Health Professionals Research Articles

Clinical, epidemiological, and molecular characteristics ofSARS-CoV-2 Infections among healthcare workers at a research center in the amazon region of BRAZIL from 2020 to 2022.

The coronavirus disease-2019 (COVID-19) pandemic has affected different sectors of society, and healthcare workers have been particularly impacted. This study aimed to describe the clinical, epidemiological, and molecular characteristics of SARS-CoV-2 infections among healthcare workers in Evandro Chagas Institute, a research reference center in Brazil, from October 2020 to July 2022. 845 samples were collected from individuals who presented clinical symptoms of respiratory infection. Nasopharyngeal positive samples were submitted through genome sequencing. Clinical, epidemiological, and the SARS-CoV-2 lineages (or variants) were analyzed. SARS-CoV-2 positivity was detected in 31.8% (269/845) of samples with a higher prevalence of females (60.2%). The highest SARS-CoV-2 positivity rates were reported in March 2021 (39%), January 2022 (65%), and July 2022 (56%). On clinical symptoms, arthralgia, chills, and diarrhea were statistically significantly detected in 2020; fever, runny nose, and arthralgia in 2021; runny nose, and cough in 2022. On molecular analysis of SARS-CoV-2, 66 samples (25.3%, 66/269) were sequenced and the most prevalent lineage was the Omicron, representing 57.6%. Studies on the epidemiological and clinical characteristics of HCW are essential to propose control measures and work management since research centers play a major role in surveillance to identify and monitor infectious diseases.

Recruiting and retaining healthcare workers in Scotland to a longitudinal COVID-19 study: a descriptive analysis

BackgroundRapid timescales for the design and delivery of research were common during the COVID-19 pandemic. The recruitment and retention of healthcare workers (HCWs) as participants in research studies are notoriously challenging, but this was exacerbated during the pandemic by the unprecedented demand placed on the workforce. The SARS-CoV-2 Immunity and Reinfection Evaluation (SIREN study) is a prospective multicentre cohort study following HCWs in the UK. This paper discusses the strategies and challenges associated with recruitment and retention of HCW participants in Scotland.MethodsThere were 44,546 HCWs recruited to the SIREN study, of whom 6,285 were recruited by research teams at ten different research sites in Scotland between October 2020 and March 2021. Information on target and actual sample size, availability of resource, recruitment rate, and recruitment and engagement strategies by site was collated from SIREN study documentation and discussions with local key SIREN site staff. Individual-level data from 6,153 HCW participants with ongoing consent for all data usage were also collated, including socio-demographic data and information on withdrawal (in first year) and opt-in to a study extension after one year. Factors associated with these outcomes were explored in logistic regression analyses.ResultsDifferent recruitment strategies were used in each site according to local agreements, protocol and staff capacity, with the recruitment period ranging from 13 to 160 days. The locally-agreed recruitment target was met in four sites. The proportion of participants who withdrew in the first year ranged from 3.1 to 24.8% by site, while subsequent opt-in to a 12-month study extension ranged from 28.6 to 74.8%. The sites with the highest proportions of withdrawals were the same four sites with lowest proportions of opt-in. On an individual level, there was a lower level of retention among younger participants, and those from lower socio-economic backgrounds and minority ethnic groups.ConclusionsSite-specific factors including research-readiness likely had a significant influence on recruitment and retention, more so than the specific recruitment or retention strategies employed. Independent of site factors, individual-level variables influenced recruitment and retention, suggesting targeted strategies may be needed to promote research engagement among particular socio-demographic groups.

Healthcare Workers’ Knowledge and Preparedness for Unprecedented Foodborne Botulism Outbreak in Saudi Arabia

Healthcare Workers’ Knowledge and Preparedness for Unprecedented Foodborne Botulism Outbreak in Saudi Arabia

Organizational silence and hidden threats to patients' dignity with schizophrenia: A qualitative study.

