Daylight-Induced Antibacterial and Antiviral Cotton Cloth for Offensive Personal Protection.

Cotton fabrics with durable and reusable daylight-induced antibacterial/antiviral functions were developed by using a novel fabrication process, which employs strong electrostatic interaction between cationic cotton fibers and anionic photosensitizers. The cationic cotton contains polycationic short chains produced by a self-propagation of 2-diehtylaminoehtyl chloride (DEAE-Cl) on the surface of cotton fibers. Then, the fabric (i.e., polyDEAE@cotton) can be readily functionalized with anionic photosensitizers like rose Bengal and sodium 2-anthraquinone sulfate to produce biocidal reactive oxygen species (ROS) under light exposure and consequently provide the photo-induced biocidal functions. The biocidal properties of the photo-induced fabrics (PIFs) were demonstrated by ROS production measurements, bactericidal performance against bacteria (e.g., E coli and L. innocua), and antiviral results against T7 bacteriophage. The PIFs achieved 99.9999% (6 log) reductions against bacteria and the bacteriophage within 60 min of daylight exposure. Moreover, the PIFs showcase excellent washability and photostability, making them ideal materials for reusable face masks and protective suits with improved biological protections compared with traditional PPE. This work demonstrated that the cationized cotton could serve as a platform for different functionalization applications, and the resulting fiber materials could inspire the development of reusable and sustainable PPE with significant bioprotective properties to fight the COVID-19 pandemic as well as the spread of other contagious diseases.

Undergarment needs after breast cancer surgery: a key survivorship consideration.

An important aspect of breast cancer survivorship is finding comfortable undergarments that work for women's post-treatment bodies. Patients who undergo mastectomy, including both those who do and do not receive reconstruction, need bras that can accommodate new breast shape, size, and feel, as well as scarring and skin sensitivity. Our research with breast cancer patients and the literature reveal that ready-to-wear bras are inadequate for the variety of patients' needs, and many women lack support and guidance to make decisions about undergarments after cancer. This commentary describes a major quality-of-life challenge for breast cancer survivors and makes recommendations for future research. Healthcare providers need more guidance and resources to be able to help their patients prepare for this aspect of survivorship. New technologies, such as biomechanical modeling, 3D body scanning, and manufacturing techniques, should be pursued in collaboration with patients, healthcare providers, and clothing designers to ease this burden for breast cancer patients.

Sunscreen Application, Safety, and Sun Protection: The Evidence.

Recently in Canada, there has been an effort to create consistent messaging about sun safety as there is a lack of up-to-date evidence-based guidelines regarding sun-protection measures. This review aimed to provide updated, evidence-based recommendations on sunscreen application, safety, and sun protection regarding the following topics for which there is clinical uncertainty: physical barriers, sunscreen properties, sunscreen application, and risk-benefit analysis.

The Brazilian Army nurses' uniforms: visual identity in World War II / Uniformes de enfermeras del Ejército Brasileño: identidad visual en la Segunda Guerra Mundial / Uniformes de enfermeiras do Exército Brasileiro: identidade visual na II Guerra Mundial

ABSTRACT Objective: To analyze the symbolic effects of the official military uniform of the nurses from Brazilian Army in World War II. Method: This research was developed using the historical method, with iconographic sources. The data were discussed based on the concepts of the social world theory, by Pierre Bourdieu. Results: The images selected demonstrate the own meaning of the uniforms, evidencing the functions and the social position of those who wear it, being private and obligatory to use it in the military field. Final considerations: In the case of the nurses from the Brazilian Expeditionary Force, the appropriation of uniforms promoted the visual communication representing military nurse in the context of war, at the same time it served for distinction purposes in the army, but not necessarily in the nursing field. Symbolically, they remained amongst the walls of the barracks even after the end of the war and, thus, they remained unknown and marked by the symbols of forgetfulness.

