Shortage Of Equipment Research Articles

Impact of Covid-19 Pandemic on Mental Wellbeing of Healthcare Professionals: A Cross-Sectional Study

BACKGROUND
 COVID 19 pandemic posed a varied group of challenges to health care workers (HCWs) like new disease with no treatment, less treatment options available, worry for infection to family members, shortage of personal protective equipment (PPEs), uncertainty, and stress associated with lockdowns. HCWs are highly vulnerable to negative mental distress; this psychological distress varies in different group of HCWs and also on different psychological domains. In this study, we wanted to assess the impact of COVID 19 on the psychological well-being of health care professionals when providing care to COVID-19 patients.
 METHODS
 A cross-sectional observational study was conducted on doctors providing care to COVID -19 patients at King George Hospital, Visakhapatnam, during the second wave of COVID from March 2021 to December 2021. The questionnaire included three domains – Personal questions, work related questions, and pandemic related questions. The response to the questions was recorded in Likert’s scale.
 RESULTS
 50 (50.00 %) were sometimes physically exhausted, 49 (49.00 %) participants were sometimes emotionally exhausted, and 46 (46.00 %) participants reported that sometimes they felt worn out (extremely tired). 54 (54.00 %) participants reported that sometimes they were frustrated with their work, and 46 (46.00 %) participants reported sometimes feeling burnt out because of the work. 48 (48.00 %) participants reported sometimes feeling depressed, 38 (38.00 %) participants stated sometime having a fear of catching COVID-19 infection, and 44 (44.00 %) participants reported consistently having to fear of family members getting infected due to the exposure in work environment.
 CONCLUSIONS
 In total, COVID-19 had a negative effect on psychological well-being of the HCWs, but that was not severe to cause any specific psychological disorders. There was no significant difference in mental health impact between the genders and age groups of the participants.

Hypofractionation as a solution to radiotherapy access in latin america: expert perspective.

Limited radiation therapy resources have resulted in an interest in developing time and cost-saving innovations to expand access to cancer treatment, in Latin America. Therefore, hypofractionated radiotherapy (HRT) is a possible solution, as this modality delivers radiation over a shorter period of time. A selected panel of Latin American (LA) experts in fields related to HRT were provided with a series of relevant questions to address, prior to the multi-day conference. Within this meeting, each narrative was discussed and edited, through numerous rounds of discussion, until agreement was achieved. The challenges identified in increasing the adoption of HRT in LA include a lack of national and regional clinical practice guidelines and cancer registries; a lack of qualified human resources and personnel education; high up-front costs of equipment; disparate resource distribution and scarce HRT research. An analysis for these overarching challenges was developed and answered with recommendations. Extending the adoption of HRT in LA can provide a path forward to increase access to radiotherapy and overcome the shortage of equipment. HRT has the potential to improve population health outcomes and patient centered care, while offering comparable local control, toxicity, palliation, and late effects for multiple indications, when compared to conventional RT. Concerted efforts from all involved stakeholders are needed to overcome the barriers in adopting this strategy in LA countries. The recommendations presented in this article can serve as a plan of action for HRT adoption in other countries in a similar situation.

Medication counselling practices amid COVID -19 pandemic and associated factors in drug retail outlets of Jimma town, Southwest Ethiopia: cross-sectional study.

Patients' good understanding and awareness of drug information received at the drug retail outlet is paramount to gaining expected outcomes. In the COVID-19 pandemic, the routine counselling practice faced multifactorial challenges. The study aimed to assess medication counseling practice and associated factors in drug retail outlets of Jimma town, southwest Ethiopia. A facility-based cross-sectional study was conducted using an interviewer administered questionnaire. The data were analysed by using SPSS version 23. A multivariable logistic regression model was used to identify factors associated with medication counselling practice. A total of 180 pharmacy professionals were enrolled in the study, about half (51.1%) of the participants reported good medication counselling provision for their patients. In A multivariable logistic regression analysis, reduced pharmacist's level of communication (AOR=0.008; CI: 0.001-0.292; p= 0.009) and shortage of personal protective equipment (AOR=0.021; CI: 0.002-0.226; p=0.002) due Covid-19 were factors associated with poor medication counselling practice. Reduced level of communication and shortage of personal protective equipment due to Covid-19 were factors associated with poor medication counselling practice. In general, Jimma town health offices and Oromia Region Health bureau should struggle in association with other stakeholders to improve the identified bottleneck of pharmacist's counselling practice.

