105 research outputs found
Stress, Motivation and Professional Satisfaction among Health Care Workers in HIV/AIDS Care and Treatment Centers in Urban Tanzania: A Cross-Sectional Study.
No full textShortages of health care workers (HCWs) represents a serious challenge to ensuring effective HIV care in resource-limited settings (RLS). Stress, motivation, and job satisfaction have been linked with HCW retention and are important in addressing HCW shortages. In this cross-sectional study HCW stress, motivation and perceived ability to meet patient needs were assessed in PEPFAR-supported urban HIV care and treatment clinics (CTCs) in Tanzania. A self-administered questionnaire measuring motivation, stress, and perceived ability to and meet patient needs was given to HCWs at 16 CTCs. Scales measuring HCW satisfaction, motivation, and stress were developed using principle components analysis. Hierarchical linear models were used to explore the association of HCW and site characteristics with reported satisfaction, stress, motivation, and ability to meet patients' needs.\ud
Seventy-three percent (279) of HCWs completed the questionnaire. Most (73%) HCWs reported minimal/no work-related stress, with 48% reporting good/excellent motivation, but 41% also reporting feeling emotionally drained. Almost all (98%) reported feeling able to help their patients, with 68% reporting work as rewarding. Most reported receipt of training and supervision, with good availability of resources. In the multivariate model, direct clinical providers reported lower motivation than management (p < 0.05) and HCWs at medium-sized sites reported higher motivation than HCWs at larger sites (p < 0.05). HCWs at small and medium sites were more likely to feel able to help patients than those from larger sites (p < 0.05 and p < 0.001 respectively). Despite significant patient loads, HCWs in these PEPFAR-supported CTCs reported high levels of motivation, job satisfaction, ability to meet patients' needs, low levels of stress but significant emotional toll. Understanding the relationship between support systems such as strong supervision and training and these outcomes is critical in designing interventions to improve motivation, reduce stress and increase retention of HCWs
Difficulties of transferring risk-based capital requirements to developing countries
No full textIn principle, financial regulation seeks to remedy recognized deficiencies in a nation's economic, political, and bureaucratic incentivestructures. But the social urgency of particular financial policy problems differ according to a country's stage of development. Regulatory strategies that make sense for industrial countries are unlikely to work the same way in developing countries. The author examines opportunities for transferring the framework of risk-based capital requirements negotiated by the G-10 countries under the auspices of the Bank for International Settlements in Basle. He finds that an unchanged transfer of the Basle framework to developing countries is economically inappropriate and politically infeasible. And its voluntary adapation is difficult because the long-run economic appropriateness of the Basle framework of solvency regulations directly opposes their short-run political embraceability. The author believes that what most urgently needs to be transferred to developing countries are elements of supervisory technology: methods of information collection and management, legal processes for prompt and equitable default resolution, and mechanisms for controlling the incentive conflicts that lead bankers and government supervisors to resist the healthy exit or recapitalization of damaged institutions. As a first step, the author recommends that the World Bank and the Bank for International Settlements promote economically beneficial reforms in information collection and management, reforms that do not preclude flexibility in current prudential standards in individual countries.Banks&Banking Reform,Environmental Economics&Policies,Financial Intermediation,Banking Law,Economic Theory&Research
A machine learning approach to predict resilience and sickness absence in the healthcare workforce during the COVID-19 pandemic
No full textDuring the COVID-19 pandemic, healthcare workers (HCWs) have faced unprecedented workloads and personal health risks leading to mental disorders and surges in sickness absence. Previous work has shown that interindividual differences in psychological resilience might explain why only some individuals are vulnerable to these consequences. However, no prognostic tools to predict individual HCW resilience during the pandemic have been developed. We deployed machine learning (ML) to predict psychological resilience during the pandemic. The models were trained in HCWs of the largest Finnish hospital, Helsinki University Hospital (HUS, N = 487), with a six-month follow-up, and prognostic generalizability was evaluated in two independent HCW validation samples (Social and Health Services in Kymenlaakso: Kymsote, N = 77 and the City of Helsinki, N = 322) with similar follow-ups never used for training the models. Using the most predictive items to predict future psychological resilience resulted in a balanced accuracy (BAC) of 72.7–74.3% in the HUS sample. Similar performances (BAC = 67–77%) were observed in the two independent validation samples. The models' predictions translated to a high probability of sickness absence during the pandemic. Our results provide the first evidence that ML techniques could be harnessed for the early detection of COVID-19-related distress among HCWs, thereby providing an avenue for potential targeted interventions
