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1.
J Environ Sci (China) ; 147: 642-651, 2025 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-39003079

RESUMO

Nowadays, it is still a challenge to prepared high efficiency and low cost formaldehyde (HCHO) removal catalysts in order to tackle the long-living indoor air pollution. Herein, δ-MnO2 is successfully synthesized by a facile ozonation strategy, where Mn2+ is oxidized by ozone (O3) bubble in an alkaline solution. It presents one of the best catalytic properties with a low 100% conversion temperature of 85°C for 50 ppm of HCHO under a GHSV of 48,000 mL/(g·hr). As a comparison, more than 6 times far longer oxidation time is needed if O3 is replaced by O2. Characterizations show that ozonation process generates a different intermediate of tetragonal ß-HMnO2, which would favor the quick transformation into the final product δ-MnO2, as compared with the relatively more thermodynamically stable monoclinic γ-HMnO2 in the O2 process. Finally, HCHO is found to be decomposed into CO2 via formate, dioxymethylene and carbonate species as identified by room temperature in-situ diffuse reflectance infrared fourier transform spectroscopy. All these results show great potency of this facile ozonation routine for the highly active δ-MnO2 synthesis in order to remove the HCHO contamination.


Assuntos
Formaldeído , Compostos de Manganês , Óxidos , Ozônio , Ozônio/química , Compostos de Manganês/química , Formaldeído/química , Óxidos/química , Poluentes Atmosféricos/química , Oxirredução , Temperatura , Poluição do Ar em Ambientes Fechados/prevenção & controle , Catálise
2.
J Environ Sci (China) ; 148: 298-305, 2025 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-39095166

RESUMO

Ultrasonic humidifiers are commonly used in households to maintain indoor humidity and generate a large number of droplets or spray aerosols. However, there have been various health concerns associated with humidifier use, largely due to aerosols generated during operation. Here, we investigated the size distribution, chemical composition, and charged fraction of aerosol particles emitted from commercial ultrasonic humidifiers. Heavy metals in water used for humidifiers were found to be highly enriched in the ultrasonic humidifier aerosols (UHA), with the enrichment factors ranging from 102 to 107. This enrichment may pose health concerns for the building occupants, as UHA concentrations of up to 106 particles/cm3 or 3 mg/m3 were observed. Furthermore, approximately 90% of UHA were observed to be electrically charged, for the first time according to our knowledge. Based on this discovery, we proposed and tested a new method to remove UHA by using a simple electrical field. The designed electrical field in this work can efficiently remove 81.4% of UHA. Therefore, applying this electrical field could be an effective method to significantly reduce the health risks by UHA.


Assuntos
Aerossóis , Umidificadores , Metais Pesados , Aerossóis/análise , Metais Pesados/análise , Poluição do Ar em Ambientes Fechados/prevenção & controle , Poluição do Ar em Ambientes Fechados/análise , Poluentes Atmosféricos/análise , Ultrassom , Monitoramento Ambiental/métodos
3.
J Environ Sci (China) ; 148: 650-664, 2025 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-39095197

RESUMO

China is the most important steel producer in the world, and its steel industry is one of the most carbon-intensive industries in China. Consequently, research on carbon emissions from the steel industry is crucial for China to achieve carbon neutrality and meet its sustainable global development goals. We constructed a carbon dioxide (CO2) emission model for China's iron and steel industry from a life cycle perspective, conducted an empirical analysis based on data from 2019, and calculated the CO2 emissions of the industry throughout its life cycle. Key emission reduction factors were identified using sensitivity analysis. The results demonstrated that the CO2 emission intensity of the steel industry was 2.33 ton CO2/ton, and the production and manufacturing stages were the main sources of CO2 emissions, accounting for 89.84% of the total steel life-cycle emissions. Notably, fossil fuel combustion had the highest sensitivity to steel CO2 emissions, with a sensitivity coefficient of 0.68, reducing the amount of fossil fuel combustion by 20% and carbon emissions by 13.60%. The sensitivities of power structure optimization and scrap consumption were similar, while that of the transportation structure adjustment was the lowest, with a sensitivity coefficient of less than 0.1. Given the current strategic goals of peak carbon and carbon neutrality, it is in the best interest of the Chinese government to actively promote energy-saving and low-carbon technologies, increase the ratio of scrap steel to steelmaking, and build a new power system.


