Frequency and component analysis of contaminants generated in preparation of anticancer agents using closed system drug transfer devices (CSTDs)

Occupational exposure of anticancer agents during their preparation has been recognized as a serious hazard. Closed system drug transfer devices (CSTDs) enable “safe” preparation of agents for medical personnel and ensure a safe hospital environment. However, artificial particles of infusion materials have been reported during CSTD use. Here, the incidence of insoluble fine particles during preparation of anticancer agents using CSTDs was examined. Visible insoluble fine particles were found in 465 (9.4%) of 4948 treatment cases at Ehime University Hospital with CSTD use. Contaminants occurred more frequently during preparation of monoclonal antibodies than cytotoxic anticancer agents (19.4% vs. 4.1%, respectively, P < 0.01). A similar survey was conducted at nine hospitals to investigate the incidence of insoluble fine particles with or without CSTDs. Insoluble fine particles were detected in 113 (15.4%) of 732 treatment cases during preparation of monoclonal antibodies with CSTD use. In contrast, the occurrence of insoluble fine particles without CSTDs was found in only 3 (0.073%) of 4113 treatment cases. Contamination with CSTDs might cause harmful effects on patients during cancer therapy. We strongly recommend the use of in-line filters combined with infusion routes after CSTD use to avoid contamination-associated adverse events.

Lifestyle segmentation of older Koreans: a longitudinal comparison of segments and life satisfaction

PurposeAging is a global phenomenon for many countries, and South Korea has become the fastest aging country in the world. The purpose of this study is to identify and validate a representative typology of older Koreans based on their lifestyle and value orientations. This study also makes a longitudinal comparison of these segments in two waves using similar survey data collected in 2009 and 2017 and examines any meaningful changes that occurred during the periods.Design/methodology/approachUsing survey data collected from 750 older adults living in four major cities in Korea, this study conducted factor and cluster analysis to identify lifestyle segmentation of elderly Koreans. Both descriptive and mean comparison analyses are followed to characterize the segments with relevant demographic and behavioral variables. In addition, this study makes a longitudinal comparison of these segments in two waves (2009 and 2017) and examines any meaningful changes that occurred during the periods.FindingsSix distinctive lifestyle segments of elderly Koreans are identified. The longitudinal comparison reveals some changes that occurred during the period. The level of importance of values and things to own has been declined during the period on most of the aspects, which can be interpreted that older Koreans become more realistic and practical. The level of life satisfaction between the two periods turned out to be similar. However, satisfaction in material comfort and health has been improved during the period, which means that the perception of their financial and physical aspects has been improved over the years.Originality/valueFirst, based on Tempest et al.’s three grey discontinuity framework (2002), the segmentation model provides comprehensive coverage of psychological transitions experienced by older people due to economic, physical and mental discontinuities with age. Second, this might be the first longitudinal study to examine the changes in segmentation over time in terms of the lifestyle of older adults. Practically, the findings of this study provide useful insights for policymakers in developing aging-related policies as well as for marketers who are interested or currently doing business in Korea or Asian consumer markets.

Wave exposure shapes reef community composition and recovery trajectories at a remote coral atoll

In a time of unprecedented ecological change, understanding natural biophysical relationships between reef resilience and physical drivers is of increasing importance. This study evaluates how wave forcing structures coral reef benthic community composition and recovery trajectories after the major 2015/2016 bleaching event in the remote Chagos Archipelago, Indian Ocean. Benthic cover and substrate rugosity were quantified from digital imagery at 23 fore reef sites around a small coral atoll (Salomon) in 2020 and compared to data from a similar survey in 2006 and opportunistic surveys in intermediate years. Cluster analysis and principal component analysis show strong separation of community composition between exposed (modelled wave exposure > 1000 J m−3) and sheltered sites (< 1000 J m−3) in 2020. This difference is driven by relatively high cover of Porites sp., other massive corals, encrusting corals, soft corals, rubble and dead table corals at sheltered sites versus high cover of pavement and sponges at exposed sites. Total coral cover and rugosity were also higher at sheltered sites. Adding data from previous years shows benthic community shifts from distinct exposure-driven assemblages and high live coral cover in 2006 towards bare pavement, dead Acropora tables and rubble after the 2015/2016 bleaching event. The subsequent recovery trajectories at sheltered and exposed sites are surprisingly parallel and lead communities towards their respective pre-bleaching communities. These results demonstrate that in the absence of human stressors, community patterns on fore reefs are strongly controlled by wave exposure, even during and after widespread coral loss from bleaching events.

