Conectar
Vaccinations are essential to ensure protection for healthcare professionals, patients and communities. However, vaccination hesitancy has been reported among healthcare professionals. Nurses are the main, first and direct point of contact for patients and citizens in most healthcare services, but only a minority of studies investigated vaccination hesitancy and uptake specifically in this population. Thus, this study aimed to explore the determinants and motivations of vaccination hesitancy and uptake among nurses.
Systematic review with a narrative synthesis approach.
We included primary research exploring determinants or motivations of vaccination hesitancy or uptake among nurses. No time or geographical limit was applied. Generalised random-effects linear models with a logit link were used to calculate the pooled estimated proportions for vaccine uptake among nurses.
We explored nine databases (2023).
The initial search identified 3452 records; 42 records were eventually included in this review. Older age, longer professional experience, lack of confidence in vaccine safety and effectiveness and cost associated with the vaccine were among the most common determinants of vaccine hesitancy. Safety concerns, complacency (e.g., beliefs of not needing the vaccine), and accessibility (e.g., logistics) were among the most common motivations for being vaccine hesitant. Having strong confidence in the vaccine, a high sense of collective responsibility, previous vaccination uptake/positive intentions towards future vaccination, weaker vaccine complacency, and older age were among the most common determinants of vaccine uptake. Willingness to protect themselves and/or others, contribute to the herd immunity, and comply with recommendations were among the most common motivations for vaccine uptake. The pooled prevalence of influenza vaccine uptake among nurses was 44% (95% CI: 35–73).
The findings of this systematic review with meta-analysis could guide the identification of strategies to reduce barriers and further improve facilitators to eventually increase vaccine uptake in nurses.
This study contributes to further understanding nurses' beliefs, barriers, and facilitators towards vaccination. By doing so, these results could guide the identification of strategies to reduce barriers and further improve facilitators to eventually increase vaccine uptake in nurses.
We have adhered to relevant EQUATOR guidelines, in particular to the PRISMA checklist.
No patient or public contribution.
PROSPERO number: CRD42020212252
There are no validated paediatric-specific diagnostic criteria for complex regional pain syndrome (CRPS). As a result, diagnostic tools developed for adults (eg, Budapest Criteria, Japanese Diagnostic Criteria, Veldman Criteria) are frequently applied in the paediatric population. However, the clinical presentations and trajectories of children can differ from adults. Given that treatment outcomes are linked to early diagnosis and intervention, the lack of paediatric-specific screening or diagnostic tools is an important knowledge gap. We aim to identify the frequency of individual criteria used in diagnosing CRPS in children and adolescents in existing literature, summarise assessment methods used to establish the diagnosis, and provide recommendations for research and clinical application.
The following databases and platforms will be searched for articles published from 2003 (year the Budapest Criteria was developed) onward: CINAHL, CENTRAL, Embase, Ovid MEDLINE, PubMed, PsycINFO and Web of Science. Our search strategy will use subject headings and text words related to the concepts of CRPS in paediatric populations, with study inclusion criteria from birth up to 18 years old, and a diagnosis of CRPS. Data will be extracted by our multidisciplinary team and findings will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.
This study does not involve human participants or unpublished data; therefore, approval from a human research ethics committee is not required. The findings of this scoping review will be disseminated through academic conferences and peer-reviewed publications.
by Alexandra Goldblatt, Michael J. Loccisano, Mazharul I. Mahe, John J. Dennehy, Fabrizio Spagnolo
The COVID-19 pandemic highlighted the role of indoor environments on disease transmission. However, our understanding of how transmission occurred evolved as the pandemic progressed. Enclosed spaces where pathogen-laden aerosols accumulate were strongly linked to increased transmission events. Most classrooms, particulalry in the U.S., do not have any mechanical ventilation systems but do have many people congregating indoors for long periods of time. Here we employ a safe, non-pathogenic surrogate virus, the bacteriophage phi6, to interrogate aerosol transmission in classroom environments that do not have any natural or mechanical ventilation in order to provide baseline understanding of how effectively aerosols facilitate new infections. We measure exposure risk using a modified passive monitoring technique compliant with applicable standards, including ISO 14698–1:2003. We find that virus-laden aerosols establish new infections over all distances tested within minutes and that the time of exposure did not change transmission rate. We further find that relative humidity, but not temperature nor a UV-based disinfection device, significantly lowered transmission rates. Our data suggest that, even without mechanical ventilation, relative humidity remains an inexpensive and highly effective mitigation strategy while UV air treatment may not.
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