Identifying the impact of COVID-19 on health systems and lessons for future emergency preparedness: A stakeholder analysis in Kenya.

The coronavirus pandemic (COVID-19) has triggered a public health and economic crisis in high and low resource settings since the beginning of 2020. With the first case being discovered on 12th March 2020, Kenya has responded by using health and non-health strategies to mitigate the direct and indirect impact of the disease on its population. However, this has had positive and negative implications for the country's overall health system. This paper aimed to understand the pandemic's impact and develop lessons for future response by identifying the key challenges and opportunities Kenya faced during the pandemic. We conducted a qualitative study with 15 key informants, purposefully sampled for in-depth interviews from September 2020 to February 2021. We conducted direct content analysis of the transcripts to understand the stakeholder's views and perceptions of how COVID-19 has affected the Kenyan healthcare system. Most of the respondents noted that Kenya's initial response was relatively good, especially in controlling the pandemic with the resources it had at the time. This included relaying information to citizens, creating technical working groups and fostering multisectoral collaboration. However, concerns were raised regarding service disruption and impact on reproductive health, HIV, TB, and non-communicable diseases services; poor coordination between the national and county governments; shortage of personal protective equipment and testing kits; and strain of human resources for health. Effective pandemic preparedness for future response calls for improved investments across the health system building blocks, including; human resources for health, financing, infrastructure, information, leadership, service delivery and medical products and technologies. These strategies will help build resilient health systems and improve self-reliance, especially for countries transitioning from donor aid such as Kenya in the event of a pandemic.

Triple-demic overwhelms paediatric units in US hospitals

Respiratory infections are overwhelming hospital paediatric units across the USA, fuelling drug and equipment shortages. Early and intense respiratory syncytial virus (RSV) and influenza seasons, joined now by climbing COVID-19 rates and rhinovirus admissions, are filling short-staffed hospitals to capacity. The situation is compounded by profits-driven closures of hospital paediatric units.

Identifying Policy Gaps in a COVID-19 Online Tool Using the Five-Factor Framework

Introduction: Worldwide health systems are being faced with unprecedented COVID-19-related challenges, ranging from the problems of a novel condition and a shortage of personal protective equipment to frequently changing medical guidelines. Many institutions were forced to innovate and many hospitals, as well as telehealth providers, set up online forward triage tools (OFTTs). Using an OFTT before visiting the emergency department or a doctor’s practice became common practice. A policy can be defined as what an institution or government chooses to do or not to do. An OFTT, in this case, has become both a policy and a practice. Methods: The study was part of a broader multiphase sequential explanatory design. First, an online survey was carried out using a questionnaire to n = 176 patients who consented during OFTT usage. Descriptive analysis was carried out to identify who used the tool, for what purpose, and if the participant followed the recommendations. The quantitative results shaped the interview guide’s development. Second, in-depth interviews were held with a purposeful sample of n = 19, selected from the OFTT users who had consented to a further qualitative study. The qualitative findings were meant to explain the quantitative results. Third, in-depth interviews were held with healthcare providers and authorities (n = 5) that were privy to the tool. Framework analysis was adopted using the five-factor framework as a lens with which to analyze the qualitative data only. Results: The five-factor framework proved useful in identifying gaps that affected the utility of the COVID-19 OFTT. The identified gaps could fit and be represented by five factors: primary, secondary, tertiary, and extraneous factors, along with a lack of systems thinking. Conclusion: A theory or framework provides a road map to systematically identify those factors affecting policy implementation. Knowing how and why policy practice gaps come about in a COVID-19 OFFT context facilitates better future OFTTs. The framework in this study, although developed in a universal health coverage (UHC) context in South Africa, proved useful in a telehealth context in Switzerland, in Europe. The importance of systems thinking in developing digital tools cannot be overemphasized.

