Factors associated with compliance with barrier gestures and social distancing measures in France

BACKGROUND

The COVID-19 pandemic led many countries to drastically limit social activities. The objective of this study is to describe the factors associated with compliance with protective measures and social distancing in the general adult population in France, between March and December 2020 (first and second waves of the epidemic), before vaccination began at the end of December 2020.

METHOD

The data come from the CoviPrev repeated cross-sectional descriptive survey, conducted between March 2020 and December 2022 in metropolitan France. The data collected from March to December 2020 (19 survey waves), from a panel representative of the general population, were used. Three periods were defined: the first epidemic wave (March-April), the inter-wave period (May-June) and the second epidemic wave (November-December). A compliance score was constructed to measure systematic compliance with the five main measures. The association between systematic compliance and different variables (sociodemographic, mental health, level of health literacy, perceived severity of COVID-19, confidence in government, perceived effectiveness of the measures) was described using bivariate and multivariate logistic regression models, using the statistical software R.

RESULTS

Systematic compliance with the preventive measures changed over time. Regardless of the period, being a woman, being over 50, perceiving COVID-19 as severe, having a high level of health literacy or anxiety were positively associated with compliance. Having a child under 16 years of age and perceiving the measures as effective were positively associated with compliance with the protective measures during the epidemic waves; conversely, having a high level of depression, living alone, not working were negatively associated in the first epidemic wave. Finally, during the inter-wave period, living in an area heavily affected during the first wave and having a high level of education were positively and negatively associated with systematic compliance with the preventive measures, respectively.

CONCLUSION

The factors associated with compliance with the protective measures and social distancing evolved during the epidemic. Monitoring this evolution, in order to adapt communication and awareness strategies, is essential in the context of pandemic response.

Impact of the COVID-19 pandemic on lung transplant patients and on a cohort of patients with rare lung disease: A single-center study

INTRODUCTION

Due to the COVID-19 pandemic, France underwent several lockdown periods during 2020. Our aim was to evaluate its clinical and social impact on lung transplant (LT) patients treated at Strasbourg University Hospital, by comparing three periods: first lockdown (T1: March-May 2020), end of the first lockdown (T2: May-October 2020), and second lockdown (T3: November-December 2020) and the incidence of COVID-19 infections. A cohort of patients with rare lung disease (RLD) was also studied during T2.

METHODS

We used clinical and paraclinical data collected during routine follow-up. A questionnaire was submitted to each patient at each period to assess their lifestyle, adherence to protective measures against COVID-19, contacts with their family and friends, and contagion risk. The incidence of new COVID-19 cases was also assessed.

RESULTS

Overall, 283 LT and 57 RLD patients were included. We observed only eight COVID-19 cases over the three periods (n = 4 during T1, n = 0 during T2, and n = 4 during T3) in LT patients, with 37.5 % of patients hospitalized, no ICU transfers, and 100 % favorable outcomes. No case of COVID-19 was diagnosed in the RLD cohort. When comparing the three periods in the LT group, fewer patients limited their out-of-home activities during T2 (p < 0.0001). The frequency of these activities increased after the first lockdown, for the purchase of basic necessities (p < 0.0001), and professional activity continued (p = 0.008). We observed a significant increase in unscheduled medical consultations and in the prescription of anti-infective treatments during the end of the lockdown (p = 0.0002 and p = 0.005, respectively). Adherence to lockdown and to protective measures was high in both groups of patients.

CONCLUSION

COVID-19 incidence remained low in both groups and there were significant lifestyle evolutions in LT patients and in those with RLD between first and second lockdown.

The impact of protective measures against COVID-19 on the wellbeing of residents in nursing homes and their relatives: a rapid review

During the COVID-19 pandemic and compared to other population groups, older people were at a heightened risk of developing lethal disease symptoms. Thus, many countries put in place protective measures to protect this "at-risk" population, especially in nursing homes, to limit the number of infections. These measures consisted mostly in the absence of social gatherings, the impossibility for relatives to enter the nursing homes, limitations in group activities, and the ban of group-eating. Although these measures were helpful to mitigate the spread of the disease, they also induced long periods of social isolation for the residents of nursing homes. This could have impacted the wellbeing and quality of life of residents and their relatives, with a possible impact on the overall health of residents. We designed this rapid review to investigate the literature on the impact of COVID-19 protective measures in nursing homes on the quality of life, wellbeing and physical health of residents and their relatives. Our results showed that most of the articles included in the review, either using qualitative or quantitative methods, evidenced a detrimental impact of protective measures on resident's and their relatives' wellbeing. We argue that, in the event of a new pandemic similar to the COVID-19, protective measures should also take into account their psychological impact, and not only their physical impact.

Gut microbiota and ionizing radiation-induced damage: Is there a link?

According to observational findings, ionizing radiation (IR) triggers dysbiosis of the intestinal microbiota, affecting the structural composition, function, and species of the gut microbiome and its metabolites. These modifications can further exacerbate IR-induced damage and amplify proinflammatory immune responses. Conversely, commensal bacteria and favorable metabolites can remodel the IR-disturbed gut microbial structure, promote a balance between anti-inflammatory and proinflammatory mechanisms in the body, and mitigate IR toxicity. The discovery of effective and safe remedies to prevent and treat radiation-induced injuries is vitally needed because of the proliferation of radiation toxicity threats produced by recent radiological public health disasters and increasing medical exposures. This review examines how the gut microbiota and its metabolites are linked to the processes of IR-induced harm. We highlight protective measures based on interventions with gut microbes to optimize the distress caused by IR damage to human health. We offer prospects for research in emerging and promising areas targeting the prevention and treatment of IR-induced damage.

Coping with a lack of evidence: living-donor kidney transplantation in the initial phase of the SARS-CoV-2 pandemic

Due to immunosuppressive therapy, transplant patients are more susceptible to viral and bacterial infections. A potentially deadly new virus haunted us in 2020: SARS-CoV‑2, causing coronavirus disease 19 (COVID-19). We analyzed the consequences of this previously unknown risk for our living-donor transplant program in the first year of the pandemic. After the complete lockdown in spring 2020, our transplant center in Linz resumed the living-donor kidney transplantation program from June to September 2020, between the first and second waves of COVID-19 in Austria. We compared the outcomes of these living-donor kidney transplantations with the transplant outcomes of the corresponding periods of the three previous years. From June 4 to September 9, 2020, five living-donor kidney transplantations were performed. All donors and recipients were screened for COVID 19 infection by PCR testing the day before surgery. Kidney transplant recipients remained isolated in single rooms until discharge from hospital. All recipients and donors remained SARS-CoV‑2 negative during the follow-up of 10 months and have been fully vaccinated to date. The number of living transplants in the studied period of 2020 was constant compared to the same months of 2017, 2018, and 2019. Living-donor kidney transplantation can be continued using testing for SARS-CoV‑2 and meticulous hygienic precautions in epidemiologically favorable phases of the SARS-CoV‑2 pandemic. Donors and recipients should be carefully selected and informed about risks and benefits.

