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Objectives: This study aimed to assess the relationship between COVID-19 infection-related conditions and depressive symptoms among medical staff after easing the zero-COVID policy in China, and to further examine the mediating role of professional burnout., Methods: A total of 1716 medical staff from all levels of health care institutions in 16 administrative districts of Beijing, China, were recruited to participate at the end of 2022 in this cross-sectional study. Several multiple linear regressions and mediating effects tests were performed to analyze the data., Results: At the beginning of the end of the zero-COVID policy in China, 91.84% of respondents reported infection with COVID-19. After adjusting for potential confounding variables, the severity of infection symptoms was significantly positively associated with high levels of depressive symptoms (β = 0.06, P < 0.001), and this association was partially mediated by professional burnout. Specifically, emotional exhaustion (95% CI, 0.131, 0.251) and depersonalization (95% CI, 0.009, 0.043) significantly mediated the association between the severity of infection symptoms and depressive symptoms., Conclusions: The mental health of medical staff with more severe symptoms of COVID-19 infection should be closely monitored. Also, interventions aimed at reducing emotional exhaustion and depersonalization may effectively reduce their risk of developing depressive symptoms.

The development of medical science allows the treatment of more and more health problems that in the past were not a factor of consumption of health resources, because at that time medical science did not have protocols for their treatment. Health problems that are now treatable, hereafter referred as "new health problems", often affect large population groups and require increased consumption of health resources. It therefore becomes necessary to increase the number of staff providing health services (doctors, nurses, etc.) and other resources. This raises the question: is it feasible to manage the "new health problems" by the existing medical staff? If not, are there other solutions? Could technology help the existing Medical Staff to sufficiently manage the "new health problems"? We will examine a pilot system "Recording and visualizing of outpatient monitoring data with smart mobile phones", which seeks to ensure the competence of existing medical staff in the effective treatment of the ever-increasing volume of transplant patients.

Introduction and Objective: Today's shortage of medical staff is a global healthcare issue. This leads to unfulfilled, growing health needs and rising wage pressure. The aim of the study is to evaluate employment trends among medical professionals in Poland from 2012-2022, paying particular attention to the employment sector, forms of employment, age, gender, and geographic distribution., Material and Methods: A quantitative analysis was carried out using public records and documents to identify trends over a decade, by the desk research method. Sources included: Organisation for Economic Co-operation and Development databases, Central Statistical Office databases and Ministry of Health Statistical Bulletins., Results: The observed increasing trend of physicians and nurses ratio after 2019, was caused mainly by a change in the methodology of calculating the indicator. There was a notable increase in the number of contracted medical professionals - 303% for nurses and 312% for midwives, and a decrease in the number of employed professionals. The number of contractors and employers in in-patient and long-term care has increased across all professional medical groups, while in outpatient care, the number has decreased. A definite ageing of medical staff was noted, with the percentage of midwives over 65 rising from 5.7% to 19.1%, and nurses over 65 rising from 5.4% to 22.3%., Conclusions: The demand for health services has increased, but the supply of medical staff has not kept pace with this demand. In addition to strategies related to increasing the number of human resources, solutions to better match resources to sectors of healthcare and better regional distribution should be considered. Solutions related to the skill-mix concept and the admission of new professions to the health sector may also be an opportunity for consideration.

This study aimed to identify the required capabilities and workload of medical staff in accelerator-based boron neutron capture therapy (BNCT). From August to September 2022, a questionnaire related to the capabilities and workload in the accelerator-based BNCT was administered to 12 physicians, 7 medical physicists and 7 radiological technologists engaged in BNCT and 6 other medical physicists who were not engaged in BNCT to compare the results acquired by those engaged in BNCT. Only 6-21% of patients referred for BNCT received it. Furthermore, 30-75% of patients who received BNCT were treated at facilities located within their local district. The median required workload per treatment was 55 h. Considering additional workloads for ineligible patients, the required workload reached ~1.2 times longer than those for only eligible patients' treatment. With respect to capabilities, discrepancies were observed in treatment planning, quality assurance and quality control, and commissioning between medical physicists and radiological technologists. Furthermore, the specialized skills required by medical physicists are impossible to acquire from the experience of conventional radiotherapies as physicians engaged in BNCT were specialized not only in radiation oncology, but also in other fields. This study indicated the required workload and staff capabilities for conducting accelerator-based BNCT considering actual clinical conditions. The workload required for BNCT depends on the occupation. It is necessary to establish an educational program and certification system for the skills required to safely and effectively provide BNCT to patients., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Japanese Radiation Research Society and Japanese Society for Radiation Oncology.)

Background: Radiation is an integral part of routine medical practice, but it carries a risk to the health of medical staff. Hence, it should be assessed periodically. The study's goal was to quantify the levels of radiation exposure for medical staff at King Faisal Medical Complex (KFMC), Taif City Saudi Arabia, and to assess their radiation protective procedures in practice., Methods: The study looked at the thermoluminescence dosimeters (TLDs) records of 50 medical professionals who were exposed to radiation while working at KFMC from 2019 to 2020 in Taif city, Saudi Arabia. In Riyadh, radiation exposure is read from skin TLDs using Harshaw model 6600 plus detectors. The Excel software was utilized to process the obtained data for calculating effective doses. A questionnaire was also distributed to the medical staff to assess their radiation protection procedures. The Statistical Package for Social Sciences (SPSS) program version 23 was used to analyze the obtained data., Results: The mean annual effective doses of the medical staff in 2019 and 2020 were determined to be 1.14 mSv and 1.4645 mSv, respectively, with no significant difference in effective doses between males and females in either year. The socio-demographic features of the medical personnel were examined, and the findings revealed that the majority of participants were male radiological technologists. The rate of adherence to radiation protection techniques was 68%, with a normally distributed dispersal. The amount of adherence varied significantly depending on nationality, occupation, and academic qualification., Conclusion: According to the research, the mean annual effective dosage for medical professionals at KFMC was significantly below the recommended level, indicating satisfactory compliance with the ALARA radiation safety concept., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: To explore the implementation of low-iodine diets by medical staff caring for patients with differentiated thyroid carcinoma prior to 131 I therapy across 58 hospitals, and offer valuable insights for the development of guidelines on low-iodine diets., Methods: Convenience sampling was utilized to conduct a survey among 163 medical staff members working in nuclear medicine departments across 58 tertiary hospitals using a self-designed questionnaire., Results: Concerning the duration of the low-iodine diet prior to treatment, the medical staff's recommendations were as follows: 58.28% suggested 2-4 weeks, 31.29% recommended more than 4 weeks, 9.2% opted for 7-13 days, and 1.23% favored less than 1 week. Regarding the timing of resuming a normal diet, the respondents' recommendations ranged from immediately after treatment (1.84%) to 3 months post-treatment (8.58%), with intermediate recommendations of 2 h (8.58%), 24-48 h (14.11%), post-discharge (12.26%), and 1 month (42.94%). Furthermore, the surveyed medical staff unanimously recommended abstaining from seafood, with 90.8% also advising against the consumption of iodized salt, 91.41% recommending avoidance of iodine-containing medications, and 71.17% advising caution with moderately high-iodine foods. Notably, 75.46% of the medical staff evaluated patient compliance with the low-iodine diet. When patients failed to adhere to the diet preparation, 33.74% of healthcare workers chose to proceed with treatment. In terms of guidance sources, 96.93% of respondents relied on relevant guidelines, 66.26% referred to the literature, and 49.69% drew upon their clinical experience. During hospitalization, 58.28% of the medical staff continued to guide patients on the low-iodine diet, while only 8.59% provided such guidance after discharge. Notably, only 20.25% of the staff considered consulting the nutrition department., Conclusion: This study underscored substantial variations in the duration and selection criteria for low-iodine diets, which were linked to a scarcity of standardized evaluations. Consequently, there is an urgent need for further research to establish detailed, practical, accessible, comprehensive, and dependable implementation programs for low-iodine diets., (© 2024. The Author(s), under exclusive licence to The Author(s) under exclusive licence to The Japanese Society of Nuclear Medicine.)

