Personal Protective Equipment Research Articles

Reusable and effective polyacrylic membranes for mecoprop and bentazon extractions

This study introduces reusable polyacrylic membranes, fabricated from commercially available monomers (1-vinyl-2-pyrrolidone and methylmethacrylate), as a promising approach for pesticide extraction. These membranes effectively remove the commonly used herbicides mecoprop (RE ≈ 99%) and bentazon (RE ≈ 95%) at low concentrations, which pose water contamination risks due to their water-soluble properties and leaf-level sorption. The membranes exhibit excellent manageability and resistance, allowing for safe handling without personal protective equipment. Additionally, the material is environmentally friendly and can be washed and reused for at least 4 cycles without a significant decrease in performance. Characterization techniques, including NMR, TGA, DSC, mechanical testing, N2 adsorption, and FTIR analysis, were used to investigate properties and assess the influence of the polymeric composition. The study focused on examining the lateral charged aminoethyl groups, which play a crucial role in sorbent-sorbate interactions. Sorption kinetics, isotherms, and permeation studies provided insights into the removal mechanism, efficiency, and permeability coefficients, revealing hydrophobic–hydrophobic interactions between the pesticides and the polymer. Molecular dynamics simulations revealed a scorpion-like conformation of the macromolecular chains surrounding the pesticides. These findings support the hydrophobic nature of the extraction mechanism and highlight the significant role of charged aminoethyl groups in facilitating this process.

Health systems challenges, mitigation strategies and adaptations to maintain essential health services during the COVID-19 pandemic: learnings from the six geopolitical regions in Nigeria

BackgroundThe COVID-19 pandemic control strategies disrupted the smooth delivery of essential health services (EHS) globally. Limited evidence exists on the health systems lens approach to analyzing the challenges encountered in maintaining EHS during the COVID-19 pandemic. This study aimed to identify the health system challenges encountered and document the mitigation strategies and adaptations made across geopolitical zones (GPZs) in Nigeria.MethodsThe national qualitative survey of key actors across the six GPZs in Nigeria involved ten states and the Federal Capital Territory (FCT) which were selected based on resilience, COVID-19 burden and security considerations. A pre-tested key informant guide was used to collect data on service utilization, changes in service utilization, reasons for changes in primary health centres’ (PHCs) service volumes, challenges experienced by health facilities in maintaining EHS, mitigation strategies implemented and adaptations to service delivery. Emerging sub-themes were categorized under the appropriate pillars of the health system.ResultsA total of 22 respondents were interviewed. The challenges experienced in maintaining EHS cut across the pillars of the health systems including: Human resources shortage, shortages in the supply of personal protective equipments, fear of contracting COVID-19 among health workers misconception, ignorance, socio-cultural issues, lockdown/transportation and lack of equipment/waiting area (. The mitigation strategies included improved political will to fund health service projects, leading to improved accessibility, affordability, and supply of consumables. The health workforce was motivated by employing, redeploying, training, and incentivizing. Service delivery was reorganized by rescheduling appointments and prioritizing some EHS such as maternal and childcare. Sustainable systems adaptations included IPC and telehealth infrastructure, training and capacity building, virtual meetings and community groups set up for sensitization and engagement.ConclusionThe mitigation strategies and adaptations implemented were important contributors to EHS recovery especially in the high resilience LGAs and have implications for future epidemic preparedness plans.

Relationship between Personal Protective Equipment (PPE) Use Behavior and Working Period with Allergic Contact Dermatitis (ACD) Symptoms in Workers at Mabar Shrimp Factory

Background. Allergic contact dermatitis (ACD) is one of the most common occupational skin diseases after irritant contact dermatitis (ICD). One of the factors causing ACD is not using personal protective equipment (PPE) and a long working period. This study aimed to analyze the relationship between PPE use behavior and working period with ACD symptoms in workers at the Mabar shrimp factory, Medan. Method. Cross-sectional research with a consecutive sampling method. Assessment of PPE use behavior and working period used a questionnaire and ACD symptoms by a doctor. The analysis used was univariate and bivariate analysis with chi-square. Results. The total number of samples that met the inclusion and exclusion criteria of the study was 100 people, 28 people had symptoms of ACD, enough knowledge, good attitudes, and unfavorable actions with a working period of >2 years. Statistical analysis showed a relationship between PPE use behavior and working period with ACD symptoms. Conclusion. All behavioral factors (knowledge, attitude, and action) and working period have a significant relationship with ACD symptoms