Hygiene knowledge and practices and determinants of occupational safety among waste and sanitation workers in Bangladesh during the COVID-19 pandemic

Waste and sanitation workers provide essential services to society. In most low-and middle-income countries, they are often mistreated and lack access to necessary personal protective equipment (PPE) and hygiene facilities that ensure occupational safety in workplaces. COVID-19 has also imposed serious health risks upon these worker groups. This study explores factors associated with poor occupational health and safety based on a conceptual framework. We conducted 499 surveys with five categories of waste and sanitation workers across ten cities in Bangladesh. We performed descriptive analysis and used Firth's logistic regression model following the conceptual framework. The analysis revealed consistent distinctions between workers considered to be in "safe" versus "unsafe" working conditions. The result showed that workers had not been adequately trained, not provided with proper equipment, and many had an informal status that prevented access to hygiene facilities. The workers who received occupational training, knew how to prevent COVID-19 by wearing a face mask, hand washing, and maintaining social distance, maintained protective measures, and practiced proper disposing of PPEs were more likely to be in safe condition. Initiatives to improve the situation of the waste workers who work in unsafe work conditions are still inadequate. Therefore, we recommend supplying proper protective equipment, ensuring a regular supply of gender-specific PPEs, and providing functional facilities necessary to practice personal hygiene and occupational safety, such as handwashing stations, changing rooms, and disposal facilities of used PPEs at the workplace. We also urge increased institutional management procedures, infrastructure that facilitates hygiene practices, and social policies to reduce occupational hazards for the waste workers in Bangladesh during and beyond the COVID-19 pandemic.

Personal Protective Measures during the COVID-19 Pandemic in Germany

OBJECTIVES

The coronavirus SARS-CoV-2 is highly contagious and can only be contained if the majority of the population takes measures to protect themselves against infection. The present study aimed to investigate personal protective measures, their development over the course of the pandemic in Germany, and potential differences in behavior in terms of sex, age, and education.

METHODS

Data from 20 waves of the serial cross-sectional study "BfR-Corona-Monitor" were analyzed. The total sample consisted of N = 20,317 respondents (about 1000 per wave). Data were collected through telephone surveys between June 2020 and March 2021.

RESULTS

To protect themselves from infection, participants primarily relied on wearing covers for mouth and nose, keeping their distance from other individuals, and washing their hands thoroughly. Analyses over time showed a strong positive correlation between the number of measures taken and the national incidence rate. Sociodemographic differences also emerged, with women and those who are higher educated as well as younger respondents taking a higher number of protective measures.

CONCLUSIONS

Our results indicated that in times of greater infection risks, individuals adapted accordingly and took more protective measures. However, on the basis of sociodemographic differences, campaigns should especially focus on older individuals, the male sex, and those with lower education to enhance their protective behavior.

Legal restrictions and mitigation strategies amongst a disabled population during COVID-19

The impact of physical disability on protective behaviors during COVID-19 has been little studied. This retrospective study compared the 699 the self-declared behaviors of 699 people with disabilities before and after the relaxation of COVID-19 restrictions in England. We found that people with disabilities in England showed high compliance with protective behaviors and mitigation strategies during a period of legal restrictions. Following the lifting of restrictions, respondents engaged in less social mixing, fewer distancing and hygiene behaviors and were less likely to use face coverings. Hierarchical regressions revealed that socio-economic status, age, and gender moderated protective behaviors: while those with higher socio-economic status were more relaxed with regard to hygiene and distancing behaviors, they were more cautious about mixing with others after the end of restrictions. Age, (male) gender, and being unvaccinated were positively associated with relaxation in the use of facemasks in public places, not needing a carer with fewer out-of-home visits. Taken together these findings suggest that the removal of restrictions had an unequal impact on the population of England, placing a disproportionate burden on some people with disabilities.

Ensuring the business continuity of production companies in conditions of COVID-19 pandemic in Poland - Applied measures analysis

The purpose of the paper is to present the results of the study of solutions implemented in Polish manufacturing companies to ensure their business continuity under COVID-19 pandemic conditions. A questionnaire survey was conducted using the mixed-model CAWI/CATI (Computer Assisted Web Interview/Computer Assisted Telephone Interview) on a representative group of 600 manufacturing companies in Poland. The research was conducted in March 2021, more than a year after the first lockdown. The study included cases of companies in most industries and companies of different sizes. The subject of the survey was to identify legal, technical, and organisational protection measures implemented in manufacturing enterprises in response to the COVID-19 pandemic in manufacturing companies in Poland. The COVID-19 pandemic has forced companies to look for solutions to work safely. Some of the identified work and production organisation solutions are innovative and can serve as models of good practice for other companies. They can also be the basis for learning lessons and preparing for future critical incidents. It is a great economic and social importance to ensure the continuity of the activities of manufacturing enterprises during the pandemic.

Assessing customer financial risk perception and attitude in the hotel industry: Exploring the role of protective measures against COVID-19

The COVID-19 pandemic has lead authorities from many countries to adopt crucial protective measures such as wearing face masks, lockdowns and social distancing. The purpose of the present study was to explore the relationships among the protective measures against virus handled by hotels with financial risk perception, customer attitude, satisfaction and behavioral intention. The study also calculates the mean comparison across the demographic variables of hotel customer satisfaction and behavioral intention. Results reported a significant contribution of the protective measures implemented by Chinese hotels against COVID-19 on financial risk perception, and a customer attitude. It also demonstrates significant and positive interaction with customer satisfaction and behavioral intention. However, financial risk perception and customer attitude did not show effects on satisfaction, while they had effects on behavioral intention. The results suggest that protective measures are an important aspect of encouraging people to visit hotels safely and continually.

Perceptions and practices of COVID-19 protective measures among the general public of North India

Background

India has a high COVID-19 burden. The Indian government responded to the pandemic by mandating its population to adhere to certain Protective Measures (PMs). Compliance to these PMs depends on their acceptability and adaptability among the general public.

Aims

To explore the perceptions and practices of COVID-19 related PMs among the general public of North India.

Methods

Qualitative study in four administrative districts (Lucknow, Etawah, Patna and Darbhanga) of North India. Two urban and two rural districts were purposefully selected. Audio in-depth interviews (IDIs) were conducted with healthy caregivers of children (2–59 months). Data was managed using Atlast Ti and analyzed using conventional content analysis.

Results

From July–Sep 2020, 60 IDIs were conducted; 36.6% (22/60) were females and 26.6% (16/60) had below primary education. Respondents concurred that most people in their society flouted the recommended PMs. The reasons for poor/non-compliance with PMs were: perceived poor susceptibility to illness, perceived less severity of COVID-19 and low perceived benefits of complying with the PMs. Respondents opined that COVID-19 is less prevalent in rural areas and among the educated population. Most respondents were aware of the recommended PMs and opined that these must be followed, however subjective norms, social norms and behavioral intentions negatively impacted compliance.

