The importance of rapid assessment tools in evaluating mental health in emergency departments among patients with chronic diseases.

Background: Rapid screening tools such as the WHO well-being Index (WWBI), Six-item screener (SIS), and the CLOX-1 test can be used to assess overall mental health and cognition, respectively. We sought to evaluate mental health with cognition in individuals with chronic diseases and stable vital signs presenting to the Emergency Department (ED). Methods: An observational study in the ED with 279 participants was conducted. Results: Chronic diseases were more prevalent among 51-70 years (43.4%) and diabetes was most common (58.8%). Fever (22.6%) and GI bleeding (32.6%) presentation were high. Participants with low WWBI had low SIS compared to the ones with higher scores (83.3% vs. 17.7%, p < 0.001) and also had low CLOX-1 compared to ones with high CLOX-1 (67.3% vs. 5%, <0.001). A positive correlation between WWBI with SIS (correlation coefficient = 0.305, p < 0.001) and CLOX-1 (0.441, <0.001). Regression analysis indicates a positive association between WWBI and the SIS (standardized regression coefficient = 0.187, 95%CI = 0.236-1.426, and p = 0.006) and CLOX 1 (0.338, 0.2-0.463, <0.001). Conclusion: In the ED, the evaluation of mental health even among cognitive impaired is feasible and crucial.

The Designing, Testing, and Utility of a 3D-Printed Respirator: A Hospital's Journey Into Self-Sustainability During COVID-19.

Objective The current global COVID-19 pandemic has disrupted supply chains and the production of essential goods and services. This includes personal protective equipment (PPE) kits, respirators, and other protective devices. Hence efforts were made to prototype and produce 3D-printed N95 respirators to fill the gap in supply. In addition, methods of sterilization were put into place for the respirators. As well as forming standard operating procedures. Methods With the use of vast open-source libraries and collaboration with engineers and doctors fighting the COVID-19 pandemic, respirator prototypes were produced with special consideration to the sizing to fit median facial sizes. Polymer plastics were mixed in various proportions to condition the respirator to be used by frontline workers in austere environments. Due to the shortage of medical-grade filter media, alternative sources were researched. Merv 13 and Merv 15 filters were selected due to their cheap costs, vast abundance, and proven filtration efficacy against particles of 0.03 microns. Studies conducted around the world have also shown its efficacy as an alternative to medical-grade air filter media. After developing standard operating procedures (SOPs) for sterilisation and respirator usage. Emergency approval was obtained and a limited number of healthcare workers were issued with this respirator (n=400). PPE kit satisfaction and self-efficacy scores were calculated from daily questionnaires during donning and doffing Results Qualitative fit-tests in all 400 healthcare workers matched those of a conventional N95 respirator. Almost all of the respondents in the PPE kit satisfaction responded positively. The self-efficacy score calculated from the general self-efficiency scale had an overall positive value, with the average score being 4.29. This demonstrated that the self-efficacy score was above average and indicated a high motivation to overcome obstacles and spend more time solving problems. The average self-efficacy score is defined between 2.5 - 3.5, and a low self-efficacy score is defined as a score below 2.5. Lastly, a regression analysis was done to test the correlation between PPE kit satisfaction and self-efficiency this demonstrated a positive correlation between PPE kit satisfaction using the 3D-printed respirator and self-efficacy (Slope: 0.416, Intercept: -1.066, R-value: 0.872, P-value: <0.01) Conclusions With supply chain disruptions and reduced or nonexistent supplies of essential medical goods. The need of a reusable, sterilisable, and efficient respirator has never been more evident. The materials used have made it sustain heavy use in austere environments. Studies have reported higher than average burnout rates in COVID-19-based healthcare workers. Studies have also shown that the rates of burnout are high in healthcare professionals without access to proper PPE kits in developing nations. This respirator was rated highly in PPE kit satisfaction and the self-efficacy score. Studies have demonstrated a correlation between high self-efficacy scores and low burnout rates in health care workers. There is also documented evidence of a positive correlation between high self-efficacy scores and general health. As the pandemic continues to evolve, so will the efforts to combat it, such as 3D printing. Interdisciplinary collaboration continues to drive our efforts to combat the pandemic and hopefully resolve it in the future.