Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 97
Filter
1.
PLoS One ; 17(6): e0268974, 2022.
Article in English | MEDLINE | ID: covidwho-1885351

ABSTRACT

OBJECTIVE: The coronavirus disease pandemic has raised concerns regarding the transmission of infections to healthcare workers. We developed a new protective device to reduce the risk of aerosol diffusion and droplet infection among healthcare workers. Here, we report the results of a theoretical evaluation of the efficacy of this device. METHODS: We used suction-capable masks with and without rubber slits, sleeves for the insertion section of endoscopes and treatment tools, and a cover for the control section of the endoscope. To simulate droplet spread from patients, we created a droplet simulation model and an aerosol simulation model. The results with and without the devices attached and with and without the suction were compared. RESULTS: The droplet simulation model showed a 95% reduction in droplets with masks with rubber slits; furthermore, a reduction of 100% was observed when the insertion sleeve was used. Evaluation of aerosol simulation when suction was applied revealed an aerosol reduction of 98% and >99% with the use of the mask without rubber slits and with the combined use of the mask and insertion sleeve, respectively. The elimination of droplet emission upon instrument removal confirmed that the instrument sleeve prevented the diffusion of droplets. The elimination of droplets upon repeated pressing of the suction button confirmed that the cover prevented the diffusion of droplets. CONCLUSION: We developed a device for infection control, in collaboration with a gastrointestinal endoscopist and Olympus Medical Systems Corporation, that was effective in reducing droplet and aerosol diffusion in this initial theoretical assessment.


Subject(s)
Otolaryngology , Rubber , Aerosols , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Pandemics/prevention & control , Protective Devices
2.
Indian J Ophthalmol ; 70(9): 3423-3424, 2022 09.
Article in English | MEDLINE | ID: covidwho-2030160
3.
Am J Infect Control ; 50(8): 878-884, 2022 08.
Article in English | MEDLINE | ID: covidwho-2000218

ABSTRACT

BACKGROUND: Face shields were widely used in 2020-2021 as facial personal protective equipment (PPE). Laboratory evidence about how protective face shields might be and whether real world user priorities and usage habits conflicted with best practice for maximum possible protection was lacking - especially in limited resource settings. METHODS: Relative protective potential of 13 face shield designs were tested in a controlled laboratory setting. Community and health care workers were surveyed in middle income country cities (Brazil and Nigeria) about their preferences and perspectives on face shields as facial PPE. Priorities about facial PPE held by survey participants were compared with the implications of the laboratory-generated test results. RESULTS: No face shield tested totally eliminated exposure. Head orientation and design features influenced the level of protection. Over 600 individuals were interviewed in Brazil and Nigeria (including 240 health care workers) in March-April 2021. Respondents commented on what influenced their preferred forms of facial PPE, how they tended to clean face shields, and their priorities in choosing a face cover product. Surveyed health care workers commonly bought personal protection equipment for use at work. CONCLUSIONS: All face shields provided some protection but none gave high levels of protection against external droplet contamination. Respondents wanted facial PPE that considered good communication, secure fixture, good visibility, comfort, fashion, and has validated protectiveness.


Subject(s)
COVID-19 , Personal Protective Equipment , COVID-19/prevention & control , Developing Countries , Health Personnel , Humans , Protective Devices
4.
Sci Total Environ ; 831: 154856, 2022 Jul 20.
Article in English | MEDLINE | ID: covidwho-1878369

ABSTRACT

Face shield is a common personal protection equipment for pandemic. In the present work, three-dimensional computational fluid dynamic (CFD) method is used to simulate a cough jet from an emitter who wears a face shield. A realistic manikin model with a simplified mouth cavity is employed. A large eddy simulation with a dynamic structure subgrid scale model is applied to model the turbulence. An Eulerian-Lagrangian approach is adopted to model the two-phase flows, with which the droplets are represented by a cloud of particles. The droplet breakup, evaporation, dispersion, drag force, and wall impingement are considered in this model. An inlet velocity profile that is based on a variable mouth opening area is considered. Special attentions have been put the vortex structure and droplet re-distribution induced by the face shield. It is found that the multiple vortices are formed when the cough jet impinges on the face shield. Some droplets move backward and others move downward after the impinging. It is also found that a small modification of the face shield significantly modifies the flow field and droplet distribution. We conclude that face shield significantly reduces the risk factor in the front of the emitter, meanwhile the risk factor in the back of the emitter increases. When the receiver standing in front of the emitter is shorter than the emitter, the risk is still very high. More attentions should be paid on the design of the face field, clothes cleaning and floor cleaning of the emitters with face shields. Based on the predicted droplet trajectory, a conceptual model for droplet flux is proposed for the scenario with the face shield.


