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1.
Artigo em Russo | MEDLINE | ID: mdl-33591669

RESUMO

The ultrasound studies are highly informative diagnostic methods. The modern ultrasound devices can be applied as component of mobile telemedicine systems that can significantly increase availability of medical care. However, application of ultrasound scanners requires inclusion of ultrasound diagnostics specialist in the medical team that is not always nor possible or appropriate. In the modern regulatory legal base, transfer of certain functions of ultrasound diagnostics specialist to average medical staff is not provided. The article considers issue of genuine development and testing method of implementation of ultrasound examinations by paramedical personnel under remote control of physician. Two organizational models were tested within the framework of organizational experiment. In the first model, physician monitored progress of examination by telemedicine monitor and, if necessary, directed actions of medical nurse. In the second model, the nurse independently obtained images of patients' organs, and physician according received visual information formulated final conclusion. The organizational experiment included patients with pathology of abdominal cavity, retroperitoneal space and lower limb arteries. Results. On the basis on results of 156 examinations, time-consuming analysis was performed, and effectiveness of developed methods was evaluated. The proposals were proposed to include additions into professional standard of ultrasound diagnostics nurse and to substantiate the need of altering the training programs for paramedical personnel.


Assuntos
Médicos , Telemedicina , Pessoal Técnico de Saúde , Humanos , Especialização
2.
Medicine (Baltimore) ; 100(6): e24666, 2021 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-33578597

RESUMO

BACKGROUND: Cardiopulmonary resuscitation (CPR) performance depends on individual ability and training. Well-trained or professional rescuers can maintain high-quality CPR for longer than laypeople. This study aimed to examine the effects of reducing resting intervals on CPR performance, physiological parameters, and hemodynamic parameters during prolonged CPR in well-trained providers. METHODS: The study enrolled 90 volunteers from the paramedic students of our institution. They were randomly divided into 3 groups: 2 minutes, 1 minute 45 seconds, and 1 minute 30 seconds rest groups. Each participant performed 5 cycles of chest compression only CPR (2 min/cycle) with different resting intervals according to grouping. CPR quality, physiological variations, and hemodynamic variations were measured for each cycle and compared across the groups. RESULTS: Of the 90 volunteers, 79 well-trained providers were finally included. The variation of the average chest compression depth across the 5 cycles showed significant differences between the 3 groups: from cycle 1 to 2: 1.2 (3.1) mm, -0.8 (2.0) mm, and -2.0 (3.0) mm in the 2 minutes, 1 minute 45 seconds, and 1 minute 30 seconds groups, respectively (P < .001); from cycle 1 to 3: 0.0 (3.0) mm, -0.7 (3.2) mm, and -2.6 (3.9) mm, respectively (P = .030). However, all 3 groups maintained the recommended rate and chest compression depth for all 5 cycles. Physiological and hemodynamic parameters showed no significant differences between the groups. CONCLUSIONS: Well-trained providers were able to maintain high-quality CPR despite reducing rest intervals. Adjusting the rest interval may help maintain overall CPR quality in special situations or where layperson rescuers are involved.


Assuntos
Reanimação Cardiopulmonar/educação , Hemodinâmica/fisiologia , Qualidade da Assistência à Saúde/estatística & dados numéricos , Descanso/fisiologia , Pessoal Técnico de Saúde/educação , Pessoal Técnico de Saúde/estatística & dados numéricos , Reanimação Cardiopulmonar/estatística & dados numéricos , Oscilação da Parede Torácica/estatística & dados numéricos , Oscilação da Parede Torácica/tendências , Auxiliares de Emergência/educação , Auxiliares de Emergência/estatística & dados numéricos , Fadiga , Feminino , Humanos , Masculino , Fenômenos Fisiológicos/fisiologia , Estudos Prospectivos , Treinamento por Simulação/métodos , Estudantes , Fatores de Tempo , Adulto Jovem
3.
BMC Palliat Care ; 20(1): 2, 2021 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-33397343