RESUMEN Objetivo: Analizar los efectos simbólicos de la vestimenta militar oficial de las enfermeras del Ejército Brasileño en la II Guerra Mundial. Método: La investigación fue desarrollada usando el método histórico con fuentes de imágenes. Los datos fueron discutidos a la luz de conceptos de la teoría del mundo social, de Pierre Bourdieu. Resultados: Las imágenes seleccionadas demuestran el significado propio de los uniformes, explicitando las funciones y la posición social de quien los porta, siendo de uso privativo y obligatorio en el campo militar. Consideraciones finales: En el caso de las enfermeras de la Fuerza Expedicionaria Brasileña, la apropiación de uniformes promovió la comunicación visual de la figura-tipo de la enfermera militar en el contexto de la guerra, al tiempo que confería distinción en el ámbito del ejército, pero no necesariamente en el campo de la enfermería. Simbólicamente, permanecieron entre los muros de los cuarteles incluso después del término de la guerra, y, por consiguiente, se mantuvieron desconocidas y marcadas por los signos del olvido.

RESUMO Objetivo: Analisar os efeitos simbólicos do vestuário militar oficial das enfermeiras do Exército Brasileiro na II Guerra Mundial. Método: A pesquisa foi desenvolvida usando o método histórico, com fontes imagéticas. Os dados foram discutidos à luz de conceitos da teoria do mundo social, de Pierre Bourdieu. Resultados: As imagens selecionadas demonstram o significado próprio dos uniformes, explicitando as funções e a posição social de quem os porta, sendo de uso privativo e obrigatório no campo militar. Considerações finais: No caso das enfermeiras da Força Expedicionária Brasileira, a apropriação de uniformes promoveu a comunicação visual da figura-tipo da enfermeira militar no contexto da guerra, ao mesmo tempo que conferiu distinção no âmbito do exército, mas não necessariamente no campo da enfermagem. Simbolicamente, elas permaneceram entre os muros dos quartéis mesmo após o término da guerra e, por conseguinte, mantiveram-se desconhecidas e marcadas pelos signos do esquecimento.

Operating Room Attire Policy and Healthcare Cost: Favoring Evidence over Action for Prevention of Surgical Site Infections.

BACKGROUND: The Association of Perioperative Registered Nurses (AORN) released new guidelines for operating room attire in 2015 in an attempt to reduce surgical site infections (SSIs). These guidelines have been adopted by the Centers for Medicare and Medicaid Services. We aimed to assess the relationships among operating room attire, SSIs, and healthcare costs. STUDY DESIGN: In March 2016, our center introduced the AORN attire policy. National Health Safety Network data from our hospital were collected on general surgery, cardiac, neurosurgery, orthopaedic, and gynecology procedures from January 2014 to November 2017. The SSI rates and microbiological culture data for 30,493 procedures before and after policy implementation were compared using propensity score matching. The associated costs of the AORN policy were analyzed. RESULTS: After 1:1 propensity score matching, 12,585 matched pairs spanning the policy change were included (25,170 patients total); before policy change (BC group) and after policy change (AC group). The rate of SSIs did not differ between groups (1.0% AC group vs 1.1% BC group; p = 0.7). There was no difference in the incidence of Staphylococcal species cultured from wounds (19.3% AC group vs 16.8% BC group; p = 0.6). Multivariable analyses demonstrated that wound classification and emergent procedures were the strongest independent predictors of SSIs. The cost of attire for 1 person entering the operating room increased from $0.07 to $0.12 before policy change to $1.11 to $1.38 after policy change. Use of the mandated operating room long-sleeved jackets alone in our institution was associated with an added cost of $1,128,078 annually, which translates to an estimated $540 million per year for all US hospitals combined. CONCLUSIONS: Implementation of the AORN guidelines has not decreased SSIs and has increased healthcare costs.

Bouffant vs Skull Cap and Impact on Surgical Site Infection: Does Operating Room Headwear Really Matter?

