Background Healthcare-associated infections are a major threat to patient safety, particularly vulnerable elderly living in nursing homes, who have an increased risk of infections and mortality. Although good hand hygiene is the most effective preventive measure against infections, few studies of hand hygiene adherence have been conducted in nursing homes. The aim of this study is to investigate hand hygiene adherence in nursing homes with students as observers using a validated observation tool. In addition, to examine when healthcare workers perform hand hygiene and when they do not. Methods This observational study used the World Health Organization’s observation tool for studying hand hygiene indication and adherence: “My five moments for hand hygiene.” For 1 week each in February and March 2021, 105 first-year nursing students conducted 7316 hand hygiene observations at 20 nursing home wards in one large municipality in Norway. Results The overall adherence rate found in this study was 58.3%. Hand hygiene adherence decreased from 65.8% in February to 51.4% in March. The adherence varied largely between the different wards, from 26.4 to 83.1%, and by occupation status, indications of hand hygiene, and use of gloves. Nursing students were found to have the greatest adherence, followed by nurses. The use of gloves reduced adherence. Healthcare workers to a larger degree conduct hand hygiene after contact with patients than before approaching them. Conclusions Hand hygiene adherence is too low to protect all residents against healthcare-associated infections, and the findings from this study indicate that there are many factors that influence hand hygiene adherence, eg., education, occupation status and glove use Increasing healthcare workers’ knowledge and skills of hand hygiene is needed to reduce healthcare-associated infections and reminders of the importance of hand hygiene adherence must be an ongoing activity. Interventions to improve hand hygiene adherence in healthcare workers is needed to reduce infections and antibiotic use in nursing homes.

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Higher education students are considered to belong to a population susceptible to poor sleep health; however, there is a lack of broader evidence reviews. This systematic review aims to map out and categorize the existing literature related to higher education students and sleep. The present evidence map is based on a comprehensive systematic literature search of ten electronic databases, which resulted in 15,286 unique citations. After title/abstract, and full-text screening: 515 studies were included in the final map. Most of the studies were cross-sectional ( n = 357, 69%), while 77 (15%) studies assessed the effectiveness of an intervention. Sixty-eight (13%) studies followed a cohort prospectively over time, and 8 (2%) studies utilized a qualitative design. The most frequent outcome was the proportion of sleep problems, which was reported in 226 (44%) studies. Weekday sleep duration was reported in 156 (30%) studies. Results from this mapping process suggest that evidence about students` sleep health is emerging; however, the evidence base is mostly quantitative and descriptive, and there is a lack of sleep health programs designed for students.

Background: After lock-down during the first wave of the COVID-19 pandemic, higher education institutions globally struggled to balance the need for infection control and educational requirements as they prepared to reopen. A particularly difficult choice was whether to offer for in-person or online teaching, since there was little or no empirical research to inform this decision. Norwegian universities and university colleges opted for a hybrid model when they reopened for the autumn semester, with some students offered more in-person teaching than others. This gave us an opportunity to study the association between different teaching modalities and COVID-19 risk, quality of life (subjective well-being), and teaching satisfaction. Methods: We conducted a prospective, observational cohort study among students in higher education institutions in Norway. Participants were surveyed biweekly from September to December in 2020. Findings: 26 754 students from 14 higher education institutions provided data to our analyses. Our best estimate for the association between two weeks of in-person teaching and COVID-19 risk was -22% (95% CI -77% to 33%), compared to online teaching. Quality of life was positively associated with in-person teaching (3% relative risk difference; 95% CI 2% to 4%), as was teaching satisfaction (10%; 95% CI 8% to 11%). Interpretation: The association between COVID-19 infection and teaching modality was highly uncertain. Shifting from in-person to online teaching seems to have a negative impact on the well-being of students in higher education.

The COVID-19 pandemic forced educational institutions to move online, and it is important to understand how students perceive learning in a digital learning environment. We aimed to investigate students’ perceived learning outcomes in a digital learning environment and associations between perceived learning outcomes and grades achieved. An anonymous electronic survey was used (n = 230, response rate 34%). A significant linear relationship between overall perceived learning outcome and grade achieved was found (B 0.644, 95% CI 0.52 to 0.77). Of the different learning activities, attending digital seminars were positively associated with grades (B 0.163, 95% CI 0.002 to 0.32). In particular, participating in voluntary colloquium group (B 0.144, 95% CI 0.03 to 0.26) and motivation to learn (B 0.265, 95% CI 0.13 to 0.41) predicted the students’ grades. Intrinsic motivation was positively associated with grades (B 0.285, 95% CI 0.12 to 0.45), and extrinsic motivation was negatively associated with grades (B-0.213, 95% CI-0.35 to -0.07). Nursing students’ perceived learning outcomes and grades were positively associated. Of the different learning activities, attending digital seminars predicted higher grades. Additionally, attending colloquium groups and being motivated to learn predicted higher grades, while high extrinsic motivation was associated with lower grades.