A new dedicated clinic for HCWs' counseling and vaccination: experience of an academic hospital

Abstract Issue Despite low healthcare workers (HCWs) vaccination coverage being a risk for hospital outbreaks, vaccine hesitancy is not unusual among HCWs. In Italy vaccinations are strongly recommended for HCWs, but there are few occasions for a dedicated counseling. Aim of the study is to evaluate the effectiveness of a new vaccination service in the academic hospital of Udine (northern Italy) in tackling vaccine hesitancy among HCWs. Description of the problem Available data on HCWs specific antibody titers revealed that in high-risk units, 25% of HCWs were certainly unprotected for at least 1/6 of the vaccine preventable diseases (VPDs): measles, rubella, mumps, varicella, pertussis, hepatitis B; only varicella coverage reached the herd immunity target. Periodic occupational health visit was the only moment to screen for VPDs protection and suggest vaccination, but the following inconvenient procedure of HCWs contacting the vaccination office outside the hospital, often lead to delays or loss. In order to improve vaccination adherence, since June 2019 a dedicated clinic has been set up inside the hospital, making vaccination counseling and administration available every two weeks, with appointments directly given by the occupational doctor. Results From June 2019 to February 2020, a total of 362 appointments were booked for the dedicated vaccination clinic, 69.7% of which actually took place as 252 HCWs actually accessed the service. Hours dedicated to the service activity were 76 hours, distributed over 19 days. Administered vaccination were 322, including 107 MMR (measles, rubella, mumps), 4 MMRV (MMR+varicella), 20 varicella, 64 hepatitis B, 127 DTPa (diphtheria, tetanus, pertussis). Lessons Making the access to vaccination more convenient in term of service location within the hospital and giving the appointment when performing the occupational health visit seems to be helpful in filling the VPDs protection among HCWs gap. Key messages Monitoring immunological status of HCWs and promoting vaccination at occupational health visit would sustain herd immunity protection for susceptible individuals in healthcare settings. The dedicated hospital vaccination clinic and the effective procedure of giving the appointment during the occupational health visit could be helpful in improving HCWs vaccine adherence

Hubungan Fungsi Seksual dengan Kecemasan Pasien Pasca-Infark Miokard Akut

Background: Sexual dysfunction and anxiety frequently happens on patients after acute myocardial infarction (AMI) and can affect patients’ quality of life. The purpose of this study was to examine the assosiation of sexual function post-AMI patients with anxiety. Methods: It was a cross-sectional study. Respondents are patients in Integrated Cardiac Clinic of Cipto Mangunkusumo Hospital that meet inclusion and exclusion criteria. They signed informed consent. Sexual function was assessed using International Index of Erectyle Function (IIEF) and anxiety was assessed using Hamilton Anxiety Rating Scale (HAM-A). Results: Post-AMI patients had erectile dysfunction (82.5%), orgasm dysfunction (72.5%) and libido dysfunction (93.8%). Respondents expressed sexual intercourse dissatisfaction (97.5%) and overall dissatisfaction (90%). The proportion of post-AMI anxiety was 52.5%. There was no assosiation between sexual function post-AMI with anxiety. Conclusion: Anxiety and sexual dysfunction post-AMI is a considerable problem. Factors that affect anxiety and sexual dysfunction post-AMI needs to be explored further so that an integrated management guidelines could be proposed.Latar Belakang: Disfungsi seksual dan kecemasan sering dialami oleh pasien pasca-infark miokard akut (acute myocardial infarct, AMI) dan dapat memengaruhi kualitas hidup. Tujuan penelitian ini adalah untuk menguji hubungan fungsi seksual dengan kecemasan pasien pasca-AMI. Metode: Penelitian ini menggunakan desain potong lintang. Responden adalah pasien rawat jalan Poliklinik Jantung Terpadu RS Cipto Mangunkusumo yang memenuhi kriteria inklusi dan eksklusi serta menandatangani informed consent. Fungsi seksual dinilai dengan International Index of Erectyle Function (IIEF) sedangan kecemasan dinilai dengan Hamilton Anxiety Rating Scale (HAM-A). Hasil: Pasien pasca-AMI mengalami disfungsi ereksi (82,5%), disfungsi orgasme (72,5%), dan disfungsi libido (93,8%). Responden pada umumnya menyatakan ketidakpuasan dalam hubungan seksual (97,5%) dan terhadap kehidupan seksual secara keseluruhan (90%). Proporsi kecemasan pasca-AMI adalah 52,5%. Tidak terdapat hubungan antara fungsi seksual dengan kecemasan pasca-AMI. Kesimpulan: Kecemasan dan disfungsi seksual merupakan masalah yang perlu diperhatikan pada pasien pasca-AMI. Faktor-faktor yang memengaruhi kecemasan dan disfungsi seksual pasca-AMI perlu dieksplorasi lebih lanjut sehingga panduan tatalaksana yang terintegrasi dapat disusun dengan baik

