scholarly journals Biological Risks In The Professionals Of Mobile Pre-Hospital Care

10.3823/2278 ◽  
2017 ◽  
Vol 10 ◽  
Author(s):  
Jacianne Nascimento Santos ◽  
Anne Milane Formiga Bezerra ◽  
Maria do Carmo Andrade Duarte de Farias ◽  
Guilherme Gadelha Pereira de Carvalho ◽  
Edineide Nunes da Silva ◽  
...  
Keyword(s):  
Hospital Care ◽  
Professional Training ◽  
Small Sample Size ◽  
Care Service ◽  
Small Sample ◽  
Chi Square ◽  
Exact Test ◽  
Employee Protection ◽  
Occupational Risks ◽  
Nursing Team

Introduction: Pre-hospital care professionals face situations in which they are very vulnerable to occupational risks of the biological type, due to direct and constant contact with patients in numerous adverse situations. Objective: To analyze the biological risks inherents to the nursing team of the Mobile Emergency Care Service (MECS) in Patos-PB. Method: The study was an exploratory, descriptive type, with a quantitative data approach. The research population was composed of all the nurses and nursing technicians employed in the MECS, Regional of Patos-PB who were available to participate in the research. Data were analyzed with SPSS software (version 21). Descriptive statistics of relative and absolute frequencies, central tendency (mean and median) and dispersion (standard deviation and minimum and maximum values) were used. Considering the small sample size, we adopted non-parametric inferential tests of Mann Whitney and Pearson's Chi-square test or Fisher's exact test, accepting as statistically significant that p <0.05. Results: The sample consisted of 45 professionals of the nursing team, with the majority (88.9%) being female and a prevalent age range from 27 to 33 years, a workload of 36 hours per week, with less than one year of performance in the service; 95.6% use the complete uniform; 97.8% make use of masks, and only 24.4% confirm wearing protective glasses; 31.1% perform reoccurrence of needles already contaminated, and 24.4% already suffered some type of accident with a sharp device. Only 24.4% said they had undergone some training on the part of the company. Conclusion: It was evidenced that the occurrence of the accidents is directly related to the exhaustion of the professionals and their lack of experience in the area, besides the lack of training offered by the service. It can be noted that the company lacks in the area of employee protection, since they do not offer a professional training course, so there is no investment in continuing health education.

A Study of Adherence to Restrictive RBC Transfusion and 30 Day Patient Outcomes

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5037-5037
Author(s):  
Zhen Wang ◽  
Elaine Zhai ◽  
Aleksic Sandra ◽  
Kibola Adam ◽  
Richard May ◽  
...  
Keyword(s):  
Cardiovascular Events ◽  
Small Sample Size ◽  
Small Sample ◽  
University Hospital ◽  
Red Blood Cell Transfusion ◽  
Current Guideline ◽  
Chi Square ◽  
Exact Test ◽  
Medicine Service ◽  
Rbc Transfusion