The COVID-19 pandemic and China’s health care system: Current impact and long-term prospects

The COVID-19 pandemic is a real crisis for global and national economies and health systems around the world. It has already taken many lives, and many people are still complaining about the consequences of being infected with this virus. The pandemic has demonstrated the weaknesses of national health systems - the unpreparedness for emergencies and their rapid prevention. These problems were expressed in the inability to detect the threat early, overloaded medical facilities, acute shortage of personal protective equipment and personnel. Nevertheless, the success of China in the fight against the virus, expressed in effective containment tactics, as well as in the reduction of COVID-19 incidence in the country, cannot be overlooked. The purpose of this article is to analyze the impact of the COVID-19 pandemic on the PRC health care system and its medical reforms. Since 2012, large-scale reforms have been carried out in China to achieve a “basic healthcare system with Chinese features.” Universal health coverage is extremely important because it helps, in addition to equality, to achieve financial well-being for citizens and economic development for the country. The following results were obtained: despite the abundance of negative consequences for the economy and health of citizens, the pandemic contributed to the successful implementation of information technologies in health care; had a positive impact on the relationship between Chinese doctors and patients (which has been in deep crisis for a long time); became the reason for China’s leadership in the world vaccine market for the first time in history. Thus, we can conclude about the dual impact of COVID-19 on the industry. The pandemic has already led to a number of significant changes, and now another wave of infections is hampering reform goals, including the Healthy China 2030 program, which will affect the health and wellbeing of 1.4 billion Chinese, but making long-term predictions in an ever-changing environment is impossible. As practice has shown, initial success in combating the disease is not enough: plans to recover from one health crisis have been replaced by yet another plan to fight the new wave of COVID-19.

1059. The Experiences of Healthcare Workers during the Second Wave of COVID-19 Crisis in the South Indian State of Kerala

Abstract Background The COVID-19 pandemic has presented an unprecedented crisis and challenge for healthcare professionals globally. This study aims to explore the challenges faced by healthcare professionals during the second wave of COVID-19 in the south Indian state of Kerala. Methods An online cross-sectional survey was designed and disseminated through social media and professional organizations to collect the relevant information from the healthcare workers. The questionnaire composed of demographics, and of questions about the employment, work role, and access to personal protective equipment. Results Of the 423 responses received, 268 (63.3%) were nurses, followed by pharmacists (7.4%), doctors (14.6%), and allied healthcare professionals (4.4%). Nearly half i.e., 198 (46.8%) of the total responders, expressed concern about work-related risks to themselves and their families. The primary concerns expressed by the participants include higher workload, psychological distress, shortage of quality personal protective equipment (PPE), lack of incentives, and social stigmatization. Just over a third of respondents (35%) perceived that care provided in their workplace was significantly worse than before the pandemic. Conclusion The study offers lessons for hospitals in middle-income and low-income countries to ensure a safe working environment for front-line healthcare workers in their fight against COVID-19. This implies the need to support with adequate safety kits, protocols, and support for both physical and mental health of the healthcare professionals. Disclosures All Authors: No reported disclosures.

HTA54 Incorporating Value of Health System Impact in Economic Evaluations of Therapies of Chronic Diseases