Introduction: Medical alliances are essential for constructing an hierarchical diagnosis and treatment (HDT) system; therefore, it is crucial to promote such alliances and evaluate their effectiveness in this regard from the medical staff perspective. This study thus investigated and analyzed the evaluations of medical staff in China concerning the effect of medical alliances on promoting HDT with the intention to encourage further establishment of medical alliances and HDT under China's new medical reform., Methods: A total of 616 medical staff personnel from 3 medical alliances in Fujian Province were surveyed, and data were analyzed using SPSS 20.0 software., Results: The level of medical institutions, posts and satisfaction with their medical alliances influenced the evaluation of medical alliance effectiveness in resolving the problem of expensive medical services. Primary medical institutions are more inclined toward policy formulation and related work; thus, the interests of primary hospitals can be guaranteed. However, tertiary hospitals must provide additional workforce, material, and financial resources to support primary hospitals., Discussion: Therefore, it is necessary to coordinate the interests of the medical staff at different levels of medical institutions. The study makes a significant contribution to the literature because it highlights the effect of medical alliances in promoting hierarchical diagnosis and treatment., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Zhao, Xie and Wu.)

Background: Many studies have covered the prevalence of obesity in different populations. However, studies on the prevalence and predictors of obesity among medical staff are lacking. The aim of our study is to investigate the prevalence of obesity among medical staff and to identify the related predictors., Methods: Using a snowballing recruitment strategy in the form of an electronic questionnaire, a cross-sectional survey was conducted among 1201 medical staff from cooperative hospitals between January and March 2022. We designed a questionnaire to investigate the participants' demographic, lifestyle, diet, physical activity, and work status., Results: The overall prevalence of obesity was 8.5%, with males (13.7%) having a greater incidence than females (5.7%) (p < 0.001). Multiple logistic regression analyses showed that alcohol drinking (OR, 2.34; 95% CI 1.23-4.42, p = 0.01), sugar-sweetened beverages consumed > 3/week (OR, 2.50; 95% CI 1.02-6.15, p = 0.046), and working a night shift > 1/week (OR, 2.17; 95% CI 1.02-4.61, p = 0.043) were independent predictive factors for obesity in men. For women, having midnight snack having midnight snack (OR, 2.93;95% CI 1.24-6.96, p = 0.015), good sleep quality (OR, 4.47; 95% CI 1.10-21.70, p = 0.038), and working a night shift > 1/week (OR, 3.62; 95% CI 1.73-7.57, p = 0.001) were independently associated with obesity., Conclusions: Obesity presented a low prevalence among medical staff. Alcohol drinking, drinking sugar-sweetened beverages > 3/week, and night shift > 1/week predicted a higher risk of obesity in males. In females, having midnight snack, good sleep quality, and night shift > 1/week were independently associated with obesity., Level of Evidence: V, descriptive study., (© 2024. The Author(s).)

Background: Quality assessments are being introduced in many countries to improve the quality of care and maintain acceptable quality levels. In South Korea, various quality assessments are being conducted to improve the quality of care, but there is insufficient evidence on intensive care units (ICUs). This study aims to evaluate the impact of ICU quality assessments on the structural indicators in medical institutions and the resulting in-hospital mortality of patients., Methods: This study used data collected in the 2nd and 3rd ICU quality assessments in 2017 and 2019. A total of 72,879 patients admitted to ICUs were included during this period, with 265 institutions that received both assessments. As for structural indicators, changes in medical personnel and equipment were assessed, and in-hospital deaths were evaluated as patient outcomes. To evaluate the association between medical staff and in-hospital mortality, a generalized estimating equation model was performed considering both hospital and patient variables., Results: Compared to the second quality evaluation, the number of intensivist physicians and experienced nurses increased in the third quality evaluation; however, there was still a gap in the workforce depending on the type of medical institution. Among all ICU patients admitted during the evaluation period, 12.0% of patients died in the hospital. In-hospital mortality decreased at the 3rd assessment, and hospitals employing intensivist physicians were associated with reduced in-hospital deaths. In addition, an increase in the number of experienced nurses was associated with a decrease in in-hospital mortality, while an increase in the nurse-to-bed ratio increased mortality., Conclusions: ICU quality assessments improved overall structural indicators, but the gap between medical institutions has not improved and interventions are required to bridge this gap. In addition, it is important to maintain skilled medical personnel to bring about better results for patients, and various efforts should be considered. This requires continuous monitoring and further research on long-term effects., (© 2024. The Author(s).)

Even though China Antarctic medical care has made huge progress, dental care has always been a neglected area. Dental health is well-known to be closely related with life quality and work efficiency. Hence, knowing the dental care situation there and providing ways to improve are urgently needed. We choose doctors who worked in China Antarctic station as a window to see the whole picture by sending questionnaire. The results showed dental visits ranked second high, the ratio of doctors who got pre-departure dental knowledge education and screen is low. What is worse, none of them got any after-departure dental check. Their dental knowledge is not as good as we expect, and they were troubled by dental problems in Antarctic. Interestingly, most dental problems were treated by non-dentist with no essential equipment, but 2/3 of them were satisfied with the outcome. As for the dental-related diet and behaviour, snacks eating and alcohol drinking are the strongest predictors of dental pain and gum problem. Those findings are crucial to Antarctic dental care and research.