Abstract Background: The American Association of Blood Banks (AABB) 2012 Guidelines recommend a restrictive transfusion strategy of 7 g/dL to 8 g/dL in asymptomatic, hemodynamically stable patients (pts) and for Hgb less than 8 g/dL in pts with preexisting cardiovascular disease. [1] Additional recommendations based on expert opinion include transfusion at threshold Hgb of 7 g/dL for hemodynamically stable ICU pts and Hgb less than 10 g/dL in pts with symptomatic anemia. We examined adherence to these guidelines and for differences in outcomes between restrictive and non-restrictive approaches at an academic hospital. Methods: We performed an IRB-approved retrospective review of all pts admitted to the Internal Medicine Service at University Hospital in Newark, New Jersey from July 1st to November 30th 2015 who received RBC transfusions. Charts were abstracted for demographic information, past medical history, indication for transfusion, presence of signs or symptoms of anemia (chest pain, orthostatic hypotension or tachycardia unresponsive to fluid resuscitation, or congestive heart failure), pre-transfusion Hgb, number of units transfused, and post-transfusion hgb. Outcomes were defined as requirement for additional transfusions, infections, cardiovascular events, adverse transfusion reactions, and death within 30 days of transfusion. Each transfusion was categorized as either adherent or non-adherent to the guidelines. Difference in outcomes between groups (adherent vs non-adherent) was tested using chi-square and Fisher's exact test with SAS studio version 3.4 (Cary, NC). Results: We reviewed 318 RBC transfusion records for 210 pts (median age: 55±17 years) with 157 (49%) transfusions in male and 161 (51%) in female pts. Site was ICU for 86 and the ward for 232 transfusions. The leading indication was acute bleeding (121 or 38%; pre-transfusion Hgb 6.9±1.3g/dL), followed by asymptomatic anemia (107 or 33%; pre-transfusion Hgb 6.8±0.8g/dL), and symptomatic anemia (91 or 29%; pre-transfusion Hgb 6.6±0.8g/dL). Of the 107 pts with asymptomatic anemia, 37 had pre-existing heart disease. Within this group, 35 were transfused at Hgb < 8g/dL (adherence of 95%). Seventy of the 107 transfusions were performed in pts without pre-existing cardiac disease. Fifty-nine were transfused at hgb < 7g/dL with an adherence of 84%. In the ICU, 21 of the 27 transfusions occurred for hgb < 7 g/dL in hemodynamically stable pts with an adherence of 78%. There were 91 transfusions for symptomatic anemia and all were adherent (100%). Regarding 30 day post-transfusion outcomes, there were 140 (44%) with subsequent transfusions; 54 (14%) infections; 7 (2.2%) cardiovascular events; 8 (2.5%) transfusion adverse reactions; 27(8%) deaths. No difference was detected for 30 day outcomes between the adherent group and the non-adherent group. (Table 1) Transfusion of at least 2unitsRBC in asymptomatic, symptomatic, and active bleeding pts were 25% (27/107), 44% (40/91), 57% (69/120) respectively. No difference in outcomes was found for the group receiving only 1 unit RBC (restrictive) compared to the group receiving 2 or more units RBC (non-restrictive). (Table 1) Conclusion: The majority of transfusions (92%) performed adhered to current guideline. While the restrictive approach was not associated with more complications or mortality, this study is limited by the small sample size and further work is being done. Acknowledgment: The authors are grateful to Dr. Koshy, Director of Blood Bank at University Hospital, for assistance. Reference: 1. Carson, J. L. et al. Red blood cell transfusion: a clinical practice guideline from the AABB. Ann Intern Med 157, 49-58 (2012). Disclosures Chang: Johnson and Johnson: Other: Stock; Amgen: Other: Research; Boehringer Ingelheim: Other: Research.

scholarly journals The Influence of Decontamination Procedures on the Surface of Two Polymeric Liners Used in Prosthodontics

Polymers ◽  
2021 ◽  
Vol 13 (24) ◽  
pp. 4340
Author(s):  
Katarzyna Mańka-Malara ◽  
Maciej Trzaskowski ◽  
Dominika Gawlak
Keyword(s):  
New York ◽  
Soft Tissues ◽  
Small Sample Size ◽  
Polymeric Materials ◽  
Small Sample ◽  
Chi Square ◽  
Exact Test ◽  
Materials Used ◽  
Cleaning Methods ◽  
The Impact