Economic assessments of healthcare interventions for health technology assessments (HTAs) limit societal impact to productivity losses. Other societal impact has been highlighted by the Covid-19 pandemic that was associated with a severe impairment of the ability of the healthcare system to provide adequate and timely care to patients in many indications due to unprecedented increases in hospitalizations. The impact of healthcare interventions on health care system capacity and security has been identified as a priority value item for consideration by HTA recently. In imperfect markets with permanent excess demand, the accounting costs of resources underestimate their opportunity costs. Hence, reliance on accounting costs in economic evaluations of interventions that can avoid future demand for care leads to undervaluation of these interventions. Attempts have been made to evaluate the value of vaccines by accounting for their impact on health system capacity, through valuing bed-days used by patients with vaccine-preventable disease by their opportunity cost. We apply theoretical methods for calculating opportunity costs of services proposed by Sandmann et al. to interventions in a chronic disease. An example is shown for chronic kidney disease that has high and increasing prevalence, and an associated surge in the demand for renal care services, coupled with supply shortages of dialysis equipment and adequate workforce, creating a situation of permanent overdemand on the market of renal care services. The quantitative magnitude of the undervaluation of delaying dialysis and renal transplant is demonstrated by accounting for opportunity costs of resource use as opposed to valuing used resources on accounting price. Its potential impact on results of economic evaluations of CKD therapies and HTA decisions is shown in a simple model on eGFR slope, and methods are assessed and compared. We generalize our findings to other chronic therapies.

Comparison of the Impact of COVID-19 on Veterans Affairs and Non-federal Hospitals: a Survey of Infection Prevention Specialists

BackgroundAs the COVID-19 pandemic evolves, it is critical to understand characteristics that have allowed US healthcare systems, including the Veterans Affairs (VA) and non-federal hospitals, to mount an effective response in the setting of limited resources and unpredictable clinical demands generated by this system shock.ObjectiveTo compare the impact of and response to resource shortages to both VA and non-federal healthcare systems during the COVID-19 pandemic.DesignCross-sectional national survey administered April 2021 through May 2022.ParticipantsLead infection preventionists from VA and non-federal hospitals across the US.Main MeasuresSurveys collected hospital demographic factors along with 11 questions aimed at assessing the effectiveness of the hospital’s COVID response.Key ResultsThe response rate was 56% (71/127) from VA and 47% (415/881) from non-federal hospitals. Compared to VA hospitals, non-federal hospitals had a larger average number of acute care (214 vs. 103 beds, p<.001) and intensive care unit (24 vs. 16, p<.001) beds. VA hospitals were more likely to report no shortages of personal protective equipment or medical supplies during the pandemic (17% vs. 9%, p=.03) and more frequently opened new units to care specifically for COVID patients (71% vs. 49%, p<.001) compared with non-federal hospitals. Non-federal hospitals more frequently experienced increased loss of staff due to resignations (76% vs. 53%, p=.001) and financial hardships stemming from the pandemic (58% vs. 7%, p<0.001).ConclusionsIn our survey-based national study, lead infection preventionists noted several distinct advantages in VA versus non-federal hospitals in their ability to expand bed capacity, retain staff, mitigate supply shortages, and avoid financial hardship. While these benefits appear to be inherent to the VA’s structure, non-federal hospitals can adapt their infrastructure to better weather future system shocks.

Plasma-generated reactive water mist for disinfection of N95 respirators laden with MS2 and T4 bacteriophage viruses

Due to the shortage of personal protective equipment (PPE) during the COVID-19 pandemic, the interest and demand for sterilization devices to reuse PPE has increased. For reuse of face masks, they must be effectively decontaminated of potential infectious agents without compromising its filtration ability during sterilization. In this study, we utilized an atmospheric pressure pulsed dielectric barrier discharge (DBD), combined with nebulized liquid microdroplets to generate plasma-activated mist (PAM). MS2 and T4 bacteriophages were used to conduct the decontamination tests on two types of N95 respirators. Results showed at least a 2-log reduction of MS2 and T4 on N95 respirators treated in one cycle with 7.8% hydrogen peroxide PAM and at least a 3-log reduction treated in 10% hydrogen peroxide PAM. In addition, it was found that there was no significant degradation in filtration efficiency of N95 respirators (3M 1860 and 1804) treated in 10% hydrogen peroxide PAM found after 20 cycles. In terms of re-useability of masks after treatment as determined, it was shown that the elastic straps of 3M 1804 were fragmented after 20 treatment cycles rendering them unusable, while the straps of 3M 1860 were not negatively affected even after 20 disinfection cycles.

