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2.
Br J Nurs ; 29(2): 82, 2020 Jan 23.
Artículo en Inglés | MEDLINE | ID: mdl-31972105
6.
Br J Nurs ; 29(1): 50-54, 2020 Jan 09.
Artículo en Inglés | MEDLINE | ID: mdl-31917945

RESUMEN

INTRODUCTION: access to water at the bedside is a cornerstone of patient care. Among bedbound inpatients, water within reach at the bedside is a basic human dignity and one that ought not to be neglected. AIM: the authors sought to identify the extent to which accessible hydration facilities were provided to a bedbound inpatient population. METHODS: a cross-sectional, point-prevalent audit of hospitalised medical inpatients across five centres was conducted. Data were collected between meal times and noted baseline demographics and admission details, adequacy of oral hydration provision at the bedside and, where provision was inadequate, factors associated with this. RESULTS: across a total surveyed patient population of 559 we identified 138 patients who were bedbound. Among these bedbound patients, 6% (n=8) had no water provided at the bedside. However, 7 of these were deemed to be unable to swallow safely. In total, 44 (32%) of the 138 bedbound patients were unable to reach the water at their bedside; 18 of these patients would have been able to drink for themselves had the water been in reach. CONCLUSION: there is significant room for improvement in ensuring patients who are immobile are able to reach drinking apparatus at the bedside. In the five centres surveyed, approximately one in five bedbound patients with no contraindication are unable to reach an essential means of hydration.


Asunto(s)
Auditoría Clínica , Deshidratación/prevención & control , Agua Potable , Hospitalización , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Inglaterra , Femenino , Hospitales Generales , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Medicina Estatal , Adulto Joven
7.
Br J Nurs ; 29(1): 75, 2020 Jan 09.
Artículo en Inglés | MEDLINE | ID: mdl-31917946

RESUMEN

Sam Foster, Chief Nurse, Oxford University Hospitals, considers the need for nurse leaders to champion progress in digital technology and information-sharing with the aim of providing better care.


Asunto(s)
Registros Electrónicos de Salud/organización & administración , Enfermeras Administradoras/psicología , Medicina Estatal/normas , Inglaterra , Humanos
8.
Br J Nurs ; 29(1): 64-65, 2020 Jan 09.
Artículo en Inglés | MEDLINE | ID: mdl-31917947

RESUMEN

John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses how a study of law can enhance a patient safety syllabus.


Asunto(s)
Personal de Salud/educación , Seguridad del Paciente/legislación & jurisprudencia , Inglaterra , Humanos , Medicina Estatal/legislación & jurisprudencia
10.
J Dent Educ ; 84(1): 105-110, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31977096

RESUMEN

The World Health Organization has indicated that Interprofessional Education (IPE) occurs when "students from two or more professions learn about, from, and with each other".1 These IPE experiences are widely thought to provide students with the opportunity to learn and practice the knowledge, skills, behaviors and attitudes that will ultimately translate into the provision of safer, higher quality, team-based patient care when they become health care practitioners in collaborative care environments. At the joint American Dental Education Association (ADEA) and Association for Dental Education in Europe (ADEE) 2019 Shaping the Future of Dental Education III conference in Brescia, Italy, delegates explored the concept of transprofessional learning, where students learn skills across a wider range of professions than health professions alone. The workshop continued the dialogue that began during the 2017 ADEA-ADEE Shaping the Future of Dental Education II conference in London, England as previously reported by Davis et al.,2 and explored the use of transprofessional learning through the lenses of dental education, applied linguistics education and law education focusing on the use of reflective practices. The workshop brought together educators from around the globe in a highly interactive setting where they had the opportunity to discuss and develop tools and practices for teaching reflective practice by using a transprofessional learning approach.