Conclusions

Since there was poor community perception of susceptibility to COVID-19 as well as poor perceived severity, the community did not understand the benefits of adhering to the recommended PMs. Therefore, future health communication strategies must take these into account to increase the possibility of success.

Dark Tetrad and COVID-19 protective measures: Mediating effects of risk-taking tendencies

Previous research has shown that Dark Triad traits are tied to non-compliance, while there is not enough research regarding sadism. As dark traits are related to risk-taking behaviors, we hypothesized that proneness to risk-taking could be a mediating mechanism explaining the relation between dark traits and non-compliance with protective measures. Sample comprised of 348 participants (77% women) who completed the Hateful Eight (a multifaceted Short Dark Tetrad scale), DOSPERT for measuring different aspects of risk-taking tendencies, and questions regarding frequency of compliance with protection measures and vaccination. Results showed that recklessness (aspect of psychopathy) and violent voyeurism (aspect of sadism) had negative effects on compliance with protective measures. These relations were fully explained by health/safety risk tendency. Deviousness (aspect of Machiavellianism) contributed to unwillingness to vaccinate against COVID-19 independently of risk-taking tendencies. Furthermore, selection of particular vaccine was not associated with dark traits, but those who selected all vaccines (both EU-approved and non-approved) had higher scores on social risks compared to those who selected only non-approved vaccines. Additionally, those who selected only EU-approved vaccines showed lower scores on ethical risks compared to the rest of the participants who were vaccinated or applied for vaccination.

A cross-sectional survey on community pharmacists readiness to fight COVID-19 in a developing country: knowledge, attitude, and practice in Lebanon

BACKGROUND

Lebanon, a developing Middle Eastern country, was hit by the COVID-19 pandemic that occurred amid a severe national economic crisis. Community pharmacists are responsible for dispensing appropriate medications and products in addition to counseling, informing and educating the public, and promoting disease prevention and infection control.

OBJECTIVE

This study aimed to assess community pharmacists' knowledge, attitude, and practice towards the COVID-19 pandemic and evaluate behavior changes and safety measures.

METHODS

An anonymous and standardized online questionnaire in English was disseminated via social media platforms to Lebanese community pharmacists. The questionnaire consisted of 95 items designed as Likert-scales and multiple-choice questions divided into four different sections: socio-demographic characteristics, knowledge-based, attitude-based, and pharmacy practice questions. Descriptive statistical analysis was used to summarize the demographic characteristics, and indices were created for knowledge, attitude, and practice by computing the correct answers for each section.

RESULTS

A total of 310 questionnaires were completed. Around 61% have expressed their fear of getting infected with COVID-19 due to occupational exposure. The respondents were able to answer 80-90% of the knowledge-based questions of the survey. A more careful/anxious attitude, but not knowledge, was associated with overall better practice (p = 0.03). Also, respondents stated that they are dispensing protective equipment items such as masks (87%), gloves (60%), and sanitizers (77%) in small quantities due to limited availability.

CONCLUSION

Our findings revealed an adequate level of knowledge and good practice towards COVID-19 among Lebanese community pharmacists. Their fears of contracting the virus and compromising the safety of those around them are justified. However, their supply of protective equipment is limited.

Coronavirus 2019-like illness and public adherence to preventive measures, Sudan 2020

INTRODUCTION

In December 2019, a novel corona virus disease was identified and was responsible for the new cases of respiratory tract infections in Wuhan, China. This virus was responsible for the pandemic with more than 84 million cases and 1.82 million deaths worldwide. In Sudan till now the reported cases exceed 23,000 with 1.400 deaths. This study aims to determine the prevalence of COVID-19 suspected cases, health seeking behavior and public adherence to protective measures.

METHODS

Descriptive community based cross-sectional study using nonprobability snowball sampling technique, conducted in Khartoum state 2020. 3499 respondents with diverse socio-demographic backgrounds were finally enrolled in the study. Data was collected through Manitoba Coronavirus 2019 screening form which distributed through online anonymous Google forms. Data was entered and analyzed by Statistical Package of Social Sciences version 23.

RESULTS

The study revealed that 26.5% of the respondents were clinically suspected with headache or fatigability being the most common symptom followed by pharyngitis and then dry cough. Asthma and chronic respiratory disease as the commonest comorbidities. Wearing facial masks and regular hand washing were found to be the most used protective measures with only 39.4% implicates social distancing in their daily life. Health seeking behavior was significantly different among suspected respondents the majority tend to use antibiotics than to isolate themselves or undergo testing.

CONCLUSION

COVID-19 suspected cases were prevalent among Sudanese population; screening capacity has to be increased with more strong policies for implications of personal protective measures in the daily life.

Obtaining Information From Different Sources Matters During the COVID-19 Pandemic

Background and Objectives

Older adults might be less information-seeking in comparison to younger adults. Yet, when a crisis hits, rather than relying on only a few information sources, it is important for people to gather information from a variety of different sources. With more information sources, people are more likely to obtain a more realistic perception of the situation and engagement of health behaviors. This study examined the association between age and information-seeking patterns, and how information-seeking patterns influenced worry about Coronavirus Disease 2019 (COVID-19) and protective measures taken during the pandemic.

Research Design and Methods

This study was conducted from March to May 2020. Ninety younger adults and 105 older adults were recruited in a 21-day daily diary study. Participants reported the types of sources where they received COVID-19-related information, worry from these information sources and protective health behaviors performed each day. Multilevel serial mediation analysis was performed.

Results

Concurrent and time-lagged analyses both revealed that older adults received information from more sources, and more frequently from traditional (e.g., newspaper and TV) and interpersonal sources (e.g., information shared by friends and families), than did younger adults. When receiving information from more sources, older adults were more worried about COVID-19 and performed more protective health behaviors.

Discussion and Implications

These results demonstrated the utility of having more information sources in the context of a public health crisis and offered suggestions for future public communication and community engagement.

COVID-19 infection rate among tertiary referral center otorhinolaryngology healthcare workers

Importance

Otorhinolaryngology is considered one of the medical specialties with a high risk for exposure to corona disease 2019 (COVID-19). Uncontrolled transmission in a hospital department poses a risk to both healthcare workers (HCWs) and patients.

Objective

To monitor SARS-CoV-2 incidence, transmission, and antibody development among HCWs to identify high risk procedures, pathways, and work areas within the department.

Methods

Prospective cohort study of HCWs using repetitive oro- and nasopharygeal swab samples, antibody tests, and self-reported symptoms questionnaires at a tertiary referral center in Copenhagen, Denmark.

Results

347/361 (96%) HCWs participated. Seven (1.9%) were positive on swab tests and none had symptoms. Fifteen (4.2%) developed antibodies. Only one case of potential transmission between HCWs was identified. Infection rates were low and no procedures or areas within the department were identified as exposing HCWs to a higher risk.

Conclusions and relevance

Adherence to the surveillance program was high. The low incidence among HCW during the first wave of the COVID-19 pandemic may reflect local transmission and infection control precautions, as well as a low infectious burden in the Danish society.