Letter: Global Neurosurgery: The Pakistani Perspective.

Letter: Global Neurosurgery: The Pakistani Perspective.

Sterilizable and Reusable UV-Resistant Graphene-Polyurethane Elastomer Composites.

Shortages of personal protective equipment (PPE) at the start of the COVID-19 pandemic caused medical workers to reuse medical supplies such as N95 masks. While ultraviolet germicidal irradiation (UVGI) is commonly used for sterilization, UVGI can also damage the elastomeric components of N95 masks, preventing effective fit and thus weakening filtration efficacy. Although PPE shortage is no longer an acute issue, the development of sterilizable and reusable UV-resistant elastomers remains of high interest from a long-term sustainability and health perspective. Here, graphene nanosheets, produced by scalable and sustainable exfoliation of graphite in ethanol using the polymer ethyl cellulose (EC), are utilized as UV-resistant additives in polyurethane (PU) elastomer composites. By increasing the graphene/EC loading up to 1 wt %, substantial UV protection is imparted by the graphene nanosheets, which strongly absorb UV light and hence suppress photoinduced degradation of the PU matrix. Additionally, graphene/EC provides mechanical reinforcement, such as increasing Young's modulus, elongation at break, and toughness, with negligible changes following UV exposure. These graphene/EC-PU composites remain mechanically robust over at least 150 sterilization cycles, enabling safe reuse following UVGI. Beyond N95 masks, these UVGI-compatible graphene/EC-PU composites have potential utility in other PPE applications to address the broader issue of single-use waste.

Competency assessment of a secondary vocational education graduate according to WorldSkills standards

Introduction. The relevance of the research topic presented in this article is due to the need to spread the practice of assessing competencies formed during the training of graduates of secondary vocational education. The implementation of the comprehensive assessment tasks of the students’ competencies of secondary vocational education is carried out by conducting intermediate and final certification in the form of a demonstration exam according to WorldSkills standards.Aim. The aim of this article was to summarise the results of scaling up the practice of conducting a demonstration exam according to WorldSkills standards in the regional and competency-based sections, to identify factors that contribute to the expansion of the use of the demonstration exam procedure when conducting attestation procedures.Methodology and research methods. The theoretical level of the study included a generalisation of the provisions of the competency-based approach to the training of students in secondary vocational education. The empirical level of the study included an analysis of statistical materials reflecting the results of demonstration exams according to the WorldSkills standards by regions and competencies (skills). The results obtained were verified based on a survey of certified WorldSkills experts. The following general scientific methods were used: analytical review of scientific literature and the content of regulatory documents, generalisation, comparison, synthesis.Results. Only 30.86% of students confirmed the compliance of the acquired knowledge with WorldSkills standards. Among the main reasons for the low preparedness of students, there is a shortage of equipment, consumables, methodological developments, and inconsistency with the content of educational programmes. The low interest of employers is due to the discrepancy between the specifics of the competencies for which demonstration exams are held and the sectoral structure of the regional economy. This situation requires a revision of the processes of training students and the introduction of elements of a competency-based approach. Thus, the formed system for conducting intermediate and final certification in the form of a demonstration exam according to WorldSkills standards needs to be harmonised, the result of which should be the interconnection of the employer’s needs in the competencies of secondary vocational education students. The solution to this problem can be based on a number of regional programmes for staffing the regional economy.Scientific novelty. The novelty of the proposed assessment methodology of the competency-based approach consists in the use of a new integrative property formed in the learning process – competency, taking into account the system of behavioural indicators describing professional activity in terms of observed behaviour.Practical significance. The results obtained will help to develop the elements of a new educational infrastructure of innovative self-development in the regions of the Russian Federation, e.g. centres for advanced training, centres for conducting demonstration exams. Moreover, research results will help eliminate barriers to the spread of the spectrum of competencies and increase in the effectiveness of the formation and development of human capital on the principles of project management in order to increase the participation of employers in the process of training and certification of secondary vocational education graduates.