RESUMO

BACKGROUND: The term 'life limiting conditions' refers to premature death following decline from chronic conditions, which is a common circumstance in which occupational therapists work with people at the end of life. The challenges for clinicians of working with these patients have long been recognised, and may have a significant impact on their professional self-care. This study aimed to evaluate a multidimensional workplace strategy to improve the professional self-care of occupational therapists working with people living with a life limiting condition. METHODS: A pre and post mixed methods survey approach were utilised, with baseline data collection prior to the implementation of a multidimensional workplace strategy. The strategy included professional resilience education, targeted supervision prompts, changes to departmental culture and the promotion of self-care services across multiple organisational levels. Follow up data collection was undertaken after the strategy had been in place for 2 years. Quantitative data were analysed descriptively, while qualitative data were subjected to thematic analysis. RESULTS: One hundred three occupational therapists responded (n = 55 pre, n = 48 post) across multiple service settings. Complex emotional responses and lived experiences were identified by participants working with patients with life limiting conditions, which were not influenced by the workplace strategy. Working with these patients was acknowledged to challenge the traditional focus of occupational therapy on rehabilitation and recovery. Participants were confident about their ability to access self-care support, and supervision emerged as a key medium. While the strategy increased the proportion of occupational therapists undertaking targeted training, around half identified ongoing unmet need around professional self-care with this patient group. Demographic factors (e.g. practice setting, years of experience) also had a significant impact on the experience and needs of participants. CONCLUSIONS: The multidimensional workplace strategy resulted in some improvements in professional self-care for occupational therapists, particularly around their use of supervision and awareness of available support resources. However, it did not impact upon their lived experience of working with people with life limiting conditions, and there remain significant gaps in our knowledge of support strategies for self-care of occupational therapist working with this patient group.


Assuntos
Estresse Ocupacional/terapia , Terapeutas Ocupacionais/psicologia , Cuidados Paliativos , Autocuidado/métodos , Assistência Terminal , Pessoal Técnico de Saúde/psicologia , Austrália , Humanos , Satisfação no Emprego , Estresse Ocupacional/psicologia
4.
BMC Palliat Care ; 20(1): 8, 2021 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-33422058

RESUMO

BACKGROUND: Palliative care improves the quality of lives of patients and families affected by advanced illnesses through the prevention and relief of suffering. While palliative care is well established in developed countries, it is inadequate or non-existent in most developing countries. Palliative care is an emerging concept in Bhutan, a tiny Himalayan Kingdom. A small community palliative care service is available in the national referral hospital with three dedicated inpatient palliative care beds. This study explored the needs for palliative care among patients diagnosed with advanced illnesses and is a component of a larger project aimed to inform a suitable palliative care model for the country. METHODS: This is a cross-sectional descriptive study. A survey, using a structured questionnaire including the EORTC QLQ-C30, was carried out among patients with advanced illness in hospitals, primary care units and communities across the country. Purposeful and snowball sampling strategies were used to recruit study participants. RESULTS: Seventy (76%), out of 93 eligible patients, agreed to participate in the survey. Participants reported low to moderate scores on physical, role, emotional, cognitive and social functioning, a moderate score for the global health/ quality of life scale and moderately high (worse) scores in symptoms including fatigue, pain, insomnia, loss of appetite and the financial impact from the disease. CONCLUSIONS: The symptom burden experienced by patients affected by advanced illnesses demonstrates the need for palliative care in Bhutan. These findings will help inform the development of a public health-focused palliative care model, modified to the Bhutanese context, as recommended by the World Health Organization.