Polymeric liners are materials commonly used in prosthodontics to reshape denture surfaces contacting the soft tissues of the oral cavity. The aim of the study was to determine the impact of different cleaning methods on two polymeric materials used in prosthodontics as non-adhesive permanent liners. The material for the research consisted of samples made from Mollosil Plus (Detax, Ettlingen, Germany)—direct polysiloxan liner; and Plastitanium (Pressing Dental, San Marino, Republic of San Marino)—an injection-molded liner. A total of 198 samples were made, 99 of each assessed material. They were exposed to different cleaning methods—a toothbrush, a toothbrush and soap, a toothbrush and toothpaste (BlendaMed, Procter&Gamble, Cincinnati, OH, USA), a toothpaste and denture cleaning paste (Protefix Hygiene Denture Paste, Queisser Pharma, Germany), denture cleansing tablets (Protefix Hygiene Cleaning Tablets, Queisse Pharma, Germany), and a disinfecting spray (Aftermat, Port Jefferson Station, New York City, NY, USA)—for 1 min, 5 min, 10 min, and 15 min. The image acquisition was performed with scanning electron microscopy and samples were analyzed for the homogeneity of their surfaces—the presence of holes, grooves, precipitate, and small and large separating pieces of the material marking departures from this homogeneity. For each type of damage, one point was given. Continuous data from two groups were compared with Mann–Whitney U testing. Due to a small sample size and distribution of variables other than normal, to compare more than two groups, Kruskal–Wallis testing with post hoc analysis (Dunn test with Bonferroni correction) was used. Categorical data were compared with the chi-square test and the Fisher’s exact test. The Mollosil Plus material should be decontaminated with the use of a toothbrush or toothbrush with soap, while Plastitanium material should be disinfected. Plastitanium samples are more susceptible to damage during the decontamination procedures than Mollosil Plus.

scholarly journals A Pilot Placebo Controlled Randomized Trial of Dexamethasone for Chronic Subdural Hematoma

2016 ◽  
Vol 43 (2) ◽  
pp. 284-290 ◽  
Author(s):  
Michel Prud’homme ◽  
François Mathieu ◽  
Nicolas Marcotte ◽  
Sylvine Cottin
Keyword(s):  
Conservative Treatment ◽  
Adverse Events ◽  
Small Sample Size ◽  
Chronic Subdural Hematoma ◽  
Symptomatic Patient ◽  
Placebo Treatment ◽  
Small Sample ◽  
Chi Square ◽  
Serious Adverse Events ◽  
Before And After

AbstractBackground: Current opinions regarding the use of dexamethasone in the treatment of chronic subdural hematomas (CSDH) are only based on observational studies. Moreover, the use of corticosteroids in asymptomatic or minimally symptomatic patient with this condition remains controversial. Here, we present data from a prospective randomized pilot study of CSDH patients treated with dexamethasone or placebo. Methods: Twenty patients with imaging-confirmed CSDH were recruited from a single center and randomized to receive dexamethasone (12 mg/day for 3 weeks followed by tapering) or placebo as a conservative treatment. Patients were followed for 6 months and the rate of success of conservative treatment with dexamethasone versus placebo was measured. Parameters such as hematoma thickness and clinical changes were also compared before and after treatment with chi-square tests. Adverse events and complications were documented. Results: During the 6-month follow-up, one of ten patients treated with corticosteroids had to undergo surgical drainage and three of ten patients were treated surgically after placebo treatment. At the end of the study, all remaining patients had complete radiological resolution. No significant differences were observed in terms of hematoma thickness profile and impression of change; however, patients experienced more severe side effects when treated with steroids as compared with placebo. Dexamethasone contributed to many serious adverse events. Conclusions: Given the small sample size, these preliminary results have not shown a clear beneficial effect of dexamethasone against placebo in our patients. However, the number of secondary effects reported was much greater for corticosteroids, and dexamethasone treatment was responsible for significant complications.

scholarly journals Patient safety in nursing care during medication administration

2018 ◽  
Vol 26 (0) ◽  
Author(s):  
Júlian Katrin Albuquerque de Oliveira ◽  
Eliana Ofélia Llapa-Rodriguez ◽  
Iza Maria Fraga Lobo ◽  
Luciana de Santana Lôbo Silva ◽  
Simone de Godoy ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Medication Administration ◽  
Test Results ◽  
Chi Square ◽  
Exact Test ◽  
Direct Observations ◽  
Nursing Team ◽  
Chi Square Test ◽  
Vascular Catheters ◽  
Multidose Vial