Assuntos
Dióxido de Carbono , Pegada de Carbono , Aço , China , Dióxido de Carbono/análise , Poluentes Atmosféricos/análise , Metalurgia , Monitoramento Ambiental , Indústrias , Poluição do Ar/estatística & dados numéricos , Poluição do Ar/prevenção & controle
4.
J Environ Sci (China) ; 148: 702-713, 2025 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-39095202

RESUMO

Chinese diesel trucks are the main contributors to NOx and particulate matter (PM) vehicle emissions. An increase in diesel trucks could aggravate air pollution and damage human health. The Chinese government has recently implemented a series of emission control technologies and measures for air quality improvement. This paper summarizes recent control technologies and measures for diesel truck emissions in China and introduces the comprehensive application of control technologies and measures in Beijing-Tianjin-Hebei and surrounding regions. Remote online monitoring technology has been adopted according to the China VI standard for heavy-duty diesel trucks, and control measures such as transportation structure adjustment and heavy pollution enterprise classification control continue to support the battle action plan for pollution control. Perspectives and suggestions are provided for promoting pollution control and supervision of diesel truck emissions: adhere to the concept of overall management and control, vigorously promote the application of systematic and technological means in emission monitoring, continuously facilitate cargo transportation structure adjustment and promote new energy freight vehicles. This paper aims to accelerate the implementation of control technologies and measures throughout China. China is endeavouring to control diesel truck exhaust pollution. China is willing to cooperate with the world to protect the global ecological environment.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Monitoramento Ambiental , Material Particulado , Emissões de Veículos , Emissões de Veículos/análise , China , Poluentes Atmosféricos/análise , Poluição do Ar/prevenção & controle , Poluição do Ar/estatística & dados numéricos , Monitoramento Ambiental/métodos , Material Particulado/análise , Veículos Automotores
5.
Notas enferm. (Córdoba) ; 25(43): 5-16, jun.2024.
Artigo em Espanhol | LILACS, BDENF - Enfermagem, BINACIS, UNISALUD | ID: biblio-1561161

RESUMO

La presente investigación pretende evaluar el nivel de cumplimiento de las metas internacionales, que representan el foco principal para la mejora de calidad y seguridad de atención de los pacientes. La seguridad del paciente involucra a todos los estudios, prácticas y acciones promovidas por las instituciones sanitarias para disminuir y eliminar los riesgos de daños innecesarios relacionados con el cuidado de la salud. Metodología: Estudio descriptivo, observacional y transversal. De fuentes primaria y secundaria, Resultados: se abordaron las metas N° 1 la cual consiste en Identificar a los pacientes correctamente y la meta N° 6 la cual se refiere a Reducir el riesgo de lesiones en pacientes como resultado de caídas. En primer lugar, se destaca el cumplimiento en la identificación correcta del paciente y en segunda instancia la mejora del cumplimiento de medidas de prevención de caídas. Conclusión: Esta proximidad de los valores obtenidos genera un aspecto positivo para mejorar la seguridad de los pacientes y que, si bien el cumplimiento de las metas no es el deseado, es cercano al porcentaje planteado. Lo que en definitiva hace a este estudio un antecedente importante en la mejora continua con vista al futuro cercano[AU]


This research aims to evaluate the level of compliance with international goals, which represent the main focus for improving the quality and safety of patient care. Patient safety involves all studies, practices and actions promoted by health institutions to reduce and eliminate the risks of unnecessary harm related to health care. Methodology: Descriptive, observational and transversal study. From primary and secondary sources, Results: goals No. 1 were addressed, which consists of Identifying patients correctly and goal No. 6, which refers to Reducing the risk of injuries in patients as a result of falls. Firstly, compliance with correct patient identification stands out and secondly, improvement in compliance with fall prevention measures. Conclusion: This proximity of the values obtained generates a positive aspect to improve patient safety and that, although the fulfillment of the goals is not as desired, it is close to the proposed percentage. Which ultimately makes this study an important precedent in continuous improvement for the near future[AU]