Asunto(s)
Educación en Odontología , Relaciones Interprofesionales , Odontología , Inglaterra , Europa (Continente) , Humanos , Lingüística , Londres
12.
N Engl J Med ; 382(4): 309-317, 2020 01 23.
Artículo en Inglés | MEDLINE | ID: mdl-31971676

RESUMEN

BACKGROUND: In September 2015, the United Kingdom introduced the multicomponent meningococcal group B vaccine (4CMenB, Bexsero) into its publicly funded national immunization program at a reduced two-dose priming schedule for infants, with a 12-month booster. METHODS: Using data from enhanced national surveillance of invasive meningococcal disease in England, we evaluated the effect of vaccination on the incidence of meningococcal group B disease during the first 3 years of the program. The effect of vaccination was assessed by comparing the observed incidence of disease with the expected incidence based on the incidence during the 4-year prevaccination period in equivalent cohorts and with the use of disease trends in cohorts of children younger than 5 years of age who were not eligible to receive the vaccine. Vaccine effectiveness was estimated with the use of the indirect screening method. RESULTS: 4CMenB uptake in England remained consistently high; data from the first 3 months of 2018 showed that 92.5% of children had completed the primary immunizations by their first birthday and 87.9% had received all three doses by 2 years. From September 2015 through August 2018, the incidence of meningococcal group B disease in England (average annual birth cohort, approximately 650,000 infants) was significantly lower in vaccine-eligible cohorts than the expected incidence (63 observed cases as compared with 253 expected cases; incidence rate ratio, 0.25; 95% confidence interval [CI], 0.19 to 0.36), with a 75% reduction in age groups that were fully eligible for vaccination. The adjusted vaccine effectiveness against meningococcal group B disease was 52.7% (95% CI, -33.5 to 83.2) with a two-dose priming schedule for infants and 59.1% (95% CI, -31.1 to 87.2) with a two-dose priming schedule plus a booster at 1 year). Over the 3-year period, there were 169 cases of meningococcal group B disease in the vaccine-eligible cohorts, and an estimated 277 cases (95% CI, 236 to 323) were prevented. CONCLUSIONS: The 4CMenB program was associated with continued positive effect against meningococcal group B disease in children in England, and protection after three doses of the vaccine was sustained for at least 2 years. (Funded by Public Health England.).


Asunto(s)
Programas de Inmunización , Infecciones Meningocócicas/prevención & control , Vacunas Meningococicas/inmunología , Neisseria meningitidis Serogrupo B , Preescolar , Intervalos de Confianza , Inglaterra/epidemiología , Humanos , Esquemas de Inmunización , Inmunización Secundaria , Incidencia , Lactante , Recién Nacido , Infecciones Meningocócicas/epidemiología , Medicina Estatal , Resultado del Tratamiento , Reino Unido
13.
Br J Nurs ; 29(2): 127, 2020 Jan 23.
Artículo en Inglés | MEDLINE | ID: mdl-31972109

RESUMEN

Sam Foster, Chief Nurse, Oxford University Hospitals, considers the problems with pensions, and the spectre of money problems generally facing nurses.


Asunto(s)
Enfermeras y Enfermeros/economía , Enfermeras y Enfermeros/psicología , Pensiones , Inglaterra , Humanos , Medicina Estatal
14.
Am J Health Syst Pharm ; 77(4): 254-258, 2020 02 07.
Artículo en Inglés | MEDLINE | ID: mdl-31907520
16.
Arch Dis Child Fetal Neonatal Ed ; 105(1): 56-63, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31123058

