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1.
Gan To Kagaku Ryoho ; 46(Suppl 1): 144-146, 2019 May.
Artigo em Japonês | MEDLINE | ID: mdl-31189841

RESUMO

In this research, we constructed a prediction model for the number of service providers for home-visit care, home-visit nursing, and home-visit bathing by using the population in the Hokushinetsu region and the current number of providers, and considered the validity of the model. Using the model, we estimated the number of providers in 2025, and subsequently, visually confirmed geographical features using a geographic information system. The adjusted R2 value of the prediction model was 0.93 for home-visit care, 0.87 for home-visit nursing, and 0.63 for home-visit bathing providers. The number of providers for home-visit care, home-visit nursing, and home-visit bathing were estimated to decrease by 67%, 67%, and 28%, respectively. The colored map by the predicted number of providers suggested a significant decrease in home-visit care in Northern Nagano, home-visit nursing in Fukui-Reihoku region, and home-visit bathing in Middle Nagano.


Assuntos
Sistemas de Informação Geográfica , Serviços de Assistência Domiciliar , Banhos , Visita Domiciliar , Humanos , Modelos Teóricos
2.
BMC Complement Altern Med ; 19(1): 103, 2019 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-31077221

RESUMO

BACKGROUND: Chinese herbal bath therapy (CHBT) is a traditional external therapy that has been used for the treatment of uremic pruritus (UP) in China. We conducted a meta-analysis to evaluate the efficacy and safety of CHBT for UP. METHODS: We searched seven databases for studies published since database inception to September 1, 2018. Randomized trials evaluating CHBT for UP were collected. The therapeutic effects of CHBT were measured by the pruritus level (via the visual analogue scale (VAS) or the symptom score scale) and the total effective rate. We combined studies using mean difference (MD) for continuous outcomes and using risk ratio for dichotomous data, both with 95% confidence intervals. RevMan V.5.3 software was used to assess the data reported and perform the meta-analysis. RESULTS: Seventeen articles including 970 patients were identified. All participants were haemodialysis (HD) patients. CHBT is administered by immersing the whole body in a prepared herbal water bath. On average, an herbal bath prescription included 11 Chinese herbs. The mean treatment duration was 4.7 weeks. Compared with basic treatment (HD or haemoperfusion (HP)) and adding a control of sham CHBT, clear hot water bath, or calamine lotion, CHBT plus basic treatment reduced the VAS score (MD = - 2.38; 95% confidence intervals [CI], - 3.02 to - 1.74; P < 0.00001) and the symptom score (MD = - 8.42; 95% confidence intervals [CI], - 12.47 to - 4.36; P < 0.00001) and had a higher total effectiveness rate (risk ratio [RR] = 1.46; 95% CI, 1.31 to 1.63; P < 0.00001). CONCLUSIONS: In conclusion, CHBT could be a complementary therapy for improving pruritic symptoms in uraemia patients. More rigorously designed, multicentre, prospective RCTs are warranted to further identify the efficacy and safety of CHBT. TRIAL REGISTRATION: Systematic review registration: [PROSPERO registration: CRD42018108506 ].


Assuntos
Banhos , Medicamentos de Ervas Chinesas/uso terapêutico , Prurido/terapia , Uremia/terapia , Humanos , Medicina Tradicional Chinesa , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
3.
Brain Nerve ; 71(5): 517-524, 2019 May.
Artigo em Japonês | MEDLINE | ID: mdl-31088999

RESUMO

Hot spring baths during winter are beneficial as they lower stress levels. A group of Japanese macaques from Jigokudani Monkey Park is unique for their regular hot spring baths in winter. To understand short-term and long-term impacts of this unique behavior, a multivariate approach should account for their social organization, life history, and the neuroendocrine mechanisms involved in the stress response. This article reviews the behavioral and physiological strategies of non-human primates for thermoregulation, the effect of cold and stress on the body, particularly the brain, with a focus on the social dynamics and reproductive strategies of the Japanese macaques.


