Young Health Care Workers Research Articles

Assessing the mental health literacy of healthcare workers at a Johannesburg tertiary hospital

Background: Good mental health literacy (MHL) has proven to aid in providing adequate and timely care, promote positive attitudes towards mental health and assist in the integration of mental healthcare with other services. Studies have shown that enhancing the MHL of healthcare workers (HCWs) can help alleviate the burden of mental illness.Aim: The study aims to explore the MHL of HCWs at a tertiary hospital in Johannesburg.Setting: The study was conducted at Helen Joseph Hospital.Methods: A quantitative, descriptive, cross-sectional study via a self-administered questionnaire consisting of: (1) a demographic, work and exposure to mental illness and mental healthcare services questionnaire and (2) the Mental Health Literacy Scale (MHLS) was employed. The MHLS identifies people with low MHL who could benefit from further interventions.Results: Two hundred and fifty-two HCWs participated in the study. The overall median MHLS score was 129, in keeping with a previous study conducted in SA and Zambia. Younger HCWs with less than 5 years of experience scored higher. Among the various professions, doctors scored highest and nurses lowest. The anaesthetic and psychiatric departments obtained the highest MHLS scores. Personal exposure to mental illness and mental health services was associated with higher MHLS scores.Conclusion: This study highlighted areas where mental health awareness and education are lacking, which are crucial for improving MHL. Targeted interventions to fill these identified gaps are therefore recommended.Contribution: To our knowledge, this was the first South African study to assess MHL among tertiary-level HCWs across various professions.

Rare cause of chronic cough in a young healthcare worker - A case of exogenous lipoid pneumonia!

ABSTRACT Exogenous lipoid pneumonia (ELP) is a rarely reported entity caused by aspirating or inhaling fat or oil-containing substances. Clinically, patients present with subacute to chronic-onset non-specific symptoms such as cough, fever, breathlessness, and general malaise. In addition, lobar or multifocal interstitial and parenchymal infiltrates on chest imaging can mimic any other infectious etiology. Diagnosis of lipoid pneumonia is often missed or delayed in many cases and requires a high index of clinical suspicion. We report a case of a 36-year-old nursing officer who presented with a cough and right-sided pneumonia on chest imaging. She was being treated empirically with antitubercular therapy without any clinical response to the treatment. ELP was diagnosed after carefully evaluating the radiological findings, reviewing the clinical history, and finding supportive evidence of lipid-laden alveolar macrophages in her broncho-alveolar lavage fluid. It is vital to uphold a heightened clinical suspicion for non-infectious etiologies in non-resolving pneumonia and investigate the patient thoroughly before resorting to empirical treatments.

Healthcare Workers' Knowledge and Attitudes Regarding Artificial Intelligence Adoption in Healthcare: A Cross-sectional Study

BackgroundThe convergence of healthcare and artificial intelligence (AI) introduces a transformative era in medical practice. However, the knowledge and attitudes of healthcare workers concerning the adoption of artificial intelligence in healthcare are currently unknown. AimsThe primary objective was to investigate the knowledge and attitudes of healthcare professionals in Dhaka city, Bangladesh, regarding the adoption of AI in healthcare. MethodsA cross-sectional research design was employed, incorporating a dual-method approach to select participants using randomness and convenience sampling techniques. Validity was ensured through a literature review, content validity, and reliability assessment (Cronbach's alpha = 0.85), and exploratory factor analysis identified robust underlying factors. Data analysis involved descriptive and inferential statistics, including Fisher's exact tests, multivariate logistic regression, and Pearson correlation analysis, conducted using STATA software, providing a comprehensive understanding of healthcare workers' AI adoption in healthcare. ResultsThis study revealed that age was a significant factor, with individuals aged 18-25 and 26-35 having higher odds of good knowledge and positive attitudes (AOR 1.56, 95% CI 1.12–2.43; AOR 1.42, 95% CI 0.98–2.34). Physicians (AOR 1.08, 95% CI 0.78–1.89), hospital workers (AOR 1.29, 95% CI 0.92–2.09), and full-time employees (AOR 1.45, 95% CI 1.12–2.34) exhibited higher odds. Attending AI conferences (AOR 1.27, 95% CI 0.92–2.23) and learning through research articles/journals (AOR 1.31, 95% CI 0.98–2.09) were positively associated with good knowledge and positive attitudes. This research also emphasized the strong correlations between knowledge and positive attitudes (r = 0.89, P < 0.001), as well as negative attitudes with poor knowledge (r = 0.65, P < 0.001). ConclusionsThe study highlights the critical need for targeted educational interventions to bridge the knowledge gaps among healthcare professionals regarding AI adoption. The findings reveal that younger healthcare workers, those in full-time employment, and individuals with exposure to AI through conferences or research are more likely to possess good knowledge and hold positive attitudes towards AI integration. These results suggest that policies and training programs must be tailored to address specific demographic differences, ensuring that all groups are equipped to engage with AI technologies. Moreover, the study emphasizes the importance of continuous professional development, which could foster a workforce capable of harnessing AI’s potential to improve patient outcomes and healthcare efficiency.