Maintaining patients' dignity is a key ethical requirement in healthcare and is emphasized in nursing standards. This issue is particularly significant for patients with schizophrenia because they face unique challenges such as physical and psychological difficulties, dependence on others, and social isolation, making them more vulnerable. Organizational factors can either threaten or preserve their dignity. However, there is little knowledge in this domain within the sociocultural context of Iran. This study aimed to explore the role of the healthcare organization in the dignity of patients with schizophrenia, based on the opinions of patients, healthcare personnel, and family caregivers. This qualitative study was conducted with 26 participants (16 patients, 4 family caregivers, 2 nurses, 3 psychologists, and 1 service worker) who were selected using a purposeful sampling method. The data were collected through semi-structured, in-depth face-to-face interviews until data saturation was reached. The data were analyzed via Graneheim and Lundman's method. The study protocol was approved by the Research Ethics Committee of Urmia University of Medical Sciences (IR.UMSU.REC.1401.099). Based on data analysis, participants reported the three following challenges as organizational hidden threats to patients' dignity: "Lack of facilities," "premature management," and "ineffective communication." The study findings indicated that the healthcare organization does not support the dignity of patients. Management inefficiency and lack of facilities are evident in psychiatric hospitals, and healthcare centers are not monitored based on standard criteria. Limited interactions between healthcare personnel and patients were identified as the main reasons for the neglect of patients with schizophrenia and the violation of their dignity. The results of this study can help healthcare policymakers in designing and implementing effective programs to preserve the dignity of patients with schizophrenia.

Advance care planning towards the end of life.

New national clinical guidelines are now available on advance care planning (ACP). Confidence in communication is important for implementation of the guidelines. This study aims to identify healthcare personnel's self-perceived confidence in communication about future medical care and patients' wishes at the end of life. Healthcare personnel in twelve geriatric units in South-Eastern Norway Regional Health Authority responded to an online questionnaire survey in autumn 2022. The four response alternatives for self-reported confidence - 'unconfident', 'fairly confident', 'very confident' and 'extremely confident'- are combined into two categories: 'limited confidence' ('unconfident' and 'fairly confident') and 'high confidence' ('very confident' and 'extremely confident'). We received responses from 289 of the 470 (61.5%) invited, with an average age of 37.8 ± 11.3 years, of whom 217 out of 289 (75%) had more than five years of professional experience. Of the doctors, 15 out of 67 (22%) reported limited confidence in communication about 'future deterioration of the patient's health condition', 20 out of 67 (30%) about 'life-sustaining treatment' and 13 out of 67 (19%) about 'preferences towards the end of life'. For other healthcare personnel, the corresponding responses were 119 out of 222 (54%), 140 out of 222 (63%) and 109 out of 222 (49%). Self-assessed confidence in communication about future deterioration, future medical care and the patient's own wishes at the end of life varies, and such confidence is limited among many health personnel in geriatric units. Measures appear to be needed to increase confidence in the communication and implementation of ACP in the Norwegian health service.

Perceptions of homelessness: Is there variation across medical careers and specialties?

Medical students, residents and faculty are all capable of holding biases towards stigmatised groups like people experiencing homelessness. This study sought to investigate how the level of training may influence perceptions of homelessness among medical students, residents and faculty. Additionally, we sought to understand how different specialities perceive people experiencing homelessness and whether this changes at various points in a career. The Health Professionals' Attitudes Towards the Homeless Inventory (HPATHI) was administered to medical students, residents and faculty at one institution in the United States. Basic demographics as well as length of time spent in practice were collected in addition to HPATHI responses. A total of 1,141 individuals were invited to complete the survey, including 736 medical students, 214 residents and 191 faculty. Two hundred and ninety individuals participated in the survey and 238 recorded complete responses were analysed for a sample response rate of 238/1141 (20.9%.) Overall perceptions of homelessness across the entire sample were positive and not greatly influenced by the level of training during a medical career. Medical students across classes were largely in agreement and there was a noticeable increase in positive perceptions for students engaged in clinical rotations. However, clinical specialties demonstrated wide variation in perceptions, with the most prominent differences amongst individuals from surgical subspecialties of General Surgery and Obstetrics & Gynaecology. Our study demonstrates the largely favourable attitudes physicians, residents and students have towards people experiencing homelessness with implications for future work to support greater exposure to underserved populations during training. Specialty choice appears to play a larger role in the formation of attitudes towards underserved populations rather than the length of time spent in a particular specialty.

