Infectious aortitis and managing it at a community military hospital.

Infectious aortitis is a rare disease process which can be of fungal, viral or bacterial aetiology. This disease process is often incidentally found during concomitant infectious processes, likely due to haematogenous spread. Common sources are from cardiac, genitourinary and gastroenterologic sources. CT imaging of the aorta is essential in identifying physiological changes-wall thickness changes, ectasia and stenosis. We present a case of a female in her early 60s with a medical history of cardiomyopathy with heart failure and reduced ejection fraction, who was initially admitted for acute cholecystitis complicated by the development of gallstone pancreatitis. Imaging evaluation incidentally noted findings consistent with aortitis with a penetrating ulcer, and blood cultures were positive for Staphylococcus aureus bacteraemia, confirming her diagnosis of infectious aortitis. She was started on intravenous antibiotics, required preoperative nutritional optimisation, and subsequently underwent an open aortic resection and aortoiliac reconstruction with rifampin-soaked Dacron graft.

Factors affecting the outcomes in stable chronic obstructive pulmonary disease patients at an Army Central Hospital / Factores que afectan los resultados en pacientes estables con enfermedad pulmonar obstructiva crónica en un Hospital Central del Ejército

Background: Of the four Asian countries, Indonesian COPD patients have the worst clinical features, which puts them at a high risk for treatment failure. There are a number of variables and patient traits that influence clinical results as a predictor of therapy outcomes. Objective: to identify the contributing components and how much they influence COPD patients’ therapy results. Methods: This cross-sectional descriptive-observational study at a tertiary army hospital involved 74 patients. A questionnaire and medical records were utilized to obtain sociodemographic characteristics and clinical data. Correlation and logistic regression analysis were conducted to identify significant factors. Results: The results showed that tumor/cancer comorbidities affected the worsening of CAT values (OR=10.89, 95%CI=1.01-117.23, p=0.049), use of ICS/LABA drugs affected the improvement of mMRC values (OR= 0.26, 95%CI=0.08-0.84, p=0.024), history of TBC disease affected the increase in exacerbation severity (OR=7.25, 95%CI=1.05-50.23, p=0.045), age from smoking >20 years affected the reduction in exacerbation severity (OR=0.03, 95%CI=0.002-0.61, p=0.022). History of alcohol use (OR=7.26 and 167.56, p=0.014 and 0.004) and comorbid pneumonia (OR=28.14 and 44.25, p=0.035 and 0.014) contributed to an increase in the frequency of exacerbations and hospitalization per year. Medium economic status affects the decrease in hospitalizations per year (OR=0.06, 95%CI=0.00-0.91, p=0.043) while the diagnosis of severe COPD and history of alcohol affected the decrease in COPD severity (ABCD) (OR=0.12 and 0.24, p=0.039 and 0.009). Conclusion: comorbidities, disease history, history of alcohol use, COPD status and the use of COPD medications contributed to variations therapeutic outcomes COPD patients. Therefore, it must be taken into account when making clinical decisions.(AU)

Arming Hospital Ships of the Future: Hybrid Wars Require a Major Change.

