Frontline Healthcare Providers Research Articles

Evaluation of academic detailing to educate clinicians regarding childhood lead poisoning prevention: a pilot study.

Environmental exposures are associated with approximately 19% of disease globally, and exposure to neurotoxic chemicals is estimated to cost the United States $50 billion per year. Despite calls from the Institute of Medicine to increase training for clinicians regarding environmental health since the 1990s, there is still little instruction in environmental health for clinicians. This leaves gaps in knowledge that need to be bridged through outreach and education to practicing clinicians. Academic detailing (AD) is an educational intervention associated with improved prescribing practices in healthcare professionals but has not been applied to preventive or environmental health. Childhood lead exposure is a common condition associated with lifetime increased risk of cognitive and behavioral problems. Ohio has more than 2 million homes built before 1978, making exposure to lead-based paint a significant public health problem; however, only 50% of high-risk children are tested for lead. Few receive health promotion information regarding lead poisoning prevention, in part because this is not a part of training for healthcare providers (HCPs). The objectives of this study were twofold: (1) implement a pilot of AD sessions on the topic of childhood lead poisoning prevention with frontline HCPs and theirstaff in different practice settings; and (2) evaluate theacceptability of these training sessions utilizing quantitative and qualitative methods. Physicians, nurses, social workers, community health workers, and clinical office staff were recruited from clinics who care for children at high risk for lead exposure. Trainings consisting of small group AD style sessions were presented at these sites. Learning objectives included increasing knowledge regarding lead testing requirements, enabling identification of lead's impact on child development and equipping participants to provide anticipatory guidance for parents regarding lead poisoning prevention. Participants provided feedback through an anonymous questionnaire and qualitative feedback. There were 46 participants (12 physicians in practice/in training, 21 nursing or office staff, and 13 community health or social workers); more than 90% of the participants reported that the training achieved its learning objectives. Small-group presentations were preferred (91%); approximately 39% of participants requested an online format. Participants preferred that the presenters be either a public health or lead clinical expert, and they suggested that future activities include clinical vignettes. Academic-detailing style training shows promise in promoting childhood lead poisoning prevention for frontline HCPs.

Factors Associated with Self-Care Practice among Adult Diabetes Patients

Background: Diabetes mellitus is a major public health problem worldwide, and the magnitude of its complication is steadily increasing in developing countries. Adherence to diabetes self-care activities is reportedly a vital strategy to halt diabetes related mortalities and morbidities. However, shortage of relevant studies on the area being made things difficult to understand the associated factors, the level of self-care practice and whether it has significantly fired up the prevalence of diabetes complications. Methods: A facility-based cross-sectional study was conducted among 213 diabetes mellitus patients follow-up at Tercha Zonal diabetes center selected by systematic random sampling. Data were entered into Epi-Data version 4.6 and exported to SPSS version 25 for analysis. Both descriptive and inferential statistics were used to describe and test the association between selected variables. Statistical significance was declared at p-value <0.05. Results: Out of the 213 study participants, only 84 (39.4%) had good self-care practices. The multivariate logistic regression analysis revealed that attending secondary education P =0.01, and college and above P <0.001, and having diabetes complications, P=0.013 were significantly associated with self-care practice. Conclusion: The study revealed that a significant number of the study participant has poor self-care practices in control of diabetes mellitus and prevention of complication. Educational level and having diabetes complications were found statistically significantly associated with a good level of self-care practice. Therefore, all frontline healthcare providers should provide basic information and counselling regarding diabetes self-care practice

Interruptions to HIV Care Delivery During Pandemics and Natural Disasters: A Qualitative Study of Challenges and Opportunities From Frontline Healthcare Providers in Western Kenya.

During public health crises, people living with HIV (PLWH) may become disengaged from care. The goal of this study was to understand the impact of the COVID-19 pandemic and recent flooding disasters on HIV care delivery in western Kenya. We conducted ten individual in-depth interviews with HIV providers across four health facilities. We used an iterative and integrated inductive and deductive data analysis approach to generate four themes. First, increased structural interruptions created exacerbating strain on health facilities. Second, there was increased physical and psychosocial burnout among providers. Third, patient uptake of services along the HIV continuum decreased, particularly among vulnerable patients. Finally, existing community-based programs and teleconsultations could be adapted to provide differentiated HIV care. Community-centric care programs, with an emphasis on overcoming the social, economic, and structural barriers will be crucial to ensure optimal care and limit the impact of public health disruptions on HIV care globally.

