article in English | Web of Science | ID: covidwho-1820337

ABSTRACT

Since March 2020, the COVID-19 pandemic forced hospitals worldwide to intensify their infection control measures to prevent health care-associated transmission of SARS-CoV-2. The correct use of personal protective equipment, especially the application of masks, was quickly identified as priority to reduce transmission with this pathogen. Here, we report a nosocomial cluster of methicillin-resistant Staphylococcus aureus (MRSA) that occurred during the COVID-19 pandemic in a gynecology/obstetrics department, despite these intensified contact precautions. Five MRSA originating from clinical samples after surgical intervention led to an outbreak investigation. Firstly, this included environmental sampling of the operation theatre (OT) and, secondly, a point prevalence screening of patients and health care workers (HCW). All detected MRSA were subjected to whole genome sequencing (WGS) and isolate relatedness was determined using core genome multilocus sequence typing (cgMLST). WGS revealed one MRSA cluster with genetically closely related five patient and two HCW isolates differing in a single cgMLST allele at maximum. The outbreak was terminated after implementation of infection control bundle strategies. Although contact precaution measures, which are also part of MRSA prevention bundle strategies, were intensified during the COVID-19 pandemic, this MRSA outbreak could take place. This illustrates the importance of adherence to classical infection prevention strategies.

2.
Journal of Forensic Medicine and Toxicology ; 38(1):102-106, 2021.
Article in English | EMBASE | ID: covidwho-1818625

ABSTRACT

In view of the ongoing pandemic, healthcare workers are rightfully concerned about performing autopsies, due to the risk of infection. An autopsy surgeon and his/her team can inadvertently be exposed to infectious diseases. Use of appropriate personal protective equipment (PPE) and mortuaries equipped with negative pressure are essential to protect the autopsy team from exposure to potentially infected bodies, bodily fluids, tissues, and aerosolized particles. Unfortunately, in a developing country like India, due to a lack of funding most mortuaries have only the bare minimum facilities. Taking these issues into consideration, the authors have developed a prototype of a Low-Cost Infection Containment Chamber (LCICC) within which autopsies or sample collection from suspected or confirmed highly infectious cadaver can be performed. This innovation could provide infectious disease experts and pathologists a safer alternative to collect specimens to aid in the management outbreaks of highly infectious diseases.

3.
Geriatric Orthopaedic Surgery and Rehabilitation ; 12:14-15, 2021.
Article in English | EMBASE | ID: covidwho-1817121

ABSTRACT

Introduction: In January 2021, Ireland was undergoing the 'Third Wave' of COVID-19, with almost 2,000 persons hospitalised with COVID-19. Over 50% of all COVID-19-related deaths in the EU have occurred in those aged 80 years and older. The same patient cohort is also at high risk sustaining a fragility fracture, leading to an admission to the orthopaedic rehabilitation ward. This study examines a patient group in whom these two scenarios coincided, describing a patient cohort who having sustained a fragility fracture, later contracted COVID-19. This study aims to describe the characteristics and outcomes of orthopaedic rehabilitation patients with COVID-19 and to examine the response of an orthopaedic rehabilitation ward to an outbreak of COVID-19. Methods: This is a retrospective observational study. Data from 26 hospitalised patients aged over 65 years with COVID-19 at an Irish orthopaedic rehabilitation ward was collected. Symptom profile, degree of COVID-19 severity, Clinical Frailty Scale (CFS), Charleston co-morbidity scores, laboratory and radiological data were reviewed. Individual treatment pathways were recorded for each patient. Infection control records were reviewed to examine the response of the ward to an outbreak of COVID-19. Results: Patient mortality rate was 7.7% (n = 2). Median survivor age was 79.5 years (IQR 70-85.5). Mean CFS and Charleston Co-morbidity scores were 4.15;(SD1.6) and 5.08, respectively. The majority of patients (n = 25, 96%) were categorised as mild COVID-19 cases. Delirium was noted in more than 10% of patients (n = 3, 11.6%). One patient (n = 1, 3.8%) required non-invasive ventilation. In those whose disease was classifies as severe (n = 2, 7.7%), intubation/resuscitation were not deemed appropriate and when they deteriorated, comfort measures were taken. The majority of patients (n = 21, 81%) were able to return home upon discharge. Three patients (11.5%) had increased care needs and required long term care to be arranged. Conclusion: An outbreak of COVID-19 requires a multidisciplinary approach with a focus on not only medical management but also clinical workforce management, patient flow, management of access to the wards and information and communications management. The overall outcomes in this group, including mortality and proportion discharged to long term care, were positive when compared to similar cohorts of elderly hospitalised patients with COVID-19. These outcomes support a multidisciplinary model of care.