Side effect of a 6 p.m curfew for preventing the spread of SARS-CoV-2: A modeling study from Toulouse, France

The spread of SARS-CoV-2 and the resulting disease Covid-19 has killed over 2 million people as of January 22, 2021. We have designed a model and used it to quantify the effect of a 6 p.m curfew on the SARS-CoV-2 epidemic in Toulouse, France. The data show that this measure can lead to the opposite effect from that intended due to larger groups of people on the authorized hours.

The effect of risk communication on preventive and protective Behaviours during the COVID-19 outbreak: mediating role of risk perception

BACKGROUND

The COVID-19 outbreak is a global pandemic, during which the community preventive and protective behaviors play a crucial role in the containment and control of infection. This study was designed to contribute to the existing knowledge on how risk communication (RC) and risk perception (RP) affect protective and preventive behaviors (PPB) during the COVID-19 outbreak.

METHODS

The required data were extracted from a national online survey of Iranian adults aged 15 and older during March 15-19, 2020 (n=3213). Data analysis was performed using structural equation modeling.

RESULTS

The study findings reveal that RC has direct and indirect positive effects on PB. Furthermore, this study also provides new evidence indicating that RP mediates the relationship between RC and PB and there is a two-way relationship between RC and RP. These interactions may have impact on risk communication strategies which should be adopted during this pandemic.

CONCLUSION

The study findings have remarkable implications for informing future communications as well as interventions during this ongoing outbreak and subsequent national risk events.

The Relationships Between Control Measures and Absenteeism in the Context of Internal Control

Background

The study tries to show the effect of Occupational Health and Safety (OHS) legislation implemented via plan-do-check-act methodology on accident and sickness absenteeism.

Methods

The data for the study gathered via a questionnaire from a large-sized organization operates in production and maintenance of passenger coaches in February–March 2019 in Turkey. The data analyzed via structural equation model analysis.

Results

The results showed that there are statistically meaningful relationships between OHS protective measures, training and informing of employees, and employee participation and accident and sickness absenteeism. In addition, a meaningful relationship between internal control and accident and sickness absenteeism was determined. Statistically meaningful relationships between emergency measures, and health surveillance and internal control, and accident and sickness absenteeism could not be determined.

Conclusion

It is concluded that the actions implemented by organizations to reduce absenteeism should be as per OHS legislation.

[The ESC recommendations for COVID-19-no guideline, but a learning guidance]

„No guideline but guidance“ ist das Motto dieses Leitfadens der European Society of Cardiology (ESC), der als lernende Orientierungshilfe für Ärzte in der Coronapandemie konzipiert ist. 62 europäische Kardiologen haben als Autoren und 29 weitere Experten als Reviewer zu dem 119 Seiten starken Dokument beigetragen. Der Leitfaden ist geprägt von einer vorsichtigen Strategie im Umgang mit einer Pandemie, von der vieles noch nicht bekannt ist. Er beschränkt sich bewusst auf kardiovaskuläre Erkrankungen. In seiner letzten Fassung vom 10. Juni 2020 gibt er zahlreiche praktische Anleitungen zur kardiovaskulären Diagnostik und Therapie unter Pandemiebedingungen. Die Empfehlungen sind oft redundante Rückgriffe auf die bekannten Leitlinien der ESC. Informativ, aber in Teilen ergänzungsbedürftig sind die Abschnitte zur Pathophysiologie und zu den Pathomechanismen, über die SARS-CoV‑2 („severe acute respiratory syndrome coronavirus 2“) spezifisch auf das Herz-Kreislauf-System wirken dürfte. Kontraproduktiv ist die Empfehlung, auf pathohistologische und molekulare Untersuchungen von Gewebe betroffener oder verstorbener Patienten zu verzichten. Den hohen Ansprüchen an einen sich immer wieder ergänzenden Leitfaden genügt die letzte verfügbare Fassung dennoch in weiten Teilen. Sie benötigt aber eine baldige Aktualisierung, wenn sie ihren Ambitionen gerecht werden will.

Protective measures undertaken during chest tube thoracostomy in COVID-19 outbreak

Background

Coronavirus disease 2019 (COVID-19) is a newly emerging infectious disease that was first reported in China and has become a worldwide pandemic. Many surgical procedures are continuing to be performed during this state of pandemic as is thoracic surgery. We present six cases of tube thoracostomy in COVID-19 patients and the modifications to the routine surgical technique.

Methods

We serially attached two closed underwater drainage systems (CUDS) together and added a high-efficiency particulate air (HEPA) filter to the port of the second CUDS, because the intrapleural air, which passes through the CUDS into the air in intensive care unit (ICU), may contain high concentrations of 2019 novel coronavirus (2019-nCoV). Second, we attached the chest drain to the first CUDS in order to prevent the spread of virus during the placement of drain into the pleural cavity. Third, just before opening the parietal pleura, ventilation was put on standby mode and the endotracheal tube was clamped to prevent viral dissemination to the environment. Fourth, we covered the incision with a gauze sponge soaked with sterile saline solution during pleural entry, to prevent viral dissemination into the environment.

Results

There were a total of six patients enrolled in our study. All these patients were diagnosed with COVID-19. The surgical indication for the chest tube thoracostomy was tension pneumothorax in all six patents. All patients had lung expansion defects and subcutaneous emphysema after intervention. Unfortunately, all of them succumbed to COVID-19, despite best available treatment. There was no COVID-19 infection reported in the healthcare professionals during this study.

Conclusions

Thoracic surgical procedures may cause dissemination of high amounts of 2019-nCoV in the environment and thus are perhaps the most dangerous surgeries to perform. Variations in the thoracic surgical techniques are necessary in order to protect the healthcare providers from COVID-19.

COVID-19 pandemic and dental hygienists in Italy: a questionnaire survey

OBJECTIVE

This online cross-sectional survey assesses the signs/symptoms, the protective measures taken and the awareness and risk perception regarding COVID-19 among Italian dental hygienists. All Italian dental hygienists were invited to participate. The ad hoc online questionnaire was divided into four domains: personal data, protective measures (-before patient arrival; -in the waiting room; -in the operating room) and PPE, awareness and risk perception.

RESULTS

Two-thousand-seven-hundred-ninety-eight subjects participated. Only 0.25% of the sample was positive to the virus. Sense of fatigue (8.19%), headache (7.81%) and sore throat (7.32%) were the most common symptoms. A statistically significant trend across the areas with a different prevalence of COVID-19 was observed related to the number of signs/symptoms (areas z = 6.38 p < 0.01). Overall, 90.55% of the sample used protective glasses or visor, 90.10% disposable gloves and 82.80% surgical mask. Regarding the confidence to avoid the infection, a statistically significant difference was found among dental hygienists belonging to the 3 years-professional-experiences groups who worked in the high COVID-19 prevalence area. The findings of this survey show that Italian dental hygienists have modified their working habits according to the professional risk related to the current pandemic and they seem correctly prepared to face the risk of a SARS-CoV-2 infection.