ABSTRACT Objective: to evaluate the conformity of care practices of the nursing team during the administration of drugs through central vascular catheter. Method: a descriptive, prospective, observational study conducted in an Intensive Care Unit. The non-probabilistic intentional sample consisted of 3402 observations of drug administrations in patients with central vascular catheters. The previously validated collection instrument was constructed based on the Guideline for Prevention of Intravascular catheter-related infections. Data was collected through direct observations of nursing practices performed by the nursing team. The analysis used analytical, descriptive and inferential statistics (Chi-square test and Fisher’s exact test). Results: a total of 3402 procedures of drug administrations were observed. Female nursing technicians performed the highest number of actions. In none of the procedures did the professional perform all necessary actions. 0.2% of drug administrations were preceded by hand hygiene and 1.3% by disinfection of the multidose vial, ampoule or injectors. Conclusion: the practice evaluated was classified as undesirable. Failure to achieve the desired conformity was probably due to the low adherence of professionals to the practice of hand hygiene and disinfection of materials, injectors and connectors.

scholarly journals The perceived health effects of e-cigarette use among adult smokers

2020 ◽  
Author(s):  
Joey Cheng ◽  
BCIT School of Health Sciences, Environmental Health ◽  
Dale Chen
Keyword(s):  
Health Effects ◽  
Smoking Status ◽  
Small Sample Size ◽  
Health Benefits ◽  
Target Population ◽  
Small Sample ◽  
Multiple Choice Questions ◽  
Chi Square ◽  
Objective Health ◽  
The Government

Background: Vaping and e-cigarettes have been an epidemic among youths in recent years. In addition, as of April 2020, there has been hundreds of vaping related illnesses causing fatalities. As such there has been increased coverage by media and the government in regard to reporting vaping-related dangers and implementing regulatory changes such as bans. These actions could deter the target population from engaging in vaping – tobacco users. Research has shown that e-cigarettes are significantly less toxic relative to tobacco and that it could be more effective as a cessation treatment relative to nicotine gums or patches. This study surveyed current perceptions of Canadians with regards to vaping in order to determine if certain groups (i.e. varying ages, smoking status) hold different opinions in terms of harm, health benefits, and support for stricter e-cigarette regulations. Methods: Self-administered online surveys created on Survey Monkey were distributed to Canadians via online platforms Reddit and Facebook. The survey assessed opinions and perceptions of Canadians through multiple choice questions and were collected over a three week period. Results: This study received 157 respondents the majority of which were under 35 (73.08%) and from British Columbia (65.38%). Thirteen chi-square tests were performed comparing group variables (age, smoking status, and awareness of vaping related news) to perception variables (perceived harm, health benefits, safety). There was no association found between age and the tested perception variables. Several associations were found where e-cigarette users viewed e-cigarettes more favourably relative to tobacco users and non-users based on chi-square results. Chi-square associations between media awareness and harm perceptions could not be established due to a small sample size (n< 30). Conclusion: The results indicated that there are associations with e-cigarette perceptions and a person’s smoking status. This may be an indication that there is possible misinformation between groups when it comes to evaluating objective health effects of e-cigarettes. Non-users and a percentage of tobacco users seem to overstate

scholarly journals Nursing team knowledge on care for patients with fungating wounds

2020 ◽  
Vol 73 (1) ◽  
Author(s):  
Fernanda Mateus Queiroz Schmidt ◽  
Flávia Firmino ◽  
Nariman de Felício Bortucan Lenza ◽  
Vera Lúcia Conceição de Gouveia Santos
Keyword(s):  
Staff Training ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Orientation Data ◽  
Exact Test ◽  
Nursing Team ◽  
Student’S T ◽  
Educational Variables ◽  
Student’S T Test

