Assessment of Knowledge, Attitude, and Practices Toward Coronavirus Disease 2019 and the Risks of Severe Acute Respiratory Syndrome Coronavirus 2 Infection Among Iranian Emergency Medical Services Workers: An Online Cross-Sectional Survey

Objective: Coronavirus disease 2019 (COVID-19), a severe acute respiratory infection, has spread rapidly around the world. To expand and enhance knowledge regarding virus prevention/transmission, this study aimed to evaluate the knowledge, attitudes, and practices of emergency medical services (EMS) workers as a part of the health care system because of their essential role in the front lines of the COVID-19 outbreak. Method(s): An online cross-sectional survey was conducted on EMS workers to assess their knowledge, attitudes, and practices toward COVID-19. The questionnaire included 5 topics: demographic information, knowledge and attitude questions, professional behavior of employees during the epidemic, and anxiety score. Result(s): A total of 86 EMS workers answered the questionnaire, and 55.63% of the respondents answered the knowledge questions correctly;knowledge appeared to have no correlation to their education, age, or experience. In addition, there was no apparent correlation between the infection rate and exposure to an infected or suspected patient. Conclusion(s): The findings of the present study indicate that more than half of the EMS workers have good knowledge about the epidemic, and the level of knowledge was not related to their demographic characteristics. The results of professional behaviors showed a high level of compliance with the principles and guidelines by workers, and the absence of a relationship between employees' contamination and exposure to infected patients supports the awareness and legality of EMS workers.Copyright © 2023 Air Medical Journal Associates

The sense of loneliness in couples and the impact of the health crisis: A review of literature

Objective: The purpose of this review is to define the feeling of loneliness within a couple while taking into consideration the factors that lead a person to feel lonely in a couple or in a romantic relationship. Our goal is to understand the effects of the feeling of loneliness on these individuals during the global health crisis brought on by COVID-19 and to take these factors into account in designing effective therapeutic care. The different manifestations of loneliness in a couple should also be highlighted. Method(s): We used the PRISMA methodology to select the relevant studies. The keywords ("Solitude" or "Loneliness") and ("Couple" or "Married" or "Partnership") allowed us to select 19 references dealing with the theme. We conducted searches of the following databases: "Cairn", "PsychInfo and Psycarticle", "PubMed and Medline", "ScienceDirect" and finally, "Web of Science" in order to find articles covering a ten-year period. Result(s): There are different definitions for the subjective experience of loneliness. The review of the literature highlights the fact that loneliness can lead to positive or negative psychological consequences (it can lead to the development of creative capacity or, on the contrary, result in depression in some cases). Attachment patterns have been shown to be the basis for the tolerance of feelings of loneliness. Indeed, an anxious attachment would encourage the couple to avoid the feeling of loneliness. According to the literature, this defensive mechanism of seeking presence in the couple would make it possible to limit the impact of loneliness. This solitude depends on the level of relational quality within the couple. A poor relational quality would lead to greater loneliness and would impact intimate relationships. Loneliness is supposedly not experienced in the same way by men and women: Men seem to be more protected by marriage while women's level of loneliness may be higher because of the household chores they have to do. Men and women would nevertheless remain subject to the phenomena of contamination, i.e., when one of the partners feels lonely, the other will also be lonely. However, it seems that marriage protects against feelings of loneliness and its negative consequences. Loneliness does not have only negative effects. It can be beneficial for developing creativity and finding oneself. The periods of confinement during the COVID-19 crisis provided people with an increase in the amount of time they didn't normally have on a daily basis. This may have been beneficial for some people and can be associated with positive emotions. Individuals who spent the lockdowns with others felt less alone and experienced less psychological distress. However, confinements did produce some negative effects on couples. The increased stress of the pandemic and the constant proximity led to an increase in spousal abuse. The consequences of confinement for couples whose relationships were already troubled resulted in frequent separation and/or divorce. The potential for conflict was related to limited financial resources, not working, and the significant risk of contracting SARS COV-2. Conclusion(s): The articles dealing with the feeling of loneliness that we reviewed presented quantitative methods to the detriment of qualitative aspects and focused largely on the negative aspects of the feeling of loneliness. Other academic disciplines, such as sociology, demonstrate a lack of understanding concerning what is at stake with the feeling of loneliness. The articles intersect and tend to highlight the attachment relationships that are formed in childhood as a determining factor in the feeling of solitude later in life. The quality of the relationship, gender, and marital status are also factors to be considered. Loneliness has a clear influence on the well-being of the relationship but it is not an individual characteristic of the relationship itself. It finally appears as an individual characteristic with an impact on the assessment of the quality of the relationship and on the appreciatio of the spouse.Copyright © 2023 Elsevier Masson SAS