INTRODUCTION: It is time to provide heavier defense systems to U.S. Navy hospital ships. They serve vital functions in both the military and emergency management spaces. They provide medical support for combat operations and can also convey the empathy and generosity of the American people when used in humanitarian assistance and disaster relief response. Hospital ships are often key to success in scenarios that require the international deployment of resources and medical expertise. Hospital ships serve a dual purpose and hence are subject to regulations that do not address all wartime mission requirements and necessary defensive capabilities. The current U.S. Navy's interpretation of the Geneva Conventions regarding the visibility, lack of defensive capabilities, and inability to use encrypted communications needlessly endangers medical platforms and personnel in the modern environment. METHODS: The authors (including senior author F.M.B.-a recognized (International Health Law expert) reviewed relevant literature and have evaluated the policies of belligerent parties in past and current conflicts. These increasingly appear to target civilian infrastructure including medical facilities and may increase the risk to hospital ships. This demonstrable current hybrid warfare appears to include purposeful attacks on health care facilities and as such hospital ships should have additional defensive measures. RESULTS: Hybrid warfare and its focus on civilian infrastructure and health care targets are highly visible in the acts of both state and non-state actors and may encourage others to purposefully target health care facilities and personnel. Evidence of this is seen in the current Russian invasion of Ukraine, where since the invasion a year ago 1,218 Ukrainian health facilities have been damaged, including 540 damaged hospitals, 173 of which were totally destroyed and turned into "piles of stones." CONCLUSIONS: In today's conflicted global environment, the clear identification of hospital ships leaving them relatively undefended and denying encrypted communication is the folly of a bygone era. Hospital ships may be targeted because they are brightly lit soft targets that can deliver a large payoff by their destruction. It is time to adapt to the global reality and move on from the tradition of painting hospital ships white, adorning them with red crosses, keeping them unarmed, maintaining open communications, and illuminating them at night. The increasing threats from hybrid warfare and unprincipled adversaries to medical platforms and providers of health care demonstrate that hospital ships must be capable of self-defense. The U.S. Navy is designing new platforms for medical missions and the debate, no matter how uncomfortable, must now occur among major decision-makers to make them more tactical and defensible.

The status of work-related COVID-19 prevention measures and risk factors in hospitals.

BACKGROUND: Health care workers (HCWs) in hospitals are at risk of infection with coronavirus disease 2019 (COVID-19). Prevention measures are necessary to protect HCWs against COVID-19. OBJECTIVE: This study aimed to determine the status of occupational risk factors and prevention measures for COVID-19 in hospitals. METHODS: This cross-sectional study was conducted in Iranian hospitals. Based on the results of reviewing the literature and guidelines, two checklists on occupational risk factors and prevention measures for COVID-19 in hospitals were designed and validated. The status of occupational risk factors and prevention measures against COVID-19 in governmental, non-governmental public, private, and military hospitals were determined using designed checklists. RESULTS: Results confirmed the validity of checklists for assessing the status of COVID-19 prevention measures in hospitals. The military hospitals had the lowest mean risk factors compared to other hospitals, but there was no significant difference in occupational risk factors of infection with COVID-19 among governmental, non-governmental public, private, and military hospitals (P-value > 0.05). In the checklist of occupational risk factors of Covid-19, the type of hospital had a significant relationship with the provision and use of personal protective equipment (P-value<0.05). The mean of implementation of prevention measures among all hospitals were not statistically significant difference (P-value > 0.05). CONCLUSION: The provided checklists could be a suitable tool for monitoring of status of prevention measures for COVID-19 in hospitals. Improving ventilation systems is necessary in most of the hospitals.

Occupational internal monitoring in nuclear medicine service of Sainte-Anne military hospital: previous considerations and results.

The Nuclear Medicine Department of Sainte-Anne military hospital in Toulon uses 99mTc, 123I and 18F unsealed sources to provide therapeutic and diagnostic care. For a few years, only ambient air and surface monitoring were performed to check the absence of internal contamination risk for workers. To verify this risk assessment hypothesis, confirmatory monitoring programme including in vivo and in vitro measurements was performed by the French defence radiation protection service (SPRA, Clamart). Here, due to the short half-life of targeted radionuclides, the analytical sensitivity was determined with estimations of minimal detectable activities and derived recording levels. It was shown that sensitivity was sufficient to detect an internal contamination leading to an effective dose of 0.1 mSv for few days post intake. At the same time, around 20 whole-body countings were performed. Results were below minimal detectable activity and were confirmed by 24-hours urine analysis. So, actual working conditions do not lead to measurable internal contamination for nuclear medicine staff.