ABSTRACT Objective: to evaluate the nursing team knowledge of a cancer hospital on care for patients with Malignant Fungating Wounds (MFW) and to analyze associated sociodemographic and educational factors. Method: an observational and cross-sectional study, conducted between September and October 2015, after approval by the Research Ethics Committee. A questionnaire was applied containing sociodemographic, educational and related components to the accomplishment of dressings, dressings choice and orientation. Data were analyzed by using Chi-square, Fisher’s exact test, Student’s t-Test and Pearson’s correlation. Results: 37 professionals participated in the study, most of whom were technicians (56.8%), women (91.9%) and with a mean age of 32 years. The professionals presented 56.5% of correct answers. There were no statistically significant associations between sociodemographic/educational variables and number of correct answers. Conclusion: there was a lack of important knowledge about care for patients with MFW, which should guide strategies for the oncology staff training.

scholarly journals Seroprevalence of torch infections among complicated pregnancies in Atbara river Nile state - Sudan

2021 ◽  
Vol 10 (1) ◽  
pp. 18-20
Author(s):  
Mohammed Ahmed Ibrahim Ahmed ◽  
Hanaa Elzain Musaad ◽  
Nahla Ahmed Mohammed Abdurrahman ◽  
Wadei Mohammed Yasin ◽  
Mosab Nouraldein Mohammed Hamad ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Small Sample Size ◽  
Education Level ◽  
Small Sample ◽  
P Value ◽  
River Nile ◽  
Serological Evidence ◽  
Chi Square ◽  
Cross Sectional ◽  
Torch Infection

Objective: The aim of this study was to find the seroprevalence of TORCH infection among volunteered pregnant women and to find out the correlation between TORCH infection and age, complicated pregnancies and education level. Methods: A descriptive cross-sectional laboratory-based study carried out between March to June 2012 at Atbara River Nile State northern Sudan. The statistical descriptive determined in means of percentages. Chi-square used for trend analysis and calculates p-values. Results: A total of (75) voluntary pregnant women, Age between 15-55 years. The most common age group was 26-35 years (37/75) 49%.Serological evidence of Toxoplasmosis were positive for (22/75) 29 %. All volunteered pregnant women were negative for other components of TORCH complex. Study showed non-significant correlation between age, education level and complicated pregnancies, P-value 0.13, 0.43 and 0.51 respectively. Conclusion: Low prevalence of Toxoplasmosis and absent of serological evidence of other TORCH complex among volunteered pregnant women in Atbara has been documented. Insignificant correlation between toxoplasmosis and age, education level as well as number of complicated pregnancies reported. This attributed, in part, to the small sample size and using screening tool as diagnostic modalities.

Outcome of rapid disease progression in the treatment break following cytoreductive nephrectomy (CN) after presurgical sunitinib in patients with primary metastatic renal cell carcinoma (RCC).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 4611-4611
Author(s):  
Axel Bex ◽  
Thomas Powles ◽  
Christian U. Blank ◽  
Simon Chowdhury ◽  
Simon Horenblas ◽  
...  
Keyword(s):  
Disease Progression ◽  
Kinase Inhibitors ◽  
Small Sample Size ◽  
Recovery Period ◽  
Significant Proportion ◽  
Disease Stabilisation ◽  
Small Sample ◽  
Phase Ii Trials ◽  
Exact Test ◽  
Poor Risk

4611 Background: There is concern that interruption of tyrosine kinase inhibitors (TKI) triggers disease progression (PD) and metastasis. This is based on preclinical models and observation of rapid PD in the postsurgical treatment break in patients pretreated with TKI. Little is known about the frequency of PD during postsurgical TKI interruption and its outcome. These data may have implications for neoadjuvant or presurgical treatment concepts. Methods: Of 66 patients from two closed phase II trials investigating 2-3 months presurgical sunitinib for primary metastatic clear-cell RCC, 45 were evaluated in this retrospective analysis because they had absence of PD prior to planned surgery and underwent CN (35 [78%] MSKCC intermediate and 10 [22%] poor risk). Patients had CT scans at the end of pretreatment and at 4 weeks post-nephrectomy before restarting sunitinib. In patients with postsurgical RECIST PD at 4 weeks when compared to the preoperative CT scan overall survival (OS) was measured from the time of nephrectomy and compared to patients without treatment break PD. Results: Median OS of 45 patients from the time of surgery was 22 months (13.0-31.5 months). Overall 14 patients progressed during treatment break (31%), with new sites of disease in 5/14 (35%). Reintroduction of sunitinib resulted in disease stabilisation or better in 13. Patients with poor risk were represented in the progressors (n=4[28%]) and non-progressors (n=6 [19%]) (p=0.7 fishers exact test). The hazard ratio (HR) for death associated with PD during treatment break was 1.90 (95% CI 0.89-4.08). OS for non-progressors was 25 months (15-NA) and 13 months (6-27) for progressors. Conclusions: A significant proportion of patients develop PD upon sunitinib withdrawal in a 4 week recovery period following CN. In view of the small sample size these data suggest a strong trend toward treatment break PD being associated with a poor outcome. It is not clear whether this PD is related to interruption of TKI, surgery or a combination of factors. The EORTC SURTIME trial investigates treatment break PD after immediate CN and CN after sunitinib and may answer this question.

