Experiences of family caregivers of persons living with dementia with and without a smart- clothes assisted home nursing program during the heightened COVID-19 alert.

BACKGROUND: The COVID-19 pandemic has required restrictions of daily activities, which has been found to impact the lives of persons living with dementia (PLWDs) and their family caregivers, who have multiple care demands. The lack of relevant studies in Taiwan emphasized the need to explore the experiences of family caregivers of older PLWDs faced with the intensified restrictions to control the spread of COVID-19, and the impact of the availability of a smart-clothes home nursing program. METHODS: This qualitative study used semi-structured interviews with family caregivers of older PLWDs. Participants were recruited from dementia clinics of a medical center in northern Taiwan from a subset of a sample from a larger study on smart-clothes assisted home nursing care. A total of 12 family caregivers who participated in the original study were interviewed during the follow-up period; seven family caregivers of a PLWD wearing a smart-vest, which transmitted information to a home care nurse; five caregivers of a PLWD not wearing a smart-vest. Interviews were conducted by telephone because the conditions of the pandemic prevented face-to-face interviews. Recorded interviews were transcribed and analyzed using content analysis. RESULTS: Interview data showed family caregivers' felt the care recipient's health was compromised and functional conditions intensified as Covid-19-related pandemic restrictions increased. Specific concerns included a lack social interactions, decreased daily activity levels, loss of interest and lack of motivation for activities, increased mood and behavioral problems, a decline in physical function and an increase in health problems. Family caregivers were also impacted by these restrictions, with significant increases in severity of caregiver role strain, including feeling trapped, a lack of in-home support, profound powerlessness, and worries about the PLWD contracting the coronavirus. The smart-clothes assisted home nursing care program offered supplementary support to family caregivers by providing on-time interactions, helping them manage health problems, enhancing predictability of the care recipient's behaviors, and providing caregivers with emotional support. CONCLUSIONS: The findings of this study support alternative care such as implementation of technology-assisted home health services to meet caregiver needs to facilitate family caregiving of PLWDs during the necessary restrictions in activities implemented during the COVID-19 pandemic. TRIAL REGISTRATION: ClinicalTrials.gov Protocol Record NCT05063045.

Assistive Relief Tool for Early Childhood and Special Psychological Symptom Groups during the Pandemic: Clothing Design Based on the Virtual Contact Principle.

During the COVID-19 pandemic, some special populations-groups of early childhood and people with autism, among others-faced more profound challenges than the common people. The lack of real physical contact such as embracing greatly affected the effectiveness of development, psychiatric treatment, and other processes for these populations. This study is aimed at developing clothing with appropriate contact pressure based on the contact comfort principle of psychology and providing a type of pressure clothing that can relieve the wearer's tension by simulating hugging, alleviating the lack of physical contact for early childhood education and special education groups during the pandemic. First, the elementary requirements of clothing design are attained using a questionnaire survey and test method. The analysis revealed that clothing should fulfill the four requirements of pressure comfort, fabric softness, wearing and taking off comfort, and visual beauty. Second, we realized the performance requirements in the fabric and accessories, style design, structure design, and functional design. Finally, the product experience is proposed through a fitting, and the reasonable opinions were fed back to the product design to enhance the functionality of clothing. The research shows that clothing can simulate hugging and can ease the loneliness of the wearer. This study can be used as a good tool to assist during the pandemic for early childhood education and special psychological symptom groups, as well as a broader group of people living alone at home, to play an adjunctive treatment and loneliness relief functions.

Modeling Clothing as a Vector for Transporting Airborne Particles and Pathogens across Indoor Microenvironments.