BACKGROUND: The American College of Surgeons guidelines indicate that skull caps are acceptable, and the Association of Perioperative Registered Nurses recommends bouffant caps. However, no scientific evidence has shown a significant advantage in surgical site infection (SSI) reduction with either cap. The objective of this study was to determine the influence of surgical cap choice on SSIs. STUDY DESIGN: Data from a previously published prospective randomized trial on the impact of hair clipping on SSIs were analyzed. Patients were grouped by the attending surgeons' preferred cap choice into either bouffant or skull cap groups. RESULTS: Overall, 1,543 patients were included in the trial. Attending surgeons wore bouffant caps in 39% and skull caps in 61% of cases. Prevalence of diabetes and tobacco use were similar between the groups. Bouffant caps were used in 71% of colon/intestinal cases, 42% of hernia/other cases, 40% of biliary cases, and only 1% of foregut cases. Overall, SSIs occurred in 8% and 5% of cases with a bouffant and skull cap, respectively (p = 0.016); with 6% vs 4% classified as superficial (p = 0.041), 0.8% vs 0.2% classified as deep (p = 0.12), and 1% vs 0.9% classified as organ space (p = 0.79); however, when adjusting for the type of operation, no significant differences in SSI rates were observed for skull caps vs bouffant caps. CONCLUSIONS: Attending surgeon preference for bouffant vs skull cap does not significantly impact SSI rates after accounting for surgical procedure type. Future guidelines should consider these clinical outcomes data and surgeon preference should dictate operating room headwear.

Avaliação da aplicação das boas práticas na comercialização de água de coco em quiosques localizados em Salvador, BA / Evaluation of the application of good practices in the commercialization of coconut water in kiosks located in Salvador, BA

O estudo objetivou avaliar as boas práticas utilizadas na comercialização de água de coco em quiosques localizados na cidade de Salvador, Bahia. Foi utilizada como instrumento de coleta uma lista de checagem baseada nas recomendações da RDC nº 218/2005, referente às boas práticas executadas por manipuladores de alimentos. Foram analisadas amostras de água de coco para contagem de coliformes totais e termotolerantes. Os quiosques obtiveram uma classificação geral de adequação às boas práticas abaixo de 50% estando enquadrados no grupo 3. As amostras analisadas evidenciaram a presença de coliformes totais e termotolerantes acima do permitido pela legislação. Os resultados obtidos permitiram concluir que as amostras analisadas de água de coco encontravam-se inapropriadas para o consumo. Uma das medidas mais importantes seria capacitar os manipuladores sobre as boas práticas de higiene para assim garantir a qualidade da água de coco ao consumidor.(AU)

The study aimed to evaluate the best practices used in the marketing of coconut water in kiosks located in the city of Salvador-Bahia. It was used as a collection tool checklist based on recommendations of the RDC nº 218/2005 regarding good practices carried out by food handlers. Analyzed samples of coconut water for count of total coliforms and termotolerantes. The kiosks have obtained a general classification of fitness the best practices below 50% being covered in Group 3. The samples showed the presence of total coliforms and termotolerantes above the permitted by legislation. The results obtained allowed to conclude that the coconut water samples analysed were inappropriate for consumption. One of the most important measures would empower thehandlers on the good hygiene practices to ensure the quality of coconut water to the consumer.

¿La imagen importa? Influencia de la vestimenta del traumatólogo en la elección y confianza del paciente / The impact of the orthopedic surgeons' attire on patient preferences

Background: The formal appearance of health care professionals may influence their trustworthiness. Aim: To determine the effect of the orthopedic surgeon's attire on patients' perceptions of credibility and reliability of professionals. Material and Methods: In a cross-sectional design, 351 patients (mean age 43 ± 17 years, 62% males) from the Department of Orthopedics and Traumatology of a Chilean regional hospital in southem of Chile were chosen to complete a questionnaire of attire preferences, in which five photographs with male and female orthopedic surgeons appeared (executive, formal attire, informal attire, scrubs and casual clothing). The influence of attire in the perception of physicians' trustworthiness to resolve medical situations was analyzed. Results: Forty four percent of patients had no physician gender predilection (p = 0.32). Forty three percent of male and 38% of female patients preferred the use of formal attire. In situations of credibility or confidence, all patients chose mostly the use of white coats with formal attire by professionals. The probability of choosing an orthopedic surgeon with a formal attire was significantly higher among patients who considered the attire and appearance of the professional to be very important (Odds ratio = 3.74; p < 0.01). Conclusions: Patients prefer orthopedic surgeons wearing white coats and formal attire, which improves credibility of these professionals to correctly solve medical situations.