Subject(s)
COVID-19 , Cough , Humans , Pandemics , Personal Protective Equipment , Protective Devices
5.
BMJ Open ; 12(4): e057073, 2022 04 26.
Article in English | MEDLINE | ID: covidwho-1854347

ABSTRACT

INTRODUCTION: Neonatal hypoxic-ischaemic encephalopathy (HIE) is an important illness associated with death or cerebral palsy. This study aims to assess the safety and tolerability of the allogenic human multilineage-differentiating stress-enduring cell (Muse cell)-based product (CL2020) cells in newborns with HIE. This is the first clinical trial of CL2020 cells in neonates. METHODS AND ANALYSIS: This is a single-centre, open-label, dose-escalation study enrolling up to 12 patients. Neonates with HIE who receive a course of therapeutic hypothermia therapy, which cools to a body temperature of 33°C-34°C for 72 hours, will be included in this study. A single intravenous injection of CL2020 cells will be administered between 5 and 14 days of age. Subjects in the low-dose and high-dose cohorts will receive 1.5 and 15 million cells per dose, respectively. The primary outcome is the occurrence of any adverse events within 12 weeks after administration. The main secondary outcome is the Bayley Scales of Infant and Toddler Development Third Edition score and the developmental quotient per the Kyoto Scale of Psychological Development 2001 at 78 weeks. ETHICS AND DISSEMINATION: This study will be conducted in accordance with the Declaration of Helsinki and Good Clinical Practice. The Nagoya University Hospital Institutional Review Board (No. 312005) approved this study on 13 November 2019. The results of this study will be published in peer-reviewed journal and reported in international conferences. TRIAL REGISTRATION NUMBERS: NCT04261335, jRCT2043190112.


Subject(s)
Hypothermia, Induced , Hypoxia-Ischemia, Brain , Body Temperature , Humans , Hypothermia, Induced/methods , Hypoxia-Ischemia, Brain/therapy , Infant , Infant, Newborn , Protective Devices , Research
8.
Am J Infect Control ; 50(3): 306-311, 2022 03.
Article in English | MEDLINE | ID: covidwho-1595112

ABSTRACT

BACKGROUND: Face shields are a critical piece of personal protective equipment and their comfort impacts compliant use and thus protectiveness. Optimal design criteria for face shield use in healthcare environments are limited. We attempt to identify factors affecting face shield usability and to test and optimize a face shield for comfort and function in health care settings. METHODS: A broad range of workers in a large health care system were surveyed regarding face shield features and usability. Quantitative and qualitative analysis informed the development of iterative prototypes which were tested against existing shields. Iterative testing and redesign utilized expert insight and feedback from participant focus groups to inform subsequent prototype designs. RESULTS: From 1,648 responses, 6 key elements were identified: ability to adjust tension, shifting load bearing from the temples, anti-fogging, ventilation, freedom of movement, and durability. Iterative prototypes received consistently excellent feedback based on use in the clinical environment, demonstrating incremental improvement. CONCLUSION: We defined elements of face shield design necessary for usability in health care and produced a highly functional face shield that satisfies frontline provider criteria and Emergency Use Authorization standards set by the Food and Drug Administration. Integrating human factors principles into rapid-cycle prototyping for personal protective equipment is feasible and valuable.


Subject(s)
COVID-19 , COVID-19/prevention & control , Health Personnel , Humans , Personal Protective Equipment , Protective Devices , SARS-CoV-2
10.
Br J Radiol ; 95(1129): 20210835, 2022 Jan 01.
Article in English | MEDLINE | ID: covidwho-1575206