An Intelligent Medical Isolation Observation Management System Based on the Internet of Things.

Since COVID-19 (coronavirus disease 2019) was discovered in December 2019, it has spread worldwide. Early isolation and medical observation management of cases and their close contacts are the key to controlling the spread of the epidemic. However, traditional medical observation requires medical staff to measure body temperature and other vital signs face to face and record them manually. There is a general shortage of human and personal protective equipment and a high risk of occupational exposure, which seriously threaten the safety of medical staff. We designed an intelligent crowd isolation medical observation management system framework based on the Internet of Things using wireless telemetry and big data cloud platform remote management technology. Through a smart wearable device with built-in sensors, vital sign data and geographical locations of medical observation subjects are collected and automatically uploaded to the big data monitoring platform on demand. According to the comprehensive analysis of the set threshold parameters, abnormal subjects are screened out, and activity tracking and health status monitoring for medical observation and management objectives are performed through monitoring and early warning management and post-event data traceability. In the trial of this system, the subjects wore the wristwatches designed in this study and real-time monitoring was conducted throughout the whole process. Additionally, for comparison, the traditional method was also used for these people. Medical staff came to measure their temperature twice a day. The subjects were 1,128 returned overseas Chinese from Europe. Compared with the traditional vital sign detection method, the system designed in this study has the advantages of a fast response, low error, stability, and good endurance. It can monitor the temperature, pulse, blood pressure, and heart rate of the monitored subject in real time. The system designed in this study and the traditional vital sign detection method were both used to monitor 1,128 close contacts with COVID-19. There were six cases of abnormal body temperature that were missed by traditional manual temperature measurement in the morning and evening, and these six cases (0.53%) were sent to the hospital for further diagnosis. The abnormal body temperature of these six cases was not found in time when the medical staff came to check the temperature on a twice-a-day basis. The system designed in this study, however, can detect the abnormal body temperature of all these six people. The sensitivity and specificity of our system were both 100%. The system designed in this study can monitor the body temperature, blood oxygen, blood pressure, heart rate, and geographical location of the monitoring subject in real time. It can be extended to COVID-19 medical observation isolation points, shelter hospitals, infectious disease wards, and nursing homes.

Hybrid combinatorial remanufacturing strategy for medical equipment in the pandemic

The COVID-19 pandemic hit the medical supply chain, creating a serious shortage of medical equipment. To meet the urgent demand, one realistic way is to collect abandoned medical equipment and then remanufacture, where the disassembled modules are shared with all stock-keeping units (SKUs) to improve utilization. However, in an emergency, the equipment should be processed sequentially and immediately, which means the decision is short-sighted with limited information. We propose a hybrid combinatorial remanufacturing (HCR) strategy and develop two reinforcement learning frameworks based on Q-learning and double deep Q network to find the optimal recovery option. In the frameworks, we transform HCR problem into a maze exploration game and propose a rule of descending epsilon-greedy selection on reweighted valid actions (DeSoRVA) and Espertate knowledge dictionary to combine the cost-minimizing objective with human judgment and the global state of the problem. A real-time environment is further implemented where the quality status of the in-transit equipment is unknown. Numerical studies show that our algorithms can learn to save cost, and the larger scale of the problem is, the more cost-down can be achieved. Moreover, the sophisticated knowledge refined by Espertate is effective and robust, which can handle remanufacturing problems at different scales corresponding to the volatility of the pandemic.

"I don't mean to be rude, but could you put a mask on while I'm here?" A qualitative study of risks experienced by domiciliary care workers in Wales during the COVID-19 pandemic.

