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.

Youth mental health in deprived urban areas: a Delphi study on the role of the GP in early intervention.

BACKGROUND: GPs, as healthcare professionals with whom young people commonly interact, have a central role in early intervention for mental health problems. However, successfully fulfilling this role is a challenge, and this is especially in deprived urban areas. AIMS: To inform a complex intervention to support GPs in this important role, we aim to identify the key areas in which general practice can help address youth mental health and strategies to enhance implementation. METHODS: We conducted a modified Delphi study which involved establishing an expert panel involving key stakeholders/service providers at two deprived urban areas. The group reviewed emerging literature on the topic at a series of meetings and consensus was facilitated by iterative surveys. RESULTS: We identified 20 individual roles in which GPs could help address youth mental health, across five domains: (1) prevention, health promotion and access, (2) assessment and identification, (3) treatment strategies, (4) interaction with other agencies/referral, and (5) ongoing support. With regard to strategies to enhance implementation, we identified a further 19 interventions, across five domains: (1) training, (2) consultation improvements, (3) service-level changes, (4) collaboration, and (5) healthcare-system changes. CONCLUSIONS: GPs have a key role in addressing youth mental health and this study highlights the key domains of this role and the key components of a complex intervention to support this role.

Evaluating broiler growth and mortality in chicks with minor navel conditions at hatching.

As commercial hatcheries become more automated, there are fewer opportunities for chicks with minor unhealed navel conditions to be identified and removed before being shipped to farms. An experiment was undertaken to evaluate the effect of common navel conditions occurring at hatching on subsequent broiler performance. In each of 2 trials, chicks with normal navels and minor navel conditions (navel button or leaky navel) were collected from a commercial hatchery on the day of hatch. Chicks were feather sexed and placed in floor pens. Individual BW and mortality were recorded weekly until shipping at 41 d of age. As expected, male broilers had heavier BW at 41 d than females. Broilers with navel buttons and leaky navels had lower 41-d BW than those that had normal navels at hatching. Birds with navel buttons also had higher mortality over the entire production period than birds with leaky or normal navels. The results of this research clearly show that when chicks have even minor navel conditions at hatching, the end result is a reduction in broiler production efficiency.

The effect of broiler breeder genetic strain and parent flock age on eggshell conductance and embryonic metabolism.

The effect of genetic strain (Ross 308; Cobb 500) and parent flock age [young (29 wk), peak (Ross = 34 wk; Cobb = 36 wk), postpeak (40 wk), mature (45 wk), old (55 wk), and very old (59 wk)] on eggshell conductance and embryonic metabolism were examined. At each flock age, eggs from each strain were incubated for 21.5 d in individual metabolic chambers to measure embryonic O(2) intake and CO(2) output. From these data, the respiratory quotient (RQ) and metabolic heat production were calculated. Data were analyzed by the GLM procedure of SAS at P < or = 0.05. Neither strain nor flock age influenced conductance. Total embryonic O(2) consumption, CO(2) output, RQ, and metabolic heat production over the entire incubation period were not affected by strain. Daily differences existed between strains for embryonic O(2) intake (1, 7, 16, 17, 19, 20 d of incubation), CO(2) output (1 to 4, 16 to 20 d of incubation), and heat production (4, 7, 16 to 19 d of incubation). Embryos from young, mature, old, and very old flocks produced significantly more total embryonic heat over the entire 21 d (1,712, 1,677, 1,808, and 1,832, respectively) than embryos from peak (1,601) and postpeak (1,693) flocks. Average RQ for the entire incubation period was higher in embryos from mature flocks compared with all other flock ages. Daily differences among embryos from different flock ages were shown for O(2) consumption (all but d 8 of incubation), CO(2) production (all but d 7 and 9 of incubation), and heat output. The results showed that genetic strain and parent flock age influence daily embryonic metabolism, especially during the early and latter days of incubation. These daily differences coincide with the days of incubation having a higher incidence of embryonic mortality; these 2 factors may be related. Further investigation into the relationship between embryonic metabolic heat production and mortality during incubation may lead to the development of specific incubation conditions for different genetic strains and flock ages.