Brief tele-mindfulness-based intervention: A multicenter randomized controlled trial.

Coronavirus disease 2019 (COVID-19) has proven to be detrimental to the psychological well-being of healthcare providers (HCP). This study was a psychological intervention during the COVID-19 pandemic to check extent to which brief mindfulness-based interventions (MBIs) and progressive muscle relaxation (PMR) affect psychological well-being, resilience, and anxiety of HCPs. A randomized trial study conducted from July to August 2020. One hundred and forty-seven COVID-19 frontline HCPs were randomized to a 2-week virtual intervention with a brief MBI or a PMR. Pre- and postintervention assessments were done using the State-Trait Anxiety-20-Item Scale, the Connor-Davidson Resilience Scale-10, and WHO-5 Well-Being Index. The final sample included 125 HCPs (64 in BMI group and 61 in PMR group) who completed pre- and post-intervention assessment. The results showed a significant improvement in the psychological well-being and reduction of the state anxiety of the two groups, but not in the trait anxiety or resiliency. Improvement was more in the group's brief MBI (81.3%) than in the group's PMR (51.8%) (P = 0.0001), concerning psychological well-being. Both the brief MBI and PMR improved the psychological well-being and reduced the anxiety of frontline healthcare providers during the COVID-19 pandemic with a slightly better improvement in the brief MBI.

Predictors of clinical deterioration of hospitalized adult medical patients: An integrative literature review protocol

Clinical deterioration of hospitalized medical patients negatively affects patient outcomes and hospital capacity. Failure to recognize and respond promptly to an individual's worsening health status can lead to complications with far-reaching impacts on the patient and family. The ability to identify patient cues that can predict clinical deterioration is an essential role for frontline health-care providers to avert an avoidable health crisis. This protocol is designed to describe an integrative literature review plan that aims to identify, analyze, and synthesize the predictors and associated factors underlying the clinical deterioration of hospitalized medical ward patients. This planned review will follow the methodology of Whittemore and Knafl (2005), which comprises five stages: problem identification, literature search, data evaluation, data analysis, and presentation. CINAHL Plus, Embase, and PubMed databases will be used in the literature search. Primary research studies focusing on the predictors or the associated factors of clinical deterioration among medical ward patients will be eligible for the review. The quality of selected articles will be critically appraised using the Joanna Briggs Institute tools. The process of findings synthesis will be conducted according to Miles and Huberman (1994), which consists of data reduction, data display, data comparison, conclusion drawing, and verification. The findings will be presented as major themes that are supported by the appropriate primary studies.

Accelerating HIV and AIDS services delivery in Kigoma region, Tanzania.

Tanzania Commission for AIDS and UNAIDS reports 1.7 million Tanzanians are HIV-positive. The Joint United Nations Program on HIV/AIDS set 95%, 95% 95% targets to be achieved by 2025. An assessment was done to understand the region's position, which found the underperformance of critical HIV and AIDS indicators. This prompted the region to accelerate HIV interventions by providing frontline healthcare providers with skills and knowledge, essential equipment, and other infrastructure, after which the assessment of the indicators was conducted to document the outcome of interventions. we conducted a descriptive study in Kigoma region in June 2022 by comparing HIV and AIDS indicators performance in the pre-intervention and post interventions arms. High-volume CTCs were purposefully selected. We used a pre-tested checklist to assess new HIV-positive on antiretroviral (ARV), pregnant women living with HIV on ARV, and people living with HIV offered multi-month dispensing. We further assessed HIV viral load (HVL) specimen collection, HIV suppression status, and HVL test results turnaround time. We cleaned the information using an MS Excel sheet and tabulated results using STATA software version 13. we assessed 27 care and clinics. The proportion gain in the index client elicitation was 13%. Sexual partners mentioned during index client elicitation had an increase of 145 individuals. The yield among consented sexual partners gained by 14%. The ARV initiation among new HIV -positive and pregnant women living with HIV gained a proportion of 2%. Multi-month dispencing was found to have an 8% increase. The turnaround time for HVL test results decreased by 21 days, and the viral load suppression status increased by 4%. the assessment demonstrated the accelerated HIV and AIDS service delivery due to implementing a comprehensive package of HIV and AIDS management. We recommend in-service capacity building regarding training, basic equipment, and infrastructure.