Purpose: In recent years, the Chinese government has implemented measures to address the rising rate of cesarean deliveries and promote vaginal births, with the aim of improving women's childbirth experience. However, non-medically necessary cesarean sections and repeated cesarean sections remain prevalent. This study seeks to explore the correlation between mode of delivery and childbirth experiences. Additionally, it examines the moderating and mediating effects of support from medical staff and women's self-assessment of health on maternal satisfaction across different delivery methods., Material and Method: This cross-sectional survey was conducted with 140 Chinese mothers who were 1-10 days post-partum at three tertiary hospitals. The mothers were asked to fill out a socio-demographic data form and questionnaires related to women's maternal satisfaction, mode of delivery, self-assessed health, and perception of medical staff support while they were in the hospital after delivery. The data from the questionnaires were analyzed and compared using SPSS 24.0 and PROCESS 3.2., Results: This study discovered that the mode of delivery (vaginal birth or C-section) and the perception of support from medical staff significantly influenced maternal satisfaction (β = 0.82, t  = 3.42; β = 0.82, t  = 10.23). Specifically, women who had a vaginal birth reported higher levels of satisfaction compared to those who had a C-section. The study also found that the perception of medical staff support played a mediating role in this relationship, indicating its influence on women's satisfaction (β = 0.78, t  = 9.58; indirect effect = 0.43, Boot SE = 0.15; 95% CI= [.12-.73]). Furthermore, women's self-assessed health acted as a moderator in the relationship between the mode of delivery and medical staff support (β = -0.53, t = -2.39; indirect effect = -0.41, Boot SE = 0.19; 95% CI= [-.80-.05])., Conclusion: The childbirth experience of Chinese women is greatly influenced by factors such as vaginal birth, their perception of care support from medical staff, and their self-assessment of health. This highlights the importance of healthcare professionals providing women-centered maternity services and childbirth education, which can help reduce unnecessary medical intervention and the need for tertiary obstetric care.

Background: In China, fragmented and inefficient health care systems are common while quality resources are limited. To promote an organized, efficient system, the government launched a medical consortium policy to vertically integrate health care through the collaboration of different levels of medical care. Logically, medical staff's knowledge, attitudes and practices (KAP) regarding the consortium are critical for its development. The objective of this study was to explore the KAP regarding the medical consortium among medical staff in a medical consortium in Sichuan Province, China., Methods: A cross-sectional survey was conducted. In total, 690 medical staff members in 3 cities of Sichuan Province, China, were interviewed from November 2018 to December 2018. The questionnaire consisted of 18 items, including 4 items related to perceived knowledge, 4 items related to attitudes and 2 items related to practices, and was rated on a 5-point Likert scale (one = strongly disagree/do not know, five = strongly agree/know)., Results: The effective response sample was 640 copies of the questionnaire, and most medical staff members (92.50%) knew about the cooperation with other hospitals in the medical consortium. Medical staff scored differently on each item in the questionnaire, with the highest score being the item 'agreeing with the ward rounds and clinical teaching and training organized by the leading hospital' (4.54 ± 0.76), and the lowest score being the item 'frequency in participating in ward rounds and clinical teaching organized by the leading hospital' (2.83 ± 1.36). In addition, the effect of demographic characteristics on KAP was evaluated by stepwise multiple regression analysis, and a significant positive correlation was found between all the studied variables by Spearman's correlation (p < 0.05)., Conclusions: This study showed that the attitudes toward and knowledge of the medical consortium significantly contribute to practices, satisfaction with the support work performed by the leading hospital and agreement of improvement after joining the medical consortium. Thus, to improve medical staff's KAP and satisfaction, publicity and educational programs in medical consortia are necessary, and the leading hospital should attach importance to the informatization construction and demand of different medical staff members., Clinical Trial Registration: There are no clinical trials in this study., (© 2023. The Author(s).)

Objectives: We aim to understand the current situation of the first aid ability and training needs of Chinese medical personnel to provide a scientific basis for formulating the contents and methods of emergency medical rescue training and thereby improve the first aid level of Chinese medical personnel., Methods: A cross-sectional survey was conducted between June 2022 and February 2023 using a two-stage cluster sampling method with a structured questionnaire sent to medical workers in 12 provinces in China. 14,527 questionnaires were included in this study. Data were collected on demographic characteristics, first aid knowledge and skills, and training needs. Variance analysis was used to compare the difference between the first aid ability and training needs of medical staff in different hospitals, and multiple linear regression analysis was carried out to evaluate first aid ability and training needs., Result: The study included 6041 patients (41.6%) in tertiary hospitals, 5838 patients (40.2%) in secondary hospitals, and 2648 patients (18.2%) in primary hospitals. There were significant differences in the first aid ability and training needs of medical staff in hospitals of different levels (p < 0.001). The score of first aid knowledge and skills in tertiary hospitals was the highest (209.7 ± 45.0), and the score of training needs in primary hospitals was the highest (240.6 ± 44.0). There was a significant correlation between first aid ability and training needs score (p < 0.001). Multiple linear regression analysis shows that geographic region, age, work tenure, gender, job title, department, professional title, monthly income, and hospital level are the influencing factors of training demand., Conclusion: Medical staff in primary hospitals generally have low first aid knowledge and skills and a strong willingness to train. Therefore, it is imperative to strengthen the training of first aid ability and research training strategies. The level of the hospital is closely related to the level of first aid, so it is necessary to recognize the commonalities and differences in medical staff's demand for first aid knowledge and skills and carry out targeted education and training., (© 2023. The Author(s).)

Background: There are some gaps between the training of drug information service competencies for medical staff and drug information patients need in China., Objective: To investigate drug information patients obtained and need for further providing directions for the training of drug information service competencies among medical staff in China from patients' perspectives., Methods: A face-to-face nationwide survey was conducted using a stratified sampling method. Data were analyzed descriptively using frequencies, percentages and mean. Several subgroup analyses using Chi-square tests were conducted to identify patients' need for drug information in China., Results: A total of 1994 questionnaires from medical institutions in China were returned. Most of the drug information obtained by patients came from physicians, and different types of drug information were important to patients. Additionally, patients had different needs for drug information due to age, gender, diagnosis and treatment status, and education level., Conclusions: The training of medical staff needs to increase the presence of nurses and pharmacists in drug information services, enhance the awareness of "patient-centered" services, and improve the ability to provide information services specific to the characteristics of patients., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Aim: The purpose of this study was to provide a comprehensive understanding of the attitudes and experiences of the medical staff regarding the hospital bed-sharing model., Design: The present research was a qualitative study., Methods: This qualitative study used in-depth individual interviews with 7 doctors, 10 clinical nurses and 3 head nurses, which were then transcribed and analysed thematically., Results: The study identified six overall themes. Issues were raised about the efficient utilization of hospital bed resources, greater challenges for nursing work, adjustment of doctors' work modes, barriers to communication between doctors, nurses, and patients, potential medical risks, and differentiation of patients' medical experience., Implications for Nursing Management: Hospital administrators and nurse managers should work together to solve the challenges that medical staff face, including strengthening nursing training, improving medical-nursing collaboration models, standardizing and effective communication strategies, and improving patient experiences., (© 2023 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Objectives: There is currently no measure of the hospital organizational environment targeting both clinicians and nurses in China. This study was conducted with the aim of developing and testing an instrument to assess the properties of the hospital organizational environment that is applicable to Chinese medical staff., Methods: Items were developed based on a literature review, semi-structured interviews and an expert review and finalized based on corrected item-total correlation, content validity, construct validity, convergent validity, discriminant validity and reliability. The two samples for testing the first and final version of the Hospital Organizational Environment Scale (HOES) included 447 and 424 participants, respectively., Results: The primary test, which comprised 18 items, contained four factors: hospital culture, work situation, organizational support and scientific research situation. The Cronbach's alphas were 0.935, 0.824, 0.943, and 0.920, respectively. The results of the validation test showed that the questionnaire had good validity and reliability., Conclusion: The HOES is a comprehensive instrument with demonstrated validity and reliability that can be adopted among medical staff to assess the organizational environment in hospitals., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Wang, Zhang, Feng, Liang, Guan and Meng.)