4.
Respirology ; 27(SUPPL 1):67, 2022.
Article in English | EMBASE | ID: covidwho-1816631

ABSTRACT

Introduction/Aim: Fewer exacerbations of chronic lung disease during the COVID-19 pandemic may be due to the introduction of measures to prevent SARS-CoV-2 transmission and the associated lower prevalence of other respiratory viruses. Our aim was to determine the acceptability of continuing with (COVID-19) infection control measures to lower future exacerbation risk. Methods: Adults with chronic lung disease in Australia were asked via an online survey to specify the infection control measures and policies that should continue, during the flu season or at all times, once most of the population have received the COVID-19 vaccine. Pre-specified thresholds: general support for measure: ≥66% of respondents;absence of significant support: ≤33%;meaningful difference between lung disease groups: ≥10%. Results: 137 people (asthma = 29, bronchiectasis = 29, COPD = 58, ILD = 21) from all Australian states and territories participated. Mean (SD) MRC breathlessness score was 2.4(1.0) and 75% were Female. 94% and 85% reported COVID-19 (86% two doses) and flu vaccination respectively. The table summarizes all survey responses. Responses were generally consistent across lung disease groups, except those with bronchiectasis were more supportive of continuation of face coverings on public transport (66%) and people with asthma would continue to physically distance outdoors (69%). People with ILD did not support (30%) face coverings outdoors during flu season but were supportive (75%) of healthcare staff wearing masks. People with bronchiectasis (24%) did not support a policy of physically distancing outdoors for everyone at all times. Conclusion: Adults with chronic lung diseases in Australia are supportive of physically distancing indoors and hand hygiene as measures to reduce exacerbations. There was lack of support for widespread continuation of face coverings but policies for use on public transport during the flu season were acceptable. Avoidance of busy places and friends/ family who are unwell with colds/flu are strategies they will adopt when majority of the population are vaccinated for COVID-19. (Figure Presented).

5.
International Journal of Pharmacy Practice ; 30(SUPPL 1):i15-i16, 2022.
Article in English | EMBASE | ID: covidwho-1816116