Esta pesquisa tem como objetivo avaliar o nível de cumprimento das metas internacionais, que representam o foco principal para a melhoria da qualidade e segurança do atendimento ao paciente. A segurança do paciente envolve todos os estudos, e ações promovidas pelas instituições de saúde para reduzir e eliminar os riscos de danos desnecessários relacionados à assistência à saúde. Metodologia: Estudo descritivo, observacional e transversal. De fontes primárias e secundárias, dependendo do indicador e do objetivo para o qual a medição está sendo realizada. Resultados: Nesta pesquisa serão abordadas as metas nº1, que consiste em Identificar corretamente os pacientes e a meta nº 6, que es Reduzir o risco de lesões nos pacientes em decorrência de quedas. Foi realizado nos dois locais. Em primeiro lugar, destaca-se o cumprimento da correta identificação do paciente e, em segundo lugar, a melhoria no cumprimento das medidas de prevenção de quedas. Conclusão: Essa proximidade dos valores obtidos gera um aspecto positivo para melhorar a segurança do paciente e que, embora o cumprimento das metas não seja o desejado, está próximo do percentual proposto. O que acaba por tornar este estudo um precedente importante na melhoria contínua com vista ao futuro próximo.


Assuntos
Humanos , Sistemas de Identificação de Pacientes , Qualidade da Assistência à Saúde , Acidentes por Quedas/prevenção & controle
6.
World J Gastroenterol ; 30(26): 3221-3228, 2024 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-39086638

RESUMO

BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1 RA) are effective in diabetes and obesity, reducing hyperglycemia by increasing insulin release and delaying gastric emptying. However, they can cause gastroparesis, raising concerns about aspiration during procedures. Recent guidelines advise discontinuing GLP-1 RA before surgery to reduce the risk of pulmonary aspiration. AIM: To evaluate the effect of GLP-1 RAs on gastric residual contents during endoscopic procedures. METHODS: A retrospective chart review at BronxCare Health System, New York, from January 2019 to October 2023, assessed gastric residue and aspiration in GLP-1 RA patients undergoing endoscopic procedures. Two groups were compared based on dietary status before the procedure. Data included demographics, symptoms of gastroparesis, opiate use, hemoglobin A1c, GLP-1 agonist indication, endoscopic details, and aspiration occurrence. IBM SPSS was used for analysis, calculating means, standard deviations, and applying Pearson's chi-square and t-tests for associations, with P < 0.05 as being significant. RESULTS: During the study, 306 patients were included, with 41.2% on a clear liquid/low residue diet and 58.8% on a regular diet before endoscopy. Most patients (63.1%) were male, with a mean age of 60 ± 12 years. The majority (85.6%) were on GLP-1 RAs for diabetes, and 10.1% reported digestive symptoms before endoscopy. Among those on a clear liquid diet, 1.5% had residual food at endoscopy compared to 10% on a regular diet, which was statistically significant (P = 0.03). Out of 31 patients with digestive symptoms, 13% had residual food, all from the regular diet group (P = 0.130). No complications were reported during or after the procedures. CONCLUSION: The study reflects a significant rise in GLP-1 RA use for diabetes and obesity. A 24-hour liquid diet seems safe for endoscopic procedures without aspiration. Patients with upper gastrointestinal symptoms might have a higher residual food risk, though not statistically significant. Further research is needed to assess risks based on diabetes duration, gastroparesis, and GLP-1 RA dosing, aiming to minimize interruptions in therapy during procedures.


Assuntos
Gastroparesia , Receptor do Peptídeo Semelhante ao Glucagon 1 , Humanos , Estudos Retrospectivos , Masculino , Feminino , Pessoa de Meia-Idade , Receptor do Peptídeo Semelhante ao Glucagon 1/agonistas , Idoso , Gastroparesia/prevenção & controle , Gastroparesia/etiologia , Gastroparesia/epidemiologia , Gastroparesia/tratamento farmacológico , Esvaziamento Gástrico/efeitos dos fármacos , Hipoglicemiantes/uso terapêutico , Hipoglicemiantes/administração & dosagem , Endoscopia Gastrointestinal/métodos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Adulto , Agonistas do Receptor do Peptídeo 1 Semelhante ao Glucagon
7.
Front Public Health ; 12: 1384561, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39086801