Eficiência do programa de higienização de uniformes em frigorífico / Efficiency of the hygiene program in a refrigerator

A qualidade da higienização industrial deve ser avaliada considerando- -se, entre outros aspectos, o risco que a contaminação alimentar representa para a saúde pública. Este trabalho buscou avaliar as condições higienicossanitárias de superfícies de 25 uniformes de frigorífico, por meio de análise microbiológica para micro-organismos mesófilos aeróbios (UFC/ cm²), conforme a técnica recomendada swab test, avaliando a eficiência do processo de lavagem dos uniformes. Observou-se que 4% das superfícies dos uniformes apresentaram contagens abaixo ou igual 4,0 x100 UFC/ cm², demonstrando condições higiênicas satisfatórias e indicando eficiência nas técnicas de higienização dos uniformes, portanto, não representando riscos de contaminação cruzada através dos uniformes. Tais achados demonstraram que o processo de higienização dos uniformes realizado pelo frigorífico é eficiente e eficaz na redução da carga microbiana, comprovando as boas condições higienicossanitárias dos mesmos.

The Standardization of Bra Cup Measurements: Redefining Bra Sizing Language.

There are many challenges in developing a standardized bra cup system, the most significant being that bra cup sizes are a continuum. Women's breasts occur as a fluid range of shapes, sizes, and volumes. Patients have specific expectations regarding bra cup size, and failure to achieve expectations remains the leading cause of patient dissatisfaction. Implant selection that determines eventual bra cup size is critical in patient education and management of patient expectations; however, this is not achievable until all speak the same bra cup language. Patient and surgeon perceptions may never be exact, but it is important to establish guidelines and standards to bridge this gap.

Qualidade higienicossanitária em feiras livres da cidade de Santa Maria, RS / Higienic sanitary quality in street markets of the city of Santa Maria, RS

Com o decorrer dos anos, houve um grande aumento de empregos informais nos municípios brasileiros. Dentre eles, podem-se citar os feirantes, os quais comercializam alimentos tanto crus como manipulados, proporcionando assim, condições favoráveis para o aumento do risco de intoxicações alimentares, devido às condições higienicossanitárias desfavoráveis. Este estudo teve o objetivo de avaliar a qualidade higienicossanitária de feiras livres distribuídas na cidade de Santa Maria - RS. Foi realizada a aplicação de um checklist com 27 perguntas direcionadas ao conhecimento das Boas Práticas de Fabricação, higiene do local, higiene e vestuário dos manipuladores e higiene dos alimentos. A pesquisa foi realizada com 25 feirantes, que aceitaram participar desta pesquisa, no entanto, os resultados permitiram constatar que os feirantes carecem de mais informações sobre higiene e conscientização da importância da mesma, pois se observou que muitos deles procedem de forma errada em relação à conservação, armazenamento e exposição dos alimentos. Elaboraram-se, portanto, panfletos informativos que foram entregues aos participantes, com alguns dados importantes em relação às boas práticas e higiene de alimentos.