Assuntos
Infecções por HIV/fisiopatologia , Determinação de Necessidades de Cuidados de Saúde , Neoplasias/fisiopatologia , Cuidados Paliativos , Qualidade de Vida , Insuficiência Renal Crônica/fisiopatologia , Tuberculose Resistente a Múltiplos Medicamentos/fisiopatologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Pessoal Técnico de Saúde , Butão , Cognição , Feminino , Infecções por HIV/psicologia , Infecções por HIV/terapia , Humanos , Hepatopatias Alcoólicas/fisiopatologia , Hepatopatias Alcoólicas/psicologia , Hepatopatias Alcoólicas/terapia , Pneumopatias/fisiopatologia , Pneumopatias/psicologia , Pneumopatias/terapia , Masculino , Pessoa de Meia-Idade , Neoplasias/psicologia , Neoplasias/terapia , Enfermeiras e Enfermeiros , Médicos , Insuficiência Renal Crônica/psicologia , Insuficiência Renal Crônica/terapia , Traumatismos da Medula Espinal/fisiopatologia , Traumatismos da Medula Espinal/psicologia , Traumatismos da Medula Espinal/terapia , Doente Terminal , Tuberculose Resistente a Múltiplos Medicamentos/psicologia , Tuberculose Resistente a Múltiplos Medicamentos/terapia , Adulto Jovem
5.
BMC Palliat Care ; 20(1): 11, 2021 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-33435954

RESUMO

BACKGROUND: Palliative care day services provide a safe environment for people with palliative care needs, enabling them to access a range of services while acting as a respite services for family caregivers. Viewed as marginal services, they are often under resourced and under researched. The aim of this study was to understand how palliative day care services contribute to client care from the perspective of management and hospice multidisciplinary teams. METHODS: A descriptive qualitative study, using six focus groups conducted with staff at three United Kingdom hospices in England, Scotland and Northern Ireland. Thirty-five participants were recruited, including management and staff. Discussions were transcribed and analysed thematically. RESULTS: Four key themes emerged: (1) variations of care, beyond heterogeneity of patients; (2) unclear referrals and inconsistent patient population; (3) recognising strengths and challenges and (4) an uncertain future. A major focus of group discussions was the model of care and the benefits of the service, however the importance of demonstrating services' effectiveness and value for money was highlighted. CONCLUSIONS: Management and hospice staff believed day-services to be a helpful introduction to palliative care, providing both social and medical support. Economic pressures and patient demand were influencing them to move from a social model to a hybrid model. Further research is needed to understand the effectiveness of the service.


Assuntos
Hospital Dia , Pessoal de Saúde , Hospitais para Doentes Terminais , Cuidados Paliativos , Cuidados Intermitentes , Pessoal Técnico de Saúde , Cuidadores , Assistência à Saúde , Grupos Focais , Acesso aos Serviços de Saúde , Humanos , Enfermeiras Administradoras , Enfermeiras e Enfermeiros , Pesquisa Qualitativa , Encaminhamento e Consulta , Reino Unido
7.
Med J Aust ; 213 Suppl 11: S3-S32.e1, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33314144