Comparative Education in the Health Professions

As the academe in health professions institutions pursue educational reforms that anchors on the systems approach to healthcare, collaborative efforts are essential to establish more responsive and dynamic professional education systems. This paper highlights comparative education as a tool to strengthen health professions education around the world by reviewing previous and the most recent studies done, and showcase how this can improve the current pedagogical landscape. Through comparative education, a holistic approach to health professions education ensures that the learner’s training is not only comprehensive but also responsive to the dynamic needs of the country, the region, and the rest of the world by the sharing of best practices, challenges, and opportunities for collaboration. The opportunities that international comparative education provide to the health professions education include the sharing of best practices and difficulties encountered, and the enhanced viewpoint from considering different perspectives. On the other hand, the main challenges include ethnocentrism and the limited resources that majority of institutions face globally especially those from the low- and middle-income countries. Truly, once the lessons learned from comparative educational engagements are integrated into the philosophical and educational foundations in our medical schools, then we are one step closer to becoming responsive to the call for a more holistic and systems – centered health professions education.

Participatory development of training videos for respiratory equipment.

During the coronavirus disease 2019 (COVID-19) pandemic, medical oxygen therapy was urgently needed for patients with hypoxaemia. Many low- and middle-income countries lacked the medical devices for oxygen therapy and experience in their use. In addition to providing medical devices for oxygen therapy for countries in need, the World Health Organization (WHO) and partners developed training videos to help local health workers select, use and maintain this equipment. Diverse health professionals, including engineers and clinicians from resource-constrained countries, collaborated in developing draft videos in their local settings. A production team refined these drafts and delivered the training videos through the platform OpenWHO. OpenWHO is WHO's free open-access platform providing courses for health workers and others. The courses, based on WHO's scientific and operational guidance, can be easily adapted, contextualized and translated. The production team refined the drafts into 32 training videos. More than 17 505 health workers participated in the OpenWHO course on COVID-19 respiratory equipment between 28 February 2022 and 30 November 2023. Participants were from 189 countries and 38% (6027/16 047) were from low- and lower-middle-income countries. Involving volunteer biomedical engineers and clinicians from low- and middle-income countries helped provide an appropriate training resource. WHO should continue to develop such training tools and offer them through OpenWHO, especially for emergencies.

Global Research Trends on Factors Affecting Tuberculosis (TB) Adherence and Dropout: A Bibliometric Study

ABSTRACT Tuberculosis (TB) remains one of the significant global health challenges, especially in resource-limited countries. Adherence to TB treatment is key to successful therapy and preventing the emergence of drug resistance. However, dropout rates or discontinuation of treatment before completion remains a major problem that needs to be addressed. This study aims to analyze global trends in research focusing on factors affecting TB treatment adherence and dropout through a bibliometric approach. Using the Publish or Perish application, relevant scientific articles with keywords such as treatment adherence, tuberculosis, treatment dropout, and influencing factors were searched from 2017 to 2024. A total of 50 articles from Google Scholar were further analyzed to identify by publication year, country, publisher, citation, and article type. The data was then processed using VOSviewer to visualize the relationship between keywords and research trends through Network Visualization, Overlay Visualization, and Density Visualization. The results of the analysis showed that Indonesia is the country with the highest number of publications, demonstrating a great commitment in addressing the TB challenge. Articles published in reputable journals, especially those adopting systematic and meta-analysis approaches, show great impact with a high number of citations. Bibliometric visualizations reveal that the focus of research lies on factors such as treatment, adherence, health workers, and access. In addition, family and community support was also found to be an important element in ensuring treatment adherence. In conclusion, this study emphasizes the need for a comprehensive and collaborative approach in improving TB treatment adherence and preventing dropouts. Further research in this area is needed to address existing gaps and develop more effective strategies in the fight against TB. Keywords: Treatment Adherence, Tuberculosis, Dropout, Influencing Factors, Health Worker

World Health Organization Guidance on Health Practitioner Regulation: An Overview