ABSTRACT

Introduction: Community pharmacy is one of the most accessible sectors in the health service and played a key role in responding to COVID-19 (1). Efforts to tackle COVID-19 have required an immediate response from the community pharmacy workforce. Aim: To examine views and experiences of community pharmacists regarding changes in practice/processes in preparation for and response to the COVID-19 pandemic. Methods: A telephone questionnaire was conducted across a geographically stratified sample of community pharmacists in Northern Ireland (NI). Based on the total number of pharmacies (N=528) and an anticipated response rate of 30%, up to 433 pharmacies were to be contacted to achieve a target sample size of n=130 (sampling fraction 24%). The questionnaire sections comprised: (1) measures taken to prevent COVID-19 infection;(2) response to the pandemic, i.e. immediate actions taken, effect on service provision and new/innovative ways of working;(3) pandemic preparedness;(4) communication with GPs and patients;(5) professional knowledge;(6) recovery and future outlook. Data were coded, entered into SPSS v27, and analysed descriptively. Free-text comments were summarised using thematic analysis. Results: One hundred and thirty community pharmacists (175 approached) completed the questionnaire (74% response rate). Pharmacists responded comprehensively to implementing infection control measures, e.g. management of social distancing in the shop (n=125, 96.2%), making adjustments to premises, e.g. barriers/screens (n=124, 95.4%), while maintaining medicines supply (n=130, 100.0%) and advice to patients (n=121, 93.1%). Patient-facing services such as minor ailments and smoking cessation were initially stopped by 115 (88.5%) and 93 (71.5%) pharmacies respectively during the first wave of the pandemic (March-May 2020);by the second wave (Sep-Dec 2020), modified services had resumed in 121 (93.1%) and 104 (79.9%) pharmacies respectively. Newly commissioned services were provided, e.g. emergency supply service (n=121, 93.1%), flu vaccination for healthcare workers (n=101, 77.7%) and volunteer deliveries to vulnerable people (n=71, 54.6%);new initiatives were developed, e.g. measures to flag/assist patients with sensitive issues (n=73, 56.2%). Pharmacies with a business continuity plan increased from 85 (65.4%) pre-pandemic to 101 (77.7%) during the second wave. Free-text responses indicated how pharmacists adapted practice in the front line to reassure and advise the public and maintain essential medicines supply. Pharmacists were least prepared for the increased workload and patients' challenging behaviour, but 126 (96.9%) reported that they felt better prepared during the second wave. Telephone was the main method of communication with patients (n=107, 82.3%) and GPs (n=114, 87.7%). Pharmacists felt they had sufficient training resources available (n=113, 86.9%) to maintain professional knowledge. Pharmacists agreed/strongly agreed that they would be able to re-establish normal services (n=114, 87.7%), were willing to administer COVID-19 vaccines (n=105, 80.7%) and provide COVID-19 testing (n=79, 60.8%) in the future. Conclusion: The high response rate is a strength of the study, but the impact is limited by not including patients or service commissioners. The pharmacy workforce remained accessible and maintained supply of essential medicines and advice to patients throughout the pandemic. Provision of modified and additional services such as vaccination reinforced the clinical and public health role of pharmacy.

6.
International Journal of Pharmacy Practice ; 30(SUPPL 1):i21-i22, 2022.
Article in English | EMBASE | ID: covidwho-1816102

ABSTRACT

Introduction: Community pharmacy has played a frontline role during the COVID-19 pandemic (1,2). Governments and professional organisations in the United Kingdom and Republic of Ireland (RoI) have acknowledged the need to support and maximise community pharmacy to maintain delivery of patient care. However, the pandemic's impact on day-to-day changes to community pharmacy practice has not been comprehensively examined across the island of Ireland. Aim: To identify changes as communicated by policy and professional bodies to community pharmacy practice across the island of Ireland in preparation for and/or response to the COVID-19 pandemic, and to compare identified changes in Northern Ireland (NI) and RoI. Methods: Government, health service, regulatory and professional organisation websites in both NI and RoI were searched using relevant search terms (e.g. pharmacist, COVID- 19). Any document (e.g. official publications/reports, website pages, circulars) containing information relating to changes to community pharmacy-related infrastructure, funding/resourcing, legislation, guidelines or policies in preparation for, and/ or response to, COVID-19, published between 1st January and 31st October 2020 was included. Guidelines on clinical use of medicines were excluded as this was considered a separate topic. Initial screening of each website was undertaken by one reviewer. Brief details of potentially relevant documents were collated in a spreadsheet. Following removal of duplicates, full-texts of identified documents were assessed for inclusion by two reviewers independently, with discrepancies resolved through discussion. A content analysis was undertaken. Results: In total, 253 documents were identified. Following removal of duplicates and screening, 98 documents were included in the analysis. Most documents were published in the first three months of the pandemic (March-May 2020). A key theme related to medication prescribing and supply, with changes implemented to ensure continued access to medicines. In both NI and RoI, significant changes were made to emergency supply arrangements (e.g. increase in allowable duration of supply at the request of patients). In RoI, legislative changes were made to recognise Healthmail as the national electronic prescription transfer system and to temporarily extend prescription validity. In NI, many community pharmacy services (e.g. Minor Ailments Service, Medicines Use Review) were 'stood down' during initial months of the pandemic. Much of the communication in NI and RoI related to operational changes to ensure business continuity. In both jurisdictions a temporary register of pharmacists was introduced to allow previously registered pharmacists to contribute to the health service response. Additionally, in NI, General Dental Practitioners were redeployed to assist with community pharmacy response. Other areas of focus across both jurisdictions included infection control within a workplace setting, dealing with situations where staff were affected by COVID-19, and the use of personal protective equipment during pharmacy service provision. Conclusion: This study examined changes in community pharmacy practice across two jurisdictions during the COVID-19 pandemic. Whilst our searches were limited to publicly accessible documents only, the overlap in identified changes reflects the similarities in challenges faced by community pharmacists in adapting and responding to COVID-19. The cross-country comparison may help pharmacists and policy-makers to identify optimal approaches for responding to any future public health crises.