Evidence suggests that human exposure to airborne particles and associated contaminants, including respiratory pathogens, can persist beyond a single microenvironment. By accumulating such contaminants from air, clothing may function as a transport vector and source of "secondary exposure". To investigate this function, a novel microenvironmental exposure modeling framework (ABICAM) was developed. This framework was applied to a para-occupational exposure scenario involving the deposition of viable SARS-CoV-2 in respiratory particles (0.5-20 µm) from a primary source onto clothing in a nonhealthcare setting and subsequent resuspension and secondary exposure in a car and home. Variability was assessed through Monte Carlo simulations. The total volume of infectious particles on the occupant's clothing immediately after work was 4800 µm3 (5th-95th percentiles: 870-32 000 µm3). This value was 61% (5-95%: 17-300%) of the occupant's primary inhalation exposure in the workplace while unmasked. By arrival at the occupant's home after a car commute, relatively rapid viral inactivation on cotton clothing had reduced the infectious volume on clothing by 80% (5-95%: 26-99%). Secondary inhalation exposure (after work) was low in the absence of close proximity and physical contact with contaminated clothing. In comparison, the average primary inhalation exposure in the workplace was higher by about 2-3 orders of magnitude. It remains theoretically possible that resuspension and physical contact with contaminated clothing can occasionally transmit SARS-CoV-2 between humans.

Child and parent preferences for the appearance of dentists with respect to personal protective equipment in paediatric dentistry.

BACKGROUND: Personal protective equipment (PPE) gained particular importance during the COVID-19 pandemic. AIM: To assess child and parent preferences for dentists' appearance concerning their PPE and to determine the relationship between the child and parent preferences. DESIGN: A total of 250 children aged 6-12 years and their parents were enrolled in the study. Standardized pictures with different sexes, attires, eye protectors, hair protectors, masks, and gloves were shown to children and their parents separately, and they were asked to choose their preferences. The dental anxiety of the children and their parents was determined using the MCDASf and MDAS, respectively. Decayed, missing, and filled tooth (DMFT) indices were employed for the children. RESULTS: Children and parents preferred a dentist of the same sex as themselves (p < .05). Anxious children preferred cartoon-printed attire, and children with low anxiety mostly preferred white coats (p = .001). Children who preferred colored coats had higher DMFT (p < .001). Statistically significant differences were found in the attire and glove preferences between children and parents (p < .001). CONCLUSIONS: The production of white and child-friendly fluid-resistant disposable gowns should be considered. PPE with colored or cartoon print was preferred under the influence of factors that could positively affect anxiety.

Hospital doctors' attire during COVID-19 and beyond: time for a permanent change.

BACKGROUND: The debate on current doctors' attire in Irish hospital resurfaced alongside COVID-19, as a shift in doctors' attire from professional attire to scrubs was observed. AIM: The current study aimed to explore whether COVID-19 has changed the way in which hospital doctors perceive their personal attire, and whether this group wish for changes implemented during COVID-19 to become permanent. METHODS: Hospital doctors (n = 151), across all specialties and seniority at University Hospital Galway (UHG), filled out a ten-point online questionnaire exploring their experience of and attitudes towards hospital attire during COVID-19. Data collected and analysed in August-September 2020. RESULTS: Seventy-six percent (119) changed their attire during COVID-19 to scrubs (54% to hospital provided; 22% to private). Thirty-eight percent (56) reported feeling uncomfortable with bringing clothing home, highlighting the infection control risk. Seventy-four per cent (110) wanted the change to scrubs as standard attire to become permanent (65% to hospital provided; 9% to private). Thirty-two percent (47) noted a change in patients' perception when wearing scrubs. CONCLUSION: Hospital doctors changed their attire during COVID-19, and 75% would like these changes to become permanent. Most (67%) did not notice a change in their patient's perception of them, raising questions about the longstanding beliefs surrounding 'professional attire'. A large number of doctors are also worried about bringing clothing home. The humble hospital scrubs have shown their worth amidst the COVID-19 pandemic. Why not continue to wear them?

Reduction of Fatigue and Musculoskeletal Complaints in Garment Sewing Operator through a Combination of Stretching Brain Gym® and Touch for Health.