The effect of education on safe use of pesticides based on the health belief model

ObjectiveIn agricultural activities, pesticide use is critical, but poisoning issues are one of the most important occupational hazards for farmers. Training can help protect farmers’ health from pesticide hazards. This study aimed to investigate the effect of education on farmers’ behavior in the safe use of pesticides using the health belief model.MethodsA quasi-experimental (pretest-post-test) study conducted on 84 farmers who were selected using the convenience sampling method. The data collection tool was a two-part questionnaire including demographic information and a questionnaire designed based on the constructs of the health belief model in using personal protective equipment while working with the pesticides. The instrument was completed before and two weeks after an educational intervention. Data analysis was performed using SPSS software version 26.ResultsThe mean age of the participants was 48.94 ± 9.14 years and 69% were male. The study showed that with increasing age, the mean score of health belief model constructs in the safe use of pesticides decreased. Female and higher-educated farmers had higher scores. After the intervention, the mean scores of health belief model constructs in the safe use of pesticides increased significantly, except perceived barriers construct which decreased significantly. Also, the frequency of protective equipment uses while working with pesticides increased significantly after the intervention and safe behaviors increased, while unsafe behaviors decreased.ConclusionThe education as an effective intervention, improves farmers’ safety attitudes and behaviors in pesticide use and it is recommended that educational programs be designed according to the characteristics of the audience.

Mechanical evaluation of elastomeric thermoplastic polyurethane additively manufactured triply periodic minimal surface area lattice structures for adjustable cushioning properties

Purpose Cushioning is a useful material property applicable for a range of applications from medical devices to personal protective equipment. The current ability to apply cushioning in a product context is limited by the appropriateness of available materials, with polyurethane foams being the current gold standard material. The purpose of this study is to investigate additively manufactured flexible printing of scaffold structures as an alternative. Design/methodology/approach In this study, this study investigates triply periodic minimal surface (TPMS) structures, including Gyroid, Diamond and Schwarz P formed in thermoplastic polyurethane (TPU), as a possible alternative. Each TPMS structure was fabricated using material extrusion additive manufacturing and evaluated to ASTM mechanical testing standard for polymers. This study focuses attention to TPMS structures fabricated for a fixed unit cell size of 10 mm and examine the compressive properties for changes in the scaffold porosity for samples fabricated in TPU with a shore hardness of 63A and 90A. Findings It was discovered that for increased porosity there was a measured reduction in the load required to deform the scaffold. Additionally, a complex relationship between the shore hardness and the stiffness of a structure. It was highlighted that through the adjustment of porosity, the compressive strength required to deform the scaffolds to a point of densification could be controlled and predicted with high repeatability. Originality/value The results indicate the ability to tailor the scaffold design parameters using both 63A and 90A TPU material, to mimic the loading properties of common polyurethane foams. The use of these structures indicates a next generation of tailored cushioning using additive manufacturing techniques by tailoring both geometry and porosity to loading and compressive strengths.

Exploring the Experiences of Health Care Providers and Managers in the COVID-19 Pandemic: A Summative Content Analysiss