Transformasi Terhadap Min bagi Menguji Taburan Terpencong

2012 ◽  
Author(s):  
Nor Haniza Sarmin ◽  
Md Hanafiah Md Zin ◽  
Rasidah Hussin
Keyword(s):  
Key Words ◽  
Simulation Study ◽  
Bias Correction ◽  
Type I Error ◽  
Small Sample Size ◽  
Small Sample ◽  
Skewed Distribution ◽  
Type I ◽  
Skewed Distributions ◽  
Chi Square

Suatu transformasi terhadap min dilakukan menggunakan penganggar pembetulan kepincangan bagi mendapatkan statistik untuk menguji min hipotesis taburan terpencong. Penghasilan statistik ini melibatkan pengubahsuaian pemboleh ubah . Kajian simulasi yang dijalankan terhadap taburan yang terpencong iaitu taburan eksponen, kuasa dua khi dan Weibull ke atas Kebarangkalian Ralat Jenis I menunjukkan bahawa statistik t3 sesuai untuk ujian satu hujung sebelah kiri dan saiz sampel yang kecil (n=5). Kata kunci: Min; statistik; taburan terpencong; penganggar pembetulan kepincangan; kebarangkalian Ralat Jenis I A transformation of mean has been done using a bias correction estimator to produce a statistic for mean hypothesis of skewed distributions. The statistic found involves a modification of the variable . A simulation study that has been done on some skewed distributions i.e. esponential, chi-square and Weibull on the Type I Error shows that t3 is suitable for the left-tailed test and a small sample size (n=5). Key words: Mean; statistic; skewed distribution; bias correction estimator; Type I Error

scholarly journals Pre-hospital assistance by ambulance in the context of coronavirus infections

2021 ◽  
Vol 74 (suppl 1) ◽  
Author(s):  
Amanda Ferreira Araujo ◽  
Eric Rosa Pereira ◽  
Sabrina da Costa Machado Duarte ◽  
Priscilla Valladares Broca
Keyword(s):  
Health Professionals ◽  
Hospital Care ◽  
Professional Training ◽  
Protective Equipment ◽  
Occupational Risks ◽  
Surgical Masks ◽  
Emergency Ambulance ◽  
Care Health ◽  
Coronavirus Infection ◽  
Safe Care

ABSTRACT Objective: To reflect on the safe care exercised by the pre-hospital care team by emergency ambulance in times of coronavirus infection. Method: A reflection and description of how to provide safe care to the patient and the professional during pre-hospital care in times of coronavirus infection. Results: To ensure the health of all those involved in the care, health professionals who work in pre-hospital care by emergency ambulance should use the recommended Personal Protective Equipment (PPE), such as the use of surgical masks and N95, N99, N100, PFF2 or PFF3, the use of an apron or overall, goggles and face shield, gloves and a hat. The entire team must receive training and demonstrate the ability to use PPE correctly and safely. Final considerations: The professional working in the pre-hospital care by ambulance is exposed to a series of occupational risks that need to be discussed and minimized through professional training.

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