RESUMO

Introduction: The COVID-19 pandemic had a great impact on several public sectors worldwide, requiring the implementation of public policies in an organized way to contain and control the disease. Thus, this study aimed to analyze public policies to face the COVID-19 pandemic in the State of Paraná, Brazil. Methods: This was a cross-sectional, retrospective, quantitative survey carried out with data from March 2020 to March 2022 in the twenty-two municipalities that host the local health regions. Data collection was documentary, carried out from the municipal Portal da Transparência website, which is dedicated to making public all expenditures, and epidemiological bulletins released by the Health Department of the state of Paraná. The variables analyzed were New Cases and Deaths, Mortality and Lethality Coefficient, Incidence Rate, Vaccination Coverage, Number of Hospital and ICU beds exclusive to COVID-19, Settled Expenses destined for COVID-19 and coping measures, namely, the Declaration of Public Health Emergency, Curfew, Mandatory use of masks, Businesses closure, Teleworking of risk groups, and Suspension of activities with crowds and of classes. After collection, data underwent descriptive analysis, and subsequently, the correlation of variables was analyzed using the Spearman test. Multiple linear regression was applied using the variable selection method called best subset selection (BSS). The dependent variables listed were incidence rate, new cases and new deaths. Results: The results showed that coping measures, as well as the application of resources for the pandemic, were implemented heterogeneously in the municipalities studied, and the progression of the disease, the distribution of beds and vaccination occurred unevenly and may be a reflection of the limited Brazilian national governance. An important correlation was observed between the incidence rate and new deaths with vaccination coverage. In addition, the regression model showed that measures such as mandatory use of masks, closure of shops, suspension of classes, and curfew showed important correlations with the variables incidence rate, cases, and new deaths. Discussion: The study highlighted the importance of carrying out a robust analysis of public policies to face emergencies of global importance so that government entities are prepared for future crises of great repercussions, such as the COVID-19 pandemic.


Assuntos
COVID-19 , Política Pública , COVID-19/epidemiologia , COVID-19/prevenção & controle , Humanos , Brasil/epidemiologia , Estudos Transversais , Estudos Retrospectivos , SARS-CoV-2 , Pandemias/prevenção & controle , Saúde Pública , Política de Saúde
9.
JMIR Res Protoc ; 13: e57101, 2024 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-39088243

RESUMO

BACKGROUND: Older adults often face loneliness due to chronic illness or loss of close ones, a situation worsened by the COVID-19 pandemic. Increased loneliness heightens the risk of diseases, especially dementia, necessitating urgent action. OBJECTIVE: This study aims to assess the impact of a virtual reality (VR)-based open-air bath program on depression and loneliness in older individuals with subjective cognitive decline/mild cognitive impairment attending the Dementia Medical Center in Kyoto, Japan. We further aim to evaluate the feasibility of the program (participant recruitment and adherence) and to measure program enjoyment and satisfaction. METHODS: The study design is a crossover trial with a 1:1 ratio, wherein 12 participants will be randomly assigned to groups 1 and 2, with group 2 serving as a waitlist control and group 1 receiving the VR program from the onset for 6 months; the VR program will be conducted 6 times (monthly). Program completion for group 1 will be followed by an observation period from months 7 to 12. Group 2 will participate in the VR program from months 7 to 12, with an observation period from months 1 to 6. Cognitive tests, psychiatric assessments, and the University of California, Los Angeles Loneliness Scale will be conducted before the study, at 6 months, and at 12 months. Results will be analyzed using repeated-measures ANOVA. Head magnetic resonance imaging and single-photon emission computed tomography scans will be performed before and after the VR program to evaluate changes and effects on brain regions. RESULTS: Recruitment began in September 2023 and data collection is expected to be completed by March 2025. Complete study results will be published by September 2025. CONCLUSIONS: This study examines the preliminary effects of VR on loneliness in older adults with predementia through open-air bath simulations. VR experiences could benefit this population, particularly those with limited outdoor activities. Quantifying VR's impact will aid in determining the size for a larger clinical trial. Qualitative results will inform participation mechanisms and guide the implementation and design of future trials. TRIAL REGISTRATION: University hospital Medical Information Network UMIN000052667; https://tinyurl.com/3yaccay5. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/57101.