Headaches in Healthcare Workers: A Prospective Study of Precipitating and Maintenance Variables and Their Relationship with Burnout as a Post-COVID Syndrome.

Headaches are a common symptom in healthcare workers (HCWs), mainly associated with high levels of stress. Different research has studied their incidence during the COVID-19 pandemic, most of them with correlational designs, and at the beginning of the pandemic and focused on the associated occupational variables. (1) To analyze the incidence of headaches in HCWs at the beginning of the COVID-19 pandemic and their maintenance six months later. (2) To explore the risk factors associated with their onset and maintenance, including sociodemographic, occupational, emotional symptomatology, and personality variables. (3) To propose a model to explain the chronification of stress in burnout, including the moderating role of chronic headaches. A prospective study (n = 259 HCWs) at three points in time during the COVID-19 pandemic, from the alarm state phase (T1: May-June 2020) to the post-pandemic stage (T3: April-July 2022), including an intermediate measure six months after T1 (T2). Descriptive analyses, Pearson's chi-square, Student's t, logistic regressions, and moderated mediation models were conducted using the Process package for SPSS. In addition to headaches, socio-demographic, occupational, emotional symptomatology, and personality variables were included. At T1 the prevalence of headaches was 69.9%. At T2 the prevalence was 73.7%. Of these, 59.5% are T1-T2 sustained headaches. Headaches at T1 were associated with age (p = 0.010) (younger HCWs), professional category (p = 0.049) (nurses), service (p = 0.023) (ICU, COVID hospitalization), non-availability of PPE (p = 0.010), additional COVID-19 symptomatology (p < 0.001), and concern for contagion of family members (p < 0.001) (higher scores). In addition, HCWs with headaches had higher levels of stress (p = 0.001), anxiety (p = 0.001), depression (p = 0.041), and sleep disorders (p < 0.001). A subsequent logistic regression analysis showed that of the above variables, the presence of additional COVID-19 symptoms (p < 0.001) and depression (p = 0.010) were the predictor variables. With regard to the maintenance of headaches (T1-T2), anxiety (p = 0.035), stress (p = 0.001), and cognitive fusion (p = 0.013) were found to be the significant variables. The tested model proposes anxiety (T1) as antecedent, cognitive fusion (T2) as mediator, burnout (T3) as consequent, and chronic headaches (yes/no) as the moderating variable between anxiety and burnout (model 5). The model is significant (F = 19.84, p < 0.001) and contributes to the explanation of 36% of the variance of burnout. The relationships in the model are all statistically significant, and specifically chronic headaches contribute to a 6-fold increase in the likelihood of burnout. The present research differentiates between precipitating and maintenance factors of headaches in HCWs. The former, more studied in previous research, are usually related to sociodemographic and occupational variables and levels of anxiety and stress. Maintenance factors, scarcely explored, are related to the maintenance of emotional symptomatology and the inability to manage intrusive thoughts (i.e., cognitive fusion). Of particular interest is that the presence of chronic headaches itself is capable of producing burnout as a post-COVID syndrome.

The emotional state of young medical workers involved in medical care for COVID-19 patients

Relevance. Few studies have identified changes in the social wellbeing of the youth throughout the COVID-19 pandemic. The objective is to assess the emotional status of young medical workers involved in medical care during COVID-19.Methods. The study was carried out in spring 2024 in the format of an online survey. The responses were assessed using a scale specifically developed for the survey to assess respondent’s emotional state as ‘favorable’, ‘unfavorable’, or ‘average’. 135 male and 164 female medical workers were interviewed. The respondents’ age ranged from 20 to 35 years, allowing to consider them representing the youth as a social group. Their work experience in providing medical care to COVID-19 patients ranged from 6 to 24 months or more. Statistica 10.0 software package was used for statistical data processing. Results and discussion. Among the interviewed young medical workers, 20.0 % (95 % CI 15.5–24.8) assessed their emotional state as ‘unfavorable’ and 18.4 % (95 % CI 14.1–22.7) as ‘favorable’. Medical workers with 12 to 24 or more months of experience in providing medical care to COVID-19 patients were significantly less likely (p ≤ 0.05) to refer to their emotional state as ‘favorable’ and significantly more likely (p ≤ 0.05) to report anxiety, the need for non-stop motion, and inability to stand still or stay seated in one place. The group of medical workers reporting ‘unfavorable’ emotional state included 54.7 % (95 % CI 49.1–60.3) contested that before starting the job in COVID-19 departments, they had only been instructed, interviewed by the management, and trained right on the job. Meanwhile, ‘favorable’ emotional state was associated with prior training throughout CME cycles. This group of young medical workers also reported practicing one of two preventive strategies, i.e either a combination of sports, adequate physical activity, and “healthy eating” or sport, adequate physical activity, and sleep schedule, thus showing the respondents’ commitment to healthy lifestyles.Conclusion. In in young medical workers, providing medical care to COVID-19 patients is accompanied by deteriorated emotional state. This process can intensify with increasing work experience. Lack of training throughout CME cycles prior to work is an unfavorable factor. Adherence to healthy lifestyles is the most common strategy among young healthcare workers to prevent adverse emotional states.