Insights into health sector governance in a turbulent environment - towards best-practice approach

The COVID-19 pandemic occurred at a high spreading rate with sudden pattern changes, high variability, and unpredictability. This generated uncertainty making it hard for authorities to predict, plan, and conventionally prepare preventive and suppressive actions. As a result, governments worldwide had to find new, more comprehensive, and complex solutions to manage the health sector in a turbulent environment. The paper?s main objective is to analyze different organizational practices that respond to the COVID-19 crisis regarding healthcare sector resilience and describe best practices. Health sector authorities should consider applying the ?new mode of governance,? which refers to a policy not limited to a single approach with less hierarchy and formalism and with a flatter governance structure. Countries that have had more success in COVID-19 crisis suppression applied ?dynamic resilience? with decentralization in decision-making, a more important role of front-line healthcare providers, high transparency, and flexibility enabling continuous adaptation to rapidly changing conditions.

Automated System for Multiplexing Detection of COVID-19 and Other Respiratory Pathogens.

Infectious diseases are global health challenge, impacted the communities worldwide particularly in the midst of COVID-19 pandemic. The need of rapid and accurate automated systems for detecting pathogens of concern has always been critical. Ideally, such systems shall detect a large panel of pathogens simultaneously regardless of well-equipped facilities and highly trained operators, thus realizing on-site diagnosis for frontline healthcare providers and in critical locations such as borders and airports. Avalon Automated Multiplex System, AAMST, is developed to automate a series of biochemistry protocols to detect nucleic acid sequences from multiple pathogens in one test. Automated processes include isolation of nucleic acids from unprocessed samples, reverse transcription and two rounds of amplifications. All procedures are carried out in a microfluidic cartridge performed by a desktop analyzer. The system was validated with reference controls and showed good agreement with their laboratory counterparts. In total 63 clinical samples, 13 positives including those from COVID-19 patients and 50 negative cases were detected, consistent with clinical diagnosis using conventional laboratory methods. The proposed system has demonstrated promising utility. It would benefit the screening and diagnosis of COVID-19 and other infectious diseases in a simple, rapid and accurate fashion. Clinical and Translational Impact Statement- A rapid and multiplex diagnostic system proposed in this work can clinically help to control spread of COVID-19 and other infectious agents as it can provide timely diagnosis, isolation and treatment to patients. Using the system at remoted clinical sites can facilitate early clinical management and surveillance.

Psychological Conditions among Nurses in Caring for the COVID-19 Patients: A Study from Referral Hospitals of Aceh, Indonesia

Introduction: Nurses as frontline health care providers during the COVID-19 pandemic were at high risk and vulnerable to virus infection. Physical and mental conditions in caring for COVID-19 patients in hospitals may be associated with the exacerbation of the nurses experiencing depression, anxiety, and stress among the nurses. Objective: The study aimed to identify the psychological conditions (depression, anxiety, and stress) among nurses providing clinical assistance in caring for COVID-19 patients. Methods: This investigation employed a comparative study with a cross-sectional study design. The respondents were 109 nurses working in the COVID-19 wards in two referral hospitals offering care for COVID-19 patients. Data were collected using the standardized DASS-21 questionnaire and analyzed using the Mann-Whitney U-test. Results: The results showed psychological conditions among nurses caring for COVID-19 patients with depression (moderate) among 60.0% and 58.8%, anxiety (severe) at 60,0% and 58.8%, and stress levels (mild) at 56% and 52.9% for hospital A and B, respectively. The study also found no significant difference in depression (p=0.890), anxiety (p=0.846), and stress levels (p=0.806, α=0.05) between the nurses in the COVID-19 wards of the two hospitals. Conclusion: The demographic data of nurses, such as age, education level, working experience, hospital facilities, attended workshops/training on the use of personal protective equipment (PPE)/Hazmat, and management of COVID-19 patients might contribute to psychological conditions (depression, anxiety, and stress) among nurses in caring for the COVID-19 patients.