Assuntos
Banhos , Fontes Termais , Macaca , Estresse Fisiológico , Animais , Regulação da Temperatura Corporal , Japão , Estações do Ano
4.
Environ Monit Assess ; 191(6): 370, 2019 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-31098733

RESUMO

The use of antiseptics for the removal of bacteria in water has become pertinent given that most hand dug wells, boreholes, and surface waters are already contaminated in their in situ condition before being used. But, the efficacy of these skin disinfectants (antiseptics) is usually not well spelt out for the aforementioned purpose, and usage may yield no good report. This study assessed the suitability of use of two widely used antiseptics in Nigeria (Dettol and Izal) on Bacillus spp., Escherichia coli and Klebsiella spp., in eliminating bacteria in bathing water. The water which were tested at four different concentrations (0.4 ml, 0.8 ml, 1.2 ml, and 1.6 ml) and at six different contact times (0, 5, 10, 15, 30, and 60 min, respectively) within which bathing is meant to take place after antiseptics were applied. Overall, One hundred and Forty-four (144) samples were analyzed, and based on our null hypothesis of no bacteria should be found in bathing water after disinfection, results showed that both antiseptics were not efficient in bacteria removal. However, the multivariable logistic regression model conducted revealed that both antiseptics were more active in destroying Klebsiella spp. than any other bacteria investigated with Izal showing more dominance (OR = 31.21; p < 0.05). The study further revealed that Izal is 3.6 times more likely to destroy bacteria than Dettol (p < 0.05), with more of the elimination occurring at contact time greater than 5 min (OR = 1.504; p = 0.043). Therefore, it is suggested that disinfectants and antiseptics of high motility and sufficient potency in a wide range of bacteria spectrum should be produced to meet the needs of consumers resulting in a better bathing water quality.


Assuntos
Anti-Infecciosos Locais/farmacologia , Banhos/normas , Desinfecção/métodos , Água Doce/microbiologia , Microbiologia da Água/normas , Qualidade da Água/normas , Anti-Infecciosos Locais/administração & dosagem , Bacillus/efeitos dos fármacos , Monitoramento Ambiental , Escherichia coli/efeitos dos fármacos , Humanos , Klebsiella/efeitos dos fármacos , Nigéria
5.
Occup Ther Int ; 2019: 5638939, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31015826

RESUMO

Introduction: With community-dwelling elders waiting to adapt their bathroom, Health and Social Services Centers in Quebec (Canada) combined human resources through cross-skilling within interdisciplinary teams. To this end, occupational therapists implemented in-house "tools" to support nonoccupational therapists in selecting bathing equipment. However, unknown psychometric properties of those in-house "tools" cast doubt on the quality of service provided to elders. Little is also known about the best processes to use to support the deimplementation of such nonevidence-based practices. This study presents the effect of a knowledge transfer and exchange intervention designed to deimplement in-house "tools" and replace them with an evidence-based tool (Algo). Methods: Censuses were conducted with the 94 Health and Social Services Centers of Quebec providing homecare services, before and after the knowledge transfer and exchange intervention (2009-2013). In 2013, the deimplementation of in-house "tools" and their replacement by Algo were measured with Knott and Wildavsky's levels of utilization. Results: Cross-skilling within interdisciplinary teams increased between censuses (87% to 98%), as did use of in-house "tools" (67% to 81%). Algo's uptake started during the knowledge transfer and exchange process as 25 Health and Social Services Centers achieved the first level of utilization. Nonetheless, no Health and Social Services Center deimplemented the in-house "tools" to use Algo. Conclusion: The knowledge transfer and exchange process led to the development of a scientifically sound clinical tool (Algo) and challenged the status quo in clinical settings regarding the use of nonevidence-based practices. However, the deimplementation of in-use practices has not yet been observed. This study highlights the need to act proactively on the deimplementation and implementation processes.


Assuntos
Prática Clínica Baseada em Evidências , Serviços de Assistência Domiciliar/organização & administração , Serviços de Assistência Domiciliar/normas , Terapia Ocupacional/organização & administração , Idoso , Banhos , Canadá , Humanos , Vida Independente , Decoração de Interiores e Mobiliário
6.
Complement Ther Med ; 43: 232-239, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30935536