9.
Hawaii Journal of Medicine and Public Health ; 80(9 Suppl. 1):102-109, 2021.
Article in English | GIM | ID: covidwho-1812931

ABSTRACT

The Republic of the Marshall Islands, American Samoa, the Federated States of Micronesia, and the Republic of Palau have been without any COVID-19 community transmission since the beginning of the global pandemic. The Commonwealth of the Northern Mariana Islands has experienced modest community transmission, and Guam has had significant COVID-19 community transmission and morbidity. Although several of these United States Affiliated Pacific Island jurisdictions made difficult strategic choices to prevent the spread of COVID-19 which have been largely successful, the built environment and the population density in the urban areas of the Pacific remain inherently conducive to rapid COVID-19 transmission. Rapid transmission could result in devastating health and economic consequences in the absence of continued vigilance and long-term strategic measures. The unique COVID-19 vulnerability of islands in the Pacific can be modeled through examination of recent outbreaks onboard several United States Naval ships and other marine vessels. The environmental characteristics that pose challenges to infection control on an isolated naval ship are analogous to the environmental characteristics of these Pacific island communities. Considering a collection of case studies of COVID-19 transmission on ships and applying to Pacific Island environments, provides a heuristic, easily accessible epidemiologic framework to identify methods for interventions that are practical and reliable towards COVID-19 containment, prevention, and control. Using accessible evidence based public health policies, infection risk can be decreased with the objective of maintaining in-country health and social stability. These case studies have also been examined for their relevance to current discussions of health care infrastructure and policy in the Pacific Islands, especially that of vaccination and repatriation of citizens marooned in other countries. The need for aggressive preparation on the parts of territories and nations not yet heavily exposed to the virus is critical to avoid a rapid "burn-through" of disease across the islands, which would likely result in catastrophic consequences.

10.
Natural Volatiles & Essential Oils ; 8(5):6235-6243, 2021.
Article in English | GIM | ID: covidwho-1812884

ABSTRACT

Background: The pandemic caused by novel coronavirus (SARS-CoV-2) in Wuhan, China In December 2019 is a highly infectious disease. Different types of masks were used during this pandemic. Aim: The aim of this study is to assess knowledge and awareness on the usage of mouth masks used during this pandemic COVID-19 among preclinical UG and interns. Materials and Methods: A cross-sectional study was conducted in Chennai,India. A self-administered questionnaire containing 13 questions was designed for preclinical UG and interns. Responses were collected and subjected to statistical analysis using SPSS software. Chi Square test was done to find the association between dependent and independent variables.

