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1.
J Hosp Med ; 14(1): 38-41, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-30667409

RESUMEN

We created Sleep for Inpatients: Empowering Staff to Act (SIESTA), which combines electronic "nudges" to forgo nocturnal vitals and medications with interprofessional education on improving patient sleep. In one "SIESTAenhanced unit," nurses received coaching and integrated SIESTA into daily huddles; a standard unit did not. Six months pre- and post-SIESTA, sleep-friendly orders rose in both units (foregoing vital signs: SIESTA unit, 4% to 34%; standard, 3% to 22%, P < .001 both; sleeppromoting VTE prophylaxis: SIESTA, 15% to 42%; standard, 12% to 28%, P < .001 both). In the SIESTAenhanced unit, nighttime room entries dropped by 44% (-6.3 disruptions/room, P < .001), and patients were more likely to report no disruptions for nighttime vital signs (70% vs 41%, P = .05) or medications (84% vs 57%, P = .031) than those in the standard unit. The standard unit was not changed. Although sleep-friendly orders were adopted in both units, a unit-based nursing empowerment approach was associated with fewer nighttime room entries and improved patient experience.

2.
Genome Announc ; 5(45)2017 Nov 09.
Artículo en Inglés | MEDLINE | ID: mdl-29122862

RESUMEN

We report here the genome sequences of three newly isolated phages that infect Mycobacterium smegmatis mc2155. Phages Findley, Hurricane, and TBond007 were discovered in geographically distinct locations and are related to cluster K mycobacteriophages, with Findley being similar to subcluster K2 phages and Hurricane and TBond007 being similar to subcluster K3 phages.

3.
Genome Announc ; 5(32)2017 Aug 10.
Artículo en Inglés | MEDLINE | ID: mdl-28798169

RESUMEN

We describe the genome sequences of three closely related mycobacteriophages, Kerberos, Pomar16, and StarStuff, isolated at similar times but from geographically distinct regions. All three genomes are similar to those of other subcluster A2 phages, such as L5 and D29, are temperate, and have siphoviral virion morphologies.

4.
J Clin Sleep Med ; 13(2): 301-306, 2017 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-27923432

RESUMEN

STUDY OBJECTIVES: Although important to recovery, sleeping in the hospital is difficult because of disruptions. Understanding how patients, hospital physicians, and nurses perceive sleep disruptions and identifying which disruptions are associated with objective sleep loss can help target improvement initiatives. METHODS: Patients and hospital staff completed the Potential Hospital Sleep Disruptions and Noises Questionnaire (PHSDNQ). Cutoff points were defined based on means, and responses were dichotomized. Perceived percent disrupted for each item was calculated, and responses were compared across groups using chi-square tests. Objective sleep time of patients was measured using wrist actigraphy. The association between patient-reported disruptions and objective sleep time was assessed using a multivariable linear regression model controlling for subject random effects. RESULTS: Twenty-eight physicians (78%), 37 nurses (88%), and 166 of their patients completed the PHSDNQ. Patients, physicians, and nurses agreed that pain, vital signs and tests were the top three disrupters to patient sleep. Significant differences among the groups' perceptions existed for alarms [24% (patients) vs. 46% (physicians) vs. 27% (nurses), p < 0.040], room temperature (15% vs. 0% vs. 5%, p < 0.031) and anxiety (18% vs. 21% vs. 38%, p < 0.031). Using survey and actigraphy data from 645 nights and 379 patients, the presence of pain was the only disruption associated with lower objective sleep duration (minutes) [-38.1 (95% confidence interval -63.2, -12.9) p < 0.003]. CONCLUSION: Hospital staff and patients agreed that pain, vital signs and tests were top sleep disrupters. However, pain was associated with the greatest objective sleep loss, highlighting the need for proactive screening and management of patient pain to improve sleep in hospitals.


Asunto(s)
Actitud del Personal de Salud , Actitud Frente a la Salud , Pacientes Internos/psicología , Personal de Hospital/psicología , Trastornos del Inicio y del Mantenimiento del Sueño/etiología , Trastornos del Inicio y del Mantenimiento del Sueño/psicología , Actigrafía , Anciano , Femenino , Humanos , Masculino , Cuerpo Médico de Hospitales/psicología , Persona de Mediana Edad , Personal de Enfermería en Hospital/psicología , Sueño , Encuestas y Cuestionarios , Factores de Tiempo
5.
J Addict Med ; 9(5): 343-51, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26428359

RESUMEN

OBJECTIVES: To review the literature on the screening, brief intervention, and referral to treatment (SBIRT) approach to alcohol and drug use with racial and ethnic subgroups in the United States and to develop recommendations for culturally competent SBIRT practice. METHODS: Articles reporting on the use of SBIRT components (screening, brief intervention, referral to treatment) for alcohol and drug use were identified through a comprehensive literature search of PubMed from 1995 to 2015. RESULTS: A synthesis of the published literature on racial and ethnic considerations regarding SBIRT components (including motivational interviewing techniques) was created using evidence-based findings. Recommendations on culturally competent use of SBIRT with specific ethnic groups are also described. CONCLUSIONS: On the basis of the literature reviewed, SBIRT offers a useful set of tools to help reduce risky or problematic substance use. Special attention to validated screeners, appropriate use of language/literacy, trust building, and incorporation of patient and community health care preferences may enhance SBIRT acceptability and effectiveness. PRACTICE IMPLICATIONS: Providers should consider the implications of previous research when adapting SBIRT for diverse populations, and use validated screening and brief intervention methods. The accompanying case illustration provides additional information relevant to clinical practice.