La Cruz Roja española en la profesionalización enfermera entre 1912 y 1939 / Spanish Red Cross In Nursing Professionalization Between 1912 And 1939. Bibliographic Review

Introducción: La fundación de la Cruz Roja Española se puede remontar a la tercera Guerra Carlista, los fines, principios y el servicio de esta institución repercutieron en el desarrollo de la profesión de enfermería en la época. Objetivo: determinar la implicación de la Cruz Roja Española en la profesionalización enfermera entre 1912 y 1939. Material y método: se realizó una búsqueda bibliográfica en los principales portales de búsqueda, así como en bibliotecas de especialización en historia de la enfermería. Resultados: la Cruz Roja Española participó en el desarrollo asistencial y formativo de la enfermería, fundando y regentando hospitales propios y hospitales de campaña para atender a los heridos surgidos de diferentes conflictos bélicos, como las propias Guerras Carlistas, la Guerra del Rif o la Guerra Civil Española. En la formación fundaron diversos Hospitales-Escuelas que impartían una formación teórico-práctica, supervisada por monjas religiosas. Conclusión: la participación de la Cruz Roja en la profesionalización enfermera radica en la colaboración, atención y asistencia de los heridos en numerosos conflictos bélicos a nivel nacional, como fueron las Guerras Carlistas, la Guerra del Rif y la Guerra Civil Española. La Cruz Roja también participó en el avance y mejora de la formación reglada hasta la época, contando con figuras como la de Dama Enfermera, Enfermeras profesionales y enfermeras especialistas. (AU)

Background: The foundation of the Spanish Red Cross can be traced back to the third Carlist War, the purposes, principles, and service of this institution had an impact on the development of the nursing profession at the time. Objective: to determine the involvement of the Spanish Red Cross in nursing professionalization between 1912 and 1939. Methods: A bibliographic search was carried out in the main search portals, as well as in specialized libraries in nursing history. Results: The Spanish Red Cross participated in the development of nursing care and training, founding and running its own hospitals and field hospitals to care for the wounded from various wars, such as the Carlist Wars themselves, the Rif War or the Spanish Civil War. In the training they founded various Hospital-Schools that provided theoretical practical training, supervised by religious nuns. Conclusion: The participation of the Red Cross in the professionalization of nursing lies in the collaboration, care, and assistance of the wounded in numerous armed conflicts at the national level, such as the Carlist Wars, the Rif War and the Spanish Civil War. The Red Cross also participated in the advancement and improvement of regulated training up to that time, with figures such as the Lady Nurse, professional nurses, and specialist nurses. (AU)

Mean platelet volume and total white blood cells as diagnostic biomarkers for acute appendicitis at Omdurman military hospital: a cross-sectional study - 2021.

BACKGROUND: Acute appendicitis (AA) is among the most common nontraumatic indications for emergent abdominal surgical procedures. However, accurately diagnosing all cases can be challenging, physical examination, biochemical markers, and imaging techniques can sometimes be insufficient. This study aimed to (a) compare the mean platelet volume (MPV) and total white blood cell count (TWBCs) in patients with or without histological evidence of an inflamed appendix and (b) determine the positive predictive value, negative predictive value, sensitivity, and specificity of both MPV and TWBCs as diagnostic biomarkers in the diagnosis of AA. We conducted this research at Omdurman Military Hospital, focusing on patients who presented with symptoms suggestive of AA. MATERIALS AND METHODS: An analytical cross-sectional study conducted at Omdurman Military Hospital from December 2020 - December 2021. The study population was patients who presented to our emergency department with symptoms and signs suggestive of AA. Participants were patients operated on as cases of AA. Data variables included sociodemographic characteristics, clinical presentations, intraoperative appendix macroscopic findings, preoperative MPV and total white blood cell count (TWBCs), and postoperative histopathological findings. RESULTS: A total of 106 patients were included in this study, with 75 (68.2%) males; half were 10-19 years old. Sixty-three patients (57.3%) had low (< 7.5 fL) MPV, whereas 47 (42.7%) had normal values. Comparing MPV to total white blood cells (TWBCs) revealed that MPV was more sensitive (84.6%) and specific (90%) than TWBCs during the first 24 h of inflammation. However, the TWBCs were more sensitive (97.2%) but less specific (94.7% vs. 100%) after 24 h of onset. CONCLUSION: In this study, MPV was lower in patients with AA, while there was an increase in TWBCs. The high sensitivity and specificity of TWBCs and MPV indicated that they form a promising diagnostic marker for AA.

