Additive Manufacturing Interventions during the COVID-19 Pandemic: South Africa

Additive manufacturing (AM), also known as 3D printing, is considered a renaissance of the manufacturing industry. Its unique capability of manufacturing 3D objects with intricate geometrical configurations has been used to produce hospital equipment and personal protective equipment (PPE) in an attempt to curb the spread of the COVID-19 pandemic in South Africa. The technology has been used by different research units to produce ventilators, respirator face masks, oscillating respiratory devices, oxygen connectors, oxygen splitters, non-invasive ventilation helmets, reusable clinician PPE, visor frames for face shields, etc. Despite the efforts of the AM community in South Africa, COVID-19 infections have continued to increase in the country. It came to light that technological interventions (including AM) alone cannot prevent the spread of the virus without the corresponding adaptive behavioural changes, such as adhering to COVID-19 prevention protocols (washing of hands, social distancing, etc.). It could be postulated that the spread of COVID-19 can only be prevented by inter-marrying the technological interventions (AM) with adaptive behavioural changes.

Pandemic turned into pandemonium: the effect on supply chains and the role of accounting information

PurposeThe purpose of this study is to examine the disruptive effects of COVID-19 on supply chains and question the role of accounting information in managing these supply chains in the face of such disruptive effects.Design/methodology/approachThe study first explains the effects of COVID-19 on the supply chains of business entities. It then explains the role of accounting information in supply chain management, questions accounting information's ability to play such a role, and makes recommendations for better accounting disclosures and accounting research for supply chains of firms. To illustrate the salient points, a case study of Fisher and Paykel Healthcare is conducted. It identifies the risks and uncertainties of supply chains exposed by COVID-19 disruptions to businesses.FindingsCOVID-19 has affected Fisher and Paykel Healthcare from both the supply-side (upstream) and demand-side (downstream) perspectives. On the supply side, it has disrupted the supply of raw materials used in the manufacture of respiratory devices and the costs of importing such materials. On the demand side, it has disrupted market logistics and customer demand. This has subsequently affected production. Such disruptions can be overcome through the dissemination of appropriate accounting information for the different stages of the supply chain to the managers. Such accounting information can also be useful to external stakeholders for minimizing their risks.Originality/valueThe study attempts to create an awareness of the supply chain uncertainties faced by managers and stakeholders arising from exogenous shocks, such as a pandemic, and how these uncertainties can be mitigated by aligning accounting information flows with the supply chain activity flows. The observations made in this paper are at a conceptual level and, therefore, can be applied to any industry.

Phthalate Exposures in the Neonatal Intensive Care Unit

Background: Di-2-ethylhexyl phthalate (DEHP), a phthalate compound found in medical devices, may cause toxic effects in premature infants. In this study, the objective is to quantify DEHP exposures from various intravenous and respiratory therapy devices, and to use these values to predict typical exposure for an infant in a neonatal unit. Methods: Common IV products used on infants are directed through various types of IV tubing (IVT) and analyzed for DEHP content. DEHP exposure for infants receiving respiratory therapy was determined indirectly through analysis of urine DEHP metabolites. By deriving these values for DEHP we calculated the daily exposure to DEHP from common IV fluids (IVF) and respiratory devices during hospitalization in a neonatal unit. Results: IVF labeled DEHP-positive showed very high concentrations of DEHP, but when passed through IVT, substantial amounts were adsorbed. DEHP was undetectable with all DEHP-negative IVF tests, except when passed through DEHP-positive IVT. The DEHP leached from most respiratory devices was relatively modest, except that detected from bubble CPAP. In 14 very low birthweight infants, the mean DEHP exposure was 182,369 mcg/kg over 81.2 days of the initial hospitalization. Ninety-eight percent of the exposure was from respiratory devices, with bubble CPAP accounting for 95% of the total DEHP exposure in these infants. Conclusions: The DEHP exposure in our neonatal unit can be reduced markedly by avoiding or modifying bubble CPAP equipment and avoiding IV tubing containing DEHP.

A Novel Magnetic Respiratory Sensor for Human Healthcare

Breathing is vital to life. Therefore, the real-time monitoring of a patient′s breathing pattern is crucial to respiratory rehabilitation therapies, such as magnetic resonance exams for respiratory-triggered imaging, chronic pulmonary disease treatment, and synchronized functional electrical stimulation. While numerous respiratory devices have been developed, they are often in direct contact with a patient, which can yield limited data. In this study, we developed a novel, non-invasive, and contactless magnetic sensing platform that can precisely monitor a patient′s breathing, movement, or sleep patterns, thus providing efficient monitoring at a clinic or home. A magneto-LC resonance (MLCR) sensor converts the magnetic oscillations generated by a patient′s breathing into an impedance spectrum, which allows for a deep analysis of one′s breath variation to identify respiratory-related diseases like COVID-19. Owing to its ultrahigh sensitivity, the MLCR sensor yields a distinct breathing pattern for each patient tested. It also provides an accurate measure of the strength of a patient′s breath at multiple stages as well as anomalous variations in respiratory rate and amplitude. The sensor can thus be applied to detect symptoms of COVID-19 in a patient, due to shortness of breath or difficulty breathing, as well as track the disease′s progress in real time.