Objective: To explore the moderating mechanism of mindfulness on perceived stress and job burnout of medical staff. Methods: From November 2020 to March 2022, 1626 medical staff were investigated by questionnaires. Chinese Version Perceived Stress Scale (CPSS), Maslach Burnout Inventory-Human Service Survey (MBI-HSS) and Mindful Attention Awareness Scale (MAAS) were used to evaluate the perceived stress, three dimensions of job burnout[depersonalization (DP), emotional exhaustion (EE), personal accomplishment (PA) ], and mindfulness level of medical staff. The Spearman rank correlation analysis was used to analyze the correlation between mindfulness and perceived stress, job burnout of medical staff. And the SPSS PROCESS macro program was used to test the moderating effect of mindfulness on perceived stress and job burnout. Results: Among the 1626 medical staff, 57.38% had perceived stress with health risk (933/1626), and 63.84% (1038/1626) had job burnout, among them, with 618 (38.01%), 274 (16.85%), and 146 (8.98%) experiencing mild, moderate and severe job burnout, respectively. The scores of mindfulness among medical staff were significantly correlated with perceived stress and various dimensions of job burnout (EE, DP and PA) ( r (s)=-0.155, -0.351, -0.315, 0.307, P <0.001). Mindfulness had a moderating effect between perceived stress and job burnout, which was achieved through three moderating pathways: perceived stress-mindfulness-EE, perceived stress-mindfulness-DP and perceived stress-mindfulness-PA (Δ R (2)=0.073, 0.06, 0.006, P <0.001) . Conclusion: Medical staff have a high level of job burnout, mindfulness plays a moderating role between perceived stress and job burnout. Specific measures can be taken to improve the level of mindfulness in medical staff, so as to prevent and alleviate job burnout of medical staff.

Objective: To understand abnormal thyroid function and its associated factors among medical staff in radiotherapy departments., Methods: Data related to medical staff in radiotherapy departments who met the inclusion and exclusion criteria were analyzed from September to December 2022 in Shenyang, Liaoning Province, including basic personal and lifestyle habits, work information, and scores on the Depression Self-Assessment Scale, Perception Stress Scale, and the Generalized Anxiety Scale. Data analysis was performed using the χ 2 test and binary logistic regression., Results: Among 484 medical staff in the radiotherapy department, 147 (30.4%) had abnormal thyroid function. Binary logistic regression analysis showed that age, years of work, smoking, occupational exposure, smoking, late-night snacking habits, depression, and stress perception were factors associated with abnormal thyroid function among medical staff in radiotherapy departments; on the other hand, physical exercise was a protective factor., Conclusion: The positive rate of thyroid dysfunction among medical personnel in the radiology department is relatively high. It is necessary to strengthen health education and awareness among relevant practitioners and improve the coverage of occupational disease prevention and control education., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Ren, Ren, Bai, Shang and Li.)

The staff of the Radiation Protection Service of a European clinical center measured the radiation dose by type-tested thermoluminescent dosemeter systems to which the medical staff was exposed, to assess the effectiveness of current procedures and equipment for optimalisation prompted by the requirements EU Basic Safety Standard 2013. There were three participating sites, the Site 1 was an external hospital, whereas Sites 2 and 3 are part of the same clinical center, who provided data regarding their personnel, from technologists, nurses and medical doctors. In this preliminary study, only a low number of cases were available and used to establish a new, more realistic yearly dose constraint, namely 6 (from two) mSv for whole-body effective dose, 15 (from two) mSv for eye lens dose and 300 (from 50) mSv for extremity dose. Furthermore, the state of safety culture and protection equipment was assessed. Collection of the sufficient amount of data for statistical evaluation is ongoing., (© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Background: Night shift work-related disturbed biological rhythm and insufficient sleep affect the functioning of brain activity and thus impair cognitive performance and mood state, which potentially leads to negative and even devastating results for both individuals and patients. A virtual reality (VR)-based restorative environment has shown to be an effective new technique to reduce stress and improve cognitive performance, but little is known about its mechanism of improving neuronal activity and connectivity., Methods: This is a randomized, controlled, single-center clinical trial. A total of 140 medical staff will be enrolled and randomized in a 1:1 allocation to either the VR immersion group (intervention group) or the control group. In the morning after the night shift, the participants in the intervention group will watch 360° panoramic videos of immersive VR natural restorative environments for 10 min, while the participants in the control group will just rest for 10 min. Assessments of abbreviated Profile of Mood States Questionnaire (POMS) and verbal fluency task (VFT) performances, as well as oxygenated hemoglobin (oxy-Hb) and deoxygenated hemoglobin (deoxy-Hb) and total hemoglobin concentration acquired by functional near-infrared spectroscopy (fNIRS) will be performed at baseline (day work), the morning after night shift but before the intervention (previous) and after intervention (post). Data collected after a night shift will be compared to baseline performance as well as between the two groups., Discussion: This trial will investigate the effects of the night shift and VR-based restorative environment intervention on mood, cognitive performance, and neuronal activity and connectivity. A positive result in this trial could encourage hospitals to apply VR technology to reduce physical and mental dysfunction during of night shifts among medical staff in every department. Furthermore, the findings from this study will contribute to understanding the underlying neuromodulation mechanisms of how restorative environments influence mood and cognition., Trial Registration: Chinese Clinical Trial Registry ChiCTR2200064769 . Registered on 17 October 2022., (© 2023. The Author(s).)

Objective: Acute severe behavioural disturbance (ASBD) is a condition seen with increasing frequency in EDs. It poses a significant risk to the patient and those around them. Little is known about the epidemiology or most effective management in the paediatric population. The aim of the present study is to clarify the practice of senior emergency doctors in Australia when managing paediatric ASBD., Methods: The present study was a voluntary electronic questionnaire distributed to and undertaken by senior medical staff in EDs affiliated with the Paediatric Research in Emergency Departments International Collaborative (PREDICT) network. Respondents reported on exposure to and confidence in managing paediatric ASBD and their current practices., Results: A total of 227 (33%) clinicians completed the survey between February and May 2020. Most clinicians were caring for at least two young people with ASBD each week (72%), felt confident regarding the majority of components of management and referred to local clinical practice guidelines (69%). Agitation/sedation rating scales were seldom used (19%). There was a significant variation in self-reported management practices. The choice of whether to use medication at all, the medication chosen and route of administration all varied greatly. Respondents were more willing to provide parenteral medication to young people reported as having recreational drug intoxication (84%) than those with neurodevelopment disorders (65%) when the same degree of agitation was reported., Conclusions: Within Australia, there is considerable variation in paediatric ASBD practice, in particular regarding medication provision. Further prospective research is required to inform best clinical practice., (© 2022 The Authors. Emergency Medicine Australasia published by John Wiley & Sons Australia, Ltd on behalf of Australasian College for Emergency Medicine.)