Post-Stroke Swallowing And Communication Complications: Prevalence And Association With Comorbid Conditions And Risk Factors.

A cross sectional study utilising convenience sampling was conducted to determine the co-morbidities and risk factors in post stroke patients with swallowing and communication complications. The study recruited 150 diagnosed cases of stroke with no gender and age limitation from Combined Military Hospital, Fatima Memorial Hospital, and Mayo Hospital, Lahore, from January to June 2015. Glasgow coma scale, Modified Massey Bedside Swallow Screener, informal clinical assessment by SLP, and medical history sheet were employed for data collection, while the data was analysed using SPSS -23. Results revealed 103 (68.7%) patients with swallowing and 99 (66%) with communication difficulties. Swallowing issues revealed significant association with age (p=.016); history of stroke (p=.017), smoking (p=.004), alcohol intake (p=.035), diabetes mellitus (p=.003), and GCS (p=.009). Communication difficulties had significant association with hypertension (p=.029), GCS (p=.000). Hence, stroke related dysphagia is associated with diabetes mellitus; level of consciousness, previous history of stroke, smoking, alcohol abuse, and age, while communication issues are associated with hypertension and level of consciousness.

Awareness of healthcare providers on environment-friendly practices in operating rooms in selected hospitals in Riyadh, Saudi Arabia.

Climate change will have a great impact on humanity in upcoming years and will affect the health of all living creatures. Hospitals play a significant role in climate change due to their substantial waste production and they are considered a profound pollution source, with the Operating Theater as a main contributor. This study was aimed to examine the level of knowledge among healthcare professionals in Saudi Arabia concerning the proper implementation of operating room (OR) environmental procedures and efficient management of hospital waste. This is a cross sectional study performed across 3 hospitals in Riyadh, Saudi Arabia. The hospitals included are Prince Sultan military hospital, National guard hospital and King Salman hospital. The study included all the staff and health workers in OR (operating room), excluding all staff and health workers not in OR. The study took place between September 1 and November 1, 2022. None of the study participants mentioned that their institute or hospital fully engaged in Greenhealth Greening the OR initiative. Almost 1 to 3rd of the study participants (38.1%) mentioned that endorsement and participation in the practice of Greenhealth Greening the OR initiative was not implemented at all, and 45% of the participants were completely unaware of such an initiative. The study's findings suggest that healthcare providers in Saudi Arabia are not fully aware of environmentally friendly practices. Further, the current initiatives undertaken by the hospital administration fall short in attaining environmentally sustainable benchmarks.

Casualty Evacuation in Korea, 1950-53: The British Experience.