Screening Strategies in Different Resource Settings

Health care-associated infections/ Hospital-acquired infections (HAIs) have a significant impact on patients' morbidity and mortality. The risk of HAIs in resource-limited settings (RLS) has been reported 2-20 times higher than that in developed countries. Moreover, multi-drug- resistant organisms (MDROs) have emerged and spread throughout the world. In addition, increases in HAIs were observed during the COVID-19 pandemic throughout the world.Thus, screening strategies/surveillance of MDROs were recommended as a core component of infection prevention and control (IPC) measures for the effective HAIs prevention. We review and summarize current critical knowledge on screening strategies in different resource settings, especially on guidelines for the prevention and control of carbapenem- resistant Enterobacteriaceae (CRE), Acinetobacter baumannii (CRAB), and Pseudomonas aeruginosa (CRPsA) in health care facilities. The guidelines (especially WHO) were strongly recommended for surveillance of CRE-CRAB-CRPsA infections and surveillance cultures of asymptomatic CRE colonization. There were conditional recommended on surveillance cultures of the environment for CRE-CRAB-CRPsA colonization/contamination. The surveillance cultures (stool samples or rectal swabs) allowed the early introduction of IPC measures to prevent transmission to other patients and the hospital environment. Given the clinical importance of CRE-CRAB-CRPsA infections, regular ongoing active surveillance of infections were required in all microbiology laboratory settings. In addition, surveillance cultures for asymptomatic CRE colonization should also be performed, guided by local epidemiology and risk assessment. The surveillance cultures of asymptomatic CRE colonization should be considered for patients with previous CRE colonization and patients with a history of recent hospitalization in endemic CRE settings or contacted CRE colonized/ infected patients. In contrast, the evidence available on surveillance cultures for CRAB and CRPsA colonization in asymptomatic patients was not sufficiently relevant for the recommendation. Nowadays, the CRE surveillance strategies have been implemented in various methods from traditional culture- based methods to molecular assays. The limitation of microbiology laboratory capacity for MDROs in RLS was concerning. However, the surveillance data would help with appropriate IPC measure implementation and outbreak investigations. Thus, the proper screening strategies and strengthening microbiology laboratory capacity, especially in RLS are challenge for improving IPC measures and patient outcomes.Copyright © 2023

SARS-CoV-2 air and surface contamination on a COVID-19 ward and at home - Extended Abstract to INDOOR AIR 2022

SARS-CoV-2 has been detected both in air and on surfaces, but questions remain about the patient-specific and environmental factors affecting virus transmission to the environment. Additionally, more detailed information on viral findings in the air is needed. In this cross-sectional study, we present results from 259 air and 252 surface samples from the surroundings of 23 hospitalized and eight home-treated COVID-19 patients between July 2020 and March 2021 and compare the results between the measured environments and patient factors. In four cases, positive environmental samples were detected even after the patients had developed a neutralizing IgG response. SARS-CoV-2 RNA was detected in multiple particle sizes and different air samplers. Appropriate infection control against airborne and surface transmission routes is needed in both environments, even after antibody production has begun. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.

Environmental hygiene in outdoor food markets in Africa: a scoping review

Outdoor food markets represent important locations where foodborne illnesses and other infectious diseases can spread. Countries in Africa face particular challenges given the importance of these markets in food supply and low rates of access to safely managed water and sanitation. We undertook a scoping review of evidence related to disease transmission in food markets in sub-Saharan Africa, North Africa and identified 46 papers for data extraction and synthesis. Vendor behaviour or awareness was reported in the majority of papers and about half reported on market infrastructure. Fewer studies have been reported on regulatory environments or food contamination. Studies on water supply, sanitation and handwashing facilities focused on the presence of services and did not evaluate quality, thus conclusions cannot be drawn on service adequacy. Studies of vendor behaviour were primarily based on self-reporting and subject to bias. Most studies reported high levels of vendor awareness of the need for hygiene, but where observations were also conducted, these showed lower levels of behaviours in practice. Our findings suggest that there are limited studies on environmental hygiene in outdoor food markets and this is an area warranting further research, including into the quality of services and addressing methodological weaknesses.