RESUMO

CHAPTER 1: RETAIL INITIATIVES TO IMPROVE THE HEALTHINESS OF FOOD ENVIRONMENTS IN RURAL, REGIONAL AND REMOTE COMMUNITIES: Objective: To synthesise the evidence for effectiveness of initiatives aimed at improving food retail environments and consumer dietary behaviour in rural, regional and remote populations in Australia and comparable countries, and to discuss the implications for future food environment initiatives for rural, regional and remote areas of Australia. STUDY DESIGN: Rapid review of articles published between January 2000 and May 2020. DATA SOURCES: We searched MEDLINE (EBSCOhost), Health and Society Database (Informit) and Rural and Remote Health Database (Informit), and included studies undertaken in rural food environment settings in Australia and other countries. DATA SYNTHESIS: Twenty-one articles met the inclusion criteria, including five conducted in Australia. Four of the Australian studies were conducted in very remote populations and in grocery stores, and one was conducted in regional Australia. All of the overseas studies were conducted in rural North America. All of them revealed a positive influence on food environment or consumer behaviour, and all were conducted in disadvantaged, rural communities. Positive outcomes were consistently revealed by studies of initiatives that focused on promotion and awareness of healthy foods and included co-design to generate community ownership and branding. CONCLUSION: Initiatives aimed at improving rural food retail environments were effective and, when implemented in different rural settings, may encourage improvements in population diets. The paucity of studies over the past 20 years in Australia shows a need for more research into effective food retail environment initiatives, modelled on examples from overseas, with studies needed across all levels of remoteness in Australia. Several retail initiatives that were undertaken in rural North America could be replicated in rural Australia and could underpin future research. CHAPTER 2: WHICH INTERVENTIONS BEST SUPPORT THE HEALTH AND WELLBEING NEEDS OF RURAL POPULATIONS EXPERIENCING NATURAL DISASTERS?: Objective: To explore and evaluate health and social care interventions delivered to rural and remote communities experiencing natural disasters in Australia and other high income countries. STUDY DESIGN: We used systematic rapid review methods. First we identified a test set of citations and generated a frequency table of Medical Subject Headings (MeSH) to index articles. Then we used combinations of MeSH terms and keywords to search the MEDLINE (Ovid) database, and screened the titles and abstracts of the retrieved references. DATA SOURCES: We identified 1438 articles via database searches, and a further 62 articles via hand searching of key journals and reference lists. We also found four relevant grey literature resources. After removing duplicates and undertaking two stages of screening, we included 28 studies in a synthesis of qualitative evidence. DATA SYNTHESIS: Four of us read and assessed the full text articles. We then conducted a thematic analysis using the three phases of the natural disaster response cycle. CONCLUSION: There is a lack of robust evaluation of programs and interventions supporting the health and wellbeing of people in rural communities affected by natural disasters. To address the cumulative and long term impacts, evidence suggests that continuous support of people's health and wellbeing is needed. By using a lens of rural adversity, the complexity of the lived experience of natural disasters by rural residents can be better understood and can inform development of new models of community-based and integrated care services. CHAPTER 3: THE IMPACT OF BUSHFIRE ON THE WELLBEING OF CHILDREN LIVING IN RURAL AND REMOTE AUSTRALIA: Objective: To investigate the impact of bushfire events on the wellbeing of children living in rural and remote Australia. STUDY DESIGN: Literature review completed using rapid realist review methods, and taking into consideration the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement for systematic reviews. DATA SOURCES: We sourced data from six databases: EBSCOhost (Education), EBSCOhost (Health), EBSCOhost (Psychology), Informit, MEDLINE and PsycINFO. We developed search terms to identify articles that could address the research question based on the inclusion criteria of peer reviewed full text journal articles published in English between 1983 and 2020. We initially identified 60 studies and, following closer review, extracted data from eight studies that met the inclusion criteria. DATA SYNTHESIS: Children exposed to bushfires may be at increased risk of poorer wellbeing outcomes. Findings suggest that the impact of bushfire exposure may not be apparent in the short term but may become more pronounced later in life. Children particularly at risk are those from more vulnerable backgrounds who may have compounding factors that limit their ability to overcome bushfire trauma. CONCLUSION: We identified the short, medium and long term impacts of bushfire exposure on the wellbeing of children in Australia. We did not identify any evidence-based interventions for supporting outcomes for this population. Given the likely increase in bushfire events in Australia, research into effective interventions should be a priority. CHAPTER 4: THE ROLE OF NATIONAL POLICIES TO ADDRESS RURAL ALLIED HEALTH, NURSING AND DENTISTRY WORKFORCE MALDISTRIBUTION: Objective: Maldistribution of the health workforce between rural, remote and metropolitan communities contributes to longstanding health inequalities. Many developed countries have implemented policies to encourage health care professionals to work in rural and remote communities. This scoping review is