Healthcare Workers Beliefs about COVID-19; a Longitudinal, Mixed Methods Analysis.

The psychological impact of COVID-19 on Health Care Workers (HCWs) has been widely reported. Few studies have sought to examine HCWs personal models of COVID-19 utilising an established theoretical framework. We undertook a mixed methods study of beliefs about COVID-19 held by HCWs in the Mid-West and South of Ireland during the first and third waves of COVID-19. Template analysis was undertaken on the free text responses of 408 HCWs about their perceptions of the Cause of COVID-19 as assessed by the Brief Illness Perception Questionnaire (B-IPQ). Responses were re-examined in the same cohort for stability at 3 months follow-up (n = 100). This analytic template was subsequently examined in a new cohort (n = 253) of HCWs in the third wave. Female HCWs perceived greater emotional impact of COVID-19 than men (t = -4.31, df405, p < 0.01). Differences between occupational groups were evident in relation to Timeline (F4,401 = 3.47, p < 0.01), Treatment Control (F4,401 = 5.64, p < 0.001) and Concerns about COVID-19 (F4,401 = 3.68, p < 0.01). Administration staff believed that treatment would be significantly more helpful and that COVID-19 would last a shorter amount of time than medical/nursing staff and HSCP. However, administration staff were significantly more concerned than HSCP about COVID-19. Template analysis on 1059 responses to the Cause items of the B-IPQ identified ten higher order categories of perceived Cause of COVID-19. The top two Causes identified at both Waves were 'individual behavioural factors' and 'overseas travel'. This study has progressed our understanding of the models HCWs hold about COVID-19 over time, and has highlighted the utility of the template analysis approach in analysing free-text questionnaire data. We suggest that group and individual occupational identities of HCWs may be of importance in shaping HCWs responses to working through COVID-19.

Clinical anti-microbial efficacy of a new zinc citrate dentifrice.

This crossover design clinical study compared the anti-microbial effects of a new 1% zinc citrate dentifrice with a control formulation. Thirty adults completed a washout phase and baseline samples of dental plaque, buccal mucosa, tongue, saliva, and plaque collected to enumerate anaerobes and streptococci. Subjects were randomly assigned a test dentifrice to use for the next 13 days. Oral samples similar to the baseline were collected on day 14 prior to oral hygiene for microbial analysis. The subject then placed a custom intra-oral stent with hydroxyapatite (HA) squares and brushed their teeth with their assigned dentifrice. Oral samples and HA squares were collected 5 h later for microbial analyses. This completed the study with one test dentifrice. The entire study was repeated with the alternate dentifrice after a second washout phase. Whereas baseline samples demonstrated no significant differences in microbial parameters between the two treatment groups (p > 0.05), subjects provided the zinc citrate dentifrice demonstrated 24-52% reductions in anaerobic bacteria and streptococci on day 14 versus the control paste (p < 0.05). In the 5-h post-brushing samples, subjects provided the zinc citrate toothpaste demonstrated 27-49% reductions for anaerobic bacteria and streptococci (p < 0.05). Additionally, in situ microbial biofilm formation on HA disks was significantly inhibited amongst the zinc citrate group (p < 0.05). Significant reductions in anaerobic bacteria and streptococci were observed amongst all intra-oral locations along with in situ biofilm formation after use of the zinc citrate dentifrice.

Urethane N-carboxyanhydrides from beta-amino acids.

A general method has been developed for the synthesis of N-tert-butyloxycarbonyl N-carboxyanhydrides from beta-amino acids using Vilsmeier complex. These beta-UNCA are stable, and the reactivity with different nucleophiles (alcohol, amine, lithium enolate) was studied.

Surveillance of occupational and work-related diseases between 1993 and 1996 in an engineering company.

There are established reporting schemes for some occupational and work-related illnesses but these schemes may underestimate the true incidence of such diseases. Not all cases may be referred to a participating physician and access to adequate diagnostic facilities are not always available. Collecting data directly from occupational health departments may overcome some problems related to under-reporting as they have good access to the entire working population within their company. The aim of this paper is to report the results from such a reporting scheme operated by a large multi-national engineering company during the period 1993-96. All UK sites of Lucas Industries (later LucasVarity) participated. A report form was completed by the occupational health department of each participating site each month. The report form gave abbreviated details of each case of occupational and work-related disease occurring at that site during the previous month. Forms were posted to a central office where the data was collated and analyzed. The incidence of respiratory diseases was broadly similar or slightly higher to that reported from other schemes. Musculoskeletal diseases were by far the most common category of disease reported. During a four year period of reporting the incidence of occupational and work-related diseases decreased overall by approximately 75%. As the reported incidence of respiratory disease was comparable with or slightly higher than that from other schemes, it appears that reporting schemes such as this can provide useful and accurate data. Musculoskeletal diseases are the most common type of disease attributed to work and should probably receive greater attention. The decrease in incidence seen in LucasVarity over time may reflect increased emphasis given to health and safety issues within the company during the reporting period.