A probabilistic model to evaluate the effectiveness of main solutions to COVID-19 spreading in university buildings according to proximity and time-based consolidated criteria

University buildings are one of the most relevant closed environments in which the COVID-19 event clearly pointed out stakeholders’ needs toward safety issues, especially because of the possibility of day-to-day presences of the same users (i.e. students, teachers) and overcrowding causing long-lasting contacts with possible “infectors”. While waiting for the vaccine, as for other public buildings, policy-makers’ measures to limit virus outbreaks combine individual’s strategies (facial masks), occupants’ capacity and access control. But, up to now, no easy-to-apply tools are available for assessing the punctual effectiveness of such measures. To fill this gap, this work proposes a quick and probabilistic simulation model based on consolidated proximity and exposure-time-based rules for virus transmission confirmed by international health organizations. The building occupancy is defined according to university scheduling, identifying the main “attraction areas” in the building (classrooms, break-areas). Scenarios are defined in terms of occupants’ densities and the above-mentioned mitigation strategies. The model is calibrated on experimental data and applied to a relevant university building. Results demonstrate the model capabilities. In particular, it underlines that if such strategies are not combined, the virus spreading can be limited by only using high protection respiratory devices (i.e. FFP3) by almost every occupant. On the contrary, the combination between access control and building capacity limitation can lead to the adoption of lighter protective devices (i.e. surgical masks), thus improving the feasibility, users’ comfort and favorable reception. Simplified rules to combine acceptable mask filters-occupants’ density are thus provided to help stakeholders in organizing users’ presences in the building during the pandemic.

Introduction

Respiratory devices have been the mainstay of treatment for obstructive sleep apnea for decades. However, despite significant technical advances in mechanisms of enhancing patient tolerance, many patients with severe disease have remained deprived of treatment. Alternative treatments for this population were largely unavailable until the introduction of upper airway stimulation therapy. By stimulating the hypoglossal nerve, this therapy activates muscles innervating the intrinsic and extrinsic muscles of the tongue, thus addressing inadequate neural activation. Since its commercial introduction, this innovative therapy has been adopted by multiple medical groups in North America and in Europe.

Medical device-related pressure injury prevention in critically ill patients: nursing care

ABSTRACT Objectives: to know the care implemented by the nursing team to prevent medical device-related pressure injuries in critically ill patients. Methods: this is a qualitative research conducted with 15 nursing professionals from Intensive Care Unit. Sampling was carried out by theoretical saturation. For data analysis, the Discourse of the Collective Subject technique was used. Results: six speeches emerged, whose central ideas were interventions for medical device-related pressure injury prevention: care in fixation; frequent repositioning; protection and padding of body areas in contact; preferences for flexible materials, when available; attention of professionals so that they do not comer under patients; early assessment and removal, when clinically possible. Final Considerations: nursing care was directed mainly to respiratory devices, catheters in general and monitoring equipment, indicating that professionals have the knowledge to provide safe assistance consistent with the literature.

Saving Lives and Livelihoods in the COVID-19 Pandemic: What Have We Learned, Particularly from Asia?

The key practices in successful government responses to the COVID-19 pandemic are (1) early border controls to contain the initial spread of the virus from abroad; (2) rapidly increasing the capacity of national health systems in terms of mobilizing staff, securing supplies (e.g., protective equipment and respiratory devices), and optimizing space (e.g., ensuring adequate numbers of acute and intensive care beds) to scale up testing-tracing-treating infrastructure; (3) promoting individual hygienic behavior such as social distancing and face mask use, which requires, respectively, active government enforcement of regulations against holding spreader events, and strong government intervention in the market to ensure adequate supplies; (4) fiscal measures to extend disaster relief to workers, businesses, and vulnerable populations; and (5) clear, concise, and consistent communications from leaders and authorities. International cooperation must have a key role in the fight against the pandemic. So far, a global response to the crisis has been glaringly absent. Although it is understandable that countries prioritize their own needs, it must be understood that no country is safe until every other country is also safe. Global access to future vaccines, supplies, tests, and treatments is the only way to ensure the virus is truly eradicated within a country. The richer countries should establish a global fund to provide the poor countries with the needed vaccine, and to enhance their efforts in testing, tracing, and treating COVID-19 cases.

Preoperative nursing consultation and self-care of cancer patients with respiratory ostomy

Objective: to demonstrate the influence of the preoperative nursing consultation in the practice of self-care performed by patients with respiratory ostomy at the A.C. Camargo Cancer Center and to describe what are the self-care practices performed and their limiting factors. Method: qualitative, exploratory study, carried out with 7 patients aged 18 years or older, who underwent preoperative nursing consultation, who underwent surgery with the manufacture of a respiratory ostomy and were able to establish verbal communication. Data was collected through semi-structured interviews and a digital recorder and submitted to content analysis. Results: male participants predominated, aged 56 years or over and completed high school. Two analytical categories were identified: “Repercussions of the actions promoted by the preoperative nursing consultation”; and “Obstacles in the search for autonomy in the care of the tracheostomy cannula”. Conclusion: nursing consultation is an important instrument to guide, form bonds and clarify doubts about care with ostomy and respiratory devices, and nursing actions can limit and even prevent the patients from developing their self-care, making it necessary that the therapeutic nursing project is planned to aggregate the patient in this process.