11.
Journal of Aesthetic Nursing ; 11(3):136-138, 2022.
Article in English | CINAHL | ID: covidwho-1811405

ABSTRACT

Dr Martyn King explains the precautions and steps that must be taken to ensure that live demonstrations can be performed safely

12.
Singapore Med J ; 63(2): 61-67, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1811330

ABSTRACT

The complete picture regarding transmission modes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is unknown. This review summarises the available evidence on its transmission modes, our preliminary research findings and implications for infection control policy, and outlines future research directions. Environmental contamination has been reported in hospital settings occupied by infected patients, and is higher in the first week of illness. Transmission via environmental surfaces or fomites is likely, but decontamination protocols are effective in minimising this risk. The extent of airborne transmission is also unclear. While several studies have detected SARS-CoV-2 ribonucleic acid in air samples, none has isolated viable virus in culture. Transmission likely lies on a spectrum between droplet and airborne transmission, depending on the patient, disease and environmental factors. Singapore's current personal protective equipment and isolation protocols are sufficient to manage this risk.


Subject(s)
COVID-19 , SARS-CoV-2 , Hospitals , Humans , Infection Control/methods , Personal Protective Equipment
13.
Infect Disord Drug Targets ; 2022.
Article in English | PubMed | ID: covidwho-1809166

ABSTRACT

BACKGROUND: The higher mortality rate in COVID-19 patients is still a concern. Though some studies mention that elderly patients with co-morbidities are at higher risk of mortality, some others report uneventful outcomes in young patients even without co-morbidities. Secondary bacterial and fungal infections, especially with nosocomial pathogens are known to be associated with worse outcome in the ongoing pandemic as well as in the previous viral outbreaks. In such a scenario, the outcome of hospitalized COVID-19 patients can be improved by timely identification of secondary infections using appropriate biomarkers and by following appropriate infection control measures to prevent the spread of nosocomial pathogens. OBJECTIVE: The study aims to find out the prevalence of bloodstream infections (BSI) among hospitalized COVID-19 patients and to analyze their laboratory markers and outcome by comparing them with those without BSI. METHODS: In this descriptive cross-sectional study, the prevalence of secondary BSI was determined among the hospitalized COVID-19 patients by including 388 blood culture bottles collected from 293 patients, which were received in the microbiology lab within the study period. RESULTS: The overall prevalence of BSI in COVID-19 patients was 39.5% (116/293), out of which 35.5% (104/293) infections were bacterial, and 4.1% (12/293) were fungal, while 8.9% (26/293) patients grew contaminants, and 51.5% (151/293) were sterile. Common causative agents of secondary BSI were found to be MDR Klebsiella pneumoniae (10.9%) and Acinetobacter baumannii (8.8%) followed by Candida species (4.1%). Patients with co-morbidities like diabetes, hypertension and COPD were at higher risk of developing BSI with significantly higher levels of sepsis markers such as Creactive protein (CRP), procalcitonin, ferritin and Interleukin-6 (IL-6). The mortality rate was significantly higher (60.2%) in patients with BSI compared to the group of patients without BSI. CONCLUSION: Our findings suggest the necessity of early diagnosis of the secondary infections using appropriate biomarkers and following proper infection control measures to prevent the spread of the nosocomial infections and improve the outcome of hospitalized COVID-19 patients.