Domiciliary care workers (DCWs) continued to provide care to adults in their own homes throughout the COVID-19 pandemic. The evidence of the impact of COVID-19 on health outcomes of DCWs is currently mixed. The OSCAR study will quantify the impact of COVID-19 upon health outcomes of DCWs in Wales, explore causes of variation and extrapolate to the rest of the UK DCW population. An embedded qualitative study aimed to explore DCW experiences during the pandemic, including factors that may have varied risk of exposure to COVID-19 and adverse health and wellbeing outcomes. Registered DCWs working throughout Wales were invited to participate in a semi-structured telephone interview. 24 DCWs were interviewed between February and July 2021. Themes were identified through inductive analysis using thematic coding. Several themes emerged relating to risk of exposure to COVID-19. First, general changes to the role of the DCW during the pandemic were identified. Second, practical challenges for DCWs in the workplace were reported, including staff shortages, clients and families not following safety procedures, initial shortages of personal protective equipment (PPE), DCW criticism of standard use PPE, client difficulty with PPE and management of rapid antigen testing. Third, lack of government/employer preparation for a pandemic was described, including the reorganisation of staff clients and services, inadequate or confusing information for many DCWs, COVID-19 training and the need for improved practical instruction and limited official standard risk assessments for DCWs. Pressure to attend work and perceptions of COVID-19 risk and vaccination was also reported. In summary, this paper describes the risk factors associated with working during the pandemic. We have mapped recommendations for each problem using these qualitative findings including tailored training and better support for isolated team members and identified the required changes at several socio-ecological levels.

Do TV‐aided model lessons in class improve student performance? Evidence from public primary schools in Papua New Guinea

AbstractLack of access to high‐quality education remains a serious concern in many developing countries. This is especially the case for rural areas, including islands suffering from a shortage of skilled teachers and sufficient educational equipment. We examine the impact of introducing TV‐aided model lessons in class to enhance the quality of teaching (the EQUITV project) on the national examination test scores of Mathematics and “Combined Subject” (a comprehensive subject comprising 30% science and 70% social studies and other topics) as well as English in the final year of primary education in Papua New Guinea. We employ a panel event study to capture the different timings of the intervention across schools over multiple time periods. We find that the project significantly and robustly improved test scores for girls only in English 3 years after the introduction of the project, but no improvement was seen for boys.

Mental health and well-being of anaesthetists during the COVID-19 pandemic: a scoping review.

The COVID-19 pandemic has imposed substantial burdens on clinicians and there is a need to better understand the impact on mental health and well-being. This scoping review investigates the prevalence of mental health concerns in anaesthetists, risk and protective factors for mental well-being, and anaesthetists' pandemic-related concerns and support. We searched online databases for articles published between January 2020 and May 2022, using search terms related to: anaesthesia; burnout, well-being, mental health or stress; and COVID-19. We identified 20 articles comprising 19 different populations of anaesthetists (n = 8680) from 14 countries. Studies identified the prevalence of the following condition in anaesthetists: burnout (14-59%); stress (50-71%); anxiety (11-74%); depression (12-67%); post-traumatic stress (17-25%); psychological distress (52%); and insomnia (17-61%). Significant risk factors for poorer mental health included: direct COVID-19-related issues (fear of self and family exposure to infection; requirement for quarantine); practitioner health factors (insomnia; comorbidities); psychosocial factors (loneliness; isolation; perceived lack of support at home and work); demographic factors (female gender; non-white ethnicity; LGBTQIA+); and workplace factors (redeployment outside area of clinical practice; increased work effort; personal protective equipment shortages). Protective factors identified included: job satisfaction; perceived organisational justice; older age; and male sex. Anaesthetists' self-reported concerns related to: personal protective equipment; resource allocation; fear of infection; fear of financial loss; increased workload; and effective communication of protocols for patient treatment. Support from family, colleagues and hospital management was identified as an important coping mechanism. Findings from this review may support the design of interventions to enhance anaesthetists' psychological health during pandemic conditions and beyond. Future research should include consistent psychological outcome measures and rigorous experimental design beyond cross-sectional studies.

SAFER framework for moving forward on the medical device right to repair

Across various industries, the right to repair (RTR) movement has gained momentum as more than 20 states have proposed RTR laws to expand access to repair of consumer products. Medical...