ABSTRACT

OBJECTIVE: To evaluate the efficacy of a barrier shield in reducing droplet transmission and its effect on image quality and radiation dose in an interventional suite. METHODS: A human cough droplet visualisation model in a supine position was developed to assess efficacy of barrier shield in reducing environmental contamination. Its effect on image quality (resolution and contrast) was evaluated via image quality test phantom. Changes in the radiation dose to patient post-shield utilisation was measured. RESULTS: Use of the shield prevented escape of visible fluorescent cough droplets from the containment area. No subjective change in line-pair resolution was observed. No significant difference in contrast-to-noise ratio was measured. Radiation dosage to patient was increased; this is predominantly attributed to the increased air gap and not the physical properties of the shield. CONCLUSION: Use of the barrier shield provided an effective added layer of personal protection in the interventional radiology theatre for aerosol generating procedures. ADVANCES IN KNOWLEDGE: This is the first time a human supine cough droplet visualisation has been developed. While multiple types of barrier shields have been described, this is the first systematic practical evaluation of a barrier shield designed for use in the interventional radiology theatre.


Subject(s)
Infectious Disease Transmission, Patient-to-Professional/prevention & control , Protective Devices , Radiology, Interventional/instrumentation , Adult , COVID-19/transmission , Cough , Equipment Design , Fluorescence , Humans , Male , Phantoms, Imaging , Radiation Dosage , Signal-To-Noise Ratio , Supine Position
11.
Curr Opin Ophthalmol ; 31(5): 374-379, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-1511065

ABSTRACT

PURPOSE OF REVIEW: The use of slit lamp shields has been recommended by the American Academy of Ophthalmology as an infection control measure during the coronavirus disease 2019 pandemic. However, there is limited evidence regarding its efficacy to reduce viral transmission risks. We aim to provide an evidence-based approach to optimize the use of slit lamp shields during clinical examination. RECENT FINDINGS: Respiratory droplets from coughing and sneezing can travel up to 50 m/s and over a distance of 2 m, with a potential area of spread of 616 cm. Slit lamp shields confer added protection against large droplets but are limited against smaller particles. A larger shield curved toward the ophthalmologist and positioned closer to the patient increases protection against large droplets. A potential improvement to the design of such shields is the use of hydrophilic materials with antiviral properties which may help to minimize splashing of infectious droplets, reducing transmission risks. These include gold or silver nanoparticles and graphene oxide. SUMMARY: Slit lamp shields serve as a barrier for large droplets, but its protection against smaller droplets is undetermined. It should be large, positioned close to the patient, and used in tandem with routine basic disinfection practices.


Subject(s)
Betacoronavirus , Coronavirus Infections/transmission , Infection Control/instrumentation , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Pneumonia, Viral/transmission , Protective Devices , Slit Lamp , COVID-19 , Humans , Infection Control/methods , Pandemics , SARS-CoV-2
13.
PLoS One ; 16(3): e0249098, 2021.
Article in English | MEDLINE | ID: covidwho-1477519

ABSTRACT

BACKGROUND: Nursing homes (NH) for the elderly have been particularly affected by the Covid-19 pandemic mainly due to their hosted vulnerable populations and poor outbreak preparedness. In Belgium, the medical humanitarian organization Médecins Sans Frontières (MSF) implemented a support project for NH including training on infection prevention and control (IPC), (re)-organization of care, and psychosocial support for NH staff. As psychosocial and mental health needs of NH residents in times of Covid-19 are poorly understood and addressed, this study aimed to better understand these needs and how staff could respond accordingly. METHODS: A qualitative study adopting thematic content analysis. Eight focus group discussions with direct caring staff and 56 in-depth interviews with residents were conducted in eight purposively and conveniently selected NHs in Brussels, Belgium, June 2020. RESULTS: NH residents experienced losses of freedom, social life, autonomy, and recreational activities that deprived them of their basic psychological needs. This had a massive impact on their mental well-being expressed in feeling depressed, anxious, and frustrated as well as decreased meaning and quality of life. Staff felt unprepared for the challenges posed by the pandemic; lacking guidelines, personal protective equipment and clarity around organization of care. They were confronted with professional and ethical dilemmas, feeling 'trapped' between IPC and the residents' wellbeing. They witnessed the detrimental effects of the measures imposed on their residents. CONCLUSION: This study revealed the insights of residents' and NH staff at the height of the early Covid-19 pandemic. Clearer outbreak plans, including psychosocial support, could have prevented the aggravated mental health conditions of both residents and staff. A holistic approach is needed in NHs in which tailor-made essential restrictive IPC measures are combined with psychosocial support measures to reduce the impact on residents' mental health impact and to enhance their quality of life.