Asunto(s)
Competencia Cultural , Técnicas y Procedimientos Diagnósticos , Grupos Étnicos , Entrevista Motivacional/métodos , Derivación y Consulta , Trastornos Relacionados con Sustancias/diagnóstico , Trastornos Relacionados con Sustancias/terapia , Técnicas y Procedimientos Diagnósticos/normas , Humanos , Entrevista Motivacional/normas , Reproducibilidad de los Resultados
6.
Acad Med ; 89(11): 1548-57, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25250747

RESUMEN

PURPOSE: To quantify the prevalence of social and behavioral sciences (SBS) topics during patient care and to rate team response to these topics once introduced. METHOD: This cross-sectional study used five independent raters to observe 80 inpatient ward teams on internal medicine and pediatric services during attending rounds at two academic hospitals over a five-month period. Patient-level primary outcomes-prevalence of SBS topic discussions and rate of positive responses to discussions-were captured using an observational tool and summarized at the team level using hierarchical models. Teams were scored on patient- and learner-centered behaviors. RESULTS: Observations were made of 80 attendings, 83 residents, 75 interns, 78 medical students, and 113 allied health providers. Teams saw a median of 8.0 patients per round (collectively, 622 patients), and 97.1% had at least one SBS topic arise (mean = 5.3 topics per patient). Common topics were pain (62%), nutrition (53%), social support (52%), and resources (39%). After adjusting for team characteristics, the number of discussion topics raised varied significantly among the four services and was associated with greater patient-centeredness. When topics were raised, 38% of teams' responses were positive. Services varied with respect to learner- and patient-centeredness, with most services above average for learner-centered, and below average for patient-centered behaviors. CONCLUSIONS: Of 30 SBS topics tracked, some were addressed commonly and others rarely. Multivariable analyses suggest that medium-sized teams can address SBS concerns by increasing time per patient and consistently adopting patient-centered behaviors.


Asunto(s)
Medicina Interna/educación , Cuerpo Médico de Hospitales/educación , Pediatría/educación , Relaciones Médico-Paciente , Rondas de Enseñanza , Centros Médicos Académicos , Conducta , Estudios Transversales , Femenino , Hospitales de Enseñanza , Humanos , Pacientes Internos/estadística & datos numéricos , Masculino , Análisis Multivariante , Grupo de Atención al Paciente/organización & administración , Prevalencia , Conducta Social , Estados Unidos
7.
Rev. cuba. aliment. nutr ; 4(2): 169-78, mayo-ago. 1990. tab
Artículo en Español | CUMED | ID: cum-556

RESUMEN

Se estudió la migración del dioctiladipato en quesos y embutidos envueltos en películas de PVC flexible y del dioctilftalato en refrescos y cervezas envasados en botellas de cristal con retapas de plastisol. Los valores de migración del dioctilftalato estuvieron entre 0,09 y 0,40 mg/L, lo cual no constituye un riesgo para la salud por estar muy por debajo del límite máximo permisible para este plastificantre. Los valores de la migración del dioctiladipato estuvieron entre 341,5 y 677,7 mg/kg en los embutidos y entre 822,9 y 1 450,2 mg/kg en los quesos, en relación directa con el contenido de grasa. No se detectaron cambios organolépticos significativos en estos alimentos atribuibles al dioctiladi. A pesar de que la migración resulta elevada, no se puede asegurar que esto pueda constituir un riesgo para la salud, ya que no existen datos suficientes sobre la toxicidad de este compuesto. Se recomienda continuar el uso de estos materiales de envase manteniendo un control sanitario sobre los mismos


Asunto(s)
Dietilhexil Ftalato/análisis , Queso/análisis , Productos de la Carne/análisis , Bebidas/análisis , Contaminación de Alimentos
8.
Rev. cuba. aliment. nutr ; 4(2): 169-78, mayo-ago. 1990. tab
Artículo en Español | LILACS | ID: lil-91482

RESUMEN

Se estudió la migración del dioctiladipato en quesos y embutidos envueltos en películas de PVC flexible y del dioctilftalato en refrescos y cervezas envasados en botellas de cristal con retapas de plastisol. Los valores de migración del dioctilftalato estuvieron entre 0,09 y 0,40 mg/L, lo cual no constituye un riesgo para la salud por estar muy por debajo del límite máximo permisible para este plastificantre. Los valores de la migración del dioctiladipato estuvieron entre 341,5 y 677,7 mg/kg en los embutidos y entre 822,9 y 1 450,2 mg/kg en los quesos, en relación directa con el contenido de grasa. No se detectaron cambios organolépticos significativos en estos alimentos atribuibles al dioctiladi. A pesar de que la migración resulta elevada, no se puede asegurar que esto pueda constituir un riesgo para la salud, ya que no existen datos suficientes sobre la toxicidad de este compuesto. Se recomienda continuar el uso de estos materiales de envase manteniendo un control sanitario sobre los mismos


Asunto(s)
Bebidas/análisis , Queso/análisis , Dietilhexil Ftalato/análisis , Contaminación de Alimentos , Productos de la Carne/análisis
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