Quantifying the impact of public health protection measures on the spread of SARS-CoV-2

The new virus, SARS-CoV-2, has probably affected millions of people world-wide since December 2019 and killed thousand. We have designed a model and used it to quantify the effect of local protective measures on the SARS-CoV-2 epidemic, assess their effectiveness and adapt health service strategies in Toulouse, France.

Post COVID-19 lockdown: measures and practices for dental institutes

Resuming regular clinical activities at dental premises after the COVID-19 lockdown period or post COVID-19 is likely to be a challenge for all dental institutes. When returning to the dental practice or training, staff and students alike should abide by the new rules and regulations. In the process of controlling viral spread, clinical dental facilities face a higher risk of disease transmission among patients as well as clinical and non-clinical staff. Aerosols formation and diffusion into the surrounding air can be a real concern of viral transmission, if no protective measures are established. We aim in this review to present the currently implemented measures and propose changes in clinical dental facilities to minimize the risk of transmission. Dental professionals should be prepared to treat every patient as a suspected COVID-19 carrier and be ready to receive and manage an overwhelming number of patients. We suggest that dental practices establish a sensible workforce shift schedule, improve ventilation levels, reduce dental aerosol generating procedures, and develop a comprehensive guidance to Healthcare Workers to reduce the risk of COVID-19 transmission.

Aedes (Stegomyia) aegypti mosquito bite hypersensitivity in a dog: a case report

BACKGROUND

Mosquitoes are vectors of several pathogens of considerable importance to humans and companion animals, including nematode helminths such as Dirofilaria immitis and Dirofilaria repens that cause heartworm disease and subcutaneous dirofilariosis, respectively. In addition to mosquito-borne pathogen transmission, mosquito bites can cause discomfort and irritation in pets, and even lead to severe hypersensitivity reactions. In the present study, we report an acute local hypersensitivity reaction in a dog following experimental exposure to Aedes (Stegomyia) aegypti.

CASE PRESENTATION

A healthy six-year-old male beagle was included in an efficacy study in which dogs (n = 28) were exposed to Ae. aegypti mosquitoes. On Day - 6, the dog was allocated to one of the study groups, consisting of seven dogs to be treated on Day 0 with an imidacloprid/flumethrin collar. After sedation, animals were exposed to approximately 50 females of Ae. aegypti for 60 (± 5) minutes on Days - 6, 1, 7, 14, 21, 28, 55, and 83. On Day - 6, no allergic reaction to the mosquito bites was observed. However, on Day 1, corresponding to the second challenge, the dog demonstrated an acute allergic reaction characterized by swelling of the face (especially in the base of the muzzle and around the eyes), redness of the eyes, and conjunctival edema of the right eye was also observed. The dog was immediately treated with an intramuscular injection of a commercially available antihistamine treatment, Pen-Hista-Strep® containing a suspension of benzylpenicillin, chlorphenamine, dexamethasone, dihydrostreptomycin, and procaine at a dosage of 1 mL per 10 kg. A few hours after treatment, the dog showed noticeable improvement.

CONCLUSIONS

This case provides the first evidence of canine acute local hypersensitivity reaction to mosquito bites under laboratory conditions. This observation suggests that invasive mosquito species such as Aedes spp. may affect the health and comfort of our companion animals, especially for pets with outdoor access without individual protective measures against insect bites.

Impact of COVID-19 pandemic on radiographers in the Republic of Cyprus. A questionnaire survey

INTRODUCTION

Imaging is essential for the initial diagnosis and monitoring of the novel coronavirus, which emerged in Wuhan, China. This study aims to assess the insight of radiographers on how the COVID-19 pandemic has affected their work routine and if protective measures are applied.

METHOD

A prospective observational study was conducted among radiographers registered in the Cyprus Society of Registered Radiologic Technologists & Radiation Therapy Technologists. A questionnaire composed of 28 multiple choice questions was utilised, and the data analysis was performed using SPSS software with the statistical significance assumed as p-value < 0.05.

RESULTS

Out of 350 registered radiographers, 101 responses were received. The results showed that there are statistically significant differences regarding the working hours, the feeling of stress, the work effectiveness, the average examination time, the presence of a protocol used among the different workplaces of the participants; a private radiology centre, a private hospital or a public hospital, with a p-value 0.0022, 0.015, 0.027, 0.001, 0.0001 respectively. Also, statistically significant differences were observed in the decontamination methods used for equipment (p-value 0.007), for air (p-value 0.04) and when decontamination takes place (p-value 0.00032) among the different workplaces of the participants. Nonetheless, the majority of radiographers believe that their workplace is sufficiently provided with PPE, cleaning supplies, equipment, and with cleaning personnel and are optimistic regarding the adequacy of these provisions in the next three months.

CONCLUSION

This study showed that in the Republic of Cyprus, there are protocols regarding protective measures against COVID-19, and the radiographers are adequately trained on how to face an infectious disease outbreak. However, work is needed in order to develop protocols that reassure the safety of patients and medical personnel while managing the excess workload effectively.

IMPLICATIONS FOR PRACTICE

This study indicates the importance of applying protective measures and protocols in the radiology departments in order to minimise the spread of the virus.

Safety and efficacy of tracheotomy for critically ill patients with coronavirus disease 2019 (COVID-19) in Wuhan: a case series of 14 patients

OBJECTIVES

Coronavirus disease 2019 (COVID-19) is a global pandemic. Critically ill patients often require prolonged intubation for mechanical ventilation to support breathing; thus, the artificial airway must be managed by tracheotomy. Therefore, studies exploring appropriate and safe methods for tracheotomy that minimize the risks of nosocomial transmission are important.

METHODS

A retrospective analysis of the clinical characteristics of 14 critically ill patients with COVID-19, who underwent bedside tracheotomy from March to April 2020 was conducted to summarize the indications for tracheotomy and key points related to personal protective equipment and surgical procedures.

RESULTS

All 14 patients were diagnosed with COVID-19 and were critically ill. All tracheotomies were performed in the late phase of the infection course. The interval between the infection and tracheotomy was 33 days, and the median interval between intubation and tracheotomy was 25.5 days. The reverse transcription-polymerase chain reaction results of secretions from the operative incision and inside the tracheotomy tube were negative. Twelve patients improved after tracheotomy, with SpO₂ levels maintained above 96%. One patient died of progressive respiratory failure; another patient died of uncontrolled septic shock. No medical staff who participated in the tracheotomy was infected.

CONCLUSIONS

Tracheotomy in critically ill patients with COVID-19 who meet the indications for tracheotomy potentially represents a safer approach to manage the airway and help improve the treatment outcomes. A tracheotomy performed in the late phase of the disease has a relatively low risk of infection. Adherence to key steps in the tracheotomy procedure and donning adequate personal protection will help medical staff avoid infection.

Facing the 2020 pandemic: What does cyberbiosecurity want us to know to safeguard the future?