Three doses of Sars-CoV-2 mRNA vaccine in older adults result in similar antibody responses but reduced cellular cytokine responses relative to younger adults

ObjectivesBooster COVID-19 vaccinations are used to protect the elderly, a group vulnerable to severe disease. We compared humoral and cellular immunity in older versus younger adults up to eight months after administering a BNT16b2 booster vaccine dose. Next, we analyzed the plasma levels of soluble T cell activation/exhaustion markers. MethodsHome-dwelling older adults (n = 68, median age 86) and younger healthcare workers (n = 35, median age 39), previously vaccinated with two doses of BNT162b2, were given a booster dose at ten months after the initial dose. Our analysis consisted of spike-specific IgG, neutralizing antibodies, memory B cells, IFN-γ and IL-2 secreting T cells and soluble T cell exhaustion/activation markers. ResultsFollowing the initial two doses, the elderly cohort exhibited lower humoral and IFN-γ responses compared to younger adults. The booster dose increased the humoral responses in both older and younger adults. At two months after the booster dose, older and younger vaccinees had comparable levels of antibodies and the responses were maintained up to 18 months. The younger cohort elicited an increase in the cellular response, while no increase was detected in the elderly. The elderly had higher plasma levels of soluble forms of the T cell activation/exhaustion markers CD25 and TIM-3, which inversely correlated with age and T-cell cytokine responses. This suggests that these markers may be related to the observed dysfunctional cellular cytokine response in older adults. However, both elderly and younger adults who experienced breakthrough infections after booster vaccination, elicited more robust humoral and IFN-γ responses. ConclusionsThe booster dose elicited neutralizing and spike-specific antibody responses in the elderly that were comparable with that of the younger cohort. However, the lack of a strong cellular cytokine response to the third dose in the elderly may explain their vulnerability to severe infection and may be a consequence of exhausted or senescent T cell responses. (https://clinicaltrials.gov/study/NCT04706390).

State COVID-19 Vaccine Mandates and Uptake Among Health Care Workers in the US

Seventeen states introduced COVID-19 vaccine mandates for health care workers (HCWs) in mid-2021. Prior research on the effect of these mandates was centered on the nursing home sector, and more evidence is needed for their effect on the entire HCW population. To examine the association between state COVID-19 vaccine mandates for HCWs and vaccine uptake in this population. This repeated cross-sectional study included biweekly, individual-level data for adults aged 25 to 64 years who were working or volunteering in health care settings obtained from the Household Pulse Survey between May 26 and October 11, 2021. Analyses were conducted between November 2022 and October 2023. Announcement of a state COVID-19 vaccine mandate for HCWs. An indicator for whether a sampled HCW ever received a COVID-19 vaccine and an indicator for whether an HCW completed or intended to complete the primary COVID-19 vaccination series. Event study analyses using staggered difference-in-differences methods compared vaccine uptake among HCWs in mandate and nonmandate states before and after each mandate announcement. The sample was further stratified by the availability of regular COVID-19 testing in place of a vaccination (ie, a test-out option) and by the ages of HCWs (25-49 or 50-64 years) to examine heterogeneous associations. The study sample included 31 142 HCWs (mean [SD] age, 45.5 [10.6] years; 72.1% female) from 45 states, 16 of which introduced COVID-19 vaccine mandates for HCWs. Results indicated a mandate-associated 3.46-percentage point (pp) (95% CI, 0.29-6.63 pp; P = .03) increase in the proportion of HCWs ever vaccinated against COVID-19 and a 3.64-pp (95% CI, 0.72-6.57 pp; P = .02) increase in the proportion that completed or intended to complete the primary vaccination series 2 weeks after mandate announcement from baseline proportions of 87.98% and 86.12%, respectively. In the stratified analyses, positive associations were only detected in mandate states with no test-out option and among HCWs aged 25 to 49 years, which suggested vaccination increases of 3.32% to 7.09% compared with baseline proportions. This repeated cross-sectional study found that state COVID-19 vaccine mandates for HCWs were associated with increased vaccine uptake among HCWs, especially among younger HCWs and those in states with no test-out option. These findings suggest the potential for vaccine mandates to further promote vaccinations in an already highly vaccinated HCW population, especially when no test-out option is in place.