Assuntos
Estudos Cross-Over , Demência , Solidão , Realidade Virtual , Humanos , Solidão/psicologia , Demência/prevenção & controle , Demência/psicologia , Idoso , Estudos Prospectivos , Masculino , Feminino , COVID-19/prevenção & controle , COVID-19/psicologia , Banhos/métodos , Disfunção Cognitiva/prevenção & controle , Disfunção Cognitiva/psicologia , Encéfalo/diagnóstico por imagem , Idoso de 80 Anos ou mais , Japão
10.
J Manag Care Spec Pharm ; 30(8): 792-804, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39088336

RESUMO

BACKGROUND: Health care resource utilization (HCRU) and direct costs incurred over 12 months following initiation of galcanezumab (GMB) or standard-of-care (SOC) preventive migraine treatments have been evaluated. However, a gap in knowledge exists in understanding longer-term HCRU and direct costs. OBJECTIVE: To compare all-cause and migraine-related HCRU and direct costs in patients with migraine initiating GMB or SOC preventive migraine treatments over a 24-month follow-up. METHODS: This retrospective study used Optum deidentified Market Clarity Data. The study included adults diagnosed with migraine, with at least 1 claim for GMB or SOC preventive migraine therapy (September 2018 to March 2020), with continuous enrollment for 12 months before and 24 months after (follow-up) the index date (date of first GMB or SOC claim). Propensity score (PS) matching (1:1) was used to balance cohorts. All-cause and migraine-related HCRU and direct costs for GMB vs SOC cohorts were reported as mean (SD) per patient per year (PPPY) over a 24-month follow-up and compared using a Z-test. Costs were inflated to 2022 US$. RESULTS: After PS matching, 2,307 patient pairs (mean age: 44.4 years; female sex: 87.3%) were identified. Compared with the SOC cohort, the GMB cohort had lower mean (SD) PPPY all-cause office visits (17.9 [17.7] vs 19.1 [18.7]; P = 0.023) and migraine-related office visits (2.6 [3.3] vs 3.0 [4.7]; P = 0.002) at follow-up. No significant differences were observed between cohorts in other all-cause and migraine-related events assessed including outpatient visits, emergency department (ED) visits, inpatient stays, and other medical visits. The mean (SD) costs PPPY were lower in the GMB cohort compared with the SOC cohort for all-cause office visits ($4,321 [7,518] vs $5,033 [7,211]; P < 0.001) at follow-up. However, the GMB cohort had higher mean (SD) PPPY all-cause total costs ($24,704 [30,705] vs $21,902 [28,213]; P = 0.001) and pharmacy costs ($9,507 [12,659] vs $5,623 [12,605]; P < 0.001) compared with the SOC cohort. Mean (SD) costs PPPY were lower in the GMB cohort for migraine-related office visits ($806 [1,690] vs $1,353 [2,805]; P < 0.001) compared with the SOC cohort. However, the GMB cohort had higher mean (SD) PPPY migraine-related total costs ($8,248 [11,486] vs $5,047 [9,749]; P < 0.001) and migraine-related pharmacy costs ($5,394 [3,986] vs $1,761 [4,133]; P < 0.001) compared with the SOC cohort. There were no significant differences between cohorts in all-cause and migraine-related costs for outpatient visits, ED visits, inpatient stays, and other medical visits. CONCLUSIONS: Although total costs were greater for GMB vs SOC following initiation, changes in a few categories of all-cause and migraine-related HCRU and direct costs were lower for GMB over a 24-month follow-up. Additional analysis evaluating indirect health care costs may offer insights into further cost savings incurred with preventive migraine treatment.


Assuntos
Anticorpos Monoclonais Humanizados , Custos de Cuidados de Saúde , Transtornos de Enxaqueca , Aceitação pelo Paciente de Cuidados de Saúde , Humanos , Transtornos de Enxaqueca/economia , Transtornos de Enxaqueca/prevenção & controle , Transtornos de Enxaqueca/tratamento farmacológico , Estudos Retrospectivos , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Estados Unidos , Anticorpos Monoclonais Humanizados/economia , Anticorpos Monoclonais Humanizados/uso terapêutico , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Custos de Cuidados de Saúde/estatística & dados numéricos , Padrão de Cuidado/economia , Recursos em Saúde/estatística & dados numéricos , Recursos em Saúde/economia , Seguimentos
11.
JCO Glob Oncol ; 10: e2400081, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39088779