As the entire world is under the grip of the coronavirus disease 2019 (COVID-19), and as many are eagerly trying to explain the origins of the virus and cause of the pandemic, it is imperative to place more attention on related potential biosafety risks. Biology and biotechnology have changed dramatically during the last ten years or so. Their reliance on digitization, automation, and their cyber-overlaps have created new vulnerabilities for unintended consequences and potentials for intended exploitation that are mostly under-appreciated. This study summarizes and elaborates on these new cyberbiosecurity challenges, (1) in terms of comprehending the evolving threat landscape and determining new risk potentials, (2) in developing adequate safeguarding measures, their validation and implementation, and (3) specific critical risks and consequences, many of them unique to the life-sciences. Drawing other's expertise and my previous work, this article reviews and critically interprets our current bio-economy situation. The goal is not to attribute causative aspects of past biosafety or biosecurity events, but to highlight the fact that the bioeconomy harbors unique features that have to be more critically assessed for their potential to unintentionally cause harm to human health or environment, or to be re-tasked with an intention to cause harm. It is concluded with recommendations that will need to be considered to help ensure converging and emerging biorisk challenges, in order to minimize vulnerabilities to the life-science enterprise, public health, and national security.

COVID-19 Pandemic's precautionary measures had hit the reset button of the quality of life at different aspects

COVID-19 is a novel coronavirus that emerged in Wuhan-China during the last quarter in 2019 and caused an infectious respiratory disease pandemic. The strategy of "Attack and Defend" was attempted to mitigate COVID-19 crisis worldwide. A list of precautionary measures were set by healthcare professional experts to protect public from infection, social physical distancing measures being the most efficient. On the other hand, Occupational Safety and Health Administration (OSHA) has established protective guidelines for healthcare workers to guarantee a healthy workplace and safe environment. The physical distancing measures have obviously reshaped the relationship between family members leading to better quality of family life. Meanwhile, travel suspension also led to slightly higher health standards with less air pollution, lower traffic induced stress levels and subsequently a greener footprint. Herein, we intend to highlight the impact of COVID-19 pandemic protective measures on family connections, as well as on environmental health. Moreover, we aimed at pointing out the effect on Saudi Arabian cultural and humanitarian behavior in dealing with the pandemic under the governance care of the custodian of the two holy mosques; King Salman Al-Saud. In fact, a combination of restrictive and protective measures is the most efficient to curb COVID-19 spread. In addition to improving the quality of social life, this pandemic revealed a healthier climate, which will certainly be visible on a large scale. Certainly, all together with solidarity we will be able to restrain COVID-19 pandemic and have a better quality of life.

[Interdisciplinary multimodal pain therapy under the protective measures of the COVID-19 pandemic : Analysis and progress report]

Aufgrund der COVID-19-Pandemie mussten elektive medizinische Leistungen auf ein Minimum reduziert werden, wovon auch die schmerzmedizinische Versorgung betroffen war. Nach diesen drastischen Einschnitten steht nun eine vorsichtige Wiederaufnahme der elektiven Versorgungen an. Dies betrifft auch die Durchführung von stationären und teilstationären interdisziplinären multimodalen Schmerztherapien (IMST). Nachdem bis dato der Großteil der schmerzmedizinischen Einrichtungen geschlossen hat, stellte sich die Frage, ob unter den geforderten Schutzmaßnahmen eine Wiederaufnahme des Regelbetriebs problemlos umsetzbar ist. Um diese Fragestellung zu beantworten führten wir eine Patientenbefragung bei Patienten durch, die einen direkten Vergleich ziehen konnten zwischen einer IMST unter Normalbedingungen und unter den aktuell benötigten Schutzmaßnahmen. Die Umfrage erfasste dabei den Beeinträchtigungsgrad der unterschiedlichen Schutzmaßnahmen bei den verschiedenen Therapiebausteinen. Die Auswertung der Fragebögen von zwei Patientengruppen sowie aller beteiligten Therapeuten ergab, dass eine interdisziplinäre multimodale Schmerztherapie auch unter den benötigten Schutzmaßnahmen ohne größere Einschränkungen möglich ist. Insbesondere das Tragen einer Mund-Nasen-Schutzmaske erwies sich als die am stärksten beeinträchtigende Schutzmaßnahme. Durch Optionen wie die Verwendung einer Schutzscheibe oder die Verlegung der Therapiebausteine ins Freie stehen aber praktikable Schutzalternativen zur Verfügung. Die Zufriedenheit sowohl von Patienten als auch von Therapeuten war trotz dieser Einschränkungen groß und die persönliche Sorge vor einer möglichen Infektion gering.

The impact of novel coronavirus SARS-CoV-2 among healthcare workers in hospitals: An aerial overview

The ongoing outbreak of COVID-19, caused by the novel coronavirus SARS-CoV-2, places healthcare workers at an increased risk of infection as they are in close contact with patients. In this article, we report an overview of cases of infected healthcare workers in China and Italy during the early periods of the COVID-19 epidemic. China's coronavirus response highlights the importance of implementing effective public health strategies. The authorities worldwide therefore, need to be extremely cautious when they implement stringent protective measures that safeguard healthcare workers in hospitals and counteract the threats created by the pandemic

[Application of tracheotomy in the treatment of severe cases of COVID-19]

Objective: To discuss the the effects, indications and protective measures of tracheotomy for severe cases of coronavirus disease 2019 (COVID-19) patients. Methods: A retrospectively analysis was conducted to explore the clinical data of COVID-19 patients who received tracheotomy in February to March 2020, and descriptive statistics were used to analyze the indication of tracheotomy, particularity of intraoperative treatment and protective measures. Results: A total of 4 cases were included in this article. All patients were successfully operated. One case had postoperative incision continuous bleeding, there were not other complications and nosocomial infection among the medical staff. The patient's condition was relieved in different degrees after the operation, who remained hospitalized. Conclusion: Tracheotomy for severe cases of COVID-19 can achieve certain curative effect, but the occurrence of tracheotomy related complications and nosocomial infection should be effectively controlled, and the risk benefit ratio of tracheotomy should be carefully weighed before surgery.

Changes in implementation of personal protective measures by ordinary Japanese citizens: A longitudinal study from the early phase to the community transmission phase of the COVID-19 outbreak

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Improvement in personal protective measures since early phase of COVID-19 outbreak.

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The prevalence of avoiding touching the eyes, nose, and mouth is still low.

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Fewer men and fewer low-income households have altered their behavior.

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Self-isolation seems difficult for people with low income levels.

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There remains room for improvement in personal protective measures by citizens.

Objectives

To clarify changes in the implementation of personal protective measures among ordinary Japanese citizens from the early phase of the COVID-19 outbreak to the community transmission phase.

Methods

This longitudinal, internet-based survey included 2141 people (50.8% men; 20–79 years). The baseline and follow-up surveys were conducted from February 25–27, 2020, and April 1–6, 2020, respectively. Participants were asked how often they implemented the five personal protective measures recommended by the World Health Organization (hand hygiene, social distancing, avoiding touching the eyes, nose and mouth, respiratory etiquette, and self-isolation) in the baseline and follow-up surveys.