Within the years, there has been a substantial increase on informal jobs in Brazilian cities. Among them, we can mention the open market sellers, who commercialize raw and manipulated foods, allowing, thus, favorable conditions for the increasing risk of food poisoning, due to unfavorable hygienic-sanitarian conditions. This study has had the goal of evaluating the hygienic-sanitarian quality at open market fairs distributed in the city of Santa Maria - RS. The application of a checklist has been done, with 27 questions directed to the knowledge of Good Practices of Manufacturing, Hygiene of the Place Hygiene and Dressing of the Manipulators and Food Hygiene. The survey has been done with 25 open market sellers, who have accepted participating, however, the results indicated that the market sellers need more information about hygiene and awareness of its importance, since it has been observed that many selling places act in a wrong way concerning conservation, storage and displaying of food. Is developed so flyers that were delivered to the participants, with some important information related to best practices and food hygiene.

Evidence-based recommendations for building better bras for women treated for breast cancer.

Participating in exercise is beneficial for women who have been treated for breast cancer. However, not being able to find a comfortable exercise bra can be a barrier to exercise participation. This study aimed to systematically investigate what breast support women treated for breast cancer want when they exercise in order to provide evidence-based recommendations to improve exercise bra designs for these women. Based on 432 responses from a national online survey, frequency and relationship data were analysed (binary logistic regression) to understand exercise bra issues pertinent to this population. These issues included being able to control for asymmetrical cup sizes, managing heightened skin sensitivity, managing fluid (size) fluctuations, managing a prosthesis and restoring body image by restoring shape. This study provides evidence-based recommendations to inform an exercise bra design that will meet the unique needs of women treated for breast cancer. Rigorous, evidence-based evaluations of exercise bras for women treated for breast cancer may contribute to their well-being and quality of life through enhanced designs.

Exercise bra discomfort is associated with insufficient exercise levels among Australian women treated for breast cancer.

PURPOSE: Although participating in exercise is beneficial for breast cancer survivors, not being able to find a comfortable exercise bra can be a barrier to exercise. It is likely that side effects specific to breast cancer treatment exacerbate exercise bra discomfort. This study aimed to determine the relationship between patient characteristics, physical side effects, exercise bra discomfort and exercise behaviours. METHODS: Four hundred thirty-two breast cancer survivors completed an online survey related to their treatment and demographic background, current exercise levels, reported exercise bra discomfort and breast cancer treatment side effects. Patient characteristics and exercise levels were considered in a binary logistic regression against reporting bra discomfort to ascertain significant relationships (p < 0.05) and predictive value (odds ratio). Pearson's chi-square statistics was used to determine significant relationships between reporting a side effect and exercise bra discomfort. RESULTS: Eight out of nine physical side effects were significantly related to reporting exercise bra discomfort. Reporting exercise bra discomfort was significantly related to not achieving a minimal recommended level of exercise. CONCLUSIONS: This is the first study in the scientific literature that systematically links the reporting of exercise bra discomfort to not achieving recommended levels of exercise. This effect of bra discomfort on exercise was found after controlling for age, surgery type and current treatment among a large cohort of women treated for breast cancer. Furthermore, results from this study suggest that physical side effects, as a result of surgery and treatment associated with breast cancer, are linked to experiencing bra discomfort during exercise.

Professional comportment: nurses, patients and family survey.

AIM: The aim of the study was to survey nurses, patients and families regarding their perceptions of nursing attire, identification and professional image. BACKGROUND: Recent changes in uniform policies have made it difficult for patients to identify the nurse. METHOD: A convenience sample of nurses (RNs, RPNs) and patients and families from an acute care facility in Canada were surveyed. Surveys included a combination of forced-choice questions and open text boxes. Quantitative data were analyzed, and a thematic content analysis was conducted. RESULTS: The nurse survey resulted in a 64% (n=642) response rate; the patient/family survey response rate was 70% (n=30). Fifty-three per cent of the patient/family advisory team members reported that the nurses did not look professional in comparison to 95% of the nurses who indicated they did. Three key themes emerged: professional image, nurse identification and adoption of a standardized uniform. CONCLUSION: Professional comportment of nurses includes attire suitable for the clinical area that reflects a professional image and allows patients and families to identify the nurses. IMPLICATIONS FOR NURSING LEADERSHIP: This study identified the need to engage nurses, patients and families to ensure professional comportment when uniform polices are developed.