an international synthesis of those policies, examining their effectiveness at recruiting and retaining nursing, dental and allied health professionals in rural communities. STUDY DESIGN: Using scoping review methods, we included primary research - published between 1 September 2009 and 30 June 2020 - that reported an evaluation of existing policy initiatives to address workforce maldistribution in high income countries with a land mass greater than 100 000 km2 . DATA SOURCES: We searched MEDLINE, Ovid Embase, Ovid Emcare, Informit, Scopus, and Web of Science. We screened 5169 articles for inclusion by title and abstract, of which we included 297 for full text screening. We then extracted data on 51 studies that had been conducted in Australia, the United States, Canada, United Kingdom and Norway. DATA SYNTHESIS: We grouped the studies based on World Health Organization recommendations on recruitment and retention of health care workers: education strategies (n = 27), regulatory change (n = 11), financial incentives (n = 6), personal and professional support (n = 4), and approaches with multiple components (n = 3). CONCLUSION: Considerable work has occurred to address workforce maldistribution at a local level, underpinned by good practice guidelines, but rarely at scale or with explicit links to coherent overarching policy. To achieve policy aspirations, multiple synergistic evidence-based initiatives are needed, and implementation must be accompanied by well designed longitudinal evaluations that assess the effectiveness of policy objectives. CHAPTER 5: AVAILABILITY AND CHARACTERISTICS OF PUBLICLY AVAILABLE HEALTH WORKFORCE DATA SOURCES IN AUSTRALIA: Objective: Many data sources are used in Australia to inform health workforce planning, but their characteristics in terms of relevance, accessibility and accuracy are uncertain. We aimed to identify and appraise publicly available data sources used to describe the Australian health workforce. STUDY DESIGN: We conducted a scoping review in which we searched bibliographic databases, websites and grey literature. Two reviewers independently undertook title and abstract screening and full text screening using Covidence software. We then assessed the relevance, accessibility and accuracy of data sources using a customised appraisal tool. DATA SOURCES: We searched for potential workforce data sources in nine databases (MEDLINE, Embase, Ovid Emcare, Scopus, Web of Science, Informit, the JBI Evidence-based Practice Database, PsycINFO and the Cochrane Library) and the grey literature, and examined several pre-defined websites. DATA SYNTHESIS: During the screening process we identified 6955 abstracts and examined 48 websites, from which we identified 12 publicly available data sources - eight primary and four secondary data sources. The primary data sources were generally of modest quality, with low scores in terms of reference period, accessibility and missing data. No single primary data source scored well across all domains of the appraisal tool. CONCLUSION: We identified several limitations of data sources used to describe the Australian health workforce. Establishment of a high quality, longitudinal, linked database that can inform all aspects of health workforce development is urgently needed, particularly for rural health workforce and services planning. CHAPTER 6: RAPID REALIST REVIEW OF OPIOID TAPERING IN THE CONTEXT OF LONG TERM OPIOID USE FOR NON-CANCER PAIN IN RURAL AREAS: Objective: To describe interventions, barriers and enablers associated with opioid tapering for patients with chronic non-cancer pain in rural primary care settings. STUDY DESIGN: Rapid realist review registered on the international register of systematic reviews (PROSPERO) and conducted in accordance with RAMESES standards. DATA SOURCES: English language, peer-reviewed articles reporting qualitative, quantitative and mixed method studies, published between January 2016 and July 2020, and accessed via MEDLINE, Embase, CINAHL Complete, PsycINFO, Informit or the Cochrane Library during June and July 2020. Grey literature relating to prescribing,deprescribing or tapering of opioids in chronic non-cancer pain, published between January 2016 and July 2020, was identified by searching national and international government, health service and peek organisation websites using Google Scholar. DATA SYNTHESIS: Our analysis of reported approaches to tapering conducted across rural and non-rural contexts showed that tapering opioids is complex and challenging, and identified several barriers and enablers. Successful outcomes in rural areas appear likely through therapeutic relationships, coordination and support, by using modalities and models of care that are appropriate in rural settings and by paying attention to harm minimisation. CONCLUSION: Rural primary care providers do not have access to resources available in metropolitan centres for dealing with patients who have chronic non-cancer pain and are taking opioid medications. They often operate alone or in small group practices, without peer support and access to multidisciplinary and specialist teams. Opioid tapering approaches described in the literature include regulation, multimodal and multidisciplinary approaches, primary care provider support, guidelines, and patient-centred strategies. There is little research to inform tapering in rural contexts. Our review provides a synthesis of the current evidence in the form of a conceptual model. This preliminary model could inform the development of a model of care for use in implementation research, which could test a variety of mechanisms for supporting decision making, reducing primary care providers' concerns about potential harms arising from opioid tapering, and improving patient outcomes.