Measuring Immunoglobulin Titers Among Healthcare Workers After Hepatitis B Vaccination: A Cross-Sectional Study in Kuwait.

Introduction Hepatitis B virus (HBV) is a highly infectious disease affecting the liver, causing life-threatening acute and chronic hepatitis. It poses a significant global public health burden and is a major occupational risk for healthcare workers (HCWs) due to transmission through blood and blood products. Given their increased risk compared to the general population, vaccination is crucial in limiting the spread of HBV and protecting HCWs. This study aims to measure the anti-HBs titers of HCWs in the Farwaniyah Health District in Kuwait after completing three doses of the HBV vaccine. Methods This cross-sectional study was conducted in the Farwaniyah Health District of Kuwait between May and July 2023. We collected data from 556 participants from various departments, including physicians, nurses, and laboratory technicians, chosen through simple random sampling. Inclusion criteria included the completion of three doses of the HBV vaccine (Engerix-B recombinant vaccine, GlaxoSmithKline Biologicals, Brentford, UK). Demographic data were collected, and blood samples were tested for hepatitis B surface antigen antibody titers using fourth-generation enzyme-linked immunosorbent assay. Participants were categorized based on sex, age, specialty, and time since the last vaccine dose. The chi-square test and Fisher's exact test assessed differences in categorical variables, with a p-value of <0.05 considered statistically significant. Results The study included 556 participants, with 304 (54.7%) women and 252 (45.3%) men. Participants were assigned into two age groups: 294 (52.9%) were 18 to 40 years oldand the remainder (262) were over 40. Most participants were nursing staff (n=392; 70.5%), followed by physicians (n=110; 19.7%) and technicians (n=54; 9.7%). A high proportion (n=340; 61.2%) received their last vaccine dose within the last five years. Overall, 375 (67.4%) HCWs developed sufficient anti-HBs titers of ≥100 mIU/mLwhile 181 (32.6%) had levels below 100 mIU/mL. Age between 18 and 40 years and receiving the vaccine within the last five years were significantly associated with protective titer levels, while sex was not. Nurses had significantly higher immunity levels compared to doctors and technicians. Conclusions HCWs in the Farwaniyah area of Kuwait generally responded positively to the HBV vaccine. Younger HCWs and those who received the vaccine more recently were more likely to have a protective immune response. Nurses demonstrated higher rates of seroconversion compared to doctors and technicians. These results suggest that HBV vaccination programs should prioritize timely booster doses, especially for older HCWs and those vaccinated longago. Monitoring antibody levels is crucial to ensure ongoing protection, particularly in high-risk groups such as nurses. Implementing these measures can enhance the effectiveness of HBV vaccination programs, reduce HBV incidence among HCWs, and contribute to a safer healthcare environment. Post-vaccination testing is essential to ensure the safety of all HCWs against HBV.

Vitamin D status in young healthcare workers: association with lipid parameters

Vitamin D status in young healthcare workers: association with lipid parameters

SARS-CoV-2 immunity and reasons for non-vaccination among healthcare workers from eastern and northern Switzerland: results from a nested multicentre cross-sectional study.

We aimed to assess the extent of SARS-CoV-2 humoral immunity elicited by previous infections and/or vaccination among healthcare workers, and to identify reasons why healthcare workers decided against vaccination. This nested cross-sectional study included volunteer healthcare workers from 14 healthcare institutions in German-speaking Switzerland. In January 2021, SARS-CoV-2 vaccines were available for healthcare workers. In May and June 2022, participants answered electronic questionnaires regarding baseline characteristics including SARS-CoV-2 vaccination status (with one or more vaccine doses defined as vaccinated) and previous SARS-CoV-2 infections. Unvaccinated participants indicated their reasons for non-vaccination. Participants underwent testing for SARS-CoV-2 anti-spike (anti-S) and anti-nucleocapsid (anti-N) antibodies. Antibody prevalence was described across age groups. In addition, we performed multivariable logistic regression to identify baseline characteristics independently associated with non-vaccination and described reasons for non-vaccination. Among 22,438 eligible employees, 3,436 (15%) participated; the median age was 43.7 years (range 16-73), 2,794 (81.3%) were female, and 1,407 (47.7%) identified as nurses; 3,414 (99.4%) underwent serology testing, among whom 3,383 (99.0%) had detectable anti-S (3,357, 98.3%) antibodies, anti-N (2,396, 70.1%) antibodies, or both (2,370, 69.4%). A total of 296 (8.6%) healthcare workers were unvaccinated, whereas 3,140 (91.4%) were vaccinated. In multivariable analysis, age (adjusted OR [aOR] 1.02 per year, 95% CI 1.01-1.03), being a physician (aOR 3.22, 95% CI 1.75-5.92) or administrator (aOR 1.88, 95% CI 1.27-2.80), and having higher education (aOR 2.23, 95% CI 1.09-4.57) were positively associated with vaccine uptake, whereas working in non-acute care (aOR 0.58, 95% CI 0.34-0.97), active smoking (aOR 0.68, 95% CI 0.51-0.91), and taking prophylactic home remedies against SARS-CoV-2 (aOR 0.42, 95% CI 0.31-0.56) were negatively associated. Important reasons for non-vaccination were a belief that the vaccine might not have long-lasting immunity (267/291, 92.1%) and a preference for gaining naturally acquired instead of vaccine-induced immunity (241/289, 83.4%). Almost all healthcare workers in our cohort had specific antibodies against SARS-CoV-2 from natural infection and/or from vaccination. Young healthcare workers and those working in non-acute settings were less likely to be vaccinated, whereas physicians and administrative staff showed higher vaccination uptake. Presumed ineffectiveness of the vaccine is an important reason for non-vaccination.