14.
BMC Infectious Diseases ; 22(1):243, 2022.
Article in English | MEDLINE | ID: covidwho-1808344

ABSTRACT

BACKGROUND: The unique characteristics of psychiatric institutions contribute to the onset and spread of infectious agents. Infection prevention and control (IPC) is essential to minimise transmission and manage outbreaks effectively. Despite abundant studies regarding IPC conducted in hospitals, to date only a few studies focused on mental health care settings. However, the general low compliance to IPC in psychiatric institutions is recognised as a serious concern. Therefore, this study aimed to assess perceived barriers and facilitators to IPC among professionals working at psychiatric institutions, and to identify recommendations reported by professionals to improve IPC. METHODS: A descriptive, qualitative study involving 16 semi-structured interviews was conducted (before COVID-19) among professionals from five Dutch psychiatric institutions. The interview guide and data analysis were informed by implementation science theories, and explored guideline, individual, interpersonal, organisational, and broader environment barriers and facilitators to IPC. Data was subjected to thematic analysis, using inductive and deductive approaches. This study followed the Consolidated criteria for Reporting Qualitative research (COREQ) guidelines. RESULTS: Our findings generated six main themes: (1) patients' non-compliance (strongly related to mental illness);(2) professionals' negative cognitions and attitude towards IPC and IPC knowledge deficits;(3) monitoring of IPC performance and mutual professional feedback;(4) social support from professional to patient;(5) organisational support and priority;and (6) financial and material resource limitations (related to financial arrangements regarding mental health services). The main recommendations reported by professionals included: (1) to increase awareness towards IPC among all staff members, by education and training, and the communication of formal agreements as institutional IPC protocols;(2) to make room for and facilitate IPC at the organisational level, by providing adequate IPC equipment and appointing a professional responsible for IPC. CONCLUSIONS: IPC implementation in psychiatric institutions is strongly influenced by factors on the patient, professional and organisational level. Professional interaction and professional-patient interaction appeared to be additional important aspects. Therefore, a multidimensional approach should be adopted to improve IPC. To coordinate this approach, psychiatric institutions should appoint a professional responsible for IPC. Moreover, a balance between mental health care and IPC needs is required to sustain IPC.

16.
BMJ Open ; 12(4):e060103, 2022.
Article in English | PubMed | ID: covidwho-1807417

ABSTRACT

OBJECTIVE: To identify, characterise and map the existing knowledge about (1) immunisation programmes that provide evidence-based support about vaccines to Canadians and reduce barriers to vaccination;and (2) barriers and facilitators to the delivery of immunisation support programmes. INTRODUCTION: Vaccine hesitancy is a complex issue that has significant repercussions for the health and safety of Canadians. Engaging in evidence-based communication about vaccines can reduce vaccine hesitancy and increase participation in immunisation programmes. METHODS: The Joanna Briggs Institute methodology for scoping reviews will be used for this scoping review. A comprehensive keyword search strategy was developed and translated for six electronic databases on 19 November 2021: CINAHL via EBSCOhost, APA PsycINFO via EBSCOhost, Academic Search Complete via EBSCOhost, Scopus, Medline via EBSCOhost and EmCare via Ovid. We will identify unpublished literature by searching websites listed in CADTH's Grey Matters checklist and other relevant sources in January 2022. Two independent raters will screen and extract data from identified material. Data will be presented in a tabular form. INCLUSION CRITERIA: We will consider Canadian programmes that target the general public and exclude papers targeting health professionals. Our review will not limit by vaccine type and will consider any intervention that aims to inform individuals about immunisation. Our primary concept involves mapping the characteristics of programmes (eg, programme description, delivery format) and our secondary concept will examine barriers and facilitators to programme delivery. ETHICS AND DISSEMINATION: Ethical approval is not required as this study is a review of the published and publicly reported literature. Findings from this review will be disseminated to academic and health system stakeholders to inform immunisation programmes across a wide range of vaccine types and settings. We intend to use the results of this review to develop an immunisation support programme in Prince Edward Island, Canada.