Assuntos
Pesquisa sobre Serviços de Saúde , Programas Médicos Regionais , Serviços de Saúde Rural , Pessoal Técnico de Saúde/provisão & distribução , Austrália , Odontólogos/provisão & distribução , Dieta Saudável , Medicina de Desastres , Abastecimento de Alimentos , Humanos , Desastres Naturais , Enfermeiras e Enfermeiros/provisão & distribução
8.
N Z Med J ; 133(1527): 116-122, 2020 12 18.
Artigo em Inglês | MEDLINE | ID: mdl-33332334

RESUMO

Across New Zealand, a huge programme of work is being initiated to improve the health information systems of our sector. The goals of this plan are to address major risks and issues such as cybersecurity and our inability to securely share health data across organisations for clinical care. To fulfil the promise of planned health IT initiatives, we must involve clinicians of all disciplines to help lead, design and implement projects. However, there is currently little pragmatic training available for clinicians to learn how to do so. In 2019, Waitemata District Health Board and the National Institute for Health Innovation developed and delivered a 'hands-on' Clinical Digital Academy training programme for multidisciplinary clinicians. This paper describes the programme, the initial cohort's evaluation feedback and recommendations for the future.


Assuntos
Sistemas de Informação em Saúde , Pessoal de Saúde/educação , Liderança , Informática Médica/educação , Pessoal Técnico de Saúde/educação , Humanos , Nova Zelândia , Enfermeiras e Enfermeiros , Médicos , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Autoeficácia
9.
Nihon Koshu Eisei Zasshi ; 67(11): 819-827, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-33361689

RESUMO

Objective Healthcare support workers play an important role in team healthcare. The objective of this study was to develop scales for measuring feelings of difficulty among home healthcare support workers when in collaborative practice with medical professionals.Methods Scale drafts consisting of 10 questions were developed by an expert panel, using qualitative data from previous studies. We conducted a questionnaire survey of 220 healthcare workers in a certain city using the developed scales, and reliability and validity of the scale were examined.Results An exploratory and confirmatory factor analysis was conducted, after which two factor structures and six questions were selected. The factors were "feelings of disrespect from medical professionals" and "communication barriers between home healthcare support workers and medical professionals". Cronbach's coefficient alpha was 0.77-0.81 for the scale and its two subscales, which demonstrated good internal consistency. Correlation coefficients between the scale and the face-to-face cooperative confidence questionnaire (FFCCQ) and interdisciplinary collaborative practice scales (ICPS) were estimated to examine the criterion-related validity. As a consequence, the score of the scale had a significant negative correlation with FFCCQ and ICPS (r=-0.36--0.42). The two subscales also had negative correlations with FFCCQ and ICPS (r=-0.17--0.42).Conclusion The scales we developed were reliable and valid for measuring home healthcare support workers' feelings of difficulty in collaborative practice with medical professionals.


Assuntos
Pessoal Técnico de Saúde/psicologia , Emoções , Serviços de Assistência Domiciliar , Visitadores Domiciliares/psicologia , Colaboração Intersetorial , Equipe de Assistência ao Paciente , Profissionalismo , Psicometria/métodos , Comportamento Social , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
11.
12.
Artigo em Inglês | MEDLINE | ID: mdl-33374768