Subjective well-being is a crucial index measuring the mental health of medical staffs, and it is necessary to examine the changes in subjective well-being (SWB) level of Chinese medical staffs with time. A cross-temporal meta-analysis was performed using papers that measured the SWB level of Chinese medical staffs between 2004 and 2020. Moreover, a time-lag analysis was conducted to define whether the macro-social indicators can explain the changes in SWB. A total of 47 papers were included in the final sample. The results revealed that score of SWB was significantly negatively correlated with the year. Score of SWB was significantly associated with six social indicators of economic condition (the residents' consumption level, housing prices, and old-age dependency ratio), social connectedness (the divorce rate and the urbanization level), and overall threat (the crime rate), which indicated that social change may account for the decline of Chinese medical staffs' SWB level. Our study revealed a decreasing trend of Chinese medical staffs' SWB level over time, which was associated with macro-social changes in diverse areas. In addition, combined with the corresponding macro-social indicators, a three-dimensional theoretical framework is proposed to explain the SWB for medical staffs as a group., (© 2022 International Association of Applied Psychology.)

Objective: The aim: To identify positions that are relevant for practical use in improving the process of human resource management in healthcare., Patients and Methods: Materials and methods: Comparative analysis of motivation theories., Conclusion: Conclusions: Human resources are a key intangible resource of a society or any organization. In today's post-industrial society, the development of a knowl¬edge-based economy with the introduction of innovative technologies, principles of teamwork; improving the educational, cultural and qualification level of employees, democratization of socio-economic life in the country against the background of increasing population mobility and competition in the context of globalization, sets requirements for human resource management in such an important area as health care, in particular, in terms of activities to increase their motivation. Understanding the essence of motivation theories proves that people have different needs, so knowledge of different motivation theories can be used to manage medical staff.

Background: The present study examines the treatment practice and attitudes of medical staff towards opioid-dependent inmates in Bavarian prisons., Method: We interviewed medical staff (n=20) from 18 Bavarian prisons about substitution practice and attitudes by semi-structured interviews., Results: With regard to the treatment routines and the attitudes of the medical staff, we found mixed results. From the perspective of the medical staff, the treatment decision depends on the patients' wishes, the severity and duration of the dependence, the length of sentence and organizational factors. Problems were discussed in particular with regard to the care situation inside and outside the prisons and difficulties in transition management., Conclusions: Substitution therapy is considered a standard treatment method in prisons today. However, our respondents highlighted some disadvantages (e. g. passing on the substitution drug). Although the treatment goal of complete abstinence was generally viewed positively by a part of the medical staff, it was not considered very realistic. From the point of view of the respondents, special attention should be paid to the continuity of the chosen treatment strategy in the context of discharge management., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Objectives: During the COVID-19 pandemic, excessive workload, a rapidly changing workplace environment, the danger of carrying the virus and transmitting the disease to their families, relatives and those they live with creates stress for the medical workers. In our study, we aimed to evaluate the state and trait anxiety levels of healthcare professionals who encounter patients with suspected COVID-19 infection and related factors., Method: Data were collected from healthcare professionals working with patients diagnosed or suspected with COVID-19 via online self-report questionnaire between 9-19 April 2020. The state (STAI-S) and trait anxiety (STAI-T) scale was used to measure anxiety., Results: A total of 291 healthcare professionals, 216 women and 75 men, participated in the study. Women's state and trait anxiety were significantly higher than men's. 11 participants without any lifetime psychiatric illness experienced psychiatric symptoms and consulted to a psychiatrist. The state anxiety of those who have children, nurses and those working in branches directly related to the pandemic (Infectious Diseases, Respiratory Diseases, Emergency Medicine, Internal Medicine, Radiology, Anesthesiology and Reanimation) was higher than others. The state anxiety of those who thought they were not protected with personal protective equipment and those who did not stay in their own home was higher than others., Conclusions: At the forefront of the fight against COVID-19, there are medical personnel who pay a serious psychological cost. Especially in terms of anxiety, we should pay attention to women, workers with children, nurses and people working in branches that are directly related to pandemics.

Objective: Taking Zhongda Hospital in China as an example, this study discusses the impact of comprehensive use of PDCA and FMEA management tools on the work efficiency, teamwork, and self-identity of medical staff., Methods: Two hundred medical staff in our hospital from January 2020 to December 2021 were selected as the research subjects, and the 200 medical staff were divided into a control group and a research group by the digital table method, with 100 cases in each group. The medical staff in the control group implemented conventional system management methods, while the research group comprehensively used PDCA and FMEA management tools based on implementing conventional system management. The differences in work efficiency, teamwork, and self-identity of medical staff were compared., Results: Before the study, there exhibited no significant difference in the work efficiency, teamwork, and self-identity scores of medical staff ( P > 0.05). After an intervention, the work efficiency, teamwork, and self-identity scores of medical staff in the study group were higher than those in the control group ( P < 0.05). After the intervention, the management quality score of the research group was higher than that of the control group ( P < 0.05); after the intervention, the medical staff in the research group had lower work efficiency, insufficient professional ability, and insufficient management system cognitive behaviours than that in the control group ( P < 0.05)., Conclusion: The comprehensive use of PDCA and FMEA management tools in internal hospital management can remarkably enhance the work efficiency, teamwork, and self-identity of medical staff., Competing Interests: The authors declare that there are no conflicts of interest., (Copyright © 2022 Hui Chen et al.)

BACKGROUND The emergence of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) and the sudden inflow of patients with severe COVID-19 (coronavirus disease 2019) symptoms increased demand for hospital and pre-hospital care, the latter being provided by emergency medical teams. The Polish Medical Air Rescue Services include the Helicopter Emergency Medical Service (HEMS) and the airplane-based Emergency Medical Service (EMS). This study aimed to present the experience of the Polish Medical Air Rescue Service during the first year of the COVID-19 pandemic and measures taken to protect patients, medical staff, and air crew from SARS-CoV-2 infection. MATERIAL AND METHODS We conducted a retrospective analysis of missions completed by the Polish Medical Air Rescue crews with respect to confirmed SARS-CoV-2 cases. We analyzed data from the medical records of the Polish Medical Air Rescue Service, which included flights to accidents and emergencies, and air patient transport missions, where medical assistance was provided to patients with confirmed SARS-CoV-2 infection in the first year of the pandemic in Poland. RESULTS Among the COVID-19 patients, the most common comorbidity was acute respiratory failure (41.58%). Emergency missions more often concerned older patients with sudden cardiac arrest, dyspnea, upper respiratory tract infection, stroke, and acute coronary syndromes. CONCLUSIONS During the first year of the COVID-19 pandemic in Poland, the Polish Medical Air Rescue Service implemented procedures to protect patients, medical staff, and air crew from SARS-CoV-2 infection. This study highlights the importance of using single-patient isolation units for patient transport between hospitals and for emergency hospital admissions when the SARS-CoV-2 status of the patients were unknown.