Background: The rapid morbidity and high mortality rates associated with COVID-19 have placed significant strain on healthcare systems. Mazandaran, as the third province, has been affected by this infectious pandemic. Objectives: The present study aimed to explore the experiences of healthcare providers and managers during the COVID-19 pandemic. Methods: The present qualitative research study was conducted using the content analysis approach between April 2022 and August 2022 to provide deep insights into the experiences of healthcare providers and managers during the COVID-19 pandemic. The participants included 15 hospital managers, comprising 2 clinical nurse supervisors, 3 matrons, and 10 chief executive officers. The participants were purposefully selected from hospitals affiliated with Mazandaran University of Medical Sciences, Iran. Data were collected through semi-structured individual interviews and the assessment of documents from the vice-chancellors of treatment, food and drug, development, and human resources. Results: The category of "challenges and strategies" emerged during the process of reducing and abstracting the codes. The challenges category evolved from three subcategories, including care and cure challenges, challenges related to providing physical resources and personal protective equipment (PPE), and challenges faced by healthcare providers. Similarly, the strategies category emerged from three subcategories, including strategies to improve patient care and treatment outcomes, strategies for procuring PPE and physical resources, and strategies for human resource management. Conclusions: The results of the present study revealed several challenges and strategies experienced by healthcare managers at Mazandaran University of Medical Sciences and hospital managers. Additionally, based on the existing infrastructure of Mazandaran University and the managerial skills of the managers, successful strategies were employed to tackle these challenges. These experiences can be utilized to inform revisions to health-related policies. Documenting these experiences can aid in better management of future infectious pandemics.

Factors Affecting Nurses’ Use of Personal Protective Equipment During the COVID-19 Pandemic: A Cross-Sectional Study

Background: A critical preventive measure during the rapid global spread of COVID-19 was the use of personal protective equipment (PPE) by healthcare professionals, especially nurses. Objectives: This study aimed to examine the factors that influenced nurses' use of PPE during the COVID-19 pandemic. Methods: An analytical cross-sectional study was conducted in 2021 and 2022. A convenience sample of 423 nurses was selected from those working in teaching hospitals affiliated with Tehran University of Medical Sciences. Data were collected using a researcher-developed questionnaire and analyzed with SPSS software version 26. Descriptive statistical tests, such as frequency, percentage, mean, and standard deviation, were used to analyze the data. Additionally, inferential tests such as the independent sample t-test and one-way analysis of variance (ANOVA) were employed. The significance level was set at P < 0.05. Results: Females constituted 70.20% of the sample. The means and standard deviations for individual and organizational factors were 3.41 ± 0.65 and 3.64 ± 0.83, respectively. The relationships between gender and individual factors, as well as education and organizational factors, were found to be statistically significant. There was also a statistically significant relationship between departments and both individual and organizational factors, and between marital status and organizational factors (P < 0.05). Conclusions: Organizational factors, including the provision of adequate PPE, were the most significant contributors to nurses' use of PPE. Conversely, the non-use of PPE was partly influenced by physical complications, such as skin issues, associated with PPE usage. Managers and policymakers can use the results of this study as a guide for future policy and decision-making to reduce or eliminate the factors inhibiting and to strengthen the factors contributing to the proper use of PPE.

Factors influencing uptake of protective behaviours by healthcare workers in England during the COVID-19 pandemic: A theory-based mixed-methods study.

Hospital infection control policies protect patients and healthcare workers (HCWs) and limit the spread of pathogens, but adherence to COVID-19 guidance varies. We examined hospital HCWs' enactment of social distancing and use of personal protective equipment (PPE) during the COVID-19 pandemic, factors influencing these behaviours, and acceptability and feasibility of strategies to increase social distancing. An online, cross-sectional survey (n = 86) and semi-structured interviews (n = 22) with HCWs in two English hospitals during the first wave of the COVID-19 pandemic (May-December 2020). The Capability, Opportunity, Motivation (COM-B) model of behaviour change underpinned survey and topic guide questions. Spearman Rho correlations examined associations between COM-B domains and behaviours. Interviews were analysed using inductive and deductive thematic analysis. Potential strategies to improve social distancing were selected using the Behaviour Change Wheel and discussed in a stakeholder workshop (n = 8 participants). Social distancing enactment was low, with 85% of participants reporting very frequently or always being in close contact with others in communal areas. PPE use was high (88% very frequently or always using PPE in typical working day). Social distancing was associated with Physical Opportunity (e.g., size of physical space), Psychological Capability (e.g., clarity of guidance), and Social Opportunity (e.g., support from managers). Use of PPE was associated with Psychological Capability (e.g., training), Physical Opportunity (e.g., availability), Social Opportunity (e.g., impact on interactions with patients), and Reflective Motivation (e.g., beliefs that PPE is effective). Local champions and team competition were viewed as feasible strategies to improve social distancing. It is valuable to understand and compare the drivers of individual protective behaviours; when faced with the same level of perceived threat, PPE use was high whereas social distancing was rarely enacted. Identified influences represent targets for intervention strategies in response to future infectious disease outbreaks.