RESUMO

The purpose of this study was to clarify the relationship of daily hot water bathing at home (DHW) and hot water spa bathing (HSPA) with the number of underlying diseases in middle-aged and elderly ambulatory patients. We defined the number of underlying diseases as the main outcome and dependent (criterion) variable. The frequency and time of DHW and the frequency of HSPA were set as explanatory variables. Multiple logistic regression analysis was performed for each frequency and time, adjusted age and sex. Odds ratio (OR) and 95% confidence interval (95% CI) were calculated. Among the 1261 patients who participated, there was no significant difference in age between males (n = 508, 72.8 ± 6.8 years) and females (n = 753, 73.5 ± 6.9 years). There was also no significant age difference between males (number of diseases: 2.7 ± 2.0 pts.) and females (number of diseases: 2.7 ± 2.1 pts.) in the occurrence of underlying diseases. Frequency and time of DHW were not associated with the occurrence of underlying diseases. However, compared with participants who utilized hot water spa at least once a week, the occurrence of underlying diseases was significantly associated with bathing frequency: one to three times per month (OR 2.72, 95% CI 1.63-4.52); twice or five times a year (OR 1.92, 95% CI 1.25-2.94). In conclusion, lower frequency of HSPA was significantly associated with increased risk of the occurrence of underlying diseases in middle-aged and elderly ambulatory patients. However, the relationship between proactive use of hot water spa and patients' mental and physical support should be clarified by well-designed cohort studies. The present study was registered as UMIN000033018 by the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) in Japan (refer: https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000037643).


Assuntos
Assistência Ambulatorial/estatística & dados numéricos , Banhos/estatística & dados numéricos , Autocuidado/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Temperatura Alta , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Água
7.
Rev. pesqui. cuid. fundam. (Online) ; 11(3): 627-633, abr.-maio 2019. tab
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-994777

RESUMO

Objective: The study's goal has been to assess the completion of the bed-bath procedure and the main care provided by the nursing team before, during and after it. Methods: It is a cross-sectional and observational study that was carried out in the Intensive Critical Unit of a teaching hospital with the participation of eight nurse technicians. Data collection was performed through an instrument structured type checklists over 30 times of observation from 1,080 actions. Results: There were observed 10 care before and 28 during and after bed-bath procedures. The bath was carried out technically without prior notice, without considering the individuality and privacy of patients, especially those undergoing mechanical ventilation. There was no participation of nurses and most of the actions taken by the nursing staff did not meet the literature recommendations. Conclusions: There is need to improving the quality of bed-bath procedures performed by the nursing team and adoption of evidence-based practices in the care process


Objetivo: Avaliar o processo de realização do banho no leito e os cuidados realizados pela equipe de enfermagem antes, durante e após o banho no leito. Métodos: estudo transversal e observacional, realizado na Unidade de Terapia Intensiva de um Hospital/Escola, com oito técnicos de enfermagem. Para a coleta de dados foi utilizado instrumento estruturado tipo checklists em 30 momentos de observação de 1080 ações. Resultados: foram observados 10 cuidados antes e 28 durante e após o banho no leito. O banho foi realizado de forma automática sem comunicação prévia, sem considerar a individualidade e privacidade do paciente, principalmente naqueles submetidos a ventilação mecânica. Não houve participação do enfermeiro e a maioria das ações realizadas pela equipe de enfermagem não atendeu às recomendações da literatura. Conclusões: há necessidade de melhoria da qualidade do banho no leito realizado pela enfermagem e adoção de práticas baseadas em evidências no processo de cuidar


Objetivo: Evaluar el proceso de finalización del baño de la cama y los principales cuidados que proporciona el personal de enfermería antes, durante y después del baño en la cama. Métodos: Transversal, observacional realizado en la UCI de un hospital / escuela con ocho técnicos de enfermería. Para la recolección de datos se utilizó instrumento de tipo estructurado listas de control 30 veces observación de 1080 la acción. Resultados: en el 10 y 28 de atención médica antes durante y después del baño en la cama. El baño se llevó a cabo técnicamente sin previo aviso, sin tener en cuenta la individualidad y la privacidad de los pacientes, especialmente aquellos sometidos a ventilación mecánica. No hubo participación de las enfermeras y la mayoría de las acciones llevadas a cabo por el personal de enfermería no cumplía con las recomendaciones de la literatura. Conclusiones: Existe la necesidad de mejorar la calidad de baño de la cama llevada a cabo por la enfermería y la adopción de prácticas basadas en la evidencia en el proceso de atención