Facing with COVID-19 epidemic such a catastrophic health emergency, the mental health status of medical staff deserves attention. We conducted a two-stage of psychological status monitoring after the end of the assistance and 14 days of isolation, further targeted the vulnerable groups in need of intervention. The study is a cross-sectional survey on 1156 Yunnan medical staff aid to Hubei. Used Cluster sampling method to collect data at 2 time points (at the end of returning from Wuhan and the 14th day of isolation), from March 18, 2020 to April 6, 2020. Female and nurse had higher rates of depressive symptoms than male and doctors and other occupations. The proportion of female with mild and above moderate anxiety levels (22.91%, 2.61%) was higher than male (17.35%, 1.03%) (p < 0.05). Female had a better impaired sleep quality (45.06%, 17.49%) more than male (28.57%, 7.94%). Medical staff supported in Wuhan and with junior professional titles reported a higher proportion of sleep quality impairment. At the 14th isolation day stage, the proportion of nurses changed from depression to health (9.15%) and from health to depression (6.1%) better than doctors. The front-line medical staffs had suffered greater psychological pressure in the treatment process of major public health emergency. Researches on the dynamic monitor for the change of psychological status after aiding epidemic areas were still in relatively blank stage. Targeting the vulnerable characteristics of aiding medical staff is significant for effective psychological intervention and sustainable operation of health system., (© 2021. The Author(s).)

Background: Medical staff scheduling problems are complex and involve numerous constraints., Objective: This research uses the task-technology fit (TTF) model to measure the technology characteristics of information technology (IT) systems as a reference for constructing a prototype for a medical staff scheduling system to identify function requirements and design human interfaces., Method: After the evaluation of the proposed scheduling system, this research excludes compatibility from the 13 technology characteristics and adds two technology characteristics for consideration: customization and scalability., Results: Based on the revised technology characteristics of the TTF model, this research develops flexible scheduling functions to satisfy daily manpower requirements and allow predetermined schedules and day-off reservations for a hospital's radiological technologists. Characterized by flexibility, customization, and scalability, the system can accommodate several algorithms to generate a better schedule that satisfies hard and soft constraints. Furthermore, the scheduler can choose the required hard and soft constraints from all constraints. The prototype of the scheduling system will be easily extended to add or modify constraints in the case of requirement or regulation changes., Conclusion: The results of this study provide a prototype for system developers to design a customized staff scheduling system for each medical unit.

Objective: The aim: Research of the ways of adequate solving of problems with understuffed healthcare system and problems with continuous professional development of doctors., Patients and Methods: Materials and methods: We have used a official statistical data for the period from 2009-2020 years. This data was analyzed with usage of systemic approach and statistical epidemiological analysis., Results: Results: According to the data from Ministry of Health of Ukraine during the first year of the pandemic (2020) the quantity of our doctors has diminished by 6.9 thousands, and quantity of nurses - by 22,5 thousands which is much bigger deficit then in period of 2018-2019 years. The insufficiency of pediatric doctors in Ukraine has reached 1000 vacancies, general physicians - 1700, family doctors - more than 3000 vacancies, surgeons - more than 950 vacancies. It is also important to involve medical experts and medical associations and unions in the process of accreditation and licensing of providers of continuous medical education., Conclusion: Conclusions: Existing deficit of medical personnel should be replenished by increasing of medical education of students in medical universities and colleges funded by government. Existing system of continuous professional development of doctors requires a lot of changes (additional activities, new technologies) which must be implied with the help of professional medical associations and unions.

Objective: This study aimed to understand the perception of patient safety and the reporting system in public in China, and make further recommendations for the optimization of the reporting system of patient safety., Methods: The following data were collected through an online questionnaire from medical staffs and patients: recognition of patient safety, comments on patient participation, comments on spontaneous reports, attitudes toward the principles of spontaneous reports, and willingness to participate. This information was presented with frequency and percentage with 95% confidence intervals (CIs). Spearman rank correlation was used to evaluate the association of those data., Results: A total of 27,493 valid questionnaires were collected in this study. The participants who knew patient safety very well, regarded patients as an essential part to enhance patient safety, viewed spontaneous reports helpful, agreed on the 3 principles of voluntariness, anonymity, and nonpunishment of the reporter, and were willing to participate in reporting were accounted for 39.2% (95% CI, 38.6%-39.8%), 31.2% (95% CI, 30.7%-31.8%), 25.2% (95% CI, 24.7%-25.7%), 24.0% (95% CI, 23.5%-24.5%), and 19.9% (95% CI, 19.4%-20.4%), respectively. A moderate positive correlation was observed between comments on spontaneous reports and attitudes toward the principles of spontaneous reports (medical staffs versus patients, rs = 0.452 versus rs = 0.439; both, P < 0.01), as well as comments on patient participation and comments on spontaneous reports (medical staffs versus patients, rs = 0.410 versus rs = 0.460; both, P < 0.01)., Conclusions: The awareness of patient safety may influence the choices of the other questions subsequently and may affect their voluntariness for safety reports ultimately. Pertinent measures, such as publicity of the relevant concept, simplification of the reporting procedures, and promotion of incentive mechanisms, should be adopted to promote the optimization of the reporting system., Competing Interests: The authors disclose no conflict of interest., (Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc.)

Introduction: Violence against medical staff has been prevalent in China over the past two decades. Although Chinese authorities have released many laws and regulations to protect medical staff from violence since 2011, the legal approach alone is unlikely to resolve this complex issue. In particular, several cases of violence against medical staff in China have caused great media sensation., Method: This paper proposes an integrated model that combines the environmental stimuli theory, broken windows theory, and rational choice theory. It adopts the fuzzy set qualitative comparative analysis (fsQCA) to untangle the causal relationship between violence against medical staff, media sensation, and judicial judgment. We examined reports of medical violence on media and news websites from January 1, 2010, to January 31, 2020, and selected 50 cases with detailed information for this study., Results: The results show that each condition is not sufficient for the absence of judicial judgment, but when combined, they are conducive to the outcome. The conditions of hospital level, medical cost, and media sensation play important roles. The providers, patients, and environmental factors are indicators of inadequate or lack of judicial judgment, which corresponds to previous expectations., Conclusions: The integrated model greatly enriches the extant theories and literature, and also yields implications for preventing violence against medical staff in China. We suggest that sustainable and innovative healthcare reform should be initiated. For example, public hospitals should remain the cornerstone of national public health security. Medical staff in public hospitals must be regarded as "civil servants". Therefore, the current legal system should be improved. The media should objectively report events concerning medical staff and improve public healthcare knowledge., Competing Interests: The authors have declared that no competing interests exist.