The association between nurse managers' transformational leadership and quality of patient care: A systematic review.

To examine and summarize the reported association of nurse managers' transformational leadership and quality of patient care based on the perceptions of registered nurses. Transformational leadership behaviors of nurse managers result in staff nurses' satisfaction and retention and patient satisfaction. Patient safety and quality of care are vital to high-performing healthcare organizations. Perceptions of registered nurses are important because nurses are frontline healthcare providers fundamental to patient safety and quality of care and are considered the final line of defense in preventing adverse events and errors and improving the safety of patients. We searched the CINAHL, ProQuest, PubMed, Science Direct, and Web of Science databases for evidence published between 2018 and 2022 in the English language. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in carrying out this meta-analysis. Nine quantitative studies were appraised using the Joanna Briggs Institute checklists and were included in the final review that involved a total sample of 3633 registered nurses. The included studies were reported across Asian, Middle East, and European countries within the past five years. The association between the transformational leadership behaviors of nurse managers and the quality of patient care was found in varying degrees (i.e., insignificant, weak, indirect, and strong direct association) based on the perceptions of registered nurses. There is a direct and indirect association between the transformational leadership behaviors of nurse managers and the quality of patient care internationally. This association is influenced by confounding and mediating factors, including gender, organizational culture, structural empowerment, and job satisfaction. Healthcare organizations need to support nursing leaders to have a stronger transformational leadership style by considering several factors that influence their leadership to improve the quality of patient care their staff nurses provide at the bedside.

Inpatient Physician and Nurse Experience During the COVID-19 Crisis at a Public Safety Net Hospital

Background: The COVID-19 pandemic has been associated with front line health care provider burnout, depression, and post-traumatic stress disorder. We sought to better understand how nurses and physicians of differing genders may have been affected differently by the COVID-19 crisis. Methods: Between July 17, 2020, and October 31, 2020, we surveyed nurses and physicians caring for COVID-19 patients at a large, academic, public safety net hospital in the southern United States. Survey questions were adapted from validated questionnaires used to determine quality of life, assess levels of anxiety, and determine how COVID-19 may have affected our nurses’ and physicians’ work, home and social lives. Results: Overall, 120 (41.7%) providers responded, including 39 (50%) physicians and 81 (38.6%) nurses. 69.3% reported disruption to their home/family, 76.3% to their social lives, and 29.8% worried about financial strain. More nurses than physicians worried about being excluded from social gatherings (59.7% v 35.1%, p=0.01). Similarly, 70.1% of nurses and 46.0% of physicians expressed concern of exposing others to COVID-19 (p=0.01). Nurses also expressed greater concern about being treated differently by others when compared to physicians (64.5% v 37.8%, p= 0.01). Female physicians reported greater difficulty separating their personal lives from their professional lives than male physicians and either male or female nurses (84.6%% vs 35% vs 33.3% vs 35.9%, p <0.05). Most physicians (89.7%) and nurses (93.8%) reported some level of anxiety, with 31.5% of respondents experiencing moderate or severe anxiety. Conclusion: Healthcare workers on the frontline of COVID-19 pandemic, regardless of profession, reported increased anxiety that extended beyond the hospital into their homes and social lives. Physicians and nurses, as well as men and women, reported different sources and degrees of stress and disruption to their work, home and social lives.

1910. A Highly Effective ID Physician and Infection Preventionist-led Interactive Webinar Series for Infection Prevention and Control Training Among Frontline Healthcare Workers