Subject(s)
COVID-19/pathology , Nursing Staff/psychology , Quality of Life , Vulnerable Populations/psychology , Aged , Aged, 80 and over , Anxiety/etiology , COVID-19/virology , Depression/etiology , Female , Focus Groups , Humans , Interviews as Topic , Male , Middle Aged , Nursing Homes , Personal Autonomy , Protective Devices/supply & distribution , Quarantine , SARS-CoV-2
16.
Texto & contexto enferm ; 30: e20200561, 2021. tab, graf
Article in English | WHO COVID, LILACS (Americas) | ID: covidwho-1341550

ABSTRACT

ABSTRACT Objective: to describe the process for the elaboration and validation of a digital educational booklet intended for health professionals on the correct use of Personal Protective Equipment in the context of COVID-19. Method: a methodological study conducted between June and September 2020, operationalized in three stages: 1ststage: bibliographic survey; 2ndstage: elaboration of the booklet with the graphic designer to help in the development process of the technology; 3rdstage: content validation of the booklet by specialists through the Delphi technique. The validation was performed by 35 health and biology professionals and the local for selection of these was the Lattes Platform, using the Delphi technique in two rounds. The Content Validation Index was considered an acceptance criterion, with an agreement ≥ 0.78 among the judges being considered a good level. Results: the first version of the booklet obtained a global Content Validation Index of 0.79. There were suggestions for improvement that were accepted and, after the Delphi 2 phase, there was the resubmission of the booklet; it presented a global Content Validation Index of 0.99. Conclusion: the booklet was validated regarding its content and is compatible with its intended purpose, being important for the promotion of knowledge about the correct procedure to put on this equipment so that prevention measures are effective and shared.


RESUMEN Objetivo: describir el proceso de elaboración y validación de una cartilla educativa digital sobre el uso correcto de Equipamos de Protección Personal en el contexto de COVID-19, destinada a los profesionales de la salud. Método: estudio metodológico realizado entre junio y septiembre de 2020, efectivizado en tres etapas: 1ª etapa: levantamiento bibliográfico; 2ª etapa: elaboración de la cartilla junto al diseñador gráfico para asistir en el proceso de desarrollo de la tecnología; 3ª etapa: validación del contenido de la cartilla a cargo de especialistas, a través de la técnica Delphi. La validación fue realizada por 35 profesionales de la salud y de biología, con Plataforma Lattes como lugar elegido para su selección, utilizando la técnica Delphi en dos rondas. Se consideró el Índice de Validez de Contenido como criterio de aceptación, con un grado de acuerdo ≥ 0,78 entre los jueces, considerándose un buen nivel. Resultados: la primera versión de la cartilla obtuve un Índice de Validez de Contenido global de 0,79. Se presentaron sugerencia de mejora que fueron aceptadas y, después de la fase Delphi 2, en la cual se volvió a presentar la cartilla para su evaluación, la misma presentó un Índice de Validez de Contenido global de 0,99. Conclusión: la cartilla fue validada en relación a su contenido y es compatible con el fin para el cual fue prevista, siendo importante la promoción del conocimiento sobre el manejo correcto de estos equipos para que las medidas de prevención sean efectivas y compartidas.


RESUMO Objetivo: descrever o processo de construção e validação de uma cartilha educativa digital destinada aos profissionais de saúde sobre o uso correto de Equipamentos de Proteção Individual no contexto da COVID-19. Método: estudo metodológico, realizado entre junho e setembro 2020, operacionalizado em três etapas: 1ª etapa: levantamento bibliográfico; a 2ª etapa: elaboração da cartilha junto ao designer gráfico para auxiliar no processo de desenvolvimento da tecnologia; 3ª etapa: validação de conteúdo da cartilha por especialistas, através da técnica Delphi. A validação foi realizada por 35 profissionais da saúde e da biologia, tendo como local para seleção destes a Plataforma Lattes, utilizando a técnica de Delphi em duas rodadas. Considerou-se o Índice de Validade de Conteúdo como critério de aceitação, com a concordância ≥ 0,78 entre os juízes, sendo um nível considerado bom. Resultados: a primeira versão da cartilha obteve Índice de Validade de Conteúdo global de 0,79. Houve sugestões de melhoria que foram acatadas e, após a fase Delphi 2, onde ocorreu a ressubmissão da cartilha, ela apresentou Índice de Validade de Conteúdo global de 0,99. Conclusão: a cartilha foi validada quanto ao seu conteúdo e é compatível com o fim a que se propõe, sendo importante a promoção do conhecimento sobre a paramentação correta destes equipamentos para que as medidas de prevenção sejam efetivas e compartilhadas.