RESUMO

To evaluate the prevalence of bloodborne infections (BBIs) and assess the incidence and selected risk factors for sharps injuries (SIs), a cross-sectional serosurvey was performed between December 2018 and October 2019 among 286 paramedics (76.5% males; mean age, 37 years) from 17 randomly selected ambulance stations in the West Pomeranian region of Poland. An ELISA system was used to detect anti-HBc, anti-HCV, and anti-HIV. HBV vaccination uptake was 95.6%; 7.3% (95% CI: 4.6-11.0%) paramedics were anti-HBc positive, and anti-HCV/anti-HIV seropositivity was not reported. Almost one-fourth of paramedics reported having had ≥1 SI during the preceding year (Me = 6.0, range 1-100). Most recent exposures primarily took place during an emergency procedure (76.7%), in an ambulance (45.2%), caused by hollow-bore needles (73.8%), and were not reported (50.0%). Additionally, 52.2% of paramedics reported needle recapping, and 52.6% did not use safety engineered devices (SEDs) at work. Mean knowledge score was low (2.6 ± 1.7); 3.4% had never participated in infection-control (IC) training, and those not trained were more likely to suffer a SI (odds ratio (OR) 4.64; p = 0.03). Due to frequent SIs, of which half are unreported, paramedics remain at risk of acquiring occupational BBIs. SI risk could be reduced by providing training on IC procedures, ensuring better compliance with safe work practices, and supplying more SEDs.


Assuntos
Pessoal Técnico de Saúde/estatística & dados numéricos , Ferimentos Penetrantes Produzidos por Agulha , Exposição Ocupacional , Adulto , Ambulâncias , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ferimentos Penetrantes Produzidos por Agulha/epidemiologia , Polônia/epidemiologia
13.
Antimicrob Resist Infect Control ; 9(1): 185, 2020 11 10.
Artigo em Inglês | MEDLINE | ID: mdl-33168097

RESUMO

BACKGROUND: Prehospital professionals such as emergency physicians or paramedics must be able to choose and adequately don and doff personal protective equipment (PPE) in order to avoid COVID-19 infection. Our aim was to evaluate the impact of a gamified e-learning module on adequacy of PPE in student paramedics. METHODS: This was a web-based, randomized 1:1, parallel-group, triple-blind controlled trial. Student paramedics from three Swiss schools were invited to participate. They were informed they would be presented with both an e-learning module and an abridged version of the current regional prehospital COVID-19 guidelines, albeit not in which order. After a set of 22 questions designed to assess baseline knowledge, the control group was shown the guidelines before answering a set of 14 post-intervention questions. The e-learning group was shown the gamified e-learning module right after the guidelines, and before answering post-intervention questions. The primary outcome was the difference in the percentage of adequate choices of PPE before and after the intervention. RESULTS: The participation rate was of 71% (98/138). A total of 90 answer sets was analyzed. Adequate choice of PPE increased significantly both in the control (50% [33;83] vs 25% [25;50], P = .013) and in the e-learning group (67% [50;83] vs 25% [25;50], P = .001) following the intervention. Though the median of the difference was higher in the e-learning group, there was no statistically significant superiority over the control (33% [0;58] vs 17% [- 17;42], P = .087). The e-learning module was of greatest benefit in the subgroup of student paramedics who were actively working in an ambulance company (42% [8;58] vs 25% [- 17;42], P = 0.021). There was no significant effect in student paramedics who were not actively working in an ambulance service (0% [- 25;33] vs 17% [- 8;50], P = .584). CONCLUSIONS: The use of a gamified e-learning module increases the rate of adequate choice of PPE only among student paramedics actively working in an ambulance service. In this subgroup, combining this teaching modality with other interventions might help spare PPE and efficiently protect against COVID-19 infection.


Assuntos
Betacoronavirus/fisiologia , Infecções por Coronavirus/prevenção & controle , Pessoal de Saúde/educação , Pandemias/prevenção & controle , Equipamento de Proteção Individual , Pneumonia Viral/prevenção & controle , Adulto , Pessoal Técnico de Saúde/educação , Pessoal Técnico de Saúde/normas , Betacoronavirus/genética , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Educação a Distância/estatística & dados numéricos , Europa (Continente) , Feminino , Pessoal de Saúde/normas , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional , Internet , Conhecimento , Aprendizagem , Masculino , Equipamento de Proteção Individual/normas , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Estudantes/psicologia , Adulto Jovem
14.
Neurodiagn J ; 60(3): 195-207, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33006508