Assuntos
Humanos , Masculino , Feminino , Banhos/enfermagem , Banhos/normas , Técnicos de Enfermagem/educação , Unidades de Terapia Intensiva , Higiene/normas , Enfermagem de Cuidados Críticos , Cuidados de Enfermagem
8.
Einstein (Sao Paulo) ; 17(2): eAO4423, 2019 Mar 07.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30843995

RESUMO

OBJECTIVE: To analyze the incidence of otorrhea in the postoperative period of patients submitted to tympanotomy to place ventilation tube, and who did not protect the ear when exposed to water. METHODS: Open, randomized-controlled trial. Eighty patients submitted to unilateral or bilateral ear grommet tympanostomy were included and divided into two groups: Auricular Protection and Non-Protection to water during bathing and activities in water. RESULTS: In the first postoperative month, the Non-Protection Group presented a significant increase in the number of patients with otorrhea and in the incidence. Four patients of the Protection Group (11%) presented at least one episode of otorrhea in this period, representing an incidence of 0.11 (standard deviation ±0.32) episode/month, whereas in the Non-Protection Group there were 12 episodes (33%; p=0.045) and incidence of 0.33 (±0.48; p=0.02). Between the 2nd and the 13th postoperative months, there was no difference between groups. Seven patients in the Protection Group (20%) had at least one episode of otorrhea, representing an incidence of 0.04 (±0.09) episodes/month, while in the Non-Protection Group there were seven episodes (22%; p=0.8) and incidence of 0.05 (±0.1; p=0.8). CONCLUSION: Patients who underwent ear protection when exposed to water had a lower incidence of otorrhea in the first postoperative month than those who did not undergo protection. From the second month, there was no difference between groups.


Assuntos
Ventilação da Orelha Média/efeitos adversos , Otite Média Supurativa/etiologia , Otite Média Supurativa/prevenção & controle , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Água/efeitos adversos , Adolescente , Adulto , Banhos/efeitos adversos , Brasil/epidemiologia , Criança , Pré-Escolar , Dispositivos de Proteção das Orelhas , Feminino , Humanos , Incidência , Lactente , Modelos Logísticos , Masculino , Otite Média Supurativa/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Fatores de Risco , Estatísticas não Paramétricas , Natação , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
10.
Lancet ; 393(10177): 1205-1215, 2019 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-30850112

RESUMO

BACKGROUND: Universal skin and nasal decolonisation reduces multidrug-resistant pathogens and bloodstream infections in intensive care units. The effect of universal decolonisation on pathogens and infections in non-critical-care units is unknown. The aim of the ABATE Infection trial was to evaluate the use of chlorhexidine bathing in non-critical-care units, with an intervention similar to one that was found to reduce multidrug-resistant organisms and bacteraemia in intensive care units. METHODS: The ABATE Infection (active bathing to eliminate infection) trial was a cluster-randomised trial of 53 hospitals comparing routine bathing to decolonisation with universal chlorhexidine and targeted nasal mupirocin in non-critical-care units. The trial was done in hospitals affiliated with HCA Healthcare and consisted of a 12-month baseline period from March 1, 2013, to Feb 28, 2014, a 2-month phase-in period from April 1, 2014, to May 31, 2014, and a 21-month intervention period from June 1, 2014, to Feb 29, 2016. Hospitals were randomised and their participating non-critical-care units assigned to either routine care or daily chlorhexidine bathing for all patients plus mupirocin for known methicillin-resistant Staphylococcus aureus (MRSA) carriers. The primary outcome was MRSA or vancomycin-resistant enterococcus clinical cultures attributed to participating units, measured in the unadjusted, intention-to-treat population as the HR for the intervention period versus the baseline period in the decolonisation group versus the HR in the routine care group. Proportional hazards models assessed differences in outcome reductions across groups, accounting for clustering within hospitals. This trial is registered with ClinicalTrials.gov, number NCT02063867. FINDINGS: There were 189 081 patients in the baseline period and 339 902 patients (156 889 patients in the routine care group and 183 013 patients in the decolonisation group) in the intervention period across 194 non-critical-care units in 53 hospitals. For the primary outcome of unit-attributable MRSA-positive or VRE-positive clinical cultures (figure 2), the HR for the intervention period versus the baseline period was 0·79 (0·73-0·87) in the decolonisation group versus 0·87 (95% CI 0·79-0·95) in the routine care group. No difference was seen in the relative HRs (p=0·17). There were 25 (<1%) adverse events, all involving chlorhexidine, among 183 013 patients in units assigned to chlorhexidine, and none were reported for mupirocin. INTERPRETATION: Decolonisation with universal chlorhexidine bathing and targeted mupirocin for MRSA carriers did not significantly reduce multidrug-resistant organisms in non-critical-care patients. FUNDING: National Institutes of Health.