17.
BMJ Open ; 12(4):e053870, 2022.
Article in English | PubMed | ID: covidwho-1807403

ABSTRACT

INTRODUCTION: Vaccine hesitancy is a global problem, impeding uptake of vaccines against measles, mumps, and rubella and those against human papillomavirus and COVID-19. Effective communication strategy is needed to address vaccine hesitancy. To guide the development of research in the field and the development of effective strategies for vaccine communication, this scoping review aims to analyse studies of interventions using narrative to encourage vaccination. METHODS AND ANALYSIS: We will search the following databases: MEDLINE, CINAHL, PsycINFO and PsycARTICLES. We will identify additional literature by searching the reference lists of eligible studies. Eligible studies will be those that quantitatively examined the persuasiveness of narrative to encourage vaccination. Two independent reviewers will screen the titles, s and full texts of all studies identified. Two independent reviewers will share the responsibility for data extraction and verification. Discrepancies will be resolved through consensus. Data such as study characteristics, participant characteristics, methodology, main results and theoretical foundation will be extracted. The findings will be synthesised in a descriptive and a narrative review. ETHICS AND DISSEMINATION: This work does not warrant any ethical or safety concerns. This scoping review will be presented at a relevant conference and published in a peer-reviewed journal.

18.
Australas J Ageing ; 2022.
Article in English | PubMed | ID: covidwho-1806999

ABSTRACT

OBJECTIVE: This study aimed to capture stakeholder views and issues arising from the implementation of the innovative single-site employment guiding principles (SSE-GP) that the Australian Government, in consultation with the sector, introduced into hot spot residential aged care facilities (RACFs) in July 2020 in response to COVID-19. METHODS: Interviews with 74 stakeholders around Australia were conducted in October-November 2020. Provider interviews included employees and managerial and human resources staff in profit and non-profit services who did, and did not, have COVID-19 outbreaks. Sector interviews included representatives from peak bodies, unions, government, academics, advocates, labour hire and registered training organisations. RESULTS: There was broad but not total agreement on SSE-GP's effectiveness. Beyond specific SSE-GP feedback, six strategic workforce issues were identified. The quality of resident care was mixed, sometimes improved and sometimes diminished. The extent of employees' multiple jobholding surprised many providers, and rostering and unplanned absenteeism are a substantial strain for both providers and employees. Innovative work practices are often difficult for smaller providers lacking employment relations specialists. Future SSE-GP is seen by larger providers as voluntary and organisation- rather than facility-specific, and unions saw only mandated SSE-GP as appropriate for future outbreaks. Last, all staff, management and executives had additional stress that placed their well-being at risk. CONCLUSIONS: Although SSE-GP revealed new and existing weaknesses in the Australian RACF workforce, the broad industry consultation and collaboration demonstrated that the sector can meet COVID-19's urgent and complex challenges. The experience provided lessons for further workforce challenges that remain to be addressed.

19.
The Canadian Journal of Psychiatry / La Revue canadienne de psychiatrie ; 66(1):17-24, 2021.
Article in English | APA PsycInfo | ID: covidwho-1801691