The Korean War was the first conflict in which helicopters were used extensively for casualty evacuation but their contribution to medical evacuation at that time is disputed. On the one hand, many cases undoubtedly survived because of helicopter transportation; on the other, the proportion of casualties evacuated appears to have been small and difficult to determine precisely. Taking the British army as a case study, this article looks more closely at arrangements for casualty evacuation in Korea, assessing the role of helicopters in relation to other elements of the evacuation system and its operation as a whole. The article is divided into several sections. The first examines the command structure of the medical system in Korea, which extended as far back as hospitals in Japan. It shows how medical support for British forces was closely integrated with that of other Commonwealth forces. It notes that rapid and effective integration was a major factor in the success of medical evacuation because it allowed ideas and equipment to be shared easily and because it fostered a spirit of cooperation. This section also highlights the Second World service of all senior Commonwealth medical officers as a factor conducive to integration. The second section provides an overview of the chain of evacuation from the frontline to hospitals in Japan. It describes the functions of the different medical institutions along the chain and how they were connected. Among other things, it shows how the chain for British and Commonwealth troops intersected with medical units of the United States such as Mobile Army Surgical Hospitals and hospital trains. In the third section of the article, there is a detail examination of evacuation by helicopter, describing how it was arranged, what its limitations were, and what types of casualty were evacuated. It estimates the proportion of casualties that were evacuated by this means. The fourth and fifth sections highlight the importance of command decisions in the effective working of the evacuation system. The fourth concentrates on the evolution of a system of forward treatment of minor cases, looking at the challenge posed by disease and other non-battle casualties. The fifth and final section of the article describes how the system of evacuation functioned as a whole, including the different means used to carry the sick and wounded in addition to helicopters. It stresses the importance of coordination between these different elements and places particular emphasis on the value of wireless communications. The article concludes that the success of casualty evacuation in Korea depended less on any single method of transportation than on effective command and control. In this respect, communication between constituent units of the evacuation chain and cooperation between British and other UN forces was crucial. Of equal and perhaps even greater importance was the decision to implement a policy of forward treatment of sickness and minor injuries. Without such a policy, the lines of evacuation would inevitably have become congested, having a detrimental effect on casualty survival rates. This policy drew on the lessons of the two world wars which were still relatively fresh in the minds of medical commanders. Although far less striking than the advent of the helicopter, prior knowledge of coalition warfare and the handling of mass casualties was crucial to medical success. If there is a lesson to be learned from the Korean War for own times, it is probably this.

Coronel (SM-M) Doctor Waldemar Vanini Perrone: segundo Director Técnico del Servicio de Sanidad Militar (1974 - 1978) / Colonel (SM-M) Dr. Waldemar Vanini Perrone: second Technical Director of the Military Health Service (1974 - 1978) / Coronel (SM-M) Dr. Waldemar Vanini Perrone: segundo Diretor Técnico do Serviço de Saúde Militar (1974 - 1978)

El 23 de diciembre de 1918 se creó por ley el Servicio de Sanidad del Ejército y la Armada, dependencia del Ministerio respectivo y remoto antecedente de la actual Dirección Nacional de Sanidad de las Fuerzas Armadas de Uruguay. Un Director General con título médico fue designado como jerarca del nuevo Servicio y presidente de su Consejo de Administración. Fue asimilado al grado militar acorde con su jerarquía administrativa: coronel. Mientras la dirección general estuvo a cargo de médicos, éstos fueron designados por ley como Directores Científicos de Sanidad Militar. El Director General Científico tuvo amplísimas atribuciones técnicas y administrativas: reglamentación de los servicios a crearse; representación de la institución; superintendencia técnica de todos los establecimientos; propuesta de nombramientos; asesoramiento del ministerio respectivo; remoción y propuesta de destituciones. El primer Director General de Sanidad fue el médico Francisco Fernández Enciso (1878-1925) quien ejerció el cargo entre 1918 y 1920. Y el último, el médico Guillermo Rodríguez Guerrero, entre 1948 y 1953. Desde entonces, y en forma definitiva, la dirección general quedó a cargo de militares de carrera, pero no médicos, asistidos de un Consejo Técnico Consultivo por médicos del hospital central. El 24 de abril de 1962, se insertó en la Orden del Servicio de Sanidad el nombramiento del coronel médico Hugo Brugnini como Subdirector del Servicio e Inspector General de Servicios de Sanidad. De acuerdo a esta documentación, la Subdirección Técnica del Servicio de Sanidad Militar se inició en 1962 y su primer titular fue el médico Hugo Brugnini. Desde entonces se han nombrado numerosos profesionales para ocupar el cargo de subdirección o lisa y llanamente dirección técnica. Quien sucedió al doctor Brugnini fue el coronel médico Waldemar Vanini, nacido en Montevideo el 16 de febrero de 1924 y fallecido en 1979 en la misma ciudad a la edad de 55 años.

[Laveran, the military doctor]. / Laveran, le médecin militaire.