Objective: The purpose of our study was to assess the knowledge and attitudes toward expanded carrier screening (ECS) between the medical staff and general population in China., Study Design: It was a survey-based cross-sectional study in Chinese. We provided an online survey for the general public nationwide. We classified the population into the medical staff and general population to evaluate the knowledge gap and provide a reference for ECS's education programs. Except for obstetrician-gynecologists and nurses in the department of Obstetrics and Gynecology, other medical staff were not included in our study. A total of 1947 questionnaires were collected from July 11, 2020 to February 10, 2021. Two hundred and eighty-four questionnaires were excluded from further analysis. The remaining 1663 cases were incorporated into the final analysis. Data were analyzed using IBM SPSS Statistics 26. Comparisons between categorical variables were tested by the use of crosstabs and χ2 test., Results: The total awareness rates of the knowledge about monogenic diseases and ECS in the respondents were low, with 35.7%, 26.1%, 3.3%, 23.3%, 24.1%, 55.2%, and 23.4% for questions Q1-Q7, respectively. Medical staff had more knowledge than general population. Knowledge about monogenic diseases and ECS was positively correlated with educational level. Most respondents showed a positive attitude toward ECS: 54.4% thought ECS was necessary, and 80.5% wanted to know more about monogenic diseases., Conclusion: Although the public had little knowledge about monogenic disease and ECS, most of them showed a positive attitude. Our cross-analysis showed that medical staff had more knowledge compared to general population. Pre-test education for ECS can be carried out by medical staff who are not qualified for genetic counseling. ECS training for medical staff, especially obstetrician-gynecologist and nurse in the department of Obstetrics and Gynecology, can reduce the workload of genetic counseling., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021. Published by Elsevier B.V.)

Objectives: Depression is highly prevalent in non-Hodgkin's lymphoma (NHL) patients undergoing chemotherapy. The social stress associated with malignancy induces neurovascular pathology promoting clinical levels of depressive symptomatology. The purpose of this study was to establish an effective depressive symptomatology risk prediction model to those patients., Methods: This study included 238 NHL patients receiving chemotherapy, 80 of whom developed depressive symptomatology. Different types of variables (sociodemographic, medical, and psychosocial) were entered in the models. Three prediction models (support vector machine-recursive feature elimination model, random forest model, and nomogram prediction model based on logistic regression analysis) were compared in order to select the one with the best predictive power. The selected model was then evaluated using calibration plots, ROC curves, and C -index. The clinical utility of the nomogram was assessed by the decision curve analysis (DCA)., Results: The nomogram prediction has the most efficient predictive ability when 10 predictors are included (AUC = 0.938). A nomogram prediction model was constructed based on the logistic regression analysis with the best predictive accuracy. Sex, age, medical insurance, marital status, education level, per capita monthly household income, pathological stage, SSRS, PSQI, and QLQ-C30 were included in the nomogram. The C -index was 0.944, the AUC value was 0.972, and the calibration curve also showed the good predictive ability of the nomogram. The DCA curve suggested that the nomogram had a strong clinical utility., Conclusions: We constructed a depressive symptomatology risk prediction model for NHL chemotherapy patients with good predictive power and clinical utility., Competing Interests: The authors declare that there are no competing interests., (Copyright © 2021 Cheng Hu et al.)

Background: Medical staff is the main force behind the construction of a healthy China. As a result of increasing social pressure, doctors are at high risk for diseases such as "sudden death" and "overwork death". It is essential that the physical and mental health of medical staff be assessed and long-term mechanisms be introduced to care for medical staff. This study sought to investigate the health status, work pressure, and occupational environments of medical staff at level A tertiary public hospitals in Shanghai to provide a basis for exploring the establishment of long-term mechanisms for the exquisite and precise care of medical staff., Methods: A questionnaire was administered to employees at 10 level A tertiary public hospitals in Shanghai using a random sampling method; 50 medical staff were surveyed at each hospital. A descriptive analysis of the data was conducted using R language., Results: A total of 478 questionnaires were collected; thus, the recovery rate was 95.6%. The analysis revealed that 61% of the medical staff surveyed believed that their health was "good," and 57% believed that they were under high pressure. Over 50% of medical staff were moderately satisfied with their practice environment and salary; however, staff's satisfaction evaluations were affected by their academic qualifications (degrees), work positions, and other factors. Reasonable salary is the primary motivating and demotivating factor., Conclusions: The party organization can play a leading role in contacting and serving employees. Further, 4 caring systems for health protection, welfare benefits, safety protection, and career planning should be offered to medical staff to ensure they are cared for with elaboration and precision.

With the spread of Coronavirus Disease 2019 globally, more than 40,000 healthcare staff rushed to Wuhan, Hubei Province to fight against this threatening disease. All staff had to wear personal protective equipment (PPE) for several hours when caring for patients, which resulted in adverse skin reactions and injuries. In this study, we used an online questionnaire to collect the self-reported skin damages among the first-line medical staff in the epidemic. The questionnaire was designed by four front-line wound care nurses and then revised through Delphi consultants. Items mainly focused on the adverse skin reactions and preventive strategies. The survey was distributed through phone application from March 15th to March 20th and received 275 responses in total. The prevalence of skin reactions (212, 77.09%) was high in both head and hands. The common clinical symptoms of skin reactions were redness, device-like mark, and burning pain in face; and dryness, dermatitis, and itch/irritation in hands. Three risk factors included gender, level of protection, and daily wearing time of PPE were identified that caused skin reactions among medical staff. 150 of 275 (54.55%) participants took preventive strategies like prophylactic dressings, however, more than 75% users had little knowledge about dressings. We suggest the frontline staff strengthened the protection of skin integrity and reduced the prevalence of adverse skin reactions after professional education., Competing Interests: he authors have declared that no competing interests exist.

Background: Shaken baby syndrome (SBS), currently functioning as abusive head trauma (AHT), is a form of violence against children mainly under 2 years of age. The number of SBS might be underestimated, as many cases of violence remain unreported. The aim of the study was the evaluation of the state knowledge of the SBS phenomenon, its scale and diagnostic methods among parents, medical staff and medical students., Methods: A total of 639 people were examined: 39% of parents, 32.5% of medical staff members, and 28.5% of medical students; 82% were women. The average age was 34.9±9.78 years, and 70% of them had children. The research tool was an anonymous survey. The 34 questions concerned numerous aspects of violence against children as well as knowledge about SBS., Results: According to 90% of the interviewees shaking a baby may be dangerous but 43% have never heard about shaken baby syndrome. Eighty-eight percent of responders stated that "SBS is a form of violence," but only 57% realize that one-time shaking can lead to death and only 19% indicated men as aggressors. Sixteen percent of medical staff members did not know how long it takes for the consequences of shaking a baby to be revealed., Conclusions: Majority of the medical staff members working with children have never heard about SBS. Only half of the surveyed understands the connection of shaking with vision loss or child's death. Among the long-term consequences of shaking a baby, the greatest knowledge concerns emotional consequences of shaking.