Expectations for Methodology and Translation of Animal Research: A Survey of Health Care Workers
No full textBACKGROUND: Health care workers (HCW) often perform, promote, and advocate use of public funds for animal research (AR); therefore, an awareness of the empirical costs and benefits of animal research is an important issue for HCW. We aim to determine what health-care-workers consider should be acceptable standards of AR methodology and translation rate to humans. METHODS: After development and validation, an e-mail survey was sent to all pediatricians and pediatric intensive care unit nurses and respiratory-therapists (RTs) affiliated with a Canadian University. We presented questions about demographics, methodology of AR, and expectations from AR. Responses of pediatricians and nurses/RTs were compared using Chi-square, with P?40% of the time; thought that misleading AR results should occur. CONCLUSIONS: HCW have high expectations for the methodological quality of, and the translation rate to humans of findings from AR. These expectations are higher than the empirical data show having been achieved. Unless these areas of AR significantly improve, HCW support of AR may be tenuous. KEYWORDS: Animal Models, Animal Research, Ethics Methodology, Bioethics and Medical Ethics, Ethics and Political Philosophy, Philosoph
Improving waste segregation while reducing costs in a tertiary-care hospital in a lower-middle-income country in Central America
No full textHealthcare waste (HCW) management and segregation are essential to ensure safety, environmental protection and cost control. Poor HCW management increase risks and costs for healthcare institutions. On-going surveillance and training are important to maintain good HCW practices. Our objectives were to evaluate and improve HCW practices at Hospital Bloom, San Salvador, El Salvador. We studied HCW disposal practices by observing waste containers, re-segregating waste placed in biohazardous waste bags, and administering a seven-itemsknowledge survey before and after training in waste management at Hospital Bloom. The training was based on national and international standards. We followed total biohazardous waste production before and after the training. The hospital staff was knowledgeable about waste segregation practices, but had poor compliance with national policies. Re-segregating waste in biohazardous waste bags showed that 61% of this waste was common waste, suggesting that the staff was possibly unaware of the cost of mis-segregating healthcare waste. After staff training in HCW management, the correct responses increased by 44% and biohazardous waste disposal at the hospital reduced by 48%. Better segregation of biohazardous waste and important savings can be obtained by HCW management education of hospital staff. Hospitals can benefit from maximising the use of available resources by sustaining best practices of HCW, especially those in hospitals in lower-middle-income countries. © The Author(s) 2013
Reliable low-power control of ultrafast vortex-core switching with the selectivity in an array of vortex states by in-plane circular-rotational magnetic fields and spin-polarized currents
No full textThe authors investigated the technological utility of counterclockwise (CCW) and clockwise (CW) circular-rotating fields (HCCW and HCW) and spin-polarized currents with an angular frequency ??H close to the vortex eigenfrequency ??D, for the reliable, low-power, and selective switching of the bistate magnetization (M) orientations of a vortex core (VC) in an array of soft magnetic nanoelements. CCW and CW circular gyrotropic motions in response to HCCW and HCW, respectively, show remarkably contrasting resonant behaviors, (i.e., extremely large-amplitude resonance versus small-amplitude nonresonance), depending on the M orientation of a given VC. Owing to this asymmetric resonance characteristics, the HCCW (HCW) with ??H ??? ??D can be used to effectively switch only the up (down) core to its downward (upward) M orientation, selectively, by sufficiently low field (???10 Oe) and current density (??? 107 A cm2). This work provides a reliable, low power, effective means of information storage, information recording, and information readout in vortex-based random access memory, simply called VRAM.open906
The Ethics of Animal Research: A Survey of Pediatric Health Care Workers
No full textINTRODUCTION: Pediatric health care workers (HCW) often perform, promote, and advocate use of public funds for animal research (AR). We aim to determine whether HCW consider common arguments (and counterarguments) in support (or not) of AR convincing. DESIGN: After development and validation, an e-mail survey was sent to all pediatricians and pediatric intensive care unit nurses and respiratory therapists (RTs) affiliated with a Canadian University. We presented questions about demographics, support for AR, and common arguments (with their counterarguments) to justify the moral permissibility (or not) of AR. Responses are reported using standard tabulations. Responses of pediatricians and nurses/RTs were compared using Chi-square, with P?