ABSTRACT: The World Health Organization has released its first comprehensive Guidance document on health practitioner regulation, addressing a critical gap in global health policy. This Commentary provides an overview of the Guidance, which aims to support countries in strengthening their regulatory systems for health practitioners. The Guidance, developed through a rigorous process involving a literature review and expert consultation, covers a broad range of health practitioners and focuses on optimizing their utilization to meet population health needs. Key highlights include the description of the global regulatory landscape, identification of regulatory challenges in all societies, and policy considerations to realize dynamic, effective, and agile regulation. The COVID-19 pandemic is cited as an important example of a catalyst for regulatory reforms that enhanced workforce availability and access. This paper, co-authored by members of the World Health Organization Technical Expert Group, emphasizes the importance of aligning regulatory systems with broader health workforce and system priorities, adopting a risk-based approach, and addressing implementation gaps. It encourages policymakers, regulators, and researchers to use the Guidance to assess and update their regulatory systems and to generate more robust evidence on the impact of health practitioner regulation on health outcomes.

Issues in the Adoption of Online Medical Care: Cross-Sectional Questionnaire Survey.

Telemedicine, or online medical care, has gained considerable attention worldwide. However, it has not been widely adopted in Japan, and the detailed status of received and provided online medical care and the reasons for its lack of popularity remain unknown. This study aims to investigate the current status of online medical care in Japan and the factors limiting its adoption from the perspective of both patients receiving and medical professionals providing online medical care. In total, 2 nationwide questionnaire surveys were conducted. The first survey, targeting both patients and healthy individuals, screened approximately 40,000 participants among 13 million people. The participants were selected to match the age distribution of the Japanese population based on government data, and their online medical care experience and medical visit status were recorded. To further investigate online medical care use and satisfaction, a web-based survey was conducted with 15% (6000/40,000) of the screened participants. The second survey, targeting medical professionals, was administered to a physician, a nurse, and a member of the administrative staff in each of 4900 randomly selected medical facilities to inquire about their online medical care practices and impressions. In addition, both surveys investigated the factors limiting online medical care expansion in Japan. The response rates among patients and healthy individuals targeted for the screening and main surveys were 92.5% (36,998/40,000) and ˃80% (1312/1478, 88.77%; 1281/1522, 84.17%; 404/478, 84.5%; and 2226/2522, 88.26% in 4 survey groups), respectively. The survey of medical professionals yielded 1552 responses (n=618, 39.82% physicians; n=428, 27.58% nurses; n=506, 32.6% administrative staff). Although the facility-level response rate was low (794/4900, 16.2%), some facility categories had relatively high response rates. Only 5.29% (1956/36,998) of the patients and healthy individuals had online medical care experience. When there were more hospitals nearby and they felt it was more work to see a physician in person, they were more likely to use online medical care (more nearby hospitals: adjusted odds ratio [aOR] 1.33, 95% CI 1.18-1.50; more work: aOR 1.48, 95% CI 1.35-1.63 per survey response point in the patient group). Similarly, these factors were substantially associated with satisfaction (more nearby hospitals: aOR 1.40, 95% CI 1.14-1.73; more work: aOR 1.50, 95% CI 1.27-1.76 per survey response point in the patient group). In both surveys, the most frequently selected factor preventing the widespread use of online medical care was patients' need to switch to face-to-face medical care for mandatory tests and procedures. Inadequate awareness of and education on online medical care were also frequently selected. Our nationwide surveys provided insights into the current status of online medical care in Japan and simultaneously identified several problems and issues related to it, which will be useful in promoting its wider adoption.

Mobile Medicine in Ukraine

Global Care Force, an international health nongovernmental organization, sent teams of physicians, physician assistants, nurses, and nurse practitioners every month to Ukraine to provide primary care for war-affected communities. I had the opportunity to partner with GCF in May 2024 during its monthly mission trip to this conflict-ravaged country. I described this medical outreach initiative in a first-person narrative in order to relay to a wider audience the realities of warfare for Ukrainian patients and health care workers. Our team treated chronic diseases in northern as well as southern Ukrainian villages near the front line near Kherson. We set up mobile medical clinics in these regions and delivered medications to patients suffering from blast injuries, hyperglycemia, hypertension, and posttraumatic stress disorder.