Objectives: As of 11 Feb 2020, a total of 1,716 medical staff infected with laboratory-confirmed the severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) in China had been reported. The predominant cause of the infection among medical staff remains unclear. We sought to explore the epidemiological, clinical characteristics and prognosis of infected medical staff. Methods: Medical staff who infected with SARS-Cov-2 and admitted to Union Hospital, Wuhan between 16 Jan to 25 Feb, 2020 were included in this single-centered, retrospective study. Data were compared by occupation and analyzed with the Kaplan-Meier and Cox regression methods. Results: A total of 101 medical staff (32 males and 69 females; median age: 33) were included in this study and 74.3% were nurses. A small proportion of the cohort had contact with specimens (3%) as well as patients infected with SARS-Cov-2 in fever clinics (15%) and isolation wards (3%). 80% of medical staff showed abnormal IL-6 levels and 33% had lymphocytopenia. Chest CT mainly manifested as bilateral (62%), septal/subpleural (77%) and groundglass opacities (48%). The major differences between doctors and nurses manifested in laboratory indicators. As of the last observed date, no patient was transferred to intensive care unit or died. Fever (HR=0.57; 95% CI 0.36-0.90) and IL-6 levels greater than 2.9 pg/ml (HR=0.50; 95% CI 0.30-0.86) were unfavorable factors for discharge. Conclusions: Our findings suggested that the infection of medical staff mainly occurred at the early stages of SARS-CoV-2 epidemic in Wuhan, and only a small proportion of infection had an exact mode. Meanwhile, medical staff infected with COVID-19 have relatively milder symptoms and favorable clinical course than ordinary patients, which may be partly due to their medical expertise, younger age and less underlying diseases. The potential risk factors of fever and IL-6 levels greater than 2.9 pg/ml could help to identify medical staff with poor prognosis at an early stage., Competing Interests: Competing Interests: The authors have declared that no competing interest exists., (© The author(s).)

Background: It is well known that unexpected pandemic has led to an increase in mental health problems among a variety of populations., Methods: In this study, an online non-probability sample survey was used to anonymously investigate the anxiety and depression symptoms among medical staff under the COVID-19 outbreak. The questionnaire included Perceived Stress Scale-10 (PSS-10), Generalized Anxiety Disorder 7-Item Scale (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). Factors associated with anxiety and depression symptoms were estimated by logistic regression analysis., Results: A total of 1090 medical staff were investigated in this study. The estimated self-reported rates of anxiety symptoms, depression symptoms and both of the two were 13.3%, 18.4% and 23.9% respectively. Factors associated with self-reported anxiety symptoms include married status (OR=2.3, 95%CI: 1.2, 4.4), not living alone (OR=0.4, 95%CI: 0.2, 0.7), never confiding their troubles to others (OR=2.2, 95%CI: 1.4, 3.5) and higher stress (OR=14.4, 95%CI: 7.8, 26.4). Factors associated with self-reported depression symptoms include not living alone (OR=0.4, 95%CI: 0.3, 0.7), sometimes/often getting care from neighbours (OR=0.6, 95%CI: 0.4, 0.9), never confiding their troubles to others (OR=2.0, 95%CI: 1.3, 3.0) and higher stress (OR=9.7, 95%CI: 6.2, 15.2)., Limitations: The study was a non-probability sample survey. Besides, scales used in this study can only identify mental health states., Conclusions: Under outbreak of COVID-19, self-reported rates of anxiety symptoms and depression symptoms were high in investigated medical staff. Psychological interventions for those at high risk with common mental problems should be integrated into the work plan to fight against the epidemic., (Copyright © 2020. Published by Elsevier B.V.)

Competing Interests: Competing interests: None declared.

Objective: To explore the psychological status of medical staff during COVID-19 epidemic, so as to provide reference and scientific basis for carrying out further psychological intervention and ensuring the mental health of medical staff. Methods: By using convenient sampling method and the Stresss-Anxiety ubscale of Depression Anxiety Stress (DASS-21) , the mental health status of 615 medical staff was investigated by the way of questionnaire star from February 4 to 16, 2020. A total of 615 questionnaires were distributed and collected, and 615 were valid, with an effective recovery rate of 100%. Results: The detection rates of psychological stress and anxiety of medical staff were 13.82% (85/615) and 25.37% (156/615) , respectively. 31-40 years old and working in key departments were risk factors for psychological stress of medical staff ( OR =1.779, 2.127) ; Women, frequently washing hands with soap/hand sanitizer/disinfectant were protective factors for psychological stress ( OR =0.520, 0.528) . Medical staff working in designated hospitals and key departments were more likely to have anxiety ( OR =2.042, 2.702) ; The high fit of the mask to the face and bridge of the nose was a protective factor for the psychological anxiety of medical staff ( OR =0.500) . Conclusion: Medical staff show higher stress and anxiety during the epidemic of COVID-19. Psychological intervention should be carried out early, focusing on men, age 31 to 40, medical staff working in designated hospitals and key departments.

Background: We questioned whether the introduction of a subjective evaluation of patient-specific goals, could be used as a valid method to assess the effectiveness of inpatient rehabilitation., Methods: In this prospective cohort study, all admissions to the UHN hemodialysis rehabilitation service between April 2013 and August 2016 were included. We introduced a system of subjective assessment, performed by the team at the time of admission and discharge. We evaluated Functional Independence Measure (FIM®) score and KDQoL for objective measures of physical function and patient-reported quality of life., Results: A total of 201 patients were included. The median FIM score at discharge correlated well with the subjective staff evaluation. FIM score changes for those with evaluations for Success, Partial success, and Not Successful were 28 [interquartile range (IQR) 20-34], 24 [IQR18-31], 16 [IQR 11-34] respectively. The median PCS at discharge for those deemed to have Success was 37.4 [IQR31.0, 44.7], and for those with Partial success & Not Successful 28.8 [IQR 22.4, 39.2]. There was no correlation with MCS scores (55.2 [IQR 51.2, 60.2], 58.4 [IQR 50.1, 63.1] respectively)., Conclusions: These results suggest the subjective staff evaluation is a brief but valid assessment of patient outcome for dialysis patients undergoing inpatient rehabilitation.

Objective: An outbreak of coronavirus disease 2019 (COVID-19) is a public health emergency of international concern and poses a big challenge to medical staff and general public. The aim is to investigate psychological impact of COVID-19 epidemic on medical staff in different working posts in China, and to explore the correlation between psychological disorder and the exposure to COVID-19., Methods: A multicenter WeChat-based online survey was conducted among medical staff in China between 26 February and 3 March 2020. Medical staff deployed to Hubei province from other provinces and medical staffs in different posts outside Hubei were selected to represent diverse exposure intensities to the threat of COVID-19. Anxiety, depression, sleep quality, stress and resilience were evaluated using scales including GAD-7, PHQ-9, PSQI, PSS-14, and CD-RISC-10. Latent class analysis was performed to identify potential staff requiring psychological support., Results: A total of 274 respondents were included, who serving at 4 posts as follows, staff backing Hubei province, isolation wards outside Hubei, fever clinic and infectious disease department, and other departments outside Hubei. The total scores of anxiety, depression, sleep quality and stress were statistically different among groups, meanwhile an increasing tendency of anxiety, depression and sleep quality scores with increasing risk of exposure to COVID-19 was found (p < 0.05). Subsequent post-hoc analysis indicated that the staff backing Hubei had higher scores of anxiety, depression, sleep quality and perceived stress (adjusted p < 0.05). The combined prevalence of anxiety, depression and insomnia of staff backing Hubei reached as high as 38%. Four-class latent class analysis showed 3 categories of population (69.4%) may need psychological support., Conclusions: High prevalence of anxiety, depression and insomnia exist in medical staff related to COVID-19. The higher the probability and intensity of exposure to COVID-19 patients, the greater the risk that medical staff will suffer from mental disorders, suggesting continuous and proper psychiatric intervention are needed., (Copyright © 2020. Published by Elsevier Ltd.)