Assuntos
Bacteriemia/prevenção & controle , Banhos/métodos , Clorexidina/administração & dosagem , Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Administração Intranasal , Idoso , Anti-Infecciosos Locais/administração & dosagem , Portador Sadio/sangue , Portador Sadio/epidemiologia , Feminino , Humanos , Controle de Infecções , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Mupirocina/administração & dosagem , Avaliação de Resultados (Cuidados de Saúde) , Infecções Estafilocócicas/prevenção & controle , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus aureus/patogenicidade
11.
Nihon Ronen Igakkai Zasshi ; 56(1): 51-58, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-30760683

RESUMO

AIM: In home-visiting bathing services (HVBs), a nurse's role is to evaluate the vital signs, judge bathing possibilities and provide treatment before/after bathing. There are no guidelines regarding specific physical criteria for judging the bathing possibility. However, the body condition of HVB users during bathing has not been investigated. Thus, the present study aimed to clarify users' actual conditions and the factors related to the judgment of the possibility of bathing. METHODS: An anonymous self-administered questionnaire survey of HVBs users was conducted by Company-A, which provides HVBs. Six hundred sixty responses were collected (response rate: 40.1%).We described the conditions of HVB users and used chi-squared tests and logistic regression analyses to confirm the factors, including the certified Long-term Care Insurance (LTCI) care rank, past medical history and physical conditions that were associated with aborted HVB experiences. RESULTS: The mean age of the care-recipients was 82.1±12.1 and 93.3% of the recipients had severe conditions, including conditions necessitation the use of medical equipment, pressure ulcers, and contracture. The logistic regression analysis showed that the LTCI-certified-care-rank, the presence of pain, and the need for treatment before bathing were significant factors. CONCLUSIONS: This study showed that users of HVBs not only had high LTCI-certified-care ranks, but that they also required pain management and pre-bathing treatment.


Assuntos
Banhos , Seguro de Assistência de Longo Prazo , Adulto , Idoso , Idoso de 80 Anos ou mais , Cuidadores , Feminino , Serviços de Assistência Domiciliar , Humanos , Julgamento , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
12.
Biomed Res Int ; 2019: 7535140, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30800676

RESUMO

Background: The effect of thermal stress on the physiological parameters of young overweight and sedentary men who sporadically use the sauna remains insufficiently investigated. Aim: The aim of the study was to determine the effect of sauna bathing on the physiological parameters of young overweight, physically inactive men and to test the correlations between physiological parameters versus anthropometric features and body composition parameters. Materials and Methods: Forty-five overweight and sedentary men aged 20.76±2.4 y were exposed to four sauna sessions of 10 minutes each (temperature: 90-91°C; relative humidity: 14-16 %) with four 5-minute cool-down breaks. Body composition was determined before sauna, and body mass and blood pressure were measured before and after sauna. Physiological parameters were monitored during four 10-minute sauna sessions. Results: A significant (p<0.0001) increase in all analyzed physiological parameters was observed during four successive 10-minute sauna sessions. Heart rate, energy expenditure, blood pressure, and body mass loss were most strongly correlated with anthropometric parameters (body mass, body mass index, and body surface area) and body composition parameters (percent body fat, body fat mass, and visceral fat level). The 60-minute treatment resulted in a significant reduction in body mass (0.65 kg). Conclusions: Repeated use of Finnish sauna induces significant changes in the physiological parameters of young sedentary overweight men, and these changes are intensified during successive treatments. Deleterious cardiovascular adaptations were most prevalent in men characterized by the highest degree of obesity and the largest body size.