Son of Louis-Theodore Laveran, holder of the Chair of Diseases and Epidemics in the Armies at the Val-de-Grâce and grandson of an artillery commander through his mother, Alphonse, born in Paris on June 18, 1845, follows in his father's footsteps by entering the Imperial School of Military Health in Strasbourg at the age of 18.After his thesis, he participated in 1870 in the war against Prussia. He was taken prisoner in Metz. He then prepared for the competitive examination to become a professor, which he passed in 1874. He was appointed to the Chair of the Val-de-Grâce, which his father had created. He then went to Algeria. It was at the military hospital in Constantine on November 6, 1880 that he indisputably discovered the haematozoa responsible for malaria in the blood of a soldier in the crew train.In 1884, he was appointed to the Chair of Military Hygiene and Legal Medicine at Val-de-Grâce. At the end of his professorship in 1894, after being refused a posting to Paris to continue his research and not being consulted for the preparation of the Madagascar expedition, which turned into a health disaster in 1895, he retired prematurely in 1897. Hosted by Émile Duclaux and Émile Roux at the Pasteur Institute in Paris, he continued his research mainly on protozoa as agents of human and animal diseases until his death. His work in medical protozoology earned him the Nobel Prize in Physiology or Medicine in 1907. During the Great War, with the benefit of his experience, he warned the Minister of War in January 1916 about the risk of malaria incurred by the army of the East in the delta of the Vardar River in Salonika. The spring would prove him right.An illustrious military doctor and scientist of international renown, Laveran died on May 18, 1922 in Paris.

Practice patterns of hepatobiliary surgery within the military.

BACKGROUND: The purpose of this study is to evaluate the trends of hepatobiliary surgeries performed at military hospitals and to discuss potential implications on resident training and military readiness. While there is data to suggest centralization of surgical specialty services leads to improved patient outcomes, the military does not currently have a specific centralization policy. Implementation of such a policy could potentially impact resident training and readiness of military surgeons. Even in the absence of such a policy, there may still be a trend toward centralization of more complex surgeries like hepatobiliary surgeries. The present study evaluates the numbers and types of hepatobiliary procedures performed at military hospitals. METHODS: This study is a retrospective review of de-identified data from Military Health System Mart (M2) from 2014 to 2020. The M2 database contains patient data from all Defense Health Agency treatment facilities, encompassing all branches of the United States Military. Variables collected include number and types of hepatobiliary procedures performed and patient demographics. The primary endpoint was the number and type of surgery for each medical facility. Linear regression was used to evaluate significant trends in numbers of surgeries over time. RESULTS: Fifty-five military hospitals performed hepatobiliary surgeries from 2014 to 2020. A total of 1,087 hepatobiliary surgeries were performed during this time; cholecystectomies, percutaneous procedures, and endoscopic procedures were excluded. There was no significant decrease in overall case volume. The most commonly performed hepatobiliary surgery was "unlisted laparoscopic liver procedure." The military training facility with the most hepatobiliary cases was Brooke Army Medical Center. CONCLUSION: The number of hepatobiliary surgeries performed in military hospitals has not significantly decreased over the years 2014-2020, despite a national trend toward centralization. Centralization of hepatobiliary surgeries in the future may impact residency training as well as military medical readiness.

Alfredo Pérez Viondi (1871-1938) teniente coronel médico. Carrera militar, sanitaria, social y política / Alfredo Pérez Viondi (1871-1938) medical lieutenant colonel. Military, health, social and political career

Revisión de la biografía militar y civil del doctor Alfredo Pérez Viondi (1871-1938), desde su nacimiento, en La Habana, hasta su fallecimiento, en Vigo. Estudios, carrera militar, participación en la Guerra de Cuba y Marruecos, pasó por Santiago, La Coruña, Madrid, Huesca, Pontevedra y Vigo. Describimos su activa participación en la sociedad de las ciudades en las que residió y citamos a personajes destacados que le influyeron. Cumplió un importante papel en la defensa de la salud pública municipal en Vigo, donde fue alcalde (1929-1930). Ocupó el cargo de gobernador civil en Huesca (1931) y el de director del Hospital Militar de Vigo (1917-1931). Sin descendencia, sus escasas cargas familiares le permitieron volcarse en una brillante carrera profesional, militar y política. (AU)