Results

Three of the five personal protective measures’ availability significantly improved during the community transmission phase compared to the early phase. Social distancing measures showed significant improvement, from 67.4% to 82.2%. However, the prevalence of avoiding touching the eyes, nose, and mouth, which had the lowest prevalence in the early phase, showed no significant improvement (approximately 60%). Multivariate logistic regression analysis revealed that men and persons of low-income households made fewer improvements than women and persons of high-income households.

Conclusions

The availability of personal protective measures by ordinary citizens is improving; however, there is potential for improvement, especially concerning avoiding touching eyes, nose, and mouth.

Respiratory Care Committee of Chinese Thoracic Society. [Expert consensus on preventing nosocomial transmission during respiratory care for critically ill patients infected by 2019 novel coronavirus pneumonia]

Definite evidence has shown that the novel coronavirus (COVID-19) could be transmitted from person to person, so far more than 1 700 bedside clinicians have been infected. A lot of respiratory treatments for critically ill patients are deemed as high-risk factors for nosocomial transmission, such as intubation, manual ventilation by resuscitator, noninvasive ventilation, high-flow nasal cannula, bronchoscopy examination, suction and patient transportation, etc, due to its high possibility to cause or worsen the spread of the virus. As such, we developed this consensus recommendations on all those high-risk treatments, based on the current evidence as well as the resource limitation in some areas, with the aim to reduce the nosocomial transmission and optimize the treatment for the COVID-19 pneumonia patients. Those recommendations include: (1)Standard prevention and protection, and patient isolation; (2)Patient wearing mask during HFNC treatment; (3)Using dual limb ventilator with filters placed at the ventilator outlets, or using heat-moisture exchanger (HME) instead of heated humidification in single limb ventilator with HME placed between exhalation port and mask; avoid using mask with exhalation port on the mask; (4)Placing filter between resuscitator and mask or artificial airway; (5)For spontaneous breathing patients, placing mask for patients during bronchoscopy examination; for patients receiving noninvasive ventilation, using the special mask with bronchoscopy port to perform bronchoscopy; (6)Using sedation and paralytics during intubation, cuff pressure should be maintained between 25-30 cmH(2)O(1 cmH(2)O=0.098 kPa); (7)In-line suction catheter is recommended and it can be used for one week; (8)Dual-limb heated wire circuits are recommended and only changed with visible soiled; (9)For patients who need breathing support during transportation, placing an HME between ventilator and patient; (10)PSV is recommended for implementing spontaneous breathing trial (SBT), avoid using T-piece to do SBT. When tracheotomy patients are weaned from ventilator, HME should be used, avoid using T-piece or tracheostomy mask. (11)Avoid unnecessary bronchial hygiene therapy; (12) For patients who need aerosol therapy, dry powder inhaler metered dose inhaler with spacer is recommended for spontaneous breathing patients; while vibrating mesh nebulizer is recommended for ventilated patients and additional filter is recommended to be placed at the expiratory port of ventilation during nebulization.

[Application of tracheotomy in the treatment of severe cases of COVID-19]

Objective: Todiscuss the the effects, indications and protective measures of tracheotomy for severe cases of 2019 novel corona virus disease(COVID-19)patients. Methods: A retrospectively analyze was conducted to explore the clinical data of ofCOVID-19 patients who received tracheotomy in February to March 2020,descriptive statistics were used to analyze the indication of tracheotomy, particularity of intraoperative treatment and protective measures. Results: A total of 4 cases were included in this article, 3 cases were successfully operated, 1 case of postoperative incision continuous bleeding, there were not other complications and nosocomial infection among the medical staff.the patient's condition was relieved in different degrees after the operation, who remain hospitalized. Conclusion: Tracheotomy for severe cases of COVID-19 can achieve certain curative effect, but the occurrence of tracheotomy related complicationsand nosocomial infection should be effectively controlled, and the risk benefit ratio of tracheotomy should be carefully weighed before surgery.

Adoption of personal protective measures by ordinary citizens during the COVID-19 outbreak in Japan

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The prevalence of WHO personal protective measures was approximately 60–85%.

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The prevalence of avoiding touching the eyes, nose, and mouth was the lowest.

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Only 34.7% implemented all 5 personal protective measures recommended by the WHO.

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Some ordinary citizens may practice insufficient personal protective measures.

Objectives

To clarify the implementation status of personal protective measures by ordinary citizens in Japan during the coronavirus disease 2019 (COVID-19) outbreak.

Methods

This was a cross-sectional study based on internet-based survey. A total of 2400 people (50% male: 20–79 years) were selected between February 25 and 27, 2020, from registrants of an Internet research company, to complete a questionnaire. Participants were asked to indicate how often they implemented the following five personal protective measures recommended by the World Health Organization (hand hygiene, social distancing measures, avoiding touching the eyes, nose and mouth, respiratory etiquette, and self-isolation). In addition, the participants responded to questions regarding the daily frequency of hand hygiene events.

Results

The prevalence of the five personal protective measures ranged from 59.8% to 83.8%, with the lowest being avoiding touching the eyes, nose, and mouth. In total, 34.7% implemented all personal protective measures. The median daily hand hygiene events were 5 per day (25th percentile, 75th percentile: 3,8).

Conclusions

The protective measures implemented by ordinary citizens are insufficient and further public awareness activities are required.

Respiratory care committee of Chinese Thoracic Society. [Expert consensus on preventing nosocomial transmission during respiratory care for critically ill patients infected by 2019 novel coronavirus pneumonia]

Definite evidence has shown that the novel coronavirus (COVID-19) could be transmitted from person to person, so far more than 1,700 bedside clinicians have been infected. A lot of respiratory treatments for critically ill patients are deemed as high-risk factors for nosocomial transmission, such as intubation, manual ventilation by resuscitator, noninvasive ventilation, high-flow nasal cannula, bronchoscopy examination, suction and patient transportation, etc, due to its high possibility to cause or worsen the spread of the virus. As such, we developed this consensus recommendations on all those high-risk treatments, based on the current evidence as well as the resource limitation in some areas, with the aim to reduce the nosocomial transmission and optimize the treatment for the COVID-19 pneumonia patients. Those recommendations include: (1) Standard prevention and protection, and patient isolation; (2) Patient wearing mask during HFNC treatment; (3) Using dual limb ventilator with filters placed at the ventilator outlets, or using heat-moisture exchanger (HME) instead of heated humidification in single limb ventilator with HME placed between exhalation port and mask; avoid using mask with exhalation port on the mask; (4) Placing filter between resuscitator and mask or artificial airway; (5) For spontaneous breathing patients, placing mask for patients during bronchoscopy examination; for patients receiving noninvasive ventilation, using the special mask with bronchoscopy port to perform bronchoscopy; (6) Using sedation and paralytics during intubation, cuff pressure should be maintained between 25-30 cmH(2)O; (7) In-line suction catheter is recommended and it can be used for one week; (8) Dual-limb heated wire circuits are recommended and only changed with visible soiled; (9. For patients who need breathing support during transportation, placing an HME between ventilator and patient; (10) PSV is recommended for implementing spontaneous breathing trial (SBT), avoid using T-piece to do SBT. When tracheotomy patients are weaned from ventilator, HME should be used, avoid using T-piece or tracheostomy mask. (11) Avoid unnecessary bronchial hygiene therapy; (12) For patients who need aerosol therapy, dry powder inhaler metered dose inhaler with spacer is recommended for spontaneous breathing patients; while vibrating mesh nebulizer is recommended for ventilated patients and additional filter is recommended to be placed at the expiratory port of ventilation during nebulization.