Knowledge, attitudes, and practices of Jamaican healthcare workers on nosocomial infection control.

The emergence of deadly infections such as methicillin-resistant Staphylococcus aureus and COVID-19 (SARS-CoV-2) highlights the need for effective infection control (IC) procedures in healthcare facilities. The aim of the study was to assess the knowledge, attitudes, and practices (KAP) of healthcare workers (HCWs) on IC procedures. A cross-sectional survey was conducted among HCWs in western Jamaica from May to August 2015. A questionnaire based on the Jamaican Health Facilities Infection and Control Policies and Procedures Manual was used to collect data on staff training in IC, and their KAP of IC. Summary statistics, ANOVA, and multiple linear regression were applied for data analyses. Among 227 participants, the mean knowledge scores were statistically higher among the younger HCWs, Physicians/Nurses, and those in clinical units. Older HCWs, non-physicians/nurses, non-clinical unit workers, HCWs at Western Regional Hospital A, and those who received ongoing IC training scored higher on attitude. The practice scores were significantly correlated with the attitude scores but not the knowledge scores. The attitude score was a significant predictor for IC practices. Six knowledge and three attitude variables were significant predictors of IC practices that the Western Regional Health Authority Officials can use to implement measures to improve IC practices among HCWs.

Perceptions of the COVID-19 Vaccine and Willingness to Receive Vaccination among Health Workers in Nigeria: A Cross-sectional Study.

COVID-19 vaccine hesitancy is a major barrier to vaccine uptake, and the achievement of herd immunity is required to reduce morbidity and mortality and protect the most vulnerable populations. In Nigeria, COVID-19 vaccine hesitancy has been high, and uptake remains very low. Healthcare workers (HCWs) in Nigeria can help support public health efforts to increase vaccine uptake. This study evaluates Nigerian HCWs' acceptance and intent to recommend the COVID-19 vaccine. Cross-sectional survey among 1,852 HCWs in primary, secondary, and tertiary care settings across Nigeria. Respondents included doctors, nurses, pharmacy workers, and clinical laboratory professionals who have direct clinical contact with patients in various healthcare settings. A 33-item questionnaire was used in the study, with two of the questions focused on the COVID-19 vaccine. The responses to the two questions were analyzed using Chi-square (c2) tests and independent t-tests to determine the acceptance of the vaccine. The majority of respondents were younger than 34 years (n = 1,227; 69.2%) and primarily worked in hospitals (n = 1,278; 72.0%). Among the respondents, 79.2% (n = 1,467) endorsed the COVID-19 vaccine as a critical tool in reducing the impact of the disease, and 76.2% (n = 1,412) will accept and recommend the vaccine to their patients. The younger HCWs were more likely to endorse and recommend the vaccine to their patients. There is a moderately high COVID-19 vaccine acceptance rate among HCWs surveyed in our study. The confidence of HCWs in its use and their willingness to recommend it to their patients can provide a potentially useful element in increasing acceptance by the larger population in Nigeria.

Evaluating hand hygiene knowledge, attitudes, and practices among healthcare workers in post-pandemic H1N1 influenza control: a cross-sectional study from China.