The purpose of this study was to assess the effect of using a combination of stretching and Brain Gym®(BG) + Touch for Health (TfH) movements to reduce fatigue and musculoskeletal complaints (MSCs) in garment-sewing operators. A quasi-experimental study was performed on 53 respondents with two sessions of stretching movements and BG + TfH movements of 5 min duration, three times a week for four weeks. Fatigue was measured using a reaction timer and MSCs were measured using a Nordic Body Map questionnaire. Wilcoxon and Mann-Whitney U tests were performed to examine the differences of pre/post and between the intervention group (IG) and control group (CG). A significant difference was found in IG for pre- and post-fatigue (p < 0.001) and MSCs (p < 0.001), while in CG there was no difference in fatigue (p = 0.200) and MSCs (p = 0.086). Significant differences were found between the IG and CG groups in terms of fatigue (p = 0.046), as well as in MSCs (p < 0.001). A significant decrease in MSCs per part body in IG was found on the left wrist, left hand, and left knee. The percentage of MSC severity decreased in all parts of the body, except the right shoulder, left elbow, and right thigh.

Feasibility of Using the Hexoskin Smart Garment for Natural Environment Observation of Respiration Topography.

Background: Limited research has been done to measure ambulatory respiratory behavior, in particular those associated with tobacco use, in the natural environment due to a lack of monitoring techniques. Respiratory topography parameters provide useful information for modeling particle deposition in the lung and assessing exposure risk and health effects associated with tobacco use. Commercially available Wearable Respiratory Monitors (WRM), such as the Hexoskin Smart Garment, have embedded sensors that measure chest motion and may be adapted for measuring ambulatory lung volume. Methods: Self-reported "everyday" and "some days" Hookah and Cigarette smokers were recruited for a 3-day natural environment observation study. Participants wore the Hexoskin shirt while using their preferred tobacco product. The shirt was calibrated on them prior to, during, and after the observation period. A novel method for calculating the calibration parameters is presented. Results: NH = 5 Hookah and NC = 3 Cigarette participants were enrolled. Calibration parameters were obtained and applied to the observed chest motion waveform from each participant to obtain their lung volume waveform. Respiratory topography parameters were derived from the lung volume waveform. Conclusion: The feasibility of using the Hexoskin for measuring ambulatory respiratory topography parameters in the natural environment is demonstrated.

Do we need a unified uniform policy?

Sam Foster, Chief Nurse, Oxford University Hospitals, considers the question of a single NHS uniform for England, with the launch of a consultation on the idea.

Women Garment Workers Face Huge Inequities in Global Supply Chain Factories Made Worse by COVID-19.

Women make up the large majority of workers in global supply chains, especially factories in the apparel supply chain. These workers face significant inequalities in wages, workplace hazards, and a special burden of gender-based violence and harassment. These "normal" conditions have been compounded by the impact of the COVID-19 pandemic, which has exacerbated long-standing structural inequities. Decades of well-financed "corporate social responsibility" programs have failed because they do not address the underlying causes of illegal and abusive working conditions. New initiatives in the past half-decade offer promise in putting the needs and rights of workers front and center. Occupational health and safety professionals can assist in the global effort to improve working and social conditions, and respect for the rights and dignity of women workers, through advocacy and action on the job, in their professional associations, and in society at large.

[Safe handling of clothing and hygiene of patients and health professionals: Scoping review]. / Manejo seguro de la ropa e higiene de la piel en pacientes y profesionales sanitarios frente a la COVID-19: scoping review.