COVID-19 pharmaceuticals in aquatic matrices: The threatening effects over cyanobacteria and microalgae

Water contamination by pharmaceuticals is a global concern due to their potential negative effects on aquatic ecosystems and human health. This study examined the presence of three repositioned drugs used for COVID-19 treatment: azithromycin (AZI), ivermectin (IVE) and hydroxychloroquine (HCQ) in water samples collected from three urban rivers in Curitiba, Brazil, during August and September 2020. We conducted a risk assessment and evaluated the individual (0, 2, 4, 20, 100 and 200 μg.L−1) and combined (mix of the drugs at 2 μg.L−1) effects of the antimicrobials on the cyanobacterium Synechococcus elongatus and microalga Chlorella vulgaris. The liquid chromatography coupled to mass spectrometry results showed that AZI and IVE were present in all collected samples, while HCQ occurred in 78 % of them. In all the studied sites, the concentrations found of AZI (up to 2.85 μg.L−1) and HCQ (up to 2.97 μg.L−1) represent environmental risks for the studied species, while IVE (up to 3.2 μg.L−1) was a risk only for Chlorella vulgaris. The hazard quotients (HQ) indices demonstrated that the microalga was less sensitive to the drugs than the cyanobacteria. HCQ and IVE had the highest values of HQ for the cyanobacteria and microalga, respectively, being the most toxic drugs for each species. Interactive effects of drugs were observed on growth, photosynthesis and antioxidant activity. The treatment with AZI + IVE resulted in cyanobacteria death, while exposure to the mixture of all three drugs led to decreased growth and photosynthesis in the cells.. On the other hand, no effect on growth was observed for C. vulgaris, although photosynthesis has been negatively affected by all treatments. The use of AZI, IVE and HCQ for COVID-19 treatment may have generated surface water contamination, which could increased their potential ecotoxicological effects. This raises the need to further investigation into their effects on aquatic ecosystems.

Association of income, education, employment and COVID-19 mortality in Brazil

The increased mortality rates from COVID-19 in Brazil have adversely affected vulnerable populations and placed a severe burden on its public health system as compared to other nations. Focusing on socioeconomic status as a risk factor in this retrospective cohort study, I investigated the association between Brazilian COVID-19mortality rate, income, school enrollment rate, and employment rate after controlling for the demographics and immunization rate. This is an important issue as an increase in incidence and mortality rates affects how governmental and public health leaders can effectively control and prevent disease spread. Using the fundamental causes of disease theory as the theoretical framework, I evaluated the underlying influence of socioeconomic factors on COVID-19 mortality at different geographic levels (region, state, and capital). Therefore, the foci of these three manuscripts is the need to assess this influence to encourage governmental response through better planning, strategies, and actions toward socioeconomic equality in Brazil, which could promote a reduction in the COVID-19 mortality rate. Most findings do not agree with the theory tested, which can be explained by a series of other factors, such as population density and heterogeneity.Thus, there are still inconsistencies regarding how minority groups are at greater risk of disease contamination and death. The social change implications of this study include a potential increase in opportunities for socioeconomic equality. A decrease in the COVID19 mortality rate could also allow Brazilians to improve individual lives with healthier families and communities. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Pretreatments for Microbial Analysis and Evaluation of Hygiene of Wet Towels and Wet Wipes