This study evaluates the knowledge, attitudes, and practices (KAP) of hand hygiene among healthcare workers, crucial for preventing healthcare-associated infections (HAIs) in medical facilities. This cross-sectional study assessed hand hygiene KAP among healthcare workers across various settings in Hubei, China utilizing a stratified random sampling approach from, December 25, 2023-to-April 25, 2024. A bilingual electronic survey, adapted from validated tools, was disseminated via email and social media to ensure a broad reach. Participants included diverse healthcare professionals who met specific inclusion criteria. Responses were analyzed using R software, employing descriptive and inferential statistics to identify key predictors of hand hygiene behavior and to confirm the reliability of the survey instrument. The survey of 2,265 healthcare workers revealed that 77% demonstrated comprehensive knowledge of hand hygiene, 80% exhibited positive attitudes, and 94% practiced effective hand hygiene. Notable findings include a significant understanding of hand hygiene's role in preventing respiratory illnesses (58%) and HAIs (41% agreed, 39% unsure). High compliance in practices like washing hands for at least 20 s was evident (84%), though gaps in confidence about hand hygiene techniques were noted (33% confident, 56% unsure). Binary logistic regression analysis indicated that younger healthcare workers (21-30 years) were more likely to exhibit both knowledge (OR = 7.4, 95% CI = 1.44-136, p = 0.059) and positive attitudes (OR = 4.48, 95% CI = 1.73-11.8, p < 0.001) compared to other age groups. Significant associations were found between higher income levels and positive attitudes toward hand hygiene (OR for ≥80,000 = 3.19, 95% CI = 2.05-5.02, p < 0.001), and between knowledge and practices, suggesting that well-informed individuals are more likely to adhere to recommended practices. The findings reveal robust hand hygiene knowledge but uncover critical confidence gaps among healthcare workers, urging immediate, targeted educational interventions to fortify adherence and prevent infection outbreaks.

Effects of the COVID-19 pandemic on the mental health of medical students and young physicians in Germany: Gender-specific results of an online survey

BackgroundHealthcare workers and medical students faced new challenges during the COVID-19 pandemic. Processes within many hospitals were completely disrupted. In addition, the face to face teaching of medical students was drastically reduced. Those at risk of developing mental health problems appear to be younger health care workers and women. ObjectiveTo investigate potential COVID-19 pandemic-related gender differences in psychological distress among medical students and physicians in their first years of practice. Design and settingAn anonymous survey was carried out online between December 1, 2021, and March 31, 2022, at the Mannheim Medical Faculty and the Würzburg Medical Faculty, Germany, after obtaining informed consent. Primary outcome measures were changes in anxiety and depression symptoms using the Hospital Anxiety and Depression Scale (HADS), and changes in participants' current quality of life using the WHO Quality of Life BREF. ResultsThe results show wave-like courses for perceived anxiety and burden overlapping with the course of the COVID-19 incidence. In comparison to men, women showed a significant higher increase in HADS (p = 0.005) and a reduced life quality (p = 0.007) after COVID-19. Both sexes showed different frequencies of the factors influencing quality of life, with the presence of a previous mental illness and mean anxiety having a significant higher negative impact in women. ConclusionFuture and young female physicians reported a disproportionate higher burden during COVID-19 compared to their male colleges. These observations suggest an increased need for support and prevention efforts especially in this vulnerable population.

2373. "Longitudinal Investigation of Avidity Maturation following Multiple Doses of BNT162b2 mRNA Vaccine Including Bivalent Boosters among Nursing Home Residents and Healthcare Workers"

Abstract Background Increased breakthrough infections among nursing home residents (NHR) are clinically consequential despite good vaccine coverage and substantial antibody titers. While vaccination blunted severe outcomes, breakthrough infections may arise from lower vaccine-induced antibody quality. We aimed to assess vaccine-induced antibody quality among NHR and younger healthcare workers (HCW) using antibody avidity. Methods We longitudinally sampled 50 NHR and 30 HCWs, with or without prior history of COVID-19, who received the BNT162b2 mRNA vaccine at 0-14 days before, 2 weeks, and 4-6 months after each vaccine dose up to the bivalent (BV) boosters. Primary outcomes included anti-spike, anti-Receptor Binding Domain (RBD), and avidity levels to the ancestral Wuhan, Delta, and Omicron BA.1 strains determined by bead-multiplex immunoassay and ability to bind after 6M urea vs. saline incubation. Results After the primary series, anti-spike and RBD titers increased significantly to all 3 strains in both NHR and HCW. Avidity levels progressively increased across all time points up to the 3rd dose. Interestingly, this increase continued 6-8 months after vaccination suggesting that affinity maturation continues to occur for many months after the primary vaccination series. NHRs without prior infection have the poorest avidity levels to Delta and Omicron, especially before the 3rd dose. The 3rd dose raised avidity levels substantially in all groups and for all strains. Avidity levels after boosting, across the 3rd and 4th doses, demonstrate evidence of durability. Preliminary findings after BV boost show a continuation of avidity maturation with a larger impact on prior infected individuals. Wuhan Spike Avidity Avidity index of the Wuhan spike antibody across different time points among naive and prior infected individuals. Prevax- before primary series; Postvax- 2 weeks after primary series; M6- 6 months after primary series; Postboost- 2 weeks after 1st monovalent booster; M3M6postboost- 3-6months post booster; Postboost 2- 2 weeks after 2nd monovalent booster. NH- Nursing home; HCW- Healthcare Workers Omicron BA.1 spike Avidity Avidity index of the BA.1 spike antibody across different time points among naive and prior infected individuals. Prevax- before primary series; Postvax- 2 weeks after primary series; M6- 6 months after primary series; Postboost- 2 weeks after 1st monovalent booster; M3M6postboost- 3-6months post booster; Postboost 2- 2 weeks after 2nd monovalent booster. NH- Nursing home; HCW- Healthcare Workers Conclusion This study underscores the importance of booster vaccination among NHR and HCWs. The booster dose increases avidity, adding to vaccine-induced antibody functional ability. Higher avidity antibodies have higher cross-reactivity to other SARS-CoV-2 strains, as Wuhan boosting improves Delta and Omicron avidity, and should improve protection from ever-evolving strains. Higher avidities may help explain how the vaccine’s protective effects persist even while antibody titers fade between vaccine doses. Disclosures Stefan Gravenstein, MD, MPH, CDC: Grant/Research Support|Genentech: Advisor/Consultant|Genentech: Grant/Research Support|GSK: Advisor/Consultant|GSK: Honoraria|Janssen: Advisor/Consultant|Janssen: Honoraria|NIH: Grant/Research Support|Pfizer: Grant/Research Support|Pfizer: Honoraria|Sanofi: Advisor/Consultant|Sanofi: Grant/Research Support|Sanofi: Honoraria|Seqirus: Grant/Research Support|Seqirus: Honoraria David Canaday, MD, Pfizer: Grant/Research Support