Qualitative Study to Explore the Occupational and Reproductive Health Challenges among Women Tobacco Farm Laborers in Mysore District, India

Tobacco farm laborers are primarily women and children working for very low wages. The aim of this study was to explore occupational and reproductive health challenges faced by women tobacco farm laborers in Mysore District, India. We conducted interviews and six focus group discussions among 41 women tobacco farm laborers. Codes and themes were generated based on deductive and inductive approaches using the socioecological model. Participants reported symptoms of green tobacco sickness including headaches, back pain, gastric problems, weakness, and allergies during menstruation, pre-natal, and post-natal periods. Participants had poor awareness about the health effects of tobacco farming, and there were gender inequalities in wages and the use of personal protective equipment. Participants received support from family and community health workers during their pregnancy and post-natal period. Women reported wanting maternity benefits from the tobacco board, as well as monetary support and nutritional supplements. There is a need for health education about the environmental dangers of tobacco among farm laborers, and more supportive policies for women farmworkers during pregnancy and post-natal periods.

Managing disrupted supply chains in Swedish hospitals during the COVID-19 pandemic

ABSTRACT The COVID-19 pandemic has disrupted global supply chains and caused widespread shortages of healthcare supplies. This mixed-methods study examined the management of supply shortages in Swedish hospitals during the COVID-19 pandemic. The key findings are that the shortage of supplies was initially severe owing to low regional and national contingency inventory levels, a lack of knowledge of supply chain management, and cost-saving measures. The perceived consequences of the shortage of personal protective equipment persisted in emergency and inpatient departments, in the later waves. Although pharmaceutical shortages later decreased, hospital managers were disappointed that they persisted. This study also highlights the effectiveness of consensus-based hourly supply agreements between service organisations and unit managers, which makes the prioritisation of the limited supply more dynamic. Despite these challenges, hospitals were able to adapt to the supply chain disruptions caused by the pandemic; however, the results emphasise the importance of preparedness for future pandemics.

Circularity of Polymers Used in Hospitals: Current Status, Challenges, and Future Solutions

AbstractPolymers are applied extensively in the healthcare sector and enable a variety of different applications. In addition to packaging and personal protective equipment, a large number of medical devices are also coated with or consist of polymers. Today's medicine is therefore inconceivable without these materials. However, the huge challenge is to design these polymers more sustainable and to find new possibilities for the future of medicine with polymers. This study therefore highlights potential ways, in how polymers applied in the healthcare sector and in particular in hospitals can be utilized in a circular manner, but also indicates what risks and challenges this entails.

Evaluating and Enhancing an Educational Intervention to Reduce Smallholder Farmers' Exposure to Pesticides in Uganda Through a Digital, Systematic Approach to Behavior Change: Protocol for a Cluster-Randomized Controlled Trial.