INTRODUCTION: In January 2020, an outbreak of pneumonia caused by a zoonotic virus (SARS-CoV-2) appeared in China. The main route of transmission is considered to be the inhalation of large respiratory drops, by deposition in the mucosa and hands or contaminated fomites. The objective is to identify the interventions to be performed during hospitalization for the correct and safe handling of clothing and hygiene of patients and health professionals. METHOD: Scoping review carried out without chronological or language delimitation in the PUBMED and Cochrane databases. Tracking standards and recommendations of national and international government entities to answer the research question on the safe handling of clothing and skin hygiene in patients and in health professionals to avoid Covid-19 infection. The data analysis was carried out in 2 stages: in the first, identification and categorization of the studies, and in the second, content analysis as an informative and classifying criterion. RESULTS: 14 documents have been selected, mainly from government entities. The recommendations are structured in 5 sections on the management of clothing and skin hygiene of infected patients and health professionals in the hospital setting. CONCLUSION: The clothing of patients and healthcare personnel are transmitting vehicles of the disease. Its correct treatment helps to improve the control of the same and the correct use of the resources available at the moment. Proper skin hygiene, especially hand cleansing, is one of the basic pillars for infection prevention and control. We highlight the similarity of some of the guidelines collected and provided by the different agencies consulted.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid contamination of surfaces on a coronavirus disease 2019 (COVID-19) ward and intensive care unit.

On coronavirus disease 2019 (COVID-19) wards, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid was frequently detected on high-touch surfaces, floors, and socks inside patient rooms. Contamination of floors and shoes was common outside patient rooms on the COVID-19 wards but decreased after improvements in floor cleaning and disinfection were implemented.

Influence of the CoViD-19 Pandemic on Mental Workload and Burnout of Fashion Retailing Workers in Spain.

This study analyzed the levels of mental workload and the presence of burnout on a sample of fashion retailing workers from Spain and its relationship with the current CoViD-19 (Coronavirus disease-19) pandemic. We established a cross-sectional design. Participants (n = 360) answered an online survey including questions about sociodemographic data, perception of CoViD-19, CarMen-Q questionnaire (workload), and MBI (burnout syndrome). The survey campaign took place in October and November 2020. The results showed that participants exhibited deep concern about the CoViD-19 pandemic and its influence in the workplace. Although the mental workload was near the middle point of the scale, participants showed moderate to high burnout levels, revealing that the sample was at risk of experiencing higher burnout levels over time as the pandemic and associated economic crisis continued. The multiple regression analysis results indicated that environmental changes, work overload, somatic symptoms, insomnia, negative job expectations, and uncertainty constituted significant mental workload predictors. Insomnia, somatic symptoms, and negative job expectations constituted significant predictors for burnout. Differences between job positions and genders in mental workload and burnout were found. In conclusion, the uncertainty at work derived from the CoViD-19 pandemic harms fashion retailing workers' psychological well-being in Spain.

COVID-19 in the autopsy room-requirements, safety, recommendations and pathological findings.

Modern technologies enable the exchange of information about the expansion of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the continually increasing number of the coronavirus disease 2019 (COVID-19) cases almost in real time. The gravity of a current epidemiological situation is represented by the mortality rates, which are scrupulously updated daily. Performing autopsies on patients with either suspected or confirmed COVID-19 is of high importance since these might not only improve clinical management but also reduce the risk of SARS-CoV-2 infection expansion. The following paper aimed to present the most crucial aspects of SARS-CoV-2 infection from the point of view of forensic experts and pathologists, recommendations and safety precautions regarding autopsies, autopsy room requirements, possible techniques, examinations used for effective viral detection, recommendations regarding burials, and gross and microscopic pathological findings of the deceased who died due to SARS-CoV-2 infection. Autopsies remain the gold standard for determining the cause of death. Therefore, it would be beneficial to perform autopsies on patients with both suspected and confirmed COVID-19, especially those with coexisting comorbidities.

COVID-19: mask efficacy is dependent on both fabric and fit.

Aim: Face masks are an important addition to our arsenal in the fight against COVID-19. The aim of this study is to present a novel method of measuring mask performance which can simultaneously assess both fabric penetration and leakage due to poor fit. Materials & methods: A synthetic aerosol is introduced into the lung of a medical dummy. A conical laser sheet surrounds the face of the dummy where it illuminates the aerosol emitted during a simulated breath. The system is demonstrated with five mask types. Conclusions: The curved laser sheet highlights both penetration through the mask fabric and leakage around the edges of the mask. A large variation in both material penetration and leakage was observed.

Modeling the stability of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on skin, currency, and clothing.