Post-traumatic stress disorder symptoms among healthcare workers during the COVID-19 pandemic: Analysis of the HERO Registry

Little is known about the mental health consequences of the COVID-19 pandemic in healthcare workers (HCWs). Past literature has shown that chronic strain caused by pandemics can adversely impact a variety of mental health outcomes in HCWs. There is growing recognition of the risk of stress and loss of resilience to HCWs during the COVID-19 pandemic, although the risk of post-traumatic stress disorder (PTSD) symptoms in HCWs during the COVID-19 pandemic remains poorly understood. We wanted to understand the relationship between the COVID-19 pandemic and the risk of PTDS symptoms in HCWs during the COVID-19 pandemic. We surveyed 2038 health care workers enrolled in the Healthcare Worker Exposure Response &amp; Outcomes (HERO) study, which is a large standardized national registry of health care workers. Participants answered questions about demographics, COVID-19 exposure, job burnout, and PTSD symptoms. We characterize the burden of PTSD symptoms among HCWs, and determined the association between high PTSD symptoms and race, gender, professional role, work setting, and geographic region using multivariable regression. In a fully adjusted model, we found that older HCWs were less likely to report high PTSD symptoms compared with younger HCWs. Additionally, we found that physicians were less likely to report high PTSD symptoms compared with nurses. These data add to the growing literature on increased risks of mental health challenges to healthcare workers during the COVID-19 pandemic.

Burnout and mental health problems among health care workers during second wave of Covid-19 pandemic: A hospital based cross sectional study

Background: Large number of healthcare workers exposed to COVID-19 might be at increased risk of developing mental and psychological disorders. This study aimed to find out the prevalence of burnout, depression, anxiety and stress and its correlates. Methods: This was hospital based cross-sectional study using printed Questionnaire conducted during second wave of COVID-19. Total 96 healthcare workers participated in this study. Depression Anxiety Stress Scale (DASS-21) and Copenhagen Burnout Inventory (CBI) were used to measure study variables. Multivariable logistic regression analysis was done to determine the associate factors. Results: The symptoms of depression, anxiety and stress were found to be 31.3%, 40.6 % and 14.6 % respectively. Doctors were 5.2 and 6 fold more likely to experience anxiety and depression respectively. The prevalence of personal, work, and client-related burnout were 43.7%, 31.3% and 14.6% respectively. Younger healthcare workers (HCWs) less than 27 years were 3.5 fold more likely to develop personal burnout. Healthcare workers who had worked for more than 100 hours/week were 5 times more likely to experience personal burnout. Doctors and nurses were 7.9 and 3.5 times more likely to develop work related burnout. Personal, work and client related burnout were significantly correlated with anxiety. Conclusion: This study finds considerate proportion of burnout, depression, anxiety and stress among HCWs. Doctors and younger HCWs with increased working hours had high level of these symptoms. Early identification of mental health disorders and awareness intervention could increase the efficiency and quality of care.

Global knowledge and attitudes towards mpox (monkeypox) among healthcare workers: a systematic review and meta-analysis.