The demand for hygiene products has increased worldwide since the outbreak of global COVID-19. As the hygiene products market is expanding, it is necessary to manage microbial contamination in wet towels and wet wipes. This study evaluated pretreatment methods for microbial recovery from wet towels and wipes and microbial contamination levels in wet towels and wipes with the pretreatment method. Escherichia coli (NCCP14038 and NCCP14039), Staphylococcus aureus (ATCC25923 and ATCC29213), and Pseudomonas aeruginosa (NCCP10250 and NCCP11229) were inoculated on five fabric materials of wet towels and wet wipes. The recovery rates of the bacteria from wet towels and wet wipes using three pretreatment methods (pummeling, hand shaking, and portion cutting method) were investigated. Using the selected pretreatment method, the contamination levels of E. coli, S. aureus, and P. aeruginosa were evaluated for 238 wet towels and 244 wet wipes, which were collected in April to August, 2019. The presence of toxA and antibiotic resistance of P. aeruginosa isolated from wet towels were evaluated. The overall recovery rates of the pummeling method and hand shaking method were higher than the portion cutting method. Considering the convenience, the pummeling method was used to investigate the microbial contamination in the wet towels and wet wipes. P. aeruginosa was detected in two wet towels at an average of 9.9x102 CFU/towel. E. coli and S. aureus were not detected in both wet towels and wipes. P. aeruginosa isolates showed no resistances to piperacillin, piperacillin-tazobactam, aztreonam, and gentamicin, but had toxA. The results indicate that the pummeling method is the most appropriate pretreatment method for the recovery of microorganisms, and microbial analysis showed that this method could be useful in monitoring microbial contamination in wet towels and wet wipes.

Efficiency of UVC radiation as an air disinfectant in a real environment

Microbial contamination of indoor air in public spaces plays an important role in the SARSCoV-2 pandemic. So far, most studies on the reduction of airborne microbial load by UVC irradiation have been conducted as simulations or in laboratory environments. The aim of our study is to demonstrate the efficiency of Upper-Room Ultraviolet Germicidal Irradiation (UVGI) in a real environment like a supermarket. Restrictions on the use of harmful SARSCoV-2 particles for testing in public areas could be circumvented by using airborne germs as indicators. The results of this study show significant germ (bacterial and fungal) reductions by use of UVGI during business hours in a supermarket. Referring to known susceptibility values of airborne germs from previous work, we were able to estimate the effectiveness of the UVGI-system used against corona viruses. It met the requirements for complete disinfection. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.

Excellent performance by avoiding microbial contamination (EPBAMC): A new portal and model for safety of respirator masks approved by bacterial contamination field research

Introduction: Over the past decades, billions of people on Earth have used respirator masks to prevent animal-to-human and human-to-human virus transmission. Recent research has shown the low risk of surface transmission of COVID-19, which turned into a pandemic since January 2020. Social distancing and the use of masks indoors are the most important factors in breaking its transmission chain. Material and Methods: However, the use of contaminated respirator masks can cause dangerous microbial and viral diseases. By adding the factor "avoiding microbial contamination”, the proposed model, called "Excellent Performance by Avoiding Microbial Contamination (EPBAMC)”, improves the WHO's three-factor optimal-performance model of the respirator masks. In this study, to evaluate the need to add the factor of "avoiding contamination”, samples of brand-new respirator masks were collected from several countries and their microbial contamination was carefully studied. The research method was such that the research steps were performed with highest accuracy rate and no double infection was created. Results: By culturing in sterilized medium, the bacterial load of the respirator masks was studied and the results were analyzed. By performing different cultures, a variety of pathogenic microorganisms were identified on half of the respirator mask samples. Some brand-new respirator mask samples contained more than one pathogen. A very important issue was that bacteria were found in brand-new respirators distributed by pharmacies that cause nosocomial infections and are resistant to antibiotics. Conclusion: The results of this study made it necessary to review the standards of the production and distribution process and the procedures for controlling and inspecting respirator masks. © 2022, Published by Frontiers in Health Informatics.

Risk factors for severe acute respiratory syndrome coronavirus 2 RNA environmental contamination in rooms of patients with coronavirus disease 2019.

The risk factors of environmental contamination by SARS-CoV-2 were unknown. We analyzed 1,320 environmental samples obtained from COVID-19 patients for 1 year. The risk factors of contamination of COVID-19 patients' surrounding environment were higher viral load in the respiratory tract and shorter duration from symptom onset to sample collection.

SARS-CoV-2 testing, infection and places of contamination in France, a national cross-sectional study, December 2021.