Review of the military and civil biography of Dr. Alfredo Pérez Viondi (1871-1938), from his birth in Havana to his death in Vigo. Studies, military career, participation in the wars of Cuba and Morocco, passing through Santiago, La Coruña, Madrid, Huesca, Pontevedra and Vigo. We describe his active participation in the society of the cities he lived and we quote prominent figures who influenced him. In Vigo, where he was mayor (1929-1930), he played a very important role in defending municipal public health. He was civil governor of Huesca (1931) and director of the Military Hospital of Vigo (1917-1931). Without children, his few family responsibilities allowed him to concentrate on a brilliant professional, military and political career. (AU)

Alfredo Pérez Viondi (1871-1938) teniente coronel médico. Carrera militar, sanitaria, social y política / Alfredo Pérez Viondi (1871-1938) medical lieutenant colonel. Military, health, social and political career

Revisión de la biografía militar y civil del doctor Alfredo Pérez Viondi (1871-1938), desde su nacimiento, en La Habana, hasta su fallecimiento, en Vigo. Estudios, carrera militar, participación en la Guerra de Cuba y Marruecos, pasó por Santiago, La Coruña, Madrid, Huesca, Pontevedra y Vigo. Describimos su activa participación en la sociedad de las ciudades en las que residió y citamos a personajes destacados que le influyeron. Cumplió un importante papel en la defensa de la salud pública municipal en Vigo, donde fue alcalde (1929-1930). Ocupó el cargo de gobernador civil en Huesca (1931) y el de director del Hospital Militar de Vigo (1917-1931). Sin descendencia, sus escasas cargas familiares le permitieron volcarse en una brillante carrera profesional, militar y política. (AU)

Review of the military and civil biography of Dr. Alfredo Pérez Viondi (1871-1938), from his birth in Havana to his death in Vigo. Studies, military career, participation in the wars of Cuba and Morocco, passing through Santiago, La Coruña, Madrid, Huesca, Pontevedra and Vigo. We describe his active participation in the society of the cities he lived and we quote prominent figures who influenced him. In Vigo, where he was mayor (1929-1930), he played a very important role in defending municipal public health. He was civil governor of Huesca (1931) and director of the Military Hospital of Vigo (1917-1931). Without children, his few family responsibilities allowed him to concentrate on a brilliant professional, military and political career. (AU)

Impact of prescription length supply policy on patient medication adherence in Thailand.

BACKGROUND: Phramongkutklao Hospital is one of the largest military hospitals in Thailand. Beginning in 2016, an institutional policy was implemented in which medication prescription length was increased from 30 to 90 days. However, there have been no formal investigations into how this policy has impacted medication adherence among patients in hospitals. As such, this study evaluated how prescription length impacted medication adherence among dyslipidemia and type-2 diabetes patients who were treated at Phramongkutklao Hospital. METHODS: This pre-post implementation study compared patients who received prescription lengths of 30 and 90 days based on information recorded in the hospital database between 2014 and 2017. Therein, we used the medication possession ratio (MPR) to estimate patient adherence. Focusing on patients with universal coverage insurance, we employed the difference-in-difference method to examine changes in adherence from before and after policy implementation, then conducted a logistic regression to test for associations between the predictors and adherence. RESULTS: We analyzed data from a total of 2,046 patients, with equal amounts of 1,023 placed into the control group (no change to 90-day prescription length) and intervention group (change from 30 to 90-day prescription length). First, we found that increased prescription length was associated with 4% and 5% higher MPRs among dyslipidemia and diabetes patients in the intervention group, respectively. Second, we found that medication adherence was correlated with sex, comorbidities, history of hospitalization, and the number of prescribed medications. CONCLUSION: Increasing the prescription length from 30 to 90 days improved medication adherence in both the dyslipidemia and type-2 diabetes patients. This shows that the policy change was successful for patients in the hospital considered for this study.