An evaluation of the Würzburg titanium miniplate osteosynthesis system for mandibular fixation.

We present an 8-year experience with the Würzburg noncompression titanium miniplate system for the rigid fixation of the mandible during elective head and neck cancer surgery in a consecutive series of 100 patients. One half of the miniplates were used to fix mandibulotomies undertaken for surgical access. The remaining half were in patients undergoing reconstruction of segmental mandibular defects, the vast majority (92%) with vascularised bone grafts. One to four variously shaped miniplates were used per patient (mean = 1.5), plate size ranging from 4 to 40 holes. Fifteen patients (15%) developed complications which included 3 mandibular osteoradionecrosis, 8 broken, 5 infected, and 4 exposed plates. Three of the eight fractured plates were associated with nonunion. In this study, the main advantages of titanium miniplate fixation, namely case of application, decreased fixation time and malleability, were accompanied by a level of morbidity which, while comparing well with alternatives, may necessitate a reappraisal of this technique of fixation.

Free tissue transfer in the management of burns.

Although the majority of burn wounds undergoing surgical treatment require only excision with split-skin grafting, the introduction of free microvascular tissue transfer has allowed for the preservation of otherwise unsalvageable deep burn injuries and the resurfacing of burn scars in areas with no available local tissue. A total of 1699 patients with burn injuries were admitted to the Burns Unit in Newcastle upon Tyne in the 5 years 1989-1993. During this period 604 patients (35.5 per cent) required surgical treatment of their burns. Of these patients 582 (96.4 per cent) underwent excision of their burns with split-skin grafting, 13 (2.1 per cent) of the patients required local flap cover and nine patients (1.5 per cent) had free tissue transfer. Free flap loss in this study was 22 per cent in burns patients as compared to only 3 per cent in patients undergoing microsurgical reconstruction for other reasons.

Promotion of cervical screening uptake by health visitor follow-up of women who repeatedly failed to attend.

BACKGROUND: It is important that if cervical screening programmes are to be successful coverage rates of the target population of women are high. In the context of a well-organized programme in Fife a project was carried out to assess the impact of health visitors following up women who had repeatedly failed to attend for screening. METHODS: Ten health visitors in Fife were randomly selected and were each asked to approach 20 women registered with the general practice to which they were attached who met the study criteria. Women were asked for their reasons for non-attendance. Subsequent attendance for cervical screening was identified through the on-line cervical cytology database. RESULTS: Two health visitors declined to participate in the project. One hundred and sixty-two women were offered a visit by a health visitor to discuss their reasons for non-attendance. Forty-two (28 per cent) of the women approached attended for a smear in the following three months. Of those visited by a health visitor 37 per cent attended for a smear. CONCLUSIONS: In Fife, local beliefs and attitudes about cervical screening together with lack of knowledge of existing clinics with female staff operating outside working hours constitute the major reasons for non-attendance. In this situation, a personal approach based on providing information and individual counselling appears to be successful in encouraging non-attenders to reconsider their decision and participate in the cervical screening programme.

Initial experience of using GRAFTAC absorbable staples to attach split skin grafts.

The GRAFTAC skin stapler with absorbable tacs has been used to attach split-skin grafts in 28 patients, under a variety of clinical situations, and the outcomes studied. This knowledge has been reviewed in the light of our existing experience with the more familiar metal staple. Details of the patients and their conditions are presented, with two illustrative case histories, including one where both Graftac and metal staples were used. The relative costs were analysed and an attempt made to compare the cost-effectiveness of tacs and staples. A rationale for use of the more expensive GRAFTAC stapler is presented.

Results of clinical assessment after primary digital nerve repair.

We have carried out a retrospective study of 88 consecutive digital nerve repairs in 84 patients who presented to this department between September 1989 and September 1991. 94% of the patients were operated on within 24 hours of the injury, and the nerves were repaired using magnifying loupes (x 4.5) 71 patients were assessed clinically 8 to 32 months post-operatively. 17% of the patients had excellent results, 51.1% good results, 22.8% fair results and 9.1% had poor results. Close correlation between age and recovery of sensation and between smoking and nerve recovery were found. Results were better in nerves that were cut cleanly (64.3% were excellent/good) than in crushed nerves (28.1%). Without the availability of an operating microscope, loupes give a satisfactory result in nerve repair, and this study compares well with reported series.