Assuntos
Composição Corporal/fisiologia , Sobrepeso/fisiopatologia , Adulto , Antropometria/métodos , Banhos/métodos , Pressão Sanguínea/fisiologia , Índice de Massa Corporal , Temperatura Corporal/fisiologia , Frequência Cardíaca/fisiologia , Humanos , Masculino , Atividade Motora/fisiologia , Obesidade/fisiopatologia , Banho a Vapor/métodos , Temperatura Ambiente , Adulto Jovem
13.
J Clin Nurs ; 28(11-12): 2235-2244, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30786096

RESUMO

AIMS AND OBJECTIVES: To gain an in-depth understanding of patients' preferences regarding two bed bath methods: soap and water and disposable wet wipes. BACKGROUND: Bed baths allow hospitalised, bedridden patients to stay clean and fresh. They serve a number of purposes: health promotion, social propriety and pure pleasure. Traditionally, soap and water have been used for personal hygiene, but in recent years soap and water have increasingly been replaced by the use of disposable wet wipes. DESIGN: A qualitative study with a hermeneutical-phenomenological approach was chosen to explore and understand patients' experiences of bed bath methods. METHODS: Semi-structured, individual, in-depth interviews with 16 bedridden patients from three wards were conducted. The software program nvivo was used to structure the transcribed interviews and assist in the initial data analysis. The data were analysed and interpreted within a phenomenological-hermeneutical framework. COREQ guidelines were used in the preparation of this paper (See Supporting information Appendix S1). RESULTS: Four overall themes were identified: "Creating a sense of cleanliness," "Preferences and concerns in different situations," "Cleanliness of hands and face" and "Clinical decision-making about bed bath method." CONCLUSIONS: Overall, patients' bed bath preference was for soap and water, but disposable wet wipes were considered a convenient alternative and preferred in certain circumstances, for example, when a patient had pain or diarrhoea. Shared decision-making regarding bed bath method is recommended. Hands and face had specific requirements. RELEVANCE TO CLINICAL PRACTICE: Nursing staff should be aware that bedridden patients have varying preferences, and it is important to incorporate the patients' preferences in the development of standards, health policies and clinical guidelines for bed bath practices.


Assuntos
Banhos/métodos , Preferência do Paciente , Adulto , Banhos/enfermagem , Tomada de Decisões , Feminino , Humanos , Masculino , Pesquisa Qualitativa , Sabões , Água
14.
Ann Vasc Surg ; 57: 174-176, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30684619

RESUMO

The etiology of surgical site infection (SSI) is multifactorial, with efforts to combat it employing "bundled" initiatives. Preoperative antiseptic wash was classified by the Centers for Disease Control and Prevention as a Category IB strongly recommended and accepted practice. Its inclusion, in a best-practice bundle, may contribute to reduction in SSIs. We describe our quality improvement initiative to increase adherence to this critical bundle element.


Assuntos
Anti-Infecciosos Locais/uso terapêutico , Banhos/normas , Clorexidina/análogos & derivados , Higiene , Pacientes Internados , Cuidados Intraoperatórios/normas , Pacotes de Assistência ao Paciente/normas , Melhoria de Qualidade/normas , Indicadores de Qualidade em Assistência à Saúde/normas , Infecção da Ferida Cirúrgica/prevenção & controle , Procedimentos Cirúrgicos Vasculares/normas , Anti-Infecciosos Locais/efeitos adversos , Banhos/efeitos adversos , Clorexidina/efeitos adversos , Clorexidina/uso terapêutico , Humanos , Cuidados Intraoperatórios/efeitos adversos , Cooperação do Paciente , Fatores de Tempo , Resultado do Tratamento , Procedimentos Cirúrgicos Vasculares/efeitos adversos
16.
Prev Vet Med ; 163: 58-67, 2019 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-30670187