RESUMO

PURPOSE: There has been a significant rise in telehealth consultations across Australia since COVID-19 was declared a worldwide pandemic. We aimed to obtain patient feedback on telehealth, identify key strengths and weaknesses, and assess the feasibility of telehealth beyond the pandemic. METHODS: A survey was developed to obtain patient feedback on telehealth. Patients attending medical oncology clinics at St George Hospital and Sutherland Hospital from April 1, 2020, to May 31, 2020, were identified. Patients who were reviewed via phone or videoconference were included in this study. Eligible patients were texted or emailed a survey link within a week of their telehealth consultation. Surveys were anonymous and completion of the survey implied informed consent. Patients who did not have a mobile number or e-mail were excluded from this study. RESULTS: One thousand fifty-nine patients were reviewed during the study period, of whom 644 (60%) were reviewed via telehealth. The survey response rate was 36.3% (230 patients responded of 634 surveys sent). Ten telehealth patients did not have a mobile number or email and were excluded. Sixty-seven percent of telehealth consults were for active surveillance, 31% for prechemotherapy/treatment reviews, 1.6% for best supportive care, and 0.5% for new consults. Seventy percent of patients were satisfied that their medical needs were met via telehealth. Ninety percent wanted another telehealth consult, and 73% wanted telehealth to continue post resolution of the pandemic. Minimizing risk of exposure to COVID-19 and patient convenience were identified as key strengths of telehealth while absence of physical examination was the main disadvantage. CONCLUSION: Majority of the patients surveyed were satisfied that telehealth safely met their medical needs. There is a considerable demand for telehealth to continue beyond the pandemic.


Assuntos
COVID-19 , Neoplasias , Satisfação do Paciente , SARS-CoV-2 , Telemedicina , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Austrália/epidemiologia , Neoplasias/terapia , Feminino , Masculino , Pessoa de Meia-Idade , Idoso , Adulto , Inquéritos e Questionários , Pandemias/prevenção & controle , Idoso de 80 Anos ou mais
13.
Georgian Med News ; (350): 68-72, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-39089274

RESUMO

Public smoke-free policy support can contribute to effective policy adoption, implementation, and impact. Furthermore, individuals may engage in behaviors to reduce secondhand smoke exposure (SHSe). This study examined factors associated with smoke-free policy support and behaviors to reduce SHSe. MATERIAL AND METHODS: We analyzed cross-sectional survey data among 261 students (Mage=22.26, SD=2.76; 55.6% female) at a large medical university in Tbilisi, Georgia. Multivariable regression analyses assessed sociodemographics, tobacco use, past-week SHSe, perceived risk of SHSe, and perceived smoke-free policy effectiveness in relation to smoke-free policy support; SHSe avoidance; and having asked others to put out cigarettes. RESULTS: Overall, 38.3% reported current smoking, 62.8% lived with someone who used tobacco, and the average number of days of SHSe was 4.07 (SD=2.17). Most commons SHSe sources were open (58.2%) and closed public places (24.1%). The majority supported the smoking ban in closed (94.6%) and open public places (59.8%); 71.6% believed it should include other places. Average ratings were relatively high for perceived risk (M=3.38, 1=no-4=serious) but lower for perceived smoke-free policy effectiveness (M=2.51, 1=not-4=quite) and avoidance of SHSe (M=3.32, 1=never-5=always); 58.6% had asked someone to put out cigarettes. Greater smoke-free policy support, avoidance of SHSe, and having asked someone to put out cigarettes (respectively) were associated with nonsmoking status and greater perceived SHSe risk (p's<.01). CONCLUSIONS: Despite general support for smoke-free policy and engagement in SHSe reduction behaviors in Georgia, additional efforts to reduce SHSe are needed (e.g., media campaigns to raise SHSe risk awareness, engaging nonsmoking adults in enforcement).