Investigating the effects of commercial probiotics on broiler chick quality and production efficiency.

A study was undertaken to test the effect of 2 commercially available probiotics on the production efficiency of broiler chickens hatched from the same breeder flock at 3 different ages (28, 43, and 57 wk). At each of the 3 breeder flock ages, 1,600 broiler chickens were hatched and randomly allocated to 1 of 4 treatments: 1) no probiotics (control), 2) probiotic 1 administered in the drinking water, 3) probiotic 1 administered as a spray, and 4) probiotic 2 administered in the feed. A coccidiostat was included in the feed, but no other antimicrobial agents were given. Broilers were then reared on straw litter in identical floor pens for a period of 6 wk. There were no significant differences in broiler BW, feed conversion, or mortality between the probiotic treatments and the control group in any of the trials. The 43-wk-old breeder flock had the highest fertility and hatchability and the lowest percentage of chicks culled at hatching. Throughout the broiler production period, the broilers from the 43- and 57-wk-old breeder flocks had higher BW and weight gains than the broilers produced at 28 wk of breeder flock age. Broiler feed conversion over the 6-wk production period decreased as the breeder flock aged. Probiotics had no effect on chick quality or production efficiency in broilers produced by the breeder flock ages examined.

Investigating the eggshell conductance and embryonic metabolism of modern and unselected domestic avian genetic strains at two flock ages.

The objective of this study was to determine if broiler strain and breeder flock age affect eggshell conductance, fertility, and hatchability parameters; heart and hepatic glycogen concentrations at hatch; and embryonic metabolism throughout incubation. The 3 broiler strains investigated were HBY, a modern commercial broiler strain selected for high breast yield; WBM, a modern commercial broiler strain selected for the whole bird market; and UN78, a female broiler parent strain unselected since 1978. Fertility and hatchability parameters for each of the 3 strains were determined when the flocks were 32, 34, 37, and 38 wk of age. Eggshell conductance was measured on separate eggs produced from flocks at 37, 45, and 53 wk of age. Concurrently, fertile hatching eggs from the 3 broiler strains at 2 flock ages (33 and 38 wk) were incubated in individual metabolic chambers. Total daily CO2 production of each embryo was measured. Strain and flock age did not influence any of the fertility or hatchability parameters. Strain had no effect on conductance, but eggs from the 37-wk-old flocks had higher conductance than eggs from the 45- or 53-wk-old flocks, which did not differ from one another. Strain had no significant effect on average total CO2 production over the entire 21.5 d of incubation. However, embryos from the 38-wk-old flock produced more total CO2 than did embryos from the 33-wk-old flocks. Also, there was an interaction between strain and flock age for total CO2 production; UN78 embryos from the 33-wk flocks had higher CO2 production than WBM embryos, and the CO2 production of HBY did not differ from either strain. When embryos from the 38-wk flocks were compared, WBM embryos had higher CO2 production than did UN78 embryos, and HBY embryos did not differ from either strain. The data showed that in the 3 strains examined in this study, genetic differences in embryonic metabolic rate were dependent upon breeder flock age.

Decision making in HIV testing among a group with low HIV risk.

Relatively little is known about how individuals (apart from gay and bisexual men) decide to have an HIV test and how, once they have presented for testing, they make decisions about proceeding through the testing trajectory. This paper reports on a qualitative study in which 55 mainly heterosexual respondents with low HIV risk were interviewed about their experiences of decision making around HIV testing. Reasons for deciding to be tested centred on a desire for reassurance and the circumstances of the respondents' current relationship. The most common relationship reason focused on a desire to confirm HIV status before beginning sexual relations or engaging in unprotected sex with a partner. Although some respondents recognized that other individuals had influenced their decision to be tested, few said that pre-test counselling had been influential in this respect. Instead, it was said to have promoted feelings of 'ownership' of a decision which had already been taken prior to counselling. The potential effects of HIV testing on HIV risk behaviour were also examined and a non-significant increase in unprotected sex was reported between the month before the test and the month after. The implications of these findings for the provision of HIV testing services are explored.