XIAP Protection of Photoreceptors in Animal Models of Retinitis Pigmentosa

BACKGROUND: Retinitis pigmentosa (RP) is a blinding genetic disorder that is caused by the death of photoreceptors in the outer nuclear layer of the retina. To date, 39 different genetic loci have been associated with the disease, and 28 mutated genes have been identified. Despite the complexity of the underlying genetic basis for RP, the final common pathway is photoreceptor cell death via apoptosis. METHODOLOGY/PRINCIPAL FINDINGS: In this study, P23H and S334ter rhodopsin transgenic rat models of RP were used to test the neuroprotective effects of anti-apoptotic gene therapy. Adeno-associated viruses (AAV) carrying the X-linked inhibitor of apoptosis (XIAP) or green fluorescent protein (GFP) were delivered subretinally into the eye of transgenic rat pups. Histological and functional measures were used to assess neuroprotection. XIAP is known to block apoptosis by inhibiting the action of caspases-3, -7 and -9. The results show that XIAP gene therapy provides long-term neuroprotection of photoreceptors at both structural and functional levels. CONCLUSIONS/SIGNIFICANCE: Our gene therapy strategy targets the apoptotic cascade, which is the final common pathway in all forms of retinitis pigmentosa. This strategy holds great promise for the treatment of RP, as it allows for the broad protection of photoreceptors, regardless of the initial disease causing mutation

Attitudes and Performance: An Analysis of Russian Workers

This paper investigates the relationship between locus of control and performance among Russian employees, using survey data collected at 28 workplaces in 2002 in Taganrog and at 47 workplaces in 2003 in Ekaterinburg. We develop a measure that allows us to categorize the Russian employees participating in our survey as exhibiting an internal or external locus of control. We then assess the extent to which there are significant differences between “internals” and “externals” in work-related attitudes that may affect performance. In particular, we focus on (1) attitudes about outcomes associated with hard work, (2) level of job satisfaction, (3) expectation of receiving a desired reward, and (4) loyalty to and involvement with one’s organization. In each case we identify where gender and generational differences emerge. Our main objective is to determine whether Russian employees who exhibit an internal locus of control perform better than employees with an external locus of control. Our performance measures include earnings, expected promotions, and assessments of the quantity and quality of work in comparison to others at the same organization doing a similar job. Controlling for a variety of worker characteristics, we find that (1) individuals who exhibit an internal locus of control perform better, but this result is not always statistically significant; (2) even among “internals,” women earn significantly less than men and have a much lower expectation of promotion; (3) even among “internals,” experience with unemployment has a negative influence on performance.http://deepblue.lib.umich.edu/bitstream/2027.42/40144/3/wp758.pd

Product innovation as a mediator in the impact of R&D expenditure and brand equity on marketing performance

This study combines the signaling theory and dynamic marketing capabilities perspective to investigate the mediating role of product innovation in the influence of R&D expenditure and brand equity on marketing performance. The study shows that MNC firms are able to use R&D expenditure to improve their product innovation and market share to a greater extent compared to SME and retailer firms. However, the stronger brand equity of MNC firms may actually hurt the performance of their new products by inhibiting product innovation. The authors use regression and probit analysis to study a panel data for 1356 food brands. Overall, this research provides fresh insights into the process by which R&D expenditure and brand equity affect product innovation and marketing performance in highly competitive product categories