The recent increase in human mpox (monkeypox) cases emphasizes the importance of early detection, prompt response and preventive management to control the spread of the disease. Healthcare workers (HCWs) play a crucial role in this process. This study aimed to determine the global knowledge and attitudes towards mpox among HCWs. This study searched multiple databases, including Google Scholar, Scopus, PubMed/MEDLINE, Science Direct, Web of Science, Embase, Springer and ProQuest, to locate various publications. The search was limited to English-language articles published between May 2022 (when the increase in mpox incidence was reported) and August 2023. The Joanna Briggs Institute (JBI) quality checklist was utilized to evaluate the quality of the included studies. Data were obtained using a Microsoft Excel spreadsheet and subsequently scrutinized through STATA software, version 14. The heterogeneity of the studies was assessed using the inverse variance and Cochran Q statistics based on the I2 test statistics. The Dersimonian and Liard random effects models were used where heterogeneity existed. Subgroup analysis and univariate and multivariable metaregression techniques were used to examine the causes of heterogeneity. A total of 22 studies, including 22 studies for knowledge (27731 HCWs) and 6 studies for attitudes (14388 HCWs), were included in the meta-analysis. The pooled estimates for good knowledge and positive attitudes among HCWs were 26.0% (95% confidence interval [CI] 17.8 to 34.2) and 34.6% (95% CI 19.0 to 50.2), respectively. Moreover, the knowledge was 34.8% (95% CI 24.1 to 45.6) among HCWs with <5y of work experience and 41.6% (95% CI 33.1 to 50) among individuals possessing >5y of professional background. Good knowledge of HCWs is at a low level. It is suggested that training sessions should be tailored towards younger HCWs with less healthcare experience. Additionally, it is essential to identify strategies on how to improve the knowledge and attitudes for better practice about the disease in HCWs worldwide.

The third dose of measles-containing vaccine induces robust immune responses against measles in young seronegative healthcare workers who had previous two-dose measles vaccination

BackgroundDespite the low measles antibody positivity rate among young healthcare workers (HCWs) who have previously received two doses of a measles-containing vaccine (MCV), whether an additional dose of MCV acts as a booster remains unknown. Thus, we aimed to evaluate the immune responses to a third dose of MCV in young HCWs. MethodsHospital-wide measles seroprevalence was assessed using enzyme-linked immunosorbent assay (ELISA). The immunogenicity of a third dose of MCV was determined in young seronegative HCWs (born between 1986 and 1997) who had previously received a two-dose measles vaccination. ResultsA total of 3033 (92.6%) HCWs had anti-measles immunoglobulin G. The lowest seropositivity rate was observed in HCWs aged 20–24 years (87.7%). In this group, HCWs who received a third dose of MCV had higher seropositivity than those who received a second dose (89.5% vs. 75.4%). A third dose of MCV was administered to 18 HCWs who did not have anti-measles IgG despite two doses. Neutralizing antibody titers increased significantly 4 weeks after the third vaccination. Although neutralizing antibody titers decreased 1 year post vaccination, 17 (94.4%) HCWs had medium (121–900 mIU/mL) or high (>900 mIU/mL) levels. Furthermore, the third dose of MCV increased the measles virus-specific T-cell effector function. ConclusionsThe third dose of MCV induced a strong immune response against measles in young seronegative HCWs who had previously received a two-dose measles vaccination.

Seroepidemiology of measles in immune generation in Taiwan: Prevalence of neutralizing antibody and immune response to reimmunization.

Secondary vaccine failure was the principal mechanic of measles reemergence in countries with high measles vaccine coverage. The information on neutralizing antibody (nAb) prevalence, epidemiological factors of waned immunity and immune response after reimmunization was essential to measles control but largely lacking in Taiwan. The nAb and factors of wanned immunity to measles were evaluated in a cohort of 333 subjects aged 11-30 years in 2010. The longitudinal immune response to reimmunization (n=30) and potential virus exposure (n=24) were assessed in young healthcare workers (HCWs) during a hospital outbreak. The nAb titer was used to define susceptibility to measles disease (<120 mIU/mL) and infection (120-900 mIU/mL). In the 2010 cohort, the susceptibility to measles diseases and infections was respectively identified in 35 (10.5%) and 226 (67.9%) subjects. A generalized linear model identified earlier ages of first immunization in childhood (P=0.0214) and subjects aged ≥18 years (versus <18 years, P=0.0425) as significant factors associated with lower nAb titers. Reimmunization of 30 seronegative HCWs resulted in seroconversion for all, with nAb titers significantly rising on day 5, peaking on day 15 and declining in month 4 post-immunization. Similar measles-specific IgG levels were observed in 24 seropositive HCWs before and 4 months after measles contact (P=0.2352). A lack of protective immunity to measles diseases might be identified in 10% of the Taiwanese population aged 11-30 years and associated with a trend toward earlier ages of the first measles vaccination. The wanned immunity can be boosted promptly by reimmunization but with uncertain durability.