An Analysis of Psychological Capital and Influencing Factors Among Disaster Care Reservists

IntroductionIn recent years, with the frequent occurrence of public health emergencies, various infectious diseases and natural disasters (earthquakes, tsunamis, and fires have placed a burden on global public health and health care systems, especially on health care workers. This study aimed to investigate the current state of psychological capital among disaster care reservists and the factors influencing it. MethodsBetween January and February 2024, a total of 330 members of the disaster nursing reserve team from 4 tertiary general hospitals in Mianyang, China, were surveyed using an online platform named Wenjuanxing to obtain information on general demographics, psychological capital, and job burnout. ResultsThe total score of psychological capital was 91.10 ± 16.15. Psychological capital was negatively correlated with emotional depletion dimension and depersonalization dimension scores (P < .01) and positively correlated with personal achievement dimension scores (P < .01). The results of multiple regression analysis revealed that the psychological capital of members in disaster nursing reserve teams was influenced by various factors such as their marital status, having children, work experience in the department, level of public recognition and respect, number of disaster relief trainings, participation in disaster relief activities, types of disaster relief activities, and level of job burnout (P < .05). This accounted for 48.9% of the total variation. DiscussionThe psychological capital of disaster nursing reserve team members is affected by several aspects, which warrant great attention. Relevant management departments should adopt appropriate strategies to effectively mobilize their self-efficacy, improve their professional identity and sense of achievement, and enhance their psychological capital level.

A New Test for Evaluating the Psychological Impact of COVID-19 in Nurses

Introduction During the COVID-19 pandemic, many health care workers were involved and suffered significant physical and psychological strain, and nursing was one of the main players. Clearly and objectively establishing the psychological impact on nurses during the pandemic is necessary for long-term recovery and to be prepared for new outbreaks in the future. Aim The aims of this study were to evaluate the perceived impact on nurses at risk of psychological stress at work during a major health care crisis and determine the psychological impact and its influencing factors. Methods An online questionnaire was designed and distributed between April 9 and April 19, 2020, in Spain. The comprehensive self-conducted questionnaire included demographic information and the Psychological Stress and Adaptation at work Score. For the analysis, descriptive statistics, logistic regressions, and receiver operating characteristic curves were determined. Results A total of 825 nurses (33% working in intensive care units and emergency departments) answered the questionnaire. A logistic regression analysis revealed that nurses with higher psychological stress scores experienced more physical overload (P = .02), higher psychological overload (P &lt; .01), poor teamwork (P = .02), more distress due to new circumstances (P &lt; .01), more personal impact of how society responded to COVID-19 (P &lt; .01), anticipation of negative future consequences (P &lt; .01), and worse balance between family and work (P &lt; .01). The area under the curve for the cutoff point of Psychological Stress and Adaptation at work Score 40 was 0.82 (95% confidence interval, 0.79-0.91), with 70% sensitivity and 81% specificity. The positive predictive value was 72%, and the negative predictive value was 80%. Conclusion Psychological Stress and Adaptation at work Score is a rapid and accurate test for evaluating the psychological well-being of health care staff that can be used when crisis prevents the use of conventional stress diagnosis methods. Higher psychological impact was observed in nurses who worked in the intensive care unit and in the hospital ward.

How Should Clinicians Share Decision Making With Patients Interested in Using Psychedelics to Feel Psychologically Safe?

This commentary on a case of a transgender patient interested in using psychedelics to feel more at peace and achieve a sense of psychological safety argues that health care practitioners can help their patients minimize potential harms of psychedelics by providing psychoeducation and resources to identify clinical trials or skilled and knowledgeable psychedelic practitioners. This approach can support patients' agency in their mental health care and ability to foster moments of peace in their lives.

