"As protective gear began to run low, guidance on protection became looser" - Healthcare workers' perspectives on infection prevention and control during the COVID-19 pandemic

ObjectivesThe COVID-19 pandemic has posed several risk factors to healthcare workers' (HCWs') emotional distress. The purpose of the study was to enhance understanding of the experiences and feelings of HCWs during the COVID-19 pandemic, with specific reference to infection prevention and control (IPC) practices and guidance, focusing on the quality and availability of personal protective equipment (PPE), guidelines, and management. With a qualitative approach, we aimed to enable a wider narrative; to gain a more detailed understanding related to PPE use and identify experiences that can be overlooked in forced-choice questionnaires. MethodsAn online questionnaire was conducted among HCWs of the City of Helsinki and Helsinki University Hospital between 12.6.2020 and 5.4.2021. Altogether 1,580 HCWs participated in the study, from whom 579 shared 1,666 free-text responses. These responses were analyzed qualitatively, and the results were combined with statistical data on the participants' working conditions and backgrounds. ResultsWe identified problems in PPE availability and changing guidelines as factors causing the most distress in the participants. Regarding availability, running out of masks and respirators emerged as the most worrying issue, and inadequate PPE was associated with the excessive workload (OR 1.51, CI 95% 1.01-2.25). The results also highlight the importance of transparent and clear communication regarding IPC instructions and guidance, and clear IPC guidance was associated with better levels of reported recovery from work (OR 1.51, CI 95% 1.06-2.14). ConclusionsOur study highlights the importance of adequate PPE provision, transparent communication, clear guidance, and supportive supervisory work in this ongoing pandemic and potential new ones. We suggest more rigorous preparation, with crisis communication planning and emergency storage of PPE.Peer reviewe

Työhyvinvointi, esimiehen vaikutus

Tiivistelmä Tämän opinnäytetyön aiheena on työhyvinvointi, ja miten esimies voi siihen vaikuttaa. Opinnäytetyön tarkoituksena oli selvittää työntekijöiden tämänhetkistä työhyvinvoinnin tilaa. Tavoitteena oli erityisesti tutkia, miten esimies voi omalla toiminnallaan parantaa työhyvinvointia ja antaa tähän kehitysehdotuksia. Opinnäytetyö tehtiin toimeksiantona Kemiran South East Finland Paper -osastolle. Kemira on suomalainen kemianyhtiö. Opinnäytetyön teoriaosuudessa käytettiin työhyvinvointiin ja esimiestyöhön liittyviä kirjalähteitä ja sähköisiä lähteitä. Lähdeaineisto oli luotettavaa, koska lähteet olivat tuoreita ja niissä oli kattavasti tietoa. Internet lähteinä käytin pääasiallisesti eri hallintolaitosten kuten työsuojeluhallinnon ja sosiaali- ja terveysministeriön verkkosivuja. Teoreettinen viitekehys koostuu työhyvinvoinnin käsitteistä ja tekijöistä, esimiestyöstä ja valitun tutkimusmenetelmän teoriasta. Tutkimusmenetelmänä käytettiin kvantitatiivista tutkimusmenetelmää. Tutkimus toteutettiin kyselynä, jossa oli kahdeksan osa-aluetta. Osa-alueet koostuivat yhteensä 43 kysymyksestä, joista 34 oli suljettuja 10 avoimia. Kysely tehtiin sähköisesti Webropol-ohjelman avulla ja lähetettiin tutkittavien sähköpostiin. Kyselyn tulokset analysoitiin SPSS-ohjelmaa apuna käyttäen. Kyselyn perusteella työhyvinvointi Kemiran South East Finland Paper -osastolla on hyvällä mallilla. Työntekijät kokivat muun muassa työkykynsä suhteessa työn fyysisiin ja psyykkisiin vaatimuksiin sekä työyhteisön ja esimiehen tuen hyvänä. Kehittämiskohteitakin kuitenkin löytyy muun muassa viestinnästä. Tutkimuksen perusteella tehdyt kehittämisehdotukset annettiin Kemiran South East Finland Paper -osaston esimiehelle.Abstract The topic of this thesis is work welfare and how a superior can affect it. The meaning of this thesis was to find out the current level of work welfare in the Kemiras South East Finland Paper department. The objective was to examine how a superior can improve work wellfare with his own actions and give development proposals. This thesis was made for the Kemiras South East Finland Paper department. Kemira is a finnish chemical company. Work wellfare and leadership sources were used in the theoretical part of this thesis. The source material was reliable because sources were fresh and they had extensive information. Occupational Safety and Healt Administration and Ministry of Social Affairs and Healt web pages were used primarily. The theoretical framework consist from concepts and factors of work wellfare, leadership, and the theory of research metod. Quantitative research method was used in this thesis. The research was executed as a survey. The survey had eight sections. The sections consisted from 43 questions, in which 34 were closed and 10 were open. The inquiry was made electronically by using Webropol program and sent to the participants by email. The inquirys results were analyzed by using SPSS program. Based on the inquiry the work wellfare is in good shape in the Kemiras South East Finland Paper department. For example employees experienced their ability to work good in relation to the works physical and mental demands. They also felt that they received support from both co-workers and the superior. Nonetheless there are still areas that are in need of developing, for instance communication. Development ideas which are based on the inquiry were given to the superior of the Kemiras South East Finland Paper department