Occupational needle stick injuries and related factors among healthcare workers in military hospitals in Tehran.

AIM: Healthcare workers (HCWs) are always at risk of experiencing occupational needle stick injuries (NSIs). The primary aim of this study was to assess the prevalence of NSIs among Iranian HCWs in military hospitals in Tehran. DESIGN: This cross-sectional study was conducted in four military hospitals in the summer of 2019 in Tehran. METHOD: By Census, 802 HCWs were included. Data were collected through a questionnaire consisting of vaccination history, safety equipment, use of safety box, history of NSIs and demographic variables. The logistics regression was used to estimate the odds ratios (OR) and 95% confidence interval (CI). The statistical significance level was set at 5%. The data were analysed using the SPSS software version 23. RESULTS: A total of 203 (25.3%, CI: 22.3-28.4) of the participants reported a history of NSIs at least once during the past year. Single HCWs had a higher risk of NSIs compared to married HCWs (OR: 1.59, 95% CI (1.09, 2.30)). Also, the night shift working (OR: 1.91, 95% CI (1.18, 3.12)), higher educational degree (OR: 2.25, 95% CI (1.21, 4.20)), working overtime (OR: 1.50, 95% CI: (1.07, 2.12)), older age (OR: 1.02, 95% CI (1.01, 1.04)) and needle recapping (OR: 2.90, 95% CI: (1.98, 4.22)) were identified as significant associated factors. The study draws attention to a relatively high prevalence of NSIs as well as high-risk activities among military HCWs. The primary source of NSIs is needle recapping. Measures such as setting up training courses for the military HCWs are needed to be planned.

[Study on the current situation and influencing factors of job involvement for employed nurses in military hospital].

Objective: To investigate the current situation of job involvement of nurses in military hospitals in Henan Province and analyze the influencing factors, so as to provide reference for improving the level of job involvement of military nurses. Methods: In February 2022, the employed nurses of 4 military hospitals in Henan Province were investigated by convenient sampling method. A total of 663 questionnaires were collected, including 632 valid questionnaires, with an effective recovery rate of 95.32%. The self-designed questionnaire was used to investigate the basic information of nurses, the Job Involvement Scale was used to investigate the job involvement of nurses, the Emotional Labor Scale for Nurses was used to investigate nurses' emotions, and the Work-Family Conflict Scale was used to investigate the work-family conflict of nurses. Independent sample t-test and univariate analysis of variance were used to compare the job involvement of military employed nurses with different demographic characteristics, Pearson correlation analysis was used to explore the correlation between emotional labor, work-family conflict and job involvement, and hierarchical regression analysis was used to explore the impact of relevant variables on the job involvement of military employed nurses. Results: The total average score of job involvement of military employed nurses was (3.68±1.13), and the scores of vitality, dedication and focus were (3.64±1.15), (3.74±1.25) and (3.67±1.21) respectively. The total score of emotional labor of nurses was 33-80 (62.95±8.12), with an average score of (3.93±0.51). The total score of work-family conflict was 18-94 (55.16±13.53), with an average score of (3.06±0.75). Professional emotional regulation, patient-centered emotional inhibition and standardized emotional play were positively related to the job involvement (r=0.46, 0.41, 0.22, P<0.01). Time-based conflict, stress-based conflict and behavior-based conflict had negative correlation with the job involvement (r=-0.12, -0.23, -0.20, P<0.01). In hierarchical regression analysis, after controlling demographic variables, emotional labor and work-family conflict accounted for 17.2% and 4.2% of the variation of job involvement. Conclusion: The job involvement of military employed nurses tends to be at a moderate level. Emotional labor and work-family conflict can significantly affect their job involvement.