RESUMEN

OBJECTIVE: To describe ethnic and socioeconomic variation in cause-specific infant mortality of preterm babies by gestational age at birth. DESIGN: National birth cohort study. SETTING: England and Wales 2006-2012. SUBJECTS: Singleton live births at 24-36 completed weeks' gestation (n=256 142). OUTCOME MEASURES: Adjusted rate ratios for death in infancy by cause (three groups), within categories of gestational age at birth (24-27, 28-31, 32-36 weeks), by baby's ethnicity (nine groups) or area deprivation score (Index of Multiple Deprivation quintiles). RESULTS: Among 24-27 week births (5% of subjects; 47% of those who died in infancy), all minority ethnic groups had lower risk of immaturity-related death than White British, the lowest rate ratios being 0.63 (95% CI 0.49 to 0.80) for Black Caribbean, 0.74 (0.64 to 0.85) for Black African and 0.75 (0.60 to 0.94) for Indian. Among 32-36 week births, all minority groups had higher risk of death from congenital anomalies than White British, the highest rate ratios being 4.50 (3.78 to 5.37) for Pakistani, 2.89 (2.10 to 3.97) for Bangladeshi and 2.06 (1.59 to 2.68) for Black African; risks of death from congenital anomalies and combined rarer causes (infection, intrapartum conditions, SIDS and unclassified) increased with deprivation, the rate ratios comparing the most with the least deprived quintile being, respectively, 1.54 (1.22 to 1.93) and 2.05 (1.55 to 2.72). There was no evidence of socioeconomic variation in deaths from immaturity-related conditions. CONCLUSIONS: Gestation-specific preterm infant mortality shows contrasting ethnic patterns of death from immaturity-related conditions in extremely-preterm babies, and congenital anomalies in moderate/late-preterm babies. Socioeconomic variation derives from congenital anomalies and rarer causes in moderate/late-preterm babies. Future research should examine biological origins of extremely preterm birth.


Asunto(s)
Grupos de Población Continentales/estadística & datos numéricos , Mortalidad Infantil/etnología , Recien Nacido Prematuro , Grupos Minoritarios/estadística & datos numéricos , Pobreza , Causas de Muerte , Estudios de Cohortes , Anomalías Congénitas/mortalidad , Inglaterra/epidemiología , Edad Gestacional , Humanos , Lactante , Recién Nacido , Enfermedades del Prematuro/mortalidad , Gales/epidemiología
17.
Ann R Coll Surg Engl ; 102(1): 36-42, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31660752

RESUMEN

INTRODUCTION: The temporal patterns and unit-based distributions of trauma patients requiring surgical intervention are poorly described in the UK. We describe the distribution of trauma patients in the UK and assess whether changes in working patterns could provide greater exposure for operative trauma training. METHODS: We searched the Trauma Audit and Research Network database to identify all patients between 1 January 2014 to 31 December 2016. Operative cases were defined as all patients who underwent laparotomy, thoracotomy or open vascular intervention. We assessed time of arrival, correlations between mechanism of injury and surgery, and the effect of changing shift patterns on exposure to trauma patients by reference to a standard 10-hour shift assuming a dedicated trauma rotation or fellowship. RESULTS: There were 159,719 patients from 194 hospitals submitted to the Network between 2014 and 2016. The busiest 20 centres accounted for 57,568 (36.0%) of cases in total. Of these 2147/57,568 patients (3.7%) required a general surgical operation; 43% of penetrating admissions (925 cases) and 2.2% of blunt admissions (1222 cases). The number of operations correlated more closely with the number of penetrating rather than blunt admissions (r = 0.89 vs r = 0.51). A diurnal pattern in trauma admissions enabled significant increases in trauma exposure with later start times. CONCLUSIONS: Centres with high volume and high penetrating rates are likely to require more general surgical input and should be identified as locations for operative trauma training. It is possible to improve the number of trauma patients seen in a shift by optimising shift start time.


Asunto(s)
Educación de Postgrado en Medicina/métodos , Cirugía General/educación , Admisión del Paciente/estadística & datos numéricos , Traumatología/educación , Heridas y Traumatismos/etiología , Adulto , Anciano , Anciano de 80 o más Años , Inglaterra , Femenino , Hospitales de Alto Volumen , Humanos , Irlanda , Masculino , Persona de Mediana Edad , Admisión y Programación de Personal/organización & administración , Admisión y Programación de Personal/estadística & datos numéricos , Estudios Retrospectivos , Horario de Trabajo por Turnos/estadística & datos numéricos , Factores de Tiempo , Centros Traumatológicos/organización & administración , Centros Traumatológicos/estadística & datos numéricos , Gales , Lugar de Trabajo/organización & administración , Lugar de Trabajo/estadística & datos numéricos , Heridas y Traumatismos/cirugía
18.
Int J Biometeorol ; 64(1): 123-136, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31707494