Assuntos
Política Antifumo , Poluição por Fumaça de Tabaco , Humanos , Poluição por Fumaça de Tabaco/prevenção & controle , Feminino , Masculino , República da Geórgia/epidemiologia , Estudos Transversais , Adulto Jovem , Adulto , Estudantes de Medicina/psicologia , Estudantes de Medicina/estatística & dados numéricos , Universidades , Conhecimentos, Atitudes e Prática em Saúde , Inquéritos e Questionários , Fumar/psicologia , Fumar/epidemiologia
14.
Georgian Med News ; (350): 63-67, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-39089273

RESUMO

The proximal femoral fracture patients in particular fractures in the trochanteric region of the femur could have treatment under the title proximal femoral nailing (PFN)-this operation is a less invasive type. The proximal femoral nail, an osteosynthetic implant, has been investigated to produce positive heeling to ensure a better fixation, several advantages of PFN include such as bleeding time during operation which leads to the need to perform reaming on the femoral canal during surgery. MATERIAL AND METHODS: The study was carried out at three teaching Hospitals in Mosul City from the period of January 2022 to December 2022, fourteen nurses from orthopaedic wards were subjected to this study, all the nurses were evaluated by the checklist, and they attended the training program which was taken from the Iraqi Ministry of Health guide for organizing nursing operations and practices inside the hospitals and medical departments. RESULTS AND DISCUSSION: More than (50%) of the study sample had a poor score in the initial evaluation for post-operative steps and after submitting the training program, the performance and practices of the nursing staff have improved significantly where the poor score decreased to approximately (25%) at P value (0.0001). CONCLUSION: The study concluded that there is a significant and clear weakness in the performance and practices of the nursing staff towards patients with upper femoral fractures in the fracture wards and that the training program that was given to them improved their performance and practices significantly and effectively.


Assuntos
Pinos Ortopédicos , Complicações Pós-Operatórias , Humanos , Complicações Pós-Operatórias/prevenção & controle , Fixação Intramedular de Fraturas/efeitos adversos , Fixação Intramedular de Fraturas/métodos , Fraturas do Fêmur/cirurgia , Feminino , Masculino , Adulto
15.
Clin Psychol Psychother ; 31(4): e3034, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39089327

RESUMO

There is increasing evidence that therapy and intervention services delivered by telehealth are effective at reducing a variety of mental health symptoms. Limited studies have indicated online services can reduce intimate partner violence (IPV), but none have tested in-person compared to telehealth-delivered interventions for men who have used IPV. Clinical outcome data from 311 parents (192 fathers and 119 linked coparent mothers) engaged in the Fathers for Change (F4C) intervention following referral by child protective services for IPV were examined to determine if in-person delivery of the intervention differed in terms of client treatment engagement and retention or outcomes. Parents who enrolled during a 1-year period prior to the COVID pandemic received their F4C therapy in person, while those who enrolled during the pandemic received their intake and most of their sessions via telehealth delivery. Parents reported significantly greater symptoms of depression, anxiety, and stress prior to treatment if they enrolled prior to COVID than if they enrolled during the pandemic. There were few differences in completion rates or outcomes based on in-person compared to telehealth delivery. Fathers were slightly more likely to complete treatment and attended a significantly higher percentage of their sessions when it was delivered by telehealth during COVID. Fathers reported significantly lower stress scores posttreatment when they received COVID telehealth delivery compared to prior to COVID in-person delivery of F4C. These findings suggest that telehealth may be an appropriate and viable option for the delivery of IPV interventions for families.


Assuntos
COVID-19 , Telemedicina , Humanos , Masculino , Telemedicina/estatística & dados numéricos , COVID-19/psicologia , COVID-19/prevenção & controle , Adulto , Feminino , Terapia Familiar/métodos , Pessoa de Meia-Idade , Violência Doméstica/psicologia , Violência Doméstica/estatística & dados numéricos , SARS-CoV-2 , Violência por Parceiro Íntimo/psicologia , Violência por Parceiro Íntimo/estatística & dados numéricos , Violência por Parceiro Íntimo/prevenção & controle
16.
Adv Surg ; 58(1): 107-119, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39089771

RESUMO

Parastomal hernias are an inevitable consequence of ostomy formation and their repairs remain a challenge to many surgeons. With multiple systems of classification and a multitude of techniques for hernia repair ranging from suture to mesh repair, the literature remains sparse with regards to the optimal method of repair. The authors describe the most commonly adopted techniques, discuss preventative measures, and review the current literature in the context of perioperative outcomes and hernia recurrence.