RESUMO

The objective of this study was to evaluate the effect of the implementation of different footbathing practices using a new biocide solution (Pink-Step™, Qalian, France) in the healing and the occurrence of bovine digital dermatitis (bDD) lesions. The investigation was conducted through a controlled within cow clinical trial in which the hind feet of cows from each farm were allocated either to the control group or to a moderate (MR) or (IR) intensive footbath-regimen groups. The trial involved 1036 cows (2072 feet) from 10 dairy farms located in western France where bDD was endemic. Split-footbaths were placed at the exit of the milking parlor of each farm, allowing the biocide to be administered to one side of the cows while using the other empty side as a negative control. The administration frequency for MR was of 2 days/week/1st-month, then 2 days/2 weeks/2nd-month, and then 2 days/month, and for IR was of 2 days/week/1st-2nd months, and then 2 days/2 weeks. Footbaths were administered during 140 days (approx.), and feet were evaluated for the at least once a month in the milking parlor. Nested survival models were used to estimate the relative impact of the footbath regimens and other concomitant risk factors on the time that bDD lesions occurred or healed. No effect of Pink-Step™ was evidenced on the bDD occurrence during the trial. The risk for bDD occurrence was increased by poor feet cleanliness at both the cow (HR 1.69, CI 1.21-2.39) and farm level (HR 2.06, CI 1.44-2.94). Otherwise, the use of Pink-Step™ in an IR was effective in improving the healing of bDD lesions (HR 1.79, CI 1.12-2.88). The time to healing was also improved in inactive lesions (HR 2.19, CI 1.42-3.37). Conversely, the time to healing was delayed in feet receiving hoof-trimming (HR 0.41, CI 0.26-0.62), in cows with a contralateral bDD lesion (HR 0.32, CI 0.22-0.46) or in late lactation (HR 0.61, CI 0.43-0.85), and finally in farms with more than 100 cows (HR 0.48, CI 0.34-0.67). These findings reinforce the crucial role of hygiene in bDD dynamics and highlight the importance of implementing multiple control measures simultaneously, such as hygiene improvements in the barn, early detection and treatment of bDD lesions and the correct usage of individual and collective treatments. The implementation of Pink-Step™ represents a promising strategy for reducing the persistence of bDD lesions in affected herds.


Assuntos
Banhos/veterinária , Doenças dos Bovinos/tratamento farmacológico , Dermatite Digital/tratamento farmacológico , Desinfetantes/uso terapêutico , Higiene da Pele/veterinária , Administração Tópica , Animais , Bovinos , Doenças dos Bovinos/prevenção & controle , Indústria de Laticínios , Dermatite Digital/prevenção & controle , Desinfetantes/administração & dosagem , Feminino , Glicolatos/administração & dosagem , Glicolatos/uso terapêutico , Ácido Láctico/administração & dosagem , Ácido Láctico/uso terapêutico , Resultado do Tratamento
17.
Sci Total Environ ; 646: 280-289, 2019 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-30055490

RESUMO

In the domestic segment, various appliances and processes consume great amount of water and, consequently, energy. In this context, the main aim of this study is to analyse the impact of water temperature, flow and bath duration in water and energy consumptions. The impact on CO2 emissions and a simple costs analysis were also carried out. It included a monitoring plan of 197 baths taken under different scenarios of water temperature and flow. It was concluded that increasing water consumption leads to an increase on energy consumption and that both resources consumptions increase with bath duration. Bath temperature had influence not only on energy consumption, as expected, but also in water consumption, what may be explained by the user's satisfaction during baths with higher temperatures. The use of a flow reducing valve is not a guarantee of water saving which can also be related to the user's satisfaction patterns, given that the introduction of a flow reducing valve can lead to a bath duration increase. In what concerns to the CO2 emissions, it was concluded, as expected, that higher values are obtained for baths with higher temperatures given their relation with higher energy consumptions patterns. A simple costs analysis revealed that having flow reducing valves, with a bath temperature of 75 °C, increased the costs with electricity and water in 119% and 32%, respectively, when compared with a temperature of 60 °C.


Assuntos
Banhos/economia , Dióxido de Carbono/análise , Conservação dos Recursos Hídricos/métodos , Banhos/estatística & dados numéricos , Conservação dos Recursos Hídricos/economia , Conservação dos Recursos Hídricos/estatística & dados numéricos , Temperatura Alta , Temperatura Ambiente , Abastecimento de Água/economia , Abastecimento de Água/métodos , Abastecimento de Água/estatística & dados numéricos
18.
Nurs Womens Health ; 23(1): 31-37, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30593766