Attitudes and practices of Australian healthcare and sports workers on the use of ankle supports for management and prevention of lateral ankle sprains: a cross-sectional survey

Explore attitudes and practices of Australian professionals using ankle taping or bracing for the management and prevention of lateral ankle sprains. Cross-sectional study. Anonymous online survey. Australian healthcare or athletic workers, registered with an official governing body, involved in the management and/or prevention of lateral ankle sprains. Quantitative data was collected from 20 close-ended questions. Qualitative data from 14 open-ended questions were categorized into topics using inductive thematic analysis. Data was analysed using descriptive statistics and presented in figures and tabular format. A total 160 respondents answered the survey; the majority were podiatrists (42.5%), physiotherapists (23%), or sports/athletic trainers (13.8%). Ankle supports were overwhelmingly recommended and considered to be effective in the management (95% and 89% bracing and taping, respectively) and prevention (96% and 92% bracing and taping, respectively) of lateral ankle sprains. For management, semi-rigid brace with straps (26%) and figure eight taping technique (42%) were the most frequently used. For prevention, the most commonly used were soft brace with straps (30%) and the figure eight taping technique (37%). Australian professionals expressed a positive attitude towards using ankle supports in the management and prevention of lateral ankle sprains.

Cardiovascular-Kidney-Metabolic Syndrome Among Healthcare Workers in Chinese Tertiary Hospital

Cardiovascular-Kidney-Metabolic Syndrome Among Healthcare Workers in Chinese Tertiary Hospital

Rapid Decision Algorithm for Patient Triage during Ebola Outbreaks.

The low specificity of Ebola virus disease clinical signs increases the risk for nosocomial transmission to patients and healthcare workers during outbreaks. Reducing this risk requires identifying patients with a high likelihood of Ebola virus infection. Analyses of retrospective data from patients suspected of having Ebola virus infection identified 13 strong predictors and time from disease onset as constituents of a prediction score for Ebola virus disease. We also noted 4 highly predictive variables that could distinguish patients at high risk for infection, independent of their scores. External validation of this algorithm on retrospective data revealed the probability of infection continuously increased with the score.

Assessment of humoral immunity to the measles virus in healthcare workers

BACKGROUND: measles is an anthroponotic viral disease characterized by high contagiousness. In the early 2000s in the Russian Federation, the infection was on the verge of elimination, but outbreaks in 2003, 2014, 2019 and the rise in incidence since 2022 refutes this situation. Cleanup vaccination of risk groups and revaccination of persons vaccinated once are ongoing. It is relevant to determine antibodies in blood serum in the vaccinated population and in persons with an unknown vaccination and post-infection history. AIM: of the study is to present the results of a study of humoral immunity to the measles virus in healthcare workers vaccinated against measles and with an unknown vaccination and post-infectious history. MATERIALS AND METHODS: the study was conducted in Kazan, Republic of Tatarstan. The study involved employees of a skin and venereal disease clinic, children's clinics, and a blood center in the amount of 133 people (including 2 men), who were vaccinated and revaccinated with live measles vaccine, after which a sufficient amount of time had passed for the formation of an immune response - 3-4 weeks, as well as 40 female employees with an unknown vaccination and post-infection history. Specific IgG to the measles virus was determined in the test blood sera using the enzyme immunoassay method using the Vector-Best kit (Novosibirsk, Russia). Statistical analysis was carried out using the StatTech v.4.1.9 program (developed by Stattech LLC, Russia). RESULTS. The study was conducted in Kazan, Republic of Tatarstan. The study involved employees of a skin and venereal disease clinic, children's clinics, and a blood center in the amount of 133 people (including 2 men), who were vaccinated and revaccinated with live measles vaccine, after which a sufficient amount of time had passed for the formation of an immune response - 3-4 weeks, as well as 40 female employees with an unknown vaccination and post-infection history. Specific IgG to the measles virus was determined in the test blood sera using the enzyme immunoassay method using the Vector-Best kit (Novosibirsk, Russia). Statistical analysis was carried out using the StatTech v.4.1.9 program (developed by Stattech LLC, Russia). CONCLUSIONS. The ongoing outbreaks of measles in 2003, 2014, 2019, 2022-2023 require constant monitoring of the epidemiological situation with the study of the post-vaccination immune response in vaccinated people and the post-infection response in people with an unknown history of measles

Misuse of External Urine Management Devices in Hospitalized Patients.

External urine management devices were introduced into healthcare as a novel solution to avoid indwelling urinary catheter placement and the associated urinary tract infection risk for adult patients. These devices are favored among healthcare workers and patients. However, the downstream impacts of this device can be detrimental to patient outcomes when immobility is promoted through their use. Clinical nurse specialists are the ideal team member to evaluate the introduction of new technology to promote patient-focused care over task-focused care.