BACKGROUND: This study aimed to describe the use of diagnostic testing for SARS-CoV-2 in France until December 2021, the characteristics of people infected, and places of contamination. METHODS: Data were collected from the national 2021 Health Barometer cross-sectional study, which was conducted between February and December 2021 and included French-speaking individuals aged 18-85 years old selected through randomly generated landline and mobile phone numbers. Participants were interviewed about COVID-19-like symptoms in the previous 12 months, diagnostic testing for SARS-CoV-2, positive diagnosis for SARS-CoV-2, and the place(s) of contamination. Determinants of diagnostic testing and of infection were studied using univariate and multivariate Poisson regressions. RESULTS: A total of 24,514 persons participated in the study. We estimated that 66.4% [65.0-67.7] of persons had been tested for SARS-CoV-2 the last time they experienced COVID-19-like symptoms, and that 9.8% [9.3-10.3] of the population in France - with or without symptoms - had been tested positive. Diagnostic testing was less frequent in men, unemployed persons, and people living alone; it was also less frequent during the first months of the pandemic. The estimated proportion of the population infected was higher in healthcare professionals (PRa: 1.5 [1.3-1.7]), those living in large cities ( > = 200 000 inhabitants, and Paris area) (1.4 [1.2-1.6]), and in households comprising > 3 persons (1.7 [1.5-2.0]). It was lower in retired persons (0.8 [0.6-0.97]) and those over 65 years old (0.6 [0.4-0.9]). Almost two-thirds (65.7%) of infected persons declared they knew where they were contaminated; 5.8% [4.5-7.4] reported being contaminated outdoors, 47.9% [44.8-51.0] in unventilated indoor environments, and 43.4% [40.3-46.6] in ventilated indoor environments. Specifically, 51.1% [48.0-54.2] declared they were contaminated at home or in a family of friend's house, 29.1% [26.4-31.9] at their workplace, 13.9% [11.9-16.1] in a healthcare structure, and 9.0% [7.4-10.8] in a public eating place (e.g., cafeteria, bar, restaurant). CONCLUSIONS: To limit viral spread, preventive actions should preferentially target persons tested least frequently and those at a higher risk of infection. They should also target contamination in households, healthcare structures, and public eating places. Importantly, contamination is most frequent in places where prevention measures are most difficult to implement.

Negligible risk of surface transmission of SARS-CoV-2 in public transportation.

BACKGROUND: Exposure to pathogens in public transport systems is a common means of spreading infection, mainly by inhaling aerosol or droplets from infected individuals. Such particles also contaminate surfaces, creating a potential surface-transmission pathway. METHODS: A fast acoustic biosensor with an antifouling nano-coating was introduced to detect SARS-CoV-2 on exposed surfaces in the Prague Public Transport System. Samples were measured directly without pre-treatment. Results with the sensor gave excellent agreement with parallel qRT-PCR measurements on 482 surface samples taken from actively used trams, buses, metro trains, and platforms between 7-9 April 2021, in the middle of the lineage Alpha SARS-CoV-2 epidemic wave when 1 in 240 people were COVID-19 positive in Prague. RESULTS: Only ten of the 482 surface swabs produced positive results and none of them contained virus particles capable of replication, indicating that positive samples contained inactive virus particles and/or fragments. Measurements of the rate of decay of SARS-CoV-2 on frequently touched surface materials showed that the virus did not remain viable longer than 1-4 hours. The rate of inactivation was the fastest on rubber handrails in metro escalators and the slowest on hard-plastic seats, window glasses, and stainless-steel grab rails. As a result of this study, Prague Public Transport Systems revised their cleaning protocols and the lengths of parking times during the pandemic. CONCLUSIONS: Our findings suggest that surface transmission played no or negligible role in spreading SARS-CoV-2 in Prague. The results also demonstrate the potential of the new biosensor to serve as a complementary screening tool in epidemic monitoring and prognosis.

Pandemic COVID-19 ends but soil pollution increases: Impacts and a new approach for risk assessment.

For three years, a large amount of manufactured pollutants such as plastics, antibiotic and disinfectant has been released into the environment due to COVID-19. The accumulation of these pollutants in the environment has exacerbated the damage to the soil system. However, since the epidemic outbreak, the focus of researchers and public attention has consistently been on human health. It is noteworthy that studies conducted in conjunction with soil pollution and CIVID-19 represent only 4 % of all COVID-19 studies. In order to enhance researchers' and the public awareness of the seriousness on the COVID-19 derived soil pollution, we propose the viewpoint that "pandemic COVOD-19 ends but soil pollution increases" and recommend a whole-cell biosensor based new method to assess the environmental risk of COVID-19 derived pollutants. This approach is expected to provide a new way for environmental risk assessment of soils affected by contaminants produced from pandemic.