Familial syndactyly type III--report of a large pedigree.

We present a pedigree containing 14 cases of familial syndactyly of the ring and little finger (Type III syndactyly). Three of these were treated surgically in this unit, and a fourth had previously been treated elsewhere by the senior author of this paper. Analysis of the pedigree confirms the autosomal dominant nature of the genetic defect, while clinical study reveals variable phenotypical expression. This is one of the largest pedigrees et reported for this variety of syndactyly.

Ten-year review of treatment of the undescended testis in the west of Ireland.

Advances continue to be made in the treatment of the undescended testis, and treatment recommendations are continually changing. We reviewed 543 patients admitted for treatment of undescended testes in the 10-year period 1977 to 1986. The side and position of the testis were recorded, the patient's age at operation and the procedure carried out. The presence of an associated inguinal hernia was noted. The necessity for reoperation was recorded and predisposing factors sought. We found the mean age at operation to be 9.5 years and this decreased significantly over the study period. Dartos pouch orchiopexy was the commonest operation (69%). No significant link was found between the procedure performed or the presence of a hernia and the need for further procedures; 2.7% of patients required such further procedures. A coherent classification of position is lacking for abnormally descended testes. We report a classification which we used to tackle this situation.

Identification and characterization of the Egr-1 gene product, a DNA-binding zinc finger protein induced by differentiation and growth signals.

Egr-1 is an immediate-early response gene induced by diverse signals that initiate growth and differentiation. Its cDNA sequence predicts a protein with zinc fingers. We have generated an antiserum to the Egr-1 gene product and identified it as an 80-kilodalton short-lived protein in serum-stimulated mouse fibroblasts. The rat Egr-1 product has also been identified in nerve growth factor-induced PC12 cells. In addition, we show by cell fractionation and immunocytochemistry that the Egr-1 protein is located in the nucleus. We also demonstrate that it is phosphorylated. In vitro-generated Egr-1 protein binds with high affinity to the sequence CGCCCCCGC in a zinc-dependent manner.

Research in occupational health. Engineering industry perspective.

Predicting the research needs within the engineering industry over the next 10 years requires a clear view of the industry's priorities and the role of the Occupational Health Practitioner in a rapidly changing and demanding world. This article describes the possible impact of manufacturing and social trends on occupational health practice and proposes priorities which favour operational requirements over fundamental scientific need.

In vivo tibia lead measurements as an index of cumulative exposure in occupationally exposed subjects.

In vivo tibia lead measurements of 20 non-occupationally exposed and 190 occupationally exposed people drawn from three factories were made using a non-invasive x ray fluorescence technique in which characteristic x rays from lead are excited by gamma rays from a cadmium-109 source. The maximum skin dose to a small region of the shin was 0.45 mSv. The relation between tibia lead and blood lead was weak in workers from one factory (r = 0.11, p greater than 0.6) and among the non-occupationally exposed subjects (r = 0.07, p greater than 0.7); however, a stronger relation was observed in the other two factories (r = 0.45, p less than 0.0001 and r = 0.53, p less than 0.0001). Correlation coefficients between tibia lead and duration of employment were consistently higher at all three factories respectively (r = 0.86, p less than 0.0001; r = 0.61, p less than 0.0001; r = 0.80, p less than 0.0001). A strong relation was observed between tibia lead and a simple, time integrated, blood lead index among workers from the two factories from which blood lead histories were available. The regression equation from two groups of workers (n = 88, 79) did not significantly differ despite different exposure conditions. The correlation coefficient for the combined data set (n = 167) was 0.84 (p less than 0.0001). This shows clearly that tibia lead, measured in vivo by x-ray fluorescence, provides a good indicator of long term exposure to lead as assessed by a cumulative blood lead index.

Lack of evidence of low ionized calcium levels in systemic hypertension.

An epidemiologic screening survey was conducted in 325 male industrial workers to investigate the relation between serum total and ionized calcium concentrations and blood pressure. No relation was found. Previous reports of lower serum ionized calcium levels in hypertensive patients may be related to methodologic deficiencies both in the selection of subjects and in ionized calcium measurement. These data do not support the concept that increased blood pressure levels are related to calcium deficiency or to abnormal plasma calcium homeostasis.