Smallholder farmers receive educational interventions on safe pesticide handling by governmental agencies, industries, or nongovernmental organizations to reduce exposure risks. However, existing educational interventions have limited effects on changing behaviors. Targeting psychosocial determinants of behavior change in educational interventions through theory- and evidence-based approaches may enhance their effectiveness. We aim at describing the intervention development and study design of a 3-arm cluster-randomized controlled trial to assess the effects in improving safe pesticide handling and reducing pesticide exposure of (1) an existing educational intervention and (2) a newly developed SMS text messaging intervention based on the Risks, Attitudes, Norms, Abilities, and Self-regulation (RANAS) behavior change approach. We enrolled 539 Ugandan smallholder farmers in 12 clusters (subcounties). The clusters, each with 45 farmers, were randomly allocated to one of the three arms: (1) educational intervention, (2) educational intervention+RANAS-based SMS text messages, or (3) control group. The educational intervention comprised a 2-day workshop that targeted multiple aspects of safe pesticide handling, whereas the SMS text messages targeted the use of personal protective equipment (PPE) and were based on the RANAS approach. For intervention development in this study, this approach includes identifying psychosocial determinants of PPE use at baseline and selecting behavior change techniques to target them in SMS text messages. The primary outcomes of the study are (1) pesticide knowledge, attitude, and practice scores indicating performance throughout the educational intervention; and (2) frequency of PPE use. Secondary outcomes are the RANAS-based behavioral determinants of PPE use, the frequency of glove use, algorithm-based pesticide exposure intensity scores, and signs and symptoms of pesticide poisoning. The outcomes were assessed in structured interviews before the intervention (baseline) and at the 12-month follow-up. The effect of the interventions among the arms will be analyzed using the intervention arms and baseline measures as predictors and the follow-up measures as outcomes in linear multivariable mixed models including the clusters as random effects. The mediating psychosocial determinants of the interventions will be assessed in multiple mediation models. The study was conducted from 2020 to 2021-baseline interviews were conducted in October 2020, and the educational intervention was delivered in November 2020. The RANAS-based SMS text messages were developed based on the baseline data for relevant behavioral determinants of PPE use and sent between February 2021 and September 2021. Follow-up interviews were conducted in October 2021. Overall, 539 farmers were enrolled in the study at baseline; 8.3% (45/539) were lost to follow-up by the end of the study. This study will contribute to a better understanding of the effectiveness and behavior change mechanisms of educational interventions by using an experimental, cluster-randomized study design to improve pesticide handling among smallholder farmers. International Standard Randomised Controlled Trial Number (ISRCTN) 18237656; https://doi.org/10.1186/ISRCTN18237656. DERR1-10.2196/55238.

Scalable fabrication of collagen fiber-waterborne polyurethane foams with enhanced toughness and thermal insulation by constructing energy dissipation networks

Natural fiber-based foams demonstrate outstanding potential for energy-efficient building and personal protective equipment applications due to their lightweight, high porosity, and sustainability. However, the weak interfacial interaction among fibers, functional additives, and the matrix hampers effective stress dissipation, largely affecting the material performance. Herein, this paper demonstrates a facile strategy for fabricating high-performance collagen fiber-based foams by constructing efficient energy dissipation networks using tannin-modified leather collagen fibers (T-LCF) and waterborne polyurethane (WPU). Tannin acts as a coupling bridge, linking the fiber and polyurethane to create a hydrogen-bonded network, enhancing energy dissipation and imparting excellent mechanical properties. Compared to WPU foam (WPUF), the T-LCF-based foam (WPUF/T-LCF) showed 65%, 34 times, and 35% improvements in tensile strength, compressive strength, and ultimate oxygen index, respectively. This study provides new insights into the cleaner production of high-performance natural fiber-based foam composites and a new way for the high-value utilization of collagen solid waste.

Multifunctional wearable Spider-Silk Inspired fabric for personal protection in extreme environments

Personal protective equipment (PPE) plays a vital role in healthcare, industry, and military settings, offering essential protection against various environmental hazards. However, the growing environmental challenges and demand for multifunctional integration make developing PPE that outperforms traditional single-function equipment a significant challenge. Herein, we present a flexible and wearable sandwich-structured film, fabricated by integrating an MXene core layer with Gd(OH)3/TPU outer layers through electrospinning and vacuum filtration process, simultaneously offering neutron and electromagnetic interference (EMI) shielding, energy harvesting, and thermal management. Mimicking spider silk's crystalline and amorphous regions, the outer layers integrate Gd(OH)3 nanorods into TPU nanofibers, thereby enhancing hydrogen bonding and achieving a high tensile strength of 22.94 MPa. Extensive hydrogen-bonding interactions firmly bind the MXene conductive core layer to the gadolinium-rich magnetic outer layers, providing excellent neutron (μ = 22.95 cm−1) and EMI shielding (SE = 35.1 dB). Additionally, the film also functions as a triboelectric nanogenerator (TENG), capturing kinetic energy to power low-voltage electronic devices, reducing reliance on external power in harsh settings. Remarkably, its superior Joule heating capability rapidly reaches various temperature (up to 78.5 ℃) by regulating external voltage to meet diverse user requirements. This study paves the way for future advancements in the realm of multifunctional PPE.