A new coronavirus (SARS-CoV-2) emerged in the winter of 2019 in Wuhan, China, and rapidly spread around the world. The extent and efficiency of SARS-CoV-2 pandemic is far greater than previous coronaviruses that emerged in the 21st Century. Here, we modeled stability of SARS-CoV-2 on skin, paper currency, and clothing to determine if these surfaces may factor in the fomite transmission dynamics of SARS-CoV-2. Skin, currency, and clothing samples were exposed to SARS-CoV-2 under laboratory conditions and incubated at three different temperatures (4°C± 2°C, 22°C± 2°C, and 37°C ± 2°C). We evaluated stability at 0 hours (h), 4 h, 8 h, 24 h, 72 h, 96 h, 7 days, and 14 days post-exposure. SARS-CoV-2 was stable on skin through the duration of the experiment at 4°C (14 days). Virus remained stable on skin for at least 96 h at 22°C and for at least 8h at 37°C. There were minimal differences between the tested currency samples. The virus remained stable on the $1 U.S.A. Bank Note for at least 96 h at 4°C while we did not detect viable virus on the $20 U.S.A. Bank Note samples beyond 72 h. The virus remained stable on both Bank Notes for at least 8 h at 22°C and 4 h at 37°C. Clothing samples were similar in stability to the currency. Viable virus remained for at least 96 h at 4°C and at least 4 h at 22°C. We did not detect viable virus on clothing samples at 37°C after initial exposure. This study confirms the inverse relationship between virus stability and temperature. Furthermore, virus stability on skin demonstrates the need for continued hand hygiene practices to minimize fomite transmission both in the general population as well as in workplaces where close contact is common.

Daylight-Induced Antibacterial and Antiviral Cotton Cloth for Offensive Personal Protection.

Cotton fabrics with durable and reusable daylight-induced antibacterial/antiviral functions were developed by using a novel fabrication process, which employs strong electrostatic interaction between cationic cotton fibers and anionic photosensitizers. The cationic cotton contains polycationic short chains produced by a self-propagation of 2-diehtylaminoehtyl chloride (DEAE-Cl) on the surface of cotton fibers. Then, the fabric (i.e., polyDEAE@cotton) can be readily functionalized with anionic photosensitizers like rose Bengal and sodium 2-anthraquinone sulfate to produce biocidal reactive oxygen species (ROS) under light exposure and consequently provide the photo-induced biocidal functions. The biocidal properties of the photo-induced fabrics (PIFs) were demonstrated by ROS production measurements, bactericidal performance against bacteria (e.g., E coli and L. innocua), and antiviral results against T7 bacteriophage. The PIFs achieved 99.9999% (6 log) reductions against bacteria and the bacteriophage within 60 min of daylight exposure. Moreover, the PIFs showcase excellent washability and photostability, making them ideal materials for reusable face masks and protective suits with improved biological protections compared with traditional PPE. This work demonstrated that the cationized cotton could serve as a platform for different functionalization applications, and the resulting fiber materials could inspire the development of reusable and sustainable PPE with significant bioprotective properties to fight the COVID-19 pandemic as well as the spread of other contagious diseases.

The impact of COVID-19 on Bangladeshi readymade garment (RMG) workers.

This paper describes the potential impact of the coronavirus disease 2019 (COVID-19) pandemic on the readymade garment (RMG) workers of Bangladesh. It articulates the RMG workers' existing vulnerability during the COVID-19 pandemic based on currently available evidence and personal conversations/communications with RMG workers. COVID-19 has already impacted RMG workers' health (both physical and mental health status) and wellbeing, and resulted in loss of employment. We argue that the COVID-19 pandemic will have long-lasting effects on the garment workers, especially related to their health issues, financial hardship and inability to pay for essentials such as food, and future employment opportunities. The stakeholders (such as the international retailers/brands, Bangladesh Garment Manufacturers and Exporters Association, Government of Bangladesh) responsible for the global supply chain RMG factories should reconsider the health and overall wellbeing needs of the RMG workers during the ongoing COVID-19 pandemic.