RESUMEN

Cold- and heat-related mortality poses significant public health concerns worldwide. Although there are numerous studies dealing with the association between extreme ambient temperature and mortality, only a small number adopt a synoptic climatological approach in order to understand the nature of weather systems that precipitate increases in cold- or heat-related mortality. In this paper, the Lamb Weather Type synoptic classification is used to examine the relationship between daily mortality and weather patterns across nine regions of England. Analysis results revealed that the population in England is more susceptible to cold weather. Furthermore, it was found that the Easterly weather types are the most hazardous for public health all-year-long; however, during the cold period, the results are more evident and spatially homogenous. Nevertheless, it is noteworthy that the most dangerous weather conditions are not always associated with extreme (high or low) temperatures, a finding which points to the complexity of weather-related health effects and highlights the importance of a synoptic climatological approach in elucidating the relationship between temperature and mortality.


Asunto(s)
Meteorología , Tiempo (Meteorología) , Animales , Frío , Inglaterra , Calor , Mortalidad , Estaciones del Año , Ovinos
19.
Ann R Coll Surg Engl ; 102(1): 25-27, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31418302

RESUMEN

BACKGROUND: Mesh is recommended for the repair of most hernias when prevention of recurrence is the primary endpoint. However, mesh may be associated with increased complications for the patient. The aim of this study was to quantify the use of mesh for abdominal wall hernia surgery in NHS England in recent years. MATERIALS AND METHODS: The NHS Digital Secondary Uses Service database for 2016/17 and 2017/18 was interrogated for numbers of patient undergoing elective primary hernia surgery. Using the specific hernia code inguinal (T201-9), umbilical (T241-9), incisional (T251-9) and other abdominal wall hernia (T271-9), the use of mesh or suture repair was determined. Recurrent and emergency hernia surgery were excluded. All data were provided by NHS RightCare. RESULTS: There are almost 100,000 hernia repairs performed annually in NHS England. For every four hernias, three are repaired with mesh. The percentage repaired by mesh varies by hernia type. Mesh repairs in inguinal, umbilical and incisional hernias accounted for 95%, 50% and 82%, respectively. CONCLUSIONS: Mesh repair for all hernia types is more common than suture repair. However, for umbilical and other abdominal wall hernias, a significant proportion are repaired without the use of mesh.


Asunto(s)
Herniorrafia/tendencias , Inglaterra , Hernia Inguinal/cirugía , Hernia Umbilical/cirugía , Herniorrafia/estadística & datos numéricos , Humanos , Hernia Incisional/cirugía , Medicina Estatal/estadística & datos numéricos , Mallas Quirúrgicas , Técnicas de Sutura/estadística & datos numéricos , Técnicas de Sutura/tendencias
20.
Waste Manag ; 102: 452-463, 2020 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-31739279

RESUMEN

Sustainable municipal solid waste (MSW) management is regarded as one of the key elements for achieving urban sustainability via mitigating global climate change, recycling resources and recovering energy. Landfill is considered as the least preferable disposal method and the EU Landfill Directive (ELD) announced in 1999 requires member countries to reduce the volume of landfilled biodegradable materials. The enforcement of ELD initiated the evolution of MSW management system UK. This study depicted and assessed the transition and performance of MSW management after the millennium in Nottingham via materials flow analysis (MFA), as well as appropriately selected indicators based on the concept of waste management hierarchy and targets set in waste management regulations. We observed improvements in waste reduction, material recycling, energy recovery, and landfill prevention. During the period 2001/02 to 2016/17, annual waste generation reduced from 463 kg/Ca to 361 kg/Ca, the recycling and composting share increased from 4.6% to 44.4%, and the landfill share reduced from 54.7% to 7.3%. These signs of progress are believed to be driven by the ELD and the associated policies and waste management targets established at the national and local levels. An alternative scenario with food waste and textile separation at source and utilizing anaerobic digestion to treat separately collected organic waste is proposed at the end of this paper to fulfil the high targets set by local government and we further suggest that the recycling share may be improved by educating and supporting the public on waste separation at the sources.


Asunto(s)
Eliminación de Residuos , Administración de Residuos , Ciudades , Inglaterra , Alimentos , Reciclaje , Residuos Sólidos , Crecimiento Sostenible , Instalaciones de Eliminación de Residuos
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