Abstract Background Nebraska Infection Control Assessment and Promotion Program (ICAP) is funded by Nebraska Department of Health and Human Services through Centers for Disease Control and Prevention (CDC) grants to support Infection Prevention and Control (IPC) activities in the state. In early 2022, ICAP launched COVID-19-specific basic infection prevention and control (IPC) training to frontline healthcare providers (HCPs) through a discussion-based webinar series using curricular materials created by the CDC Project Firstline. Here, we report pre- and post-training survey responses demonstrating improvement in participants' perceived knowledge across a number of IPC domains. Methods Training was completed over a 14-week period via a weekly, interactive 30-minute webinars with a new topic covered each week. A survey was administered to participants prior to the webinar series and at the conclusion of training to assess effectiveness. The pre-survey evaluated HCP confidence in their knowledge of each of the 14 topics to be covered in the course. The post-survey evaluated both confidence and perceived value in each of the training topics. Results Prior to the training series, a mean 40.3% of participants judge themselves “very confident” in IPC topics, versus 52.7% “somewhat confident” and 7.1% “not confident” (figure 1); by the end of the training, these levels had improved to 85.4%, 14.3%, and 0.4%, respectively (figure 2). The largest gains in the category “very confident” concerned “source control” (+65%) and “COVID-19 variants” (+63%). A majority of participants perceived each topic covered in the series to be “very valuable” (figure 3); 98% of participants indicated interest in a future IPC training series and 95% indicated that they would recommend the training series to a colleague. Figure 1Results of a pre-course survey on knowledge of training topics completed by participants.Figure 2Results of a post-course survey on knowledge of training topics completed by participants.Figure 3Results of a post-course survey on value of the training course completed by participants. Conclusion This survey data suggests that a discussion-based webinar using CDC Project Firstline materials is highly effective at conveying fundamental concepts in infection control to frontline HCPs. Moreover, HCPs rated themselves as likely to return, suggesting this format is a promising modality for simple and widespread dissemination of IPC training. Disclosures M. Salman Ashraf, MBBS, Merck & Co. Inc: Grant/Research Support.

Evidence-based Practice and Quality Improvement in Allied Healthcare Education

Evidence-based practice (EBP) is acknowledged as a fundamental component of training for healthcare professionals, including respiratory therapists and other allied healthcare professionals. Understanding the key similarities, advantages and differences between it and quality improvement (QI) can help to advance allied healthcare education (AHE) and clinical practice. However, the differences between ”best EBP” and actual clinical care show how difficult it is to become competent in this field. Professional education to support EBP continues to be a significant and pressing concern. The importance of QI in medical education is becoming more widely recognized, which is also equipping allied health professionals with the knowledge and abilities to improve patient experiences and outcomes, population health, and monitoring and managing per capita healthcare costs. All frontline healthcare providers, including AHPs and RTs, should possess the fundamental capability to implement EBP and QI. Integrating EBP and QI into AHE improves the ability of AHPs to engage in safe clinical practice, which in turn increases the quality of patient care.

Inequitable Care Delivery for COVID-19 Positive People of Color and People With Disabilities

<h3>Research Objectives</h3> To explore provider observations of inequitable care delivery towards COVID-19 positive patients who are Black, Indigenous, and People of Color (BIPOC) and/or have disabilities and to identify ways health providers may be contributing to and compounding inequitable care. <h3>Design</h3> Qualitative research design using thematic analysis of data collected via individual semi-structured interviews between April and November 2021. <h3>Setting</h3> Hospitalized and ambulatory care. <h3>Participants</h3> A total of 19 pandemic frontline health care providers including nine physicians, five nurses, three rehabilitation professionals, and two nurse practitioners from Washington, Florida, Illinois, and New York were recruited through convenience and snowball sampling. The majority of participants were female (n=12) and White (n=11). <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> A semi-structured interview guide included questions regarding equity in treatments among COVID-19 patients who are BIPOC or have disabilities and perceptions around stigma related to COVID-19. <h3>Results</h3> Discriminatory treatment included decreased care (i.e., less explanation due to communication barriers, less interaction with health care providers, no access to telehealth follow-ups), delayed care, and fewer options for care. Health care providers' bias and stigma (racism, ableism, and ageism), patient mistrust and provider-patient disconnect, lack of resources (e.g., staff, interpreter services, funding, or collaboration across health systems), fear of transmission, and burnout were mentioned as drivers for discriminatory treatment. COVID-19 related health system policies such as visitor restrictions and telehealth follow-ups also inadvertently resulted in discriminatory practices towards BIPOC patients and patients with disabilities. <h3>Conclusions</h3> BIPOC patients and patients with disabilities may experience lower quality of healthcare related to COVID-19 due to factors such as providers' biases, fear, burnout, and lack of needed resources in their work settings. In addition, COVID-19-related restrictions and policies compounded existing inequitable care for these populations. <h3>Author(s) Disclosures</h3> Authors do not have conflicts to disclose.