Evaluation of Knowledge and Risk Perception about Antibiotic Resistance in Biology and Mathematics Young Students in Nîmes University in France

In response to the antimicrobial resistance issue, the World Health Organization developed and conducted a survey in 2015 dealing with habits, antibiotic use, awareness of appropriate use and sensitization to the issue of antibacterial resistance. In France, we conducted a similar survey to investigate the use of antibiotics and students’ perceptions of the antibiotic resistance risk. Our results indicated that antibiotics are moderately taken (42% in the last six months), but mistakes remain in appropriate practices and knowledge. Many people still believe that the body develops resistance to antibiotics and 24% responded that antibiotics can be stopped before the end of the treatment if they feel better. Furthermore, only 14% said antibiotics could be used to treat gonorrhea while 57% indicated that influenza could be treated with antibiotics. We looked at risk perception as well, and noticed that students in biology were more aware of risk (mean score = 48.87) and health consequences (mean score = 40.33) than mathematics students (mean score = 44.11 and 37.44). They were more aware of the threat, had a better understanding of antibiotic resistance and their denial of this risk was less significant (mean score = 27.04 against 23.81). However, the importance of providing a minimum level of knowledge to young students has been emphasized, regardless of the field of expertise.

Mental Health and Well-Being During the First vs. Second COVID-19 Pandemic Lockdown in Cyprus

Introduction: Following the onset of the COVID-19 pandemic, most countries imposed strict governmental lockdowns. Research investigating the psychological impact of pandemic-induced lockdowns is accumulating, though to date no study has examined the psychological health and associated parameters of well-being in countries that underwent additional lockdowns as the pandemic continued into resurgence “waves.” Aim: The present study provides an overview of the psychological impact of COVID-19 across the two lockdowns in the Cypriot population. Methods: In total, 957 participants completed an online survey during the first lockdown, 134 of whom completed a similar survey again during the second lockdown. The outcomes assessed included stress, positive and negative affect, and well-being. Results: The results indicated no population-wide severe reactions in the participants. Repeated measures analyses showed similar mental health levels during both the first and the second lockdowns. Further inspection of participants’ scores indicated that, for all mental health variables, approximately half of the participants improved, while the other half deteriorated. Discussion: Perceived social support and psychological flexibility predicted most psychological outcomes during both lockdowns. Further research is necessary to understand the continuing effects of the pandemic and associated lockdowns on mental health.

Case Study the Benefits of Integrating 3D Printing into Prosthetics by Comparing a Traditional Manufactured Prosthesis to a 3D Manufactured Transradial Prosthesis

This research study will be looking at the benefits and time-frame benefits of 3D printing. The purpose of this is to prove how the data collected agrees with past research studies on how the integration of 3D printing technology into the field of orthotics and prosthetics is considered beneficial. Participant one was given two sets of 10 questions to find a statistical significance between a traditional transradial prosthesis and a 3D manufactured transradial prosthesis. By doing this I then compared participant one's answers to a similar survey given to participants two and three, then drew the connection of how it is much more beneficial while also accounting for confounding variables. Consequently, this study concluded that the majority of answers benefited the integration of 3D printing. It proved this by having the participant explain their answers and also compare a traditional prosthesis to a 3D printed prosthesis specifically explaining the time-frame difference and the benefits of having the digitally manufactured prosthesis. This indicated how my research did support the past research done on this specific topic on how it is beneficial that 3D manufacturing should be integrated into prosthetics and orthotics. This study is solely correlational and analyzed data, meaning, it does not actually prove anything but was simply done to show the connection of the topic. With the results of this research it will add more support to the current body of research.

Quality of referrals to a rheumatology service before and after implementation of a triage system with telemedicine support

Purpose To evaluate the quality of referrals for a first Rheumatology consultation at a tertiary care center in a southern Brazilian capital (Porto Alegre, RS), having as background findings from a similar survey performed in 2007/2008. Since then, our state has implemented referral protocols and a triage system with teleconsulting support exclusively for referrals from locations outside the capital, permitting a comparison between patients screened and not screened by the new system. Methods Physicians of the Rheumatology Service at Hospital Nossa Senhora da Conceição prospectively collected information regarding first visits over a 6-month period (Oct 2017 to March 2018). We recorded demographic characteristics, diagnostic hypotheses, date of referral, and the municipality of origin (within the state of Rio Grande do Sul). We considered adequate referrals from primary health care when a systemic autoimmune inflammatory disease (SIRD) was suspected at first evaluation by the attending rheumatologist. Results Three hundred fifty-seven patients/appointments were eligible for analysis (193 from the capital and 164 from small and medium towns). In 2007/2008, suspected SIRD occurred in 76/260 (29.2%) and 73/222 (32.9%) among patients from the capital and outside counties, respectively (P = 0.387). In 2017/2018, suspected SIRD occurred in 75/193 (38.9%) and 111/164 (67.7%) in patients from the capital and outside counties, respectively (difference: 28.8, 95% CI: 19.0 to 38.9, P < 0.001), indicating a marked improvement in referrals submitted to the new triage system. Conclusion The quality of Rheumatology referrals in our state improved over the 10-year interval under study, particularly among patients from locations submitted to referral protocols and teleconsulting support.