Assuntos
Herniorrafia , Telas Cirúrgicas , Humanos , Herniorrafia/métodos , Herniorrafia/efeitos adversos , Hérnia Incisional/cirurgia , Hérnia Incisional/etiologia , Hérnia Incisional/prevenção & controle , Hérnia Ventral/cirurgia , Hérnia Ventral/etiologia , Estomas Cirúrgicos/efeitos adversos , Resultado do Tratamento , Recidiva , Técnicas de Sutura
17.
Adv Surg ; 58(1): 65-77, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39089787

RESUMO

Breast cancer related lymphedema (BCRL) affects many breast cancer survivors and drastically affects their quality of life. There are several surveillance methods for BCRL that are critical at early detection. Prevention of BCRL involves knowledge of alternatives to aggressive axillary surgery, avoidance of axillary surgery, and de-escalation of axillary surgery. There are also techniques to better delineate the anatomy in the axilla to avoid taking nodes that drain the upper extremity. A multidisciplinary approach with medical oncology and radiation oncology can also help avoid unnecessary surgery or radiation that can together strongly increase the risk of BCRL.


Assuntos
Axila , Linfedema Relacionado a Câncer de Mama , Neoplasias da Mama , Excisão de Linfonodo , Humanos , Feminino , Linfedema Relacionado a Câncer de Mama/prevenção & controle , Linfedema Relacionado a Câncer de Mama/etiologia , Linfedema Relacionado a Câncer de Mama/terapia , Neoplasias da Mama/cirurgia , Excisão de Linfonodo/efeitos adversos , Linfedema/etiologia , Linfedema/prevenção & controle , Qualidade de Vida , Mastectomia/efeitos adversos
18.
Adv Surg ; 58(1): 79-85, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39089788

RESUMO

Pancreatoduodenectomy is a complex surgical procedure with a high rate of morbidity, of which surgical-site infections (SSIs) make a large portion. Reduction of SSI rates is critical to decrease hospital lengths of stay, readmissions, delays in adjuvant therapies, and financial health care burden. Current clinical guidelines recommend the administration of cefoxitin as surgical prophylaxis prior to pancreatoduodenectomy. In April 2023, a randomized controlled trial was published in JAMA which showed that piperacillin-tazobactam as perioperative surgical prophylaxis prior to pancreatoduodenectomy decreased 30 day SSI rates (primary outcome), clinically relevant postoperative pancreatic fistula, postoperative sepsis, and Clostridium difficile infection rates.


Assuntos
Antibacterianos , Antibioticoprofilaxia , Pancreaticoduodenectomia , Infecção da Ferida Cirúrgica , Humanos , Pancreaticoduodenectomia/efeitos adversos , Infecção da Ferida Cirúrgica/prevenção & controle , Antibacterianos/uso terapêutico , Antibacterianos/administração & dosagem , Antibioticoprofilaxia/métodos , Cefoxitina/uso terapêutico , Cefoxitina/administração & dosagem , Combinação Piperacilina e Tazobactam/uso terapêutico , Combinação Piperacilina e Tazobactam/administração & dosagem
19.
Radiologia (Engl Ed) ; 66(4): 374-380, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39089797

RESUMO

Coaching is an effective tool that seeks personal reflection as a way for people to find their own solutions. In this article we show our results when applying it in our Radiology Service. The article includes a bibliographic review on its potential applications in Medicine and in Radiology. We specifically reviewed the fields of improving self-care and preventing burnout as well as the teaching field, both for residents in training and for certified radiologists.


Assuntos
Tutoria , Serviço Hospitalar de Radiologia , Tutoria/métodos , Humanos , Serviço Hospitalar de Radiologia/organização & administração , Esgotamento Profissional/prevenção & controle , Radiologia/educação , Internato e Residência/métodos
20.
Cleve Clin J Med ; 91(8): 503-510, 2024 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-39089852

RESUMO

Internists are integral in the multidisciplinary approach to diabetic retinopathy, contributing significantly to the management of diabetes and diabetes-related complications. Effective screening processes, timely referrals, and strategic diabetes management are imperative to prevent and mitigate the consequences of diabetic retinopathy. The evolution of treatments for diabetic retinopathy has markedly improved vision outcomes and reduced the burden on patients. Despite these advances, a collaborative approach to care is essential to prevent the progression of vision impairment and manage associated complications.


Assuntos
Retinopatia Diabética , Programas de Rastreamento , Humanos , Retinopatia Diabética/diagnóstico , Retinopatia Diabética/prevenção & controle , Retinopatia Diabética/terapia , Programas de Rastreamento/métodos
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