The use of personal protection equipment does not negatively affect paramedics’ attention and dexterity: a prospective triple-cross over randomized controlled non-inferiority trial

Background The COVID-19 pandemic led to widespread use of personal protection equipment (PPE), including filtering face piece (FFP) masks, throughout the world. PPE. Previous studies indicate that PPE impairs neurocognitive performance in healthcare workers. Concerns for personnel safety have led to special recommendations regarding basic life support (BLS) in patients with a potential SARS-CoV-2 infection, including the use of PPE. Established instruments are available to assess attention and dexterity in BLS settings, respectively. We aimed to evaluate the influence of PPE with different types of FFP masks on these two neuropsychological components of EMS personnel during BLS. Methods This was a randomized controlled non-inferiority triple-crossover study. Teams of paramedics completed three 12-min long BLS scenarios on a manikin after having climbed three flights of stairs with equipment, each in three experimental conditions: (a) without pandemic PPE, (b) with PPE including a FFP2 mask with an expiration valve and (c) with PPE including an FFP2 mask without an expiration valve. The teams and intervention sequences were randomized. We measured the shift in concentration performance using the d2 test and dexterity using the nine-hole peg test (NHPT). We compared results between the three conditions. For the primary outcome, the non-inferiority margin was set at 20 points. Results Forty-eight paramedics participated. Concentration performance was significantly better after each scenario, with no differences noted between groups: d2 shift control versus with valve − 8.3 (95% CI − 19.4 to 2.7) points; control versus without valve − 8.5 (− 19.7 to 2.7) points; with valve versus without valve 0.1 (− 11.1 to 11.3) points. Similar results were found for the NHPT: + 0.3 (− 0.7 to 1.4), − 0.4 (− 1.4 to 0.7), 0.7 (− 0.4 to 1.8) s respectively. Conclusion Attention increases when performing BLS. Attention and dexterity are not inferior when wearing PPE, including FFP2 masks. PPE should be used on a low-threshold basis.

Cost-Effectiveness of Public Health Measures to Control COVID-19 in China: A Microsimulation Modeling Study

This study aimed to assess the cost-effectiveness of various public health measures in dealing with coronavirus disease 2019 (COVID-19) in China. A stochastic agent-based model was used to simulate the progress of the COVID-19 outbreak in scenario I (imported one case) and scenario II (imported four cases) with a series of public health measures. The main outcomes included the avoided infections and incremental cost-effectiveness ratios (ICERs). Sensitivity analyses were performed to assess uncertainty. The results indicated that isolation-and-quarantine averted the COVID-19 outbreak at the lowest ICERs. The joint strategy of personal protection and isolation-and-quarantine averted one more case than only isolation-and-quarantine with additional costs. The effectiveness of isolation-and-quarantine decreased with lowering quarantine probability and increasing delay time. The strategy that included community containment would be cost-effective when the number of imported cases was >65, or the delay time of the quarantine was more than 5 days, or the quarantine probability was below 25%, based on current assumptions. In conclusion, isolation-and-quarantine was the most cost-effective intervention. However, personal protection combined with isolation-and-quarantine was the optimal strategy for averting more cases. The community containment could be more cost-effective as the efficiency of isolation-and-quarantine drops and the imported cases increases.

Design and validation of a tool to assess the safety principles of working with nanomaterials in nanotechnology laboratories

Introduction: The unique properties of nanomaterials, in addition to their applications in science and technology, can be a threat to human health and the environment. Exposure to these materials may occur in workplaces or research laboratories. It can be said that about half of people with occupational exposure to nanomaterials work in academic environments and laboratories. So, the present study was conducted to design and validate a tool to investigate the principles of working safely with nanomaterials in research laboratories. Materials & Methods: The tool was designed using reports, instructions and articles related to " Methods of working safely with nanomaterials". The validity of the tool was assessed using Lawshe method by calculating CVI and CVR. The reliability of the instrument was evaluated using Cronbach's alpha coefficient and kappa coefficient. Results: The tool was designed in 5 sections: "General Information", "Transportation and Storage of Nanomaterials", "Engineering Controls", "Administrative Controls" and "Personal Protection Equipment". After validation, 5 items did not get the necessary points to stay in the tool and were removed. The Cronbach's alpha value for each section of the tool was more than 0.80, indicating that the was "appropriate". Conclusion: According to the results, it seems that the tool studied in this study is compatible for the designed purpose and is ready to be used as a questionnaire or checklist.

Challenges experienced by Portuguese professionals in humanitude care for institutionalized elderly people during the pandemic

Objective: To understand the challenges experienced by Portuguese workers in humanitude care for institutionalized elderly people during the pandemic. Method: This is a qualitative study, supported by reflections on the Humanitude Care Methodology, carried out with workers from different areas in a nursing home for elderly people in Portugal. Data collection took place between September and October 2020, from individual and online interviews. The categorization proposed by Bardin was adopted as the analysis technique. Results: Three categories emerged: (1) self-protection and of the other with the subcategories fear of being contaminated and fear of contaminating the elderly; (2) maintenance of affective relationships, broken down into the subcategories absence of family members in the nursing home and personal protective equipment as a barrier to communication and approximation; and (3) confinement of the elderly who attended the Day Center, with the subcategories lack of family support/loneliness and change in the elderly’s routine. Conclusion: The main challenges experienced by Portuguese workers are related to the necessary changes in the performance of care practices due to the use of personal protection that was not used before, limitations in affective relationships, and restrictions in interaction spaces.

Microscopy and the COVID-19 Pandemic, What We Need to Know?-The Hygiene Protocols and Digitalization

The COVID-19 pandemic has reemphasized the significance of personal protection at all the levels, from public places to hospitals, to working spaces to residence and at individual levels. It is inevitable for personnel in a common working space to share items multiple times one after the other frequently. Laboratory is one such arena and is also of great concern as it is associated with handling pathogenic specimens, investigating and diagnosing pathologies. By nature, it can be of great concern due to the possibility of higher chances of cross contamination. This fact is made even more precarious by the current COVID 19 pandemic. Hence there is a great need for a set of guidelines, appropriate protocols, best hygiene practices and digitalization in reporting and teaching learning, to be followed in the laboratory to prevent cross contamination. Microscopy work area is part of laboratory where microscopes are placed and used by the professionals for pathological diagnosis or research. Though there are set guidelines to be followed for most aspects of the laboratory, the cleanliness and personal protective guidelines for microscopes are sparse. Use of a disposable or reusable plastic film for covering microscopes, selection of suitable disinfectant, use of proper cleaning and protective tools and safeguarding the sensitive parts of microscope are highly recommended.

Does Jesus Endorse Armed Self-Defense in Luke 22:36?

In Luke 22:36, Jesus instructs his disciples to buy swords. The best understanding of this passage is that Jesus is endorsing the carrying of weapons for personal protection. This article outlines the self-defense interpretation and defends it against several objections. I then argue that the injunction to buy a sword can be extended to gun ownership as a modern-day application. After making the scriptural case for gun ownership, I then sketch a brief philosophical argument for a strong moral right to gun ownership. Various theological, philosophical, and empirical objections are considered and found lacking.

Mosquitoes and Bromeliads

Water can collect in the central tanks or axils of bromeliads, and immature stages of mosquitoes sometimes inhabit these small pools. This article provides recommendations for environmentally acceptable ways to control the production of nuisance mosquitoes in bromeliads; suggestions for planting species of bromeliads less likely to favor the production of mosquito-borne disease vectors; and general advice about personal protection against mosquito bites.