Subject(s)
Humans , Adult , Middle Aged , Protective Devices , Nursing Methodology Research , Health Education , Coronavirus Infections , Validation Study
18.
Prim Care Companion CNS Disord ; 23(4)2021 07 08.
Article in English | MEDLINE | ID: covidwho-1302621

ABSTRACT

Objective: To investigate the impact of masks and plastic partitions on patient-doctor communication and subjective anxiety for infection in patients with psychiatric disorders.Methods: Subjects were patients who visited a psychiatric clinic in Japan from April 27 to August 31, 2020. Anxiety of being infected and the psychological barrier to communication were evaluated on a 5-point scale.Results: The final analysis included 425 patients. Most participants answered that there was no change with regard to communication when the doctor was wearing a mask (n = 353, 91.0%) or using a plastic partition (n = 318, 82.8%). Most participants responded that anxiety for being infected was very mild, a little mild, or not changed by the doctor wearing a mask and using a plastic partition. Most participants felt significantly less anxiety with the doctor wearing a mask/using a plastic partition before than after the state of emergency declaration (P = .005 for mask and P < .001 for plastic partition). Participants in the older age range felt significantly higher anxiety compared to those in the younger and middle age range groups from doctors wearing masks (P < .001) and compared to those in the middle age range group from plastic partitions (P = .001).Conclusions: Use of masks and plastic partitions in psychiatric practice is recommended, as it may result in reduction of anxiety for infection without affecting patient-doctor communication in patients with psychiatric disorders. The generalizability of the results of the present study should be tested.


Subject(s)
Anxiety/psychology , Attitude to Health , COVID-19/prevention & control , Communicable Disease Control , Masks , Mentally Ill Persons/psychology , Physician-Patient Relations , Protective Devices , Adolescent , Adult , Aged , Female , Hospitals, Psychiatric , Humans , Male , Middle Aged , Outpatient Clinics, Hospital , Young Adult
19.
Dermatitis ; 32(1): 5-9, 2021.
Article in English | MEDLINE | ID: covidwho-1272982

ABSTRACT

Acetophenone azine (CAS 729-43-1) was recently discovered as a potent allergen in shin pads and footwear containing the foam elastomer ethyl vinyl acetate. The compound is probably not intentionally added to ethyl vinyl acetate but is likely the result of reactions between other additives that take place during the manufacturing process. A patch testing concentration of 0.1% in acetone or petrolatum is recommended. Acetophenone azine should be part of patch testing shoe series, as well as plastics and glues series. The compound is not currently available from patch testing materials suppliers, a situation that hopefully will be corrected.


Subject(s)
Allergens , Dermatitis, Allergic Contact/etiology , Hydrazines/adverse effects , Imines/adverse effects , Protective Devices , Shoes , Sports Equipment , Humans , Vinyl Compounds
20.
JNMA J Nepal Med Assoc ; 59(236): 361-364, 2021 Apr 30.
Article in English | MEDLINE | ID: covidwho-1257584

ABSTRACT

INTRODUCTION: Healthcare workers are always at the risk of exposure to different diseases like respiratory illness including COVID-19. Using appropriate face mask or respiratory protective equipment correctly can prevent transmission of diseases from and to healthcare workers while caring for patients. The study aimed to find out the practice regarding use of face masks during the COVID-19 pandemic in a tertiary care center. METHODS: A descriptive cross-sectional study was conducted at a tertiary care hospital during June-July 2020 after receiving ethical approval from the review committee regarding practice of use of face masks. Convenience sampling method was used and a sample size of 162 was taken. Descriptive statistical analysis was done. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. RESULTS: Among 162 participants, 123 (75.9%) knew the correct way of using the masks (72.5-79.3 at 95% Confidence Interval). CONCLUSIONS: In this study regarding practice of use of face masks, most of the healthcare workers knew the correct way of using masks and practised hygiene before and after using masks.


Subject(s)
COVID-19 , Pandemics , Cross-Sectional Studies , Health Personnel , Humans , Protective Devices , SARS-CoV-2 , Tertiary Care Centers
SELECTION OF CITATIONS
SEARCH DETAIL