IoT Based Smart Helmet for Industry Rutuja Kokate

The safety and well-being of industrial workers has become a primary concern for organizations worldwide. One of the critical aspects of industrial safety is the use of personal protective equipment (PPE), including helmets. This project proposes the development of an IoT-based smart helmet designed to enhance the safety and efficiency of industrial workers. The smart helmet integrates multiple sensors, such as temperature, humidity, motion, and gas sensors, to monitor the worker's environment in real-time. These sensors gather data on potential hazards like extreme temperatures, toxic gases, or sudden impacts. The helmet also includes a communication system that enables seamless interaction with control centers or other team members. The mining industry, a vital contributor to global economic growth and infrastructure development, grapples with inherent safety challenges posed by hazardous environments and unpredictable events. In response to these concerns, this abstract introduces the "Smart Helmet for Air Quality and Hazardous Event Detection" – a groundbreaking technology tailored specifically for mining. This advanced helmet integrates sensors like the MQ3 gas sensor, temperature and humidity sensors, LED lights with automatic controls, and a GPS module. Real-time data from these sensors are transmitted to an IoT platform, enabling continuous monitoring and immediate alerts. Traditional safety measures, including personal protective equipment and periodic monitoring, fall short in addressing the dynamic conditions of mining environments. The Smart Helmet offers a comprehensive solution by providing continuous air quality and environmental monitoring, coupled with automatic lighting and location tracking. This innovation marks a paradigm shift in mining safety, addressing the urgent need for proactive measures to safeguard the well-being of miners in the face of persistent safety challenges. Key Words: Safety, Sensors, IoT, Smart Helmet, Air quality monitoring

Leveraging YOLO Models for Safety Equipment Detection on Construction Sites

Occupational safety encompasses a range of practices adopted to protect the health and safety of employees. In the construction and industrial sectors, employees may be exposed to various risks such as falls, impacts, temperature changes and the effects of chemical substances. For this reason, personal protective equipment (PPE) is an important element for protecting employees against risks. The effective use of equipment such as a hardhat, mask, and vest makes an important contribution to the prevention of occupational accidents and health problems by ensuring the safety of employees. This study conducted three separate experiments investigating the potential of deep learning methods on occupational safety. In the first experiment, the YOLOv5n and YOLOv8n models were trained on the same data set with ten classes, and their performance was compared. In the second experiment, the YOLOv8n model was trained on a 2-class dataset to examine how the number of classes affected the model's performance. As a result of the experiments, it was seen that it emphasized the potential of deep learning and object detection methods to quickly and effectively monitor and evaluate the use of personal protective equipment.

A new era for African health systems: Market shaping and the African Continental Free Trade Area (AfCFTA)

AbstractThe COVID‐19 pandemic has forced a reflection on the origins of supplies in African healthcare market and underscored the need for an increase in local manufacturing of medical supplies. Several African countries’ health markets have been heavily reliant on imports. First, this article demonstrates how the African healthcare market has had a high import dependency and the role that the African Continental Free Trade Area (AfCFTA) could play to reverse this. It is estimated that African countries import between 80% and 94% of medical supplies, 75% of testing kits, between 70% and 95% of pharmaceuticals, and 99% of vaccines. Second, during the COVID‐19 pandemic, countries imposed export restrictions which impacted the flow of medical supplies to African countries. This finding highlighted the limited production capabilities on the African continent and reiterated the need to strengthen continental value chains and local manufacturing capacity to establish the continent's New Public Health Order. Third, there was the emergence of local innovations seeking to minimize the impact of these supply chain disruptions. Using case studies on the local production of COVID‐19 testing kits and personal protective equipment, the article highlights progress made toward health market reform. It calls attention to the implementation of the AfCFTA to strengthen the supply, manufacturing, and trade of medical resources. Fourth, this article highlights countries that have African‐made pharmaceuticals and vaccinations and the importance of regional hubs to expand these products in African healthcare markets. It concludes by discussing investments made to expand local manufacturing of health products.