<?.05 considered significant. RESULTS: Response rate was 53/115(46%) (pediatricians), and 73/120(61%) (nurses/RTs). Pediatricians and nurses/RTs are supportive of AR. Most considered benefits arguments sufficient to justify AR; however, most acknowledged that counterarguments suggesting alternative research methods may be available, or that it is unclear why the same benefits arguments do not apply to using humans in research, significantly weakened benefits arguments. Almost all were not convinced of the moral permissibility of AR by characteristics of non-human-animals arguments, including that non-human-animals may not be sentient, or are simply property. Most were not convinced of the moral permissibility of AR by human exceptionalism arguments, including that humans have more advanced mental abilities, are of a special kind, can enter into social contracts, or face a lifeboat situation. Counterarguments explained much of this, including that not all humans have these more advanced abilities [the argument from species overlap], and that the notion of kind is arbitrary [e.g., why are we not of the kind sentient animal or subject-of-a-life]. Pediatrician and nurse/RT responses were similar. CONCLUSIONS: Most respondents were not convinced of the moral permissibility of AR when given common arguments and counterarguments from the literature. HCW should seriously consider arguments on both sides of the AR debate. KEYWORDS: Survey, Animals, Animal research, Ethics, Bioethics and Medical Ethics, Ethics and Political Philosophy, Medicine and Health Science
Formulating Design Recommendations for the Acceptance of the Use and Results of Point-of-Care Testing in Low- and Middle-Income Countries: A Literature Review
No full textIn low- and middle-income countries (LMIC), diagnostics are not always available in remote areas. Hospitals and healthcare centres are often too far from the community, and waiting times are up to a few hours even for relatively simple procedures. Moreover, travelling to the healthcare centre and taking the diagnostic test is frequently unaffordable. Point of Care Tests (POCTs) can improve the availability, accessibility and affordability of the diagnostics by providing the test at the time and place of patient care. Although many POCTs have been developed already, there remain challenges to enable the healthcare workers (HCW) and the patients to use the device in practice. In this paper, we aim to provide a systemic overview of the barriers and opportunities for the adoption of use and acceptance of the results of POCTs based on the literature. The barriers and opportunities were clustered into six themes and used to draw out recommendations for the future design.Design for Sustainabilit
De-isolation of vaccinated COVID-19 health care workers using rapid antigen detection test
No full textBACKGROUND: COVID-19 de-isolation guidelines of health care workers (HCW) were formulated based on evidence describing the duration of infectious viral shedding of the wild SARS-CoV-2 virus. During the periods of COVID-19 vaccination and variants, a test-based approach was recommended to end isolation of HCW, based on emerging data describing the viral kinetics of COVID-19 variants. While Rapid antigen detection tests (RADT) are increasingly used in the diagnosis of COVID-19, their use is limited in de-isolation. METHODS: We described the use of RADT in the de-isolation of COVID-19 vaccinated HCW with mild infection who were asymptomatic on day 7 post diagnosis in a single center retrospective cohort study during the Omicron surge. RESULTS: Of the 480 HCWs, 173 (36%) had positive RADT. The positivity rate of RADT was not different in HCW who received two doses versus three doses of vaccine (34.4% versus 40.3%, p = 0.239). CONCLUSIONS: A symptom based, test-based approach using RADT is a useful tool in the de-isolation of HCW, with mild disease, in the era of Omicron. Further studies are required to evaluate the role of RADT in de-isolation of patients with severe COVID-19 disease
What proportion of healthcare worker masks carry virus? A systematic review
No full textOBJECTIVE:Concerns have been raised by healthcare organisations in New Zealand that routine mask use by healthcare workers (HCW) may increase the risk of transmission of SARS-CoV-2 through increased face touching. Routine mask use by frontline HCW was not recommended when seeing 'low risk' patients. The aim of this review was to determine the carriage of respiratory viruses on facemasks used by HCW. METHODS:A systematic review was conducted with structured searches of medical and allied health databases. Two authors independently screened articles for inclusion, with substantial agreement (k = 0.66, 95% CI 0.54-0.79). Studies that at least one author recommended for full text review were reviewed in full for inclusion. Two authors independently extracted data from included studies including the setting, method of analysis and results. There was exact agreement on the proportion of virus detected on masks. RESULTS:We retrieved 1233 titles, 47 underwent full text review and five studies reported in four articles were included. The studies were limited by small numbers and failure to test all eligible masks in some studies. The proportion in each study ranged from 0 (95% CI 0-10) to 25% (95% CI 8-54). No study reported clinical respiratory illness as a result of virus on the masks. CONCLUSIONS:Although limited, current evidence suggests that viral carriage on the outer surface of surgical masks worn by HCW treating patients with clinical respiratory illness is low and there was not strong evidence to support the assumption that mask use may increase the risk of viral transmission
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