Perceptions of Healthcare Providers and Caregivers Regarding Procedures for Early Detection of Developmental Delays in Infants and Toddlers in Saudi Arabia.

This study aimed to explore current practices adopted by frontline healthcare providers for the early detection of developmental delays in infants and toddlers in Saudi Arabia, with a specific focus on motor and speech delays and caregivers' perceptions of early detection of developmental delays and their awareness of well-child visits. Two cross-sectional surveys were conducted and distributed. The first survey was performed among healthcare providers who worked directly with infants and toddlers in the first 3 years of life, and the second survey was performed among caregivers of infants and toddlers who received healthcare services. Participants were recruited via online groups, social media platforms, and clinics. Overall, 60% of the healthcare providers played a role in identifying medical conditions that could be associated with delays and disabilities. However, they did not consistently check for normal development or developmental delays. Furthermore, the healthcare providers reported low frequencies of documenting developmental growth. The caregivers' survey results showed that 67% were familiar with the concept of "well-child visits", and the most frequently discussed topic by the healthcare providers was motor development. Well-defined, government-supported standards are needed to encourage regular well-child visits and implement efficient practices for the early detection of developmental delays.

A survey of health status of healthcare providers in a square cabin hospital during the new corona omicron outbreak: A cross-sectional study.

The coronavirus omicron variant outbroke in early 2022 in Shanghai. Although previous studies indicated that long working hours in a square cabin hospital might increase the risk of mental health among frontline healthcare providers, few studies have investigated whether the mental health risk could be reduced among well-trained professionals following the new guidelines. This study aimed to investigate the health situation of frontline healthcare providers in Shanghai square cabin during the omicron variant circulation. An online survey was used to evaluate those healthcare providers working in the square cabin hospitals from March 1, 2022, to May 31, 2022. The first online survey was conducted and emailed to the health providers on April 1. The second survey was conducted and sent to the nonrespondents on May 31. Overall, 142 frontline healthcare providers completed the online survey. Their mental health was assessed by the Insomnia Severity Index Scale, the Generalized Anxiety Disorder Scale, the Patient Health Questionnaire-9, and the Psychological Resilience Scale. We estimated multiple clinical systems and identified factors associated with those symptoms among participants. Multivariable logistic regression models were used to assess the risk factors of these symptoms. Overall, 66.20%, 45.07%, and 27.46% of frontline healthcare providers in Shanghai City reported symptoms of insomnia, depression, and anxiety, respectively. In addition, the most common symptoms included dry eyes (57.75%), lumbar muscle strain (47.18%), dry mouth (35.92%), itching (31.69%), headache (29.58%), and sore throat (28.87%) among the frontline healthcare providers. There was no statistical difference in symptoms by gender, age, personnel category, or job position (p > 0.05). In the case of an unexpected pandemic, the mental health of healthcare providers is not optimistic. This situation still exists more than 2 years after the global outbreak of the COVID-19 pandemic. Therefore, the physical and mental health of long-term healthcare providers working in a square cabin hospital still needs monitoring.

HPV self-collection: what are we waiting for? Exploration of attitudes from frontline healthcare providers

ObjectivePolymerase chain reaction based human papilloma virus (HPV) self-collection for cervical cancer screening is well established. It is utilized worldwide, accepted by patients, is cost-effective, has comparable sensitivity to provider-collected...

Parasympathetic Versus Sympathetic Changes in Heart Rate Variability After a Multimodal Integrative Medicine Intervention for Frontline COVID-19 Personnel.