Is There Progress towards Environmental Sustainability among Road Haulage Companies?

Road freight transport contributes to a significant and growing share of greenhouse gas emissions. This study analyses the development of environmental practices and awareness of road freight hauliers and whether hauliers witness an interest from their shippers towards energy efficiency. Results of an original survey (N = 256) conducted in 2019 among Finnish hauliers are presented and compared with those from a similar survey completed in 2011 (N = 295). The results highlight the lack of improvement in hauliers’ environmental practices during a decade when ambitious climate goals were set. Even though hauliers share the view that emissions from road freight transport must be reduced in future, their environmental practices did not change much during the 2010s. The hauliers rarely perceive an interest from their shippers towards energy efficiency. The results show that hauliers should be supported and encouraged to pursue more environmentally aware practices. Shippers in the supply chain should be a driver, not an obstacle, to increasing road hauliers’ sustainability. There should be more communication between hauliers and supply chain actors, and environmental sustainability should gain more importance when selecting carriers.

COVID-19 Vaccine Acceptability and Adherence to Preventive Measures in Somalia: Results of an Online Survey

Most countries are currently gravitating towards vaccination as mainstay strategy to quell COVID-19 transmission. Between December 2020 and January 2021, we conducted a follow-up online survey in Somalia to monitor adherence to COVID-19 preventive measures, and COVID-19 vaccine acceptability and reasons for vaccine hesitancy. Adherence was measured via a composite adherence score based on four measures (physical distancing, face mask use, hand hygiene, and mouth covering when coughing/sneezing). We analyzed 4543 responses (mean age: 23.5 ± 6.4 years, 62.4% males). The mean adherence score during this survey was lower than the score during a similar survey in April 2020. A total of 76.8% of respondents were willing to receive the COVID-19 vaccine. Flu-like symptoms were more frequently reported in the current survey compared to previous surveys. Multiple logistic regression showed that participants who experienced flu-like symptoms, those in the healthcare sector, and those with higher adherence scores had higher odds for vaccine acceptability while being a female reduced the willingness to be vaccinated. In conclusion, our data suggest that the decreasing adherence to COVID-19 preventive measures may have caused increased flu-like symptoms over time. COVID-19 vaccine acceptance in Somalia is relatively high but could be improved by addressing factors that contribute to vaccine hesitancy.

Vaccination coverage in cancer outpatients: An interventional multicenter before/after study.

e24026 Background: Despite largely diffused guidelines, Pneumococcal and Influenza vaccination coverage (VC) remains insufficient in cancer patients receiving chemotherapy. We evaluated VC and carried out an interventional study to improve VC in cancer patients treated in 3 medical oncology departments in 3 hospitals of North-of-France. Methods: Using a standardized questionnaire, we assessed the VC in adult cancer patients receiving anticancer treatment in day hospital between 02 and 07 Dec. 2019. Then, in each hospital, we organized trainings with physicians to discuss the current vaccination guidelines (January 2020). Finally, to assess the impact of this intervention on Pneumococcal and Influenza VC, we have conducted a similar survey using the same questionnaire in March 2020. Since there were no specific guidelines on Diphtheria-Tetanus-Pertussis (DTP) VC and we did not expect an improvement, we have monitored DTP VC as internal control. Results: 272 patients have been enrolled in the “before study” in the 3 hospitals, whereas 156 patients have been enrolled in the “after study” in only 2 hospitals (the after-study was not feasible in 3rd hospital because of COVID-19 pandemic national containment). Predictors associated with DTP VC was age, with Pneumococcal VC was center and with Influenza VC were age, gender and tumor histology (adenocarcinoma vs others). Influenza VC was significantly improved after intervention (42.6 vs 55.1% with p = 0.016) especially in fragile patients, but Pneumococcal VC was not (11.8 vs 15.4% with p = 0.357). Conclusions: As expected, VC was very low in cancer patients, our figures are consistent with literature data. The impact of intervention (training of physicians) is limited without improvement of Pneumococcal VC. We presume that this increase in Influenza VC mainly reflects the overall result of national Influenza vaccination campaign.