Masennuksen lääkkeetön hoito : Kuvaileva kirjallisuuskatsaus

Opinnäytetyöni aiheena on masennuksen lääkkeetön hoito. Työ toteutettiin kuvaile- vana kirjallisuuskatsauksena. Työn tavoitteena on tutkia, mitä näyttöön perustuvaa tietoa löytyy masennuksen lääkkeettömistä hoitokeinoista. Opinnäytetyön teoriaosuudessa käydään läpi masennukseen liittyviä käsitteitä ja kar- toitetaan erilaisia masennustiloja. Teoriaosuudessa käydään läpi myös masennuksen diagnosointi ja keskeisimmät oireet. Lähteinä käytettiin sekä kirja- että sähköisiä läh- teitä. Tutkimusosuudessa käydään läpi kuusitoista eri keinoa masennuksen hoitoon lääk- keettömästi. Näitä keinoja ovat erilaiset psykoterapiat, neuromodulaatiohoidot, mu- siikki- ja taideterapia, liikunta, ravitsemus, kirkasvalohoito ja mindfulness. Lähes jo- kaisesta hoitokeinosta on mainittu yksi tai useampi tutkimus. Opinnäytetyön tiedonhaussa käytettiin neljää eri tietokantaa: Pubmed, Medic, Psy- cINFO ja Cinahl. Tiedonhaku suoritettiin käyttämällä lähinnä englanninkielisiä haku- sanoja, kuten ́Depression AND Physical Activity ́. Tutkimustuloksia rajasin muun mu- assa julkaisuvuoden perusteella. Opinnäytetyöhön valikoitui lopulta 14 tutkimusta. Tutkimusten perusteella jokaiselle tutkimukseen mukaan otetulla lääkkeettömällä hoi- tokeinolla oli positiivisia vaikutuksia masennuksen hoidossa.The topic of this thesis is Non-Pharmacological Treatment for Depression. The thesis was executed as descriptive literature review. The aim for this thesis was to research various non-pharmacological treatments for depression. Concept of depression and various types of depression are discussed in the theoreti- cal part of the thesis. Also in this part the diagnosis of depression and the main symp- toms are explained. Both book and electrical sources were used in this part. Sixteen different non-pharmacological treatment options are explained in the study part of thesis. These treatment options are different kinds of psychotherapies, neuro- modulation treatment, music and art therapy, physical activity, dietary, bright light therapy and mindfulness. Four different databases were used on this thesis. These databases were Pubmed, Medic, PsycINFO and Cinalh. Information retrieval was carried out using English keywords like ́Depression AND Physical Activity ́. Research results were limited for example by publishing year. At the end fourteen studies were chosen for the thesis. Based on the studies used on the thesis all the non-pharmacological treatment op- tions have a positive effect on the treatment of depression

The effect of room air cleaners on infection control in day care centres

The aim of this study was to assess the effectiveness of air cleaning in reducing the risk of respiratory infection in two day care centres using a simple and robust calculation model. Additionally, we aimed to identify potential hotspots for infections in indoor setting and focus countermeasures accordingly. Initial results from an interventional clinical study are provided as proof-of-concept for the model. We constructed a mathematical model to assess the number of persons at risk for airborne infection transmission in day care. Utilizing the model, we used portable air cleaners in two day care units (A and B, number of children participating in the study n = 43) and compared infection incidents between the two intervention units to the rest of the units in city of Helsinki (n = 607). The intervention buildings had mechanical supply and exhaust air ventilation. The risk modelling suggests that the use of air cleaners reduced the expected number of persons at infection transmission risk significantly. At day care centre A the average reduction was 60% (range 52% - 88%) and at day care centre B 53% (range 14% - 59%). During the approximately six month study period, we observed a significant difference in the days absent from day care due to infections between the intervention and reference day care units. On average, the parents were absent from work due to child’s illness in reference day care centers for 5.53 days and 3.77 days in intervention day care centers during the study period (p=0.009). In relative terms the reduction was approximately 32%. Our study offers compelling evidence to support increasing non-infectious air flow rates in daycare centers during periods requiring infection risk management. This can be implemented with portable air cleaners as an effective and cost-efficient strategy for mitigating the spread of respiratory infections among children. The clinical results support the findings suggested by the theoretical model

High-volume evacuation mitigates viral aerosol spread in dental procedures

Abstract Dental healthcare personnel (DHCP) are subjected to microbe-containing aerosols and splatters in their everyday work. Safer work conditions must be developed to ensure the functioning of the healthcare system. By simulating dental procedures, we aimed to compare the virus-containing aerosol generation of four common dental instruments, and high-volume evacuation (HVE) in their mitigation. Moreover, we combined the detection of infectious viruses with RT-qPCR to form a fuller view of virus-containing aerosol spread in dental procedures. The air–water syringe produced the highest number of aerosols. HVE greatly reduced aerosol concentrations during procedures. The air–water syringe spread infectious virus-containing aerosols throughout the room, while other instruments only did so to close proximity. Additionally, infectious viruses were detected on the face shields of DHCP. Virus genomes were detected throughout the room with all instruments, indicating that more resilient viruses might remain infectious and pose a health hazard. HVE reduced the spread of both infectious viruses and viral genomes, however, it did not fully prevent them. We recommend meticulous use of HVE, a well-fitting mask and face shields in dental procedures. We advise particular caution when operating with the air–water syringe. Due to limited repetitions, this study should be considered a proof-of-concept report