Monitoring of Particle Environmental Pollution and Fungal Isolations During Hospital Building-Work Activities in a Hematology Ward

Building-work activities could cause dust contamination and fungal spores' dissemination. A significant relationship was found between building-work activities and the incidence of invasive aspergillosis, in profoundly immunocompromised patients. Renovation-works activities were carried out by four building sites of the hematology ward in a Teaching Hospital without the interruption of clinical activities. These sites were monitored by environmental sampling to determine the particles and fungi count. Clinical surveillance was made using galactomannan antigen test as a proxy for invasive aspergillosis diagnosis. A definitive diagnosis of IA was confirmed by clinical and radiological features. The galactomannan antigen test showed no significant difference between presence (2,75%) and absence (5,03%) of renovation work activities (p=0,522). During the renovation activities, an increment of IA cases with respect to the control period was not recorded. The particle counts showed higher values of small and big-diameter particles before the renovation works if compared to the end of the activities. It was probably due to the containment measures implemented during and immediately after the final phases of the building site. The Fungi counts showed no significant differences between the phase before and after the renovation activities. Our findings show that is possible to perform renovation work, during clinical activities, by increasing clinical and environmental surveillance.

Sanitation workers from Portugal: Is there evidence of Leptospira spp?

Leptospires are spirochetes of Leptospira genus. Infection in humans occurs by penetration into the mucous membranes, or into the skin (small wounds or abrasions). Humans are infected when they contact with urine of rodents, the main reservoirs. We aimed to evaluate the presence of anti-Leptospira spp antibodies and leptospiral DNA in sanitation workers (occupational group with increased risk) from Lisbon and Tagus Valley Region (Portugal). Blood samples were collected from 347 sanitation workers, being applied a questionnaire to analyze exposure to rodents and preventive measures. The samples were screened by MACROLepto-test, for the presence of antibodies against pathogenic leptospires. "Positive" and "Non conclusive" samples were then tested with Microscopic Agglutination Test (MAT). Two nested-PCR protocols (primers LeptoA-LeptoB and lipL32) were applied for Leptospira spp DNA detection. It was not observed anti-Leptospira spp antibodies in the worker's samples. However, it was detected non-pathogenic leptospires in a serum sample. Furthermore, 77% had previously seen rodents in the workplace and 94% always used Personal Protective Equipment (PPE). Despite the regular presence of rodents in their workplace, the use of PPE and hygiene measures seemed to be able to prevent the workers contact with this infectious agent.

Young adults and HIV. Awareness and risk behaviour of a group living in Spain

INTRODUCTION

Sexual intercourse is currently the main route of HIV infection in Spain. Despite decreases in new infections among women and drug users, the rate remains stable in men. The aim of this study was to assess risk behaviour and HIV awareness in a sample of young adults in Spain.

METHODS

A cross-sectional, observational, descriptive study was performed on a non-HIV infected sample, using a questionnaire on sexual health and HIV awareness adapted from the Spanish National Institute of Statistics. A sexual risk variable was included (high and low), which was classified as high if subjects had had three or more sexual partners and did not always use a condom in all their sexual encounters.

RESULTS

243 subjects were included (65.6% women) aged between 16 and 36years (mean=25.7; SD=4.1) (16-24years: 134 subjects; 25-29years: 60 subjects; over 30years: 47 subjects). Approximately 40.9% said that they used a condom in all sexual relations and 61% did not perceive any risk of infection. There were no significant differences in awareness of infection routes between the high and low risk profiles. Washing after sex, having few partners, spermicide use and having undetectable viral load were protective measures significantly associated with differences in sexual risk (P<.05).

CONCLUSIONS

The main finding of the study was the underestimation of risk of infection, analysed after differences found between self-assessment and sexual risk. Both positive and negative results were found concerning HIV awareness.

Knowledge about Radiation Related Health Hazards and Protective Measures among Patients Waiting for Radiologic Imaging in Jimma University Hospital, Southwest Ethiopia

BACKGROUND

Radiologic diagnostic and therapeutic procedures using ionizing radiation carry potential health risks. Hence, clients' knowledge about radiation would play a key role in reducing unnecessary imaging and its impacts. However, information on client's knowledge in low income countries specifically in the Ethiopian context has been was limited. Therefore, the aim of this study was to assess knowledge about radiation related hazards and protective measures among patients waiting for radiologic imaging.

METHODS

Descriptive cross sectional study design was employed on 388 patients waiting for radiologic imaging in Jimma University Hospital from Dec.25/2014 to Jan. 10/2015. Eligible participants were interviewed using pretested questionnaire. Data were entered and analyzed using IBM SPSS version 21. A descriptive analysis was conducted to get summary values of clients' radiation related knowledge.

RESULTS

A total of 386 clients were included to the analysis.Two hundred and three (52.6%) participants had ever heard radiation related health hazards. Among these, 74.9% mentioned infertility, 64.0% indicated cancer followed by 26.6% who mentioned cataract as radiation related health hazards. A large number of clients (75.6%) had no idea about radiation protective measures, whereas 22% of them mentioned not entering examination room unless ordered by health professionals and 10.6% indicated covering sensitive body parts with lead (pb). The majority (85.8%) of the clients did not support unjustified repeated radiation imaging for diagnostic or other purposes.

CONCLUSION

The overall knowledge of clients about radiation imaging seems inadequate. Thus, comprehensive awareness raising programmes targeted at different settinsg and levels should be designed and implemented.

French policy for managing the post-accident phase of a nuclear accident

In 2005, at the request of the French Government, the Nuclear Safety Authority (ASN) established a Steering Committee for the Management of the Post-Accident Phase of a Nuclear Accident or a Radiological Emergency, with the objective of establishing a policy framework. Under the supervision of ASN, this Committee, involving several tens of experts from different backgrounds (e.g. relevant ministerial offices, expert agencies, local information commissions around nuclear installations, non-governmental organisations, elected officials, licensees, and international experts), developed a number of recommendations over a 7-year period. First published in November 2012, these recommendations cover the immediate post-emergency situation, and the transition and longer-term periods of the post-accident phase in the case of medium-scale nuclear accidents causing short-term radioactive release (less than 24 h) that might occur at French nuclear facilities. They also apply to actions to be undertaken in the event of accidents during the transportation of radioactive materials. These recommendations are an important first step in preparation for the management of a post-accident situation in France in the case of a nuclear accident.