A bacteriophage-based validation of a personal protective equipment doffing procedure to be used with high-consequence pathogens.

To determine if the high-level personal protective equipment used in the treatment of high-consequence infectious diseases is effective at stopping the spread of pathogens to healthcare personnel (HCP) while doffing. Personal protective equipment (PPE) is fundamental to the safety of HCPs. HCPs treating patients with high-consequence infectious diseases use several layers of PPE, forming complex protective ensembles. With high-containment PPE, step-by-step procedures are often used for donning and doffing to minimize contamination risk to the HCP, but these procedures are rarely empirically validated and instead rely on following infection prevention best practices. A doffing protocol video for a high-containment PPE ensemble was evaluated to determine potential contamination pathways. These potential pathways were tested using fluorescence and genetically marked bacteriophages. The experiments revealed existing protocols permit contamination pathways allowing for transmission of bacteriophages to HCPs. Updates to the doffing protocols were generated based on the discovered contamination pathways. This updated doffing protocol eliminated the movement of viable bacteriophages from the outside of the PPE to the skin of the HCP. Our results illustrate the need for quantitative, scientific investigations of infection prevention practices, such as doffing PPE.

Healthcare-associated infections in Iranian pediatric and adult intensive care units: A comprehensive review of risk factors, etiology, molecular epidemiology, antimicrobial sensitivity, and prevention strategies during the COVID-19 pandemic.

The current review article provides a comprehensive analysis of nosocomial infections in pediatric and adult intensive care units (ICUs) in Iran. We examine the risk factors and etiology of nosocomial infections, with a particular focus on molecular epidemiology and antimicrobial sensitivity. In this article, we explore a range of prevention strategies, including hand hygiene, personal protective equipment, environmental cleaning, antibiotic stewardship, education, and training. Moreover, we discuss the impact of the COVID-19 pandemic on infection control measures in ICUs and provide valuable insights for healthcare professionals and policymakers seeking to address this critical public health issue. In conclusion, this review article can serve as a valuable resource for those interested in understanding and improving infection control in ICUs and beyond.

Nudging intensive care unit personnel towards sustainable behaviour.

The health care sector is among the most carbon-intensive sectors, contributing to societal problems like climate change. Previous research demonstrated that especially the use of personal protective equipment (e.g., aprons) in critical care contributes to this problem. To reduce personal protective equipment waste, new sustainable policies are needed. Policies are only effective if people comply. Our aim is to examine whether compliance with sustainable policies in critical care can be increased through behavioural influencing. Specifically, we examined the effectiveness of two sets of nudges (i.e., a Prime + Visual prompt nudge and a Social norm nudge) on decreasing apron usage in an intensive care unit (ICU). We conducted a field experiment with a pre- and post-intervention measurement. Upon the introduction of the new sustainable policy, apron usage data were collected for 9 days before (132 observations) and 9 days after (114 observations) the nudge interventions were implemented. Neither the Prime + Visual prompt nudge, nor the Social norm nudge decreased apron usage. While previous studies have found that primes, visual nudges and social norm nudges can increase sustainable behaviour, we did not find evidence for this in our ICU field experiment. Future research is needed to determine whether this null finding reflects reality, or whether it was due to methodological decisions and limitations of the presented experiment. The presented study highlights the importance of studying behavioural interventions that were previously proven successful in the lab and in other field contexts, in the complex setting of critical care. Results previously found in other contexts may not generalize directly to a critical care context. The unique characteristics of the critical care context also pose methodological challenges that may have affected the outcomes of this experiment.