Frontline healthcare providers (HCPs) working in COVID-19 hospital departments need to deal with considerable physical and emotional stress on a daily basis. We conducted a pilot study to examine changes in heart rate variability (HRV) in frontline COVID-19 personnel after an integrative medicine (IM) intervention. HCPs working in isolated COVID-19 inpatient departments underwent a single 30-minute individually tailored IM sessions combining various IM modalities (acupuncture, mind-body, and/or manual-movement modalities, including anthroposophic medicine). HRV parameters were compared during the first IM session at 3-minute intervals, at the beginning of treatments, and after 20 minutes. Root mean square of successive RR interval differences (RMSSD) was measured, as were domains of time (standard deviation of NN intervals, percentage of successive RR intervals that differ by more than 50 milliseconds) and frequency (low frequency/high frequency [LF/HF] ratio). Preintervention and postintervention concerns were assessed using the Measure Yourself Concerns and Well-being questionnaire, with posttreatment free-text narratives analyzed for clusters of emotional- and spiritual-related keywords (ESKs). A total of 114 HCPs underwent an IM treatment session, and their HRV values were measured, of which 75 (65.8%) expressed ESKs. The RMSSD increased only in the ESK-expressing group ( p < .001). LF/HF ratios decreased in both groups, with HF power increasing in the ESK-expressing ( p = .043) and LF power decreasing in the non-ESK-expressing groups ( p = .004). Increased parasympathetic activity was observed in all HCPs after the IM intervention, particularly among those expressing ESKs. LF/HF parameters suggest different relaxation-associated mechanisms, with increased HF (regulated predominantly by parasympathetic tone) in the ESK-expressing and decreased LF (regulated partially by sympathetic tone) in the nonexpressing group. Additional research needs to explore the relationship between subjective effects of the IM intervention and physiological mechanisms of relaxation in HCPs working in stressful environments. ClinicalTrials.gov identifier NCT05104827.

The proportion and determinants of COVID-19 infection among medical doctors in Sudan, 2020: A cross-sectional survey.

Globally, frontline health care providers are among the most affected population group by the COVID-19 pandemic. Knowing the factors contributing to the transmission of COVID-19 infection among frontline health care providers is essential for implementing tailored control measures and protecting this vital population group. This study aimed to estimate the proportion and to identify factors associated with COVID-19 infection among medical doctors in Sudan. A web-based survey was used to collect data from medical doctors who were working in Sudan during the study period. Data were analyzed using SPSS® version 25; Descriptive analysis in terms of means (SD) for continuous variables, frequencies, and percentages with 95% CI for the categorical variable was conducted. Chi-square test and binary logistic regression for associations between the outcome variables (risk of exposure to COVID-19 infection and ever tested positive for COVID-19 infection) and independent variables (socio-demographic and infection control standards) were also performed. Out of 352 valid responses, 13.6% had tested positive for COVID-19 infection at least once during the pandemic. More than one-third have identified colleagues as the main sources of infection compared to 21% of patients (p-value &lt; 0.04). Doctors who received training on COVID-19 were 60% less likely to have positive tests for COVID-19 (p-value &lt;0.03), while lack of PPE and hand hygiene utilities had no statistically significant associations with testing positive for COVID-19 infection. In conclusion, a significant proportion of doctors have contracted COVID-19 infection from their colleagues. This calls for restricting infection control practices at hospitals, doctor's doormats, and any other shared places that allow day-to-day interaction between doctors and their colleagues. Also, urgent need for training doctors on COVID-19 infection control practices as it has been identified as the key protective factor.

Predicting the Demand for Medical Care in Disaster-Affected Areas using the Minimum Data Set and Machine Learning

Background/Introduction:The Minimum Data Set (MDS) has allowed governments of disaster-affected countries to collect, examine, and evaluate standardized medical data from Emergency Medical Teams in real-time. However, little study has been conducted on the use of MDS data to predict health care needs.Objectives:This research proposes an outlook on the use of machine learning and MDS data to predict the need for medical care in disaster-affected areas.Method/Description:The characteristics of the data collected by MDS and the optimal machine learning model were discussed.Results/Outcomes:The primary causes of disease after disasters are trauma (MDS Nos. 4–8), which frequently occurs immediately after a disaster, and infectious diseases (MDS Nos. 9–18), which can increase due to decreasing hygiene conditions. Furthermore, certain infectious diseases can spread quickly because of living in congested evacuation centers, and early detection is crucial.Therefore, predicting the need for medical care in a disaster area is complicated and requires a combination of many machine-learning models. Data-driven methods are mostly linear approaches and cannot capture the dynamics of infectious disease transmission. Additionally, statistical models depend heavily on assumptions, making real-time infection prediction challenging. Thus, deep learning is employed to model without losing the temporal component.Conclusion:Real-time prediction of health care needs using machine learning and MDS can be useful to policymakers by enabling them to better deploy and allocate health care resources, which is useful to patients and front-line health care providers. More detailed predictions for regions and diseases are also anticipated.