RESUMO

OBJECTIVE: To develop an evidence-based practice project to evaluate the effect of delaying a newborn's first bath on exclusive breastfeeding rates at discharge. DESIGN: A pre- and post-implementation evaluation of the effect of delaying the first bath on exclusive breastfeeding rates at discharge. SETTING: A postpartum unit in a southern California community hospital. PARTICIPANTS: Breastfeeding dyads of women and newborns (>37 weeks gestational age) who were admitted to the postpartum unit. INTERVENTION/MEASUREMENTS: Postpartum nurses involved in the unit practice council, in collaboration with unit leadership, changed the newborn's first bath practice through development of a bathing guideline, nurse education, and mother education. Measurements of the practice change included time of the first bath and exclusive breastfeeding rates at discharge. RESULTS: We observed an increased time for the newborn's first bath from 6.88 hours to 13.71 hours (p ≤ .001). The number of times women chose not to bathe their newborns while in the hospital also increased by approximately seven times, from 0.16% to 1.1%. The rate of exclusive breastfeeding at discharge did not change significantly after implementation (p ≥ .05), regardless of when the first bath was given. CONCLUSION: Delaying a newborn's first bath was not associated with an increase in exclusive breastfeeding rates. More research is needed to determine the effect of bath times.


Assuntos
Banhos/normas , Aleitamento Materno/métodos , Tempo para o Tratamento , Adulto , Banhos/métodos , Banhos/estatística & dados numéricos , Aleitamento Materno/estatística & dados numéricos , California , Distribuição de Qui-Quadrado , Prática Clínica Baseada em Evidências/métodos , Prática Clínica Baseada em Evidências/estatística & dados numéricos , Feminino , Humanos , Recém-Nascido , Fatores de Tempo
19.
Dermatol Clin ; 37(1): 11-20, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30466683

RESUMO

Herein we review recent developments in our understanding and treatment of atopic dermatitis. Key insights from the recent literature are summarized, from findings on the pathogenesis of this multifactorial disease to a new and more nuanced understanding of its natural history. Therapeutic advances and new data on comorbidities are also discussed.


Assuntos
Dermatite Atópica/tratamento farmacológico , Dermatite Atópica/etiologia , Anticorpos Monoclonais/uso terapêutico , Banhos , Compostos de Boro/uso terapêutico , Compostos Bicíclicos Heterocíclicos com Pontes/uso terapêutico , Comorbidade , Dermatite Atópica/complicações , Dermatite Atópica/fisiopatologia , Fármacos Dermatológicos/uso terapêutico , Exposição Ambiental/efeitos adversos , Humanos , Inibidores de Janus Quinases/uso terapêutico , Dor/etiologia , Educação de Pacientes como Assunto , Hipersensibilidade a Amendoim/prevenção & controle , Inibidores da Fosfodiesterase 4/uso terapêutico , Hipoclorito de Sódio/uso terapêutico
20.
Artigo em Inglês | MEDLINE | ID: mdl-30544878

RESUMO

Background: To evaluate the effectiveness of pharmacological and non-pharmacological pain relief methods and to compare them. Materials and methods: 258 women were included in the study and interviewed using a questionnaire and the visual analogue scale for pain. They were divided into six groups depending on chosen method of labour pain relief: epidural anaesthesia (EA; n = 42), water immersion and water birth (WB; n = 40), nitrous oxide gas for pain control (G; n = 40), transcutaneous electrical nerve stimulation (TENS) (n = 50), multiple management (MM; n = 42), none (N; n = 44). Results: The average age of the women was 29.4 ± 3.74 years and 60.47% of them were nulliparous (n = 156). Mean values of labour pain intensity were 6.81 ± 2.26 during the first stage of labour; 7.86 ± 2.06 during the second stage, and 3.22 ± 2.46 during the third stage. There was no significant difference in pain level between epidural analgesia and gas groups in the first stage of labour (p = 0.74). Nevertheless, epidural analgesia reduced pain level during the second and third stage (both p < 0.01). The highest satisfaction level pertains to water immersion (n = 38; 95%). Conclusion: Epidural analgesia is the gold standard of labour pain relief, however water birth was found to be associated with the highest satisfaction level of the parturient women. The contentment of childbirth depends not only on the level of experienced pain, but also on the care provided to the parturient during pregnancy and labour.


Assuntos
Analgesia Obstétrica/métodos , Parto Obstétrico , Dor do Parto , Manejo da Dor/métodos , Satisfação do Paciente/estatística & dados numéricos , Adulto , Banhos , Feminino , Humanos , Imersão , Óxido Nitroso , Medição da Dor , Gravidez , Estimulação Elétrica Nervosa Transcutânea , Resultado do Tratamento , Água
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