ABSTRACT

Objectives: To examine the relationship between perceived adequacy of personal protective equipment (PPE) and workplace-based infection control procedures (ICP) and mental health symptoms among a sample of health-care workers in Canada within the context of the current COVID-19 pandemic. Methods: A convenience-based internet survey of health-care workers in Canada was facilitated through various labor organizations between April 7 and May 13, 2020. A total of 7,298 respondents started the survey, of which 5,988 reported information on the main exposures and outcomes. Anxiety symptoms were assessed using the Generalized Anxiety Disorder (GAD-2) screener, and depression symptoms using the Patient Health Questionnaire (PHQ-2) screener. We assessed the perceived need and adequacy of 8 types of PPE and 10 different ICP. Regression analyses examined the proportion of GAD-2 and PHQ-2 scores of 3 and higher across levels of PPE and ICP, adjusted for a range of demographic, occupation, workplace, and COVID-19-specific measures. Results: A total of 54.8% (95% confidence interval [CI], 53.5% to 56.1%) of the sample had GAD-2 scores of 3 and higher, and 42.3% (95% CI, 41.0% to 43.6%) of the sample had PHQ-2 scores of 3 and higher. Absolute differences of 18% (95% CI, 12% to 23%) and 17% (95% CI, 12% to 22%) were observed in the prevalence of GAD-2 scores of 3 and higher between workers whose perceived PPE needs and ICP needs were met compared to those who needs were not met. Differences of between 11% (95% CI, 6% to 17%) and 19% (95% CI, 14% to 24%) were observed in PHQ-2 scores of 3 and higher across these same PPE and ICP categories. Conclusions: Our results suggest strengthening employer-based infection control strategies likely has important implications for the mental health symptoms among health-care workers in Canada. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (French) Objectifs: Examiner la relation entre le caractere adequat percu de l'equipement de protection personnel (EPP) et les procedures de controle des infections (PCI) en milieu de travail et les symptomes de sante mentale au sein d'un echantillon de travailleurs de la sante du Canada, dans le contexte de la pandemie COVID-19 en cours. Methodes: Un sondage de commodite sur Internet des travailleurs de la sante du Canada auquel ont collabore diverses organisations professionnelles entre le 7 avril et le 13 mai 2020. En tout, 7 298 repondants ont commence le sondage, et 5 988 d'entre eux ont donne de l'information sur les expositions principales et les resultats. Les symptomes anxieux etaient evalues a l'aide du depisteur du trouble d'anxiete generalisee (GAD-2), et les symptomes de depression, a l'aide du questionnaire sur la sante du patient (PHQ-2). Nous avons evalue le besoin et le caractere adequat percus de 8 types d'EPP, et de 10 PCI differentes. Des analyses de regression ont examine la proportion des scores au GAD-2 et au PHQ-2 de 3 et plus eleves pour les niveaux d'EPP et de PCI, ajustes pour une serie de donnees demographiques, d'occupations, de milieux de travail, et de mesures specifiques pour la COVID-19. Resultats: Un total de 54,8% (intervalle de confiance a 95% 53,5% a 56,1%) de l'echantillon avait des scores au GAD-2 de trois et plus, et 42,3% (IC a 95% 41,0% a 43,6%) de l'echantillon avait des scores au PHQ-2 de trois et plus. Des differences absolues de 18% (IC a 95% 12% a 23%) et de 17% (IC a 95% 12% a 22%) ont ete observees dans la prevalence des scores au GAD-2 de trois et plus entre les travailleurs qui percevaient que leurs besoins d'EPP et de PCI etaient combles, compare a ceux dont les besoins n'etaient pas combles. Des differences entre 11% (IC a 95% 6% a 17%) et 19% (IC a 95% 14% a 24%) ont ete observees dans les scores au PHQ-2 de trois et plus dans les memes categories d'EPP et de PCI. Conclusions: Nos resultats suggerent qu'un resserrement des strategies de controle des infections par l'employeur a probablement des implications importantes pour les symptomes de sante mentale chez les travailleurs de la sante du Canada. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

20.
Pathogens ; 11(4), 2022.
Article in English | EMBASE | ID: covidwho-1798887

ABSTRACT

A One Health approach to the epidemiology, management, surveillance, and control of leptospirosis relies on accessible and accurate diagnostics that can be applied to humans and companion animals and livestock. Diagnosis should be multifaceted and take into account exposure risk, clinical presentation, and multiple direct and/or indirect diagnostic approaches. Methods of direct detection of Leptospira spp. include culture, histopathology and immunostaining of tissues or clinical specimens, and nucleic acid amplification tests (NAATs). Indirect serologic methods to detect leptospiral antibodies include the microscopic agglutination test (MAT), the enzyme-linked immunosorbent assay (ELISA), and lateral flow methods. Rapid diagnostics that can be applied at the point-of-care;NAAT and lateral flow serologic tests are essential for management of acute infection and control of outbreaks. Culture is essential to an understanding of regional knowledge of circulating strains, and we discuss recent improvements in methods for cultivation, genomic sequencing, and serotyping. We review the limitations of NAATs, MAT, and other diagnostic approaches in the context of our expanding understanding of the diversity of pathogenic Leptospira spp. Novel approaches are needed, such as loop mediated isothermal amplification (LAMP) and clustered regularly interspaced short palindromic repeats (CRISPR)-based approaches to leptospiral nucleic acid detection.

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