RESUMO

Since 1995, ASET has periodically published updates to recommendations for best practices in infection prevention for Neurodiagnostic technologists. The latest installment was accepted in December 2019 for publication in Volume 60, Issue 1, before we had much knowledge or understanding about the SARS-CoV-2, the virus that causes COVID-19. This Technical Tips article is presented as an addendum to the 2020 update and includes important information about infection prevention measures specific to procedure protocols when working with patients positive or under investigation for a highly infectious disease, and when working with patients in general during the current pandemic. All Neurodiagnostic technologists who have direct patient care are responsible for ensuring the use of best practices to prevent the spread of infection.


Assuntos
Infecções por Coronavirus/prevenção & controle , Eletroencefalografia/métodos , Controle de Infecções/métodos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Pandemias/prevenção & controle , Equipamento de Proteção Individual , Pneumonia Viral/prevenção & controle , Pessoal Técnico de Saúde , Betacoronavirus , Técnicas de Diagnóstico Neurológico/instrumentação , Desinfecção/métodos , Eletroencefalografia/instrumentação , Contaminação de Equipamentos , Humanos , Polissonografia/instrumentação , Polissonografia/métodos
15.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 5180-5183, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019152

RESUMO

Cerebral palsy is a neurodevelopmental condition that affects 17 million individuals worldwide. Traditionally, methods of therapy are repetitive and monotonous, generating immense difficulty in maintaining patient motivation and engagement. This project's objective was to provide a novel method of therapeutic intervention that was co-designed by therapists and had the capacity to increase patient motivation and enjoyment. The system developed incorporated the use of muscle activations retrieved from a bespoke surface electromyography subsystem, to control custom computer games to increase therapy uptake. The safety and functionality of this device was verified through a series of trials performed on adults without any muscular impairments. Furthermore, a feasibility evaluation was conducted whereby the system was demonstrated to a group of healthcare professionals to gain their feedback. The trial results confirmed the safety and functionality of the system, with professional therapists confirming its clinical potential and its perceived benefits.


Assuntos
Paralisia Cerebral , Pessoal Técnico de Saúde , Biorretroalimentação Psicológica , Paralisia Cerebral/terapia , Criança , Eletromiografia , Humanos
16.
Neuroradiol J ; 33(5): 353-367, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32894991

RESUMO

The ongoing COVID-19 pandemic has forced every radiology set-up to evolve and formulate guidelines for day-to-day functioning. The sub-speciality of neuroradiology, both diagnostic and neuro-intervention, forms a very important part of any radiology or 'neuro-care' set-up. The present document is a consensus statement of the Indian Society of Neuroradiology, prepared after reviewing the available data and working experience. It scientifically tries to answer many questions faced by neuroradiologists everyday in practice. It encompasses simple things such as which patients need to be imaged, what precautions are essential, the work-flows, cleaning of radiology equipment, how to carry out neuro-interventions in COVID-suspect patients, and what procedures/tests to avoid, or their alternatives, to minimise the spread of COVID infection both to the patients and health care personnel. As radiology set-ups can be large, every sub-speciality may have certain precautions which will not be covered in general guidelines, and this document tries to answer those for neuroradiologists. Carefully evolved Standards of Operating Procedure (SOPs) and guidelines are the need of the hour to guide in providing uninterrupted and adequate services to the needy without compromising the safety of the specialised work force and facilities involved.


Assuntos
Infecções por Coronavirus/prevenção & controle , Controle de Infecções/métodos , Neuroimagem/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Radiologia Intervencionista/métodos , Pessoal Técnico de Saúde , Betacoronavirus , Desinfecção , Emergências , Fumigação , Humanos , Índia , Equipamento de Proteção Individual , Admissão e Escalonamento de Pessoal , Radiologia/métodos , Sociedades Médicas , Ventilação
19.
PLoS One ; 15(9): e0239559, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32986736

RESUMO

BACKGROUND: Overdose response has become an increasingly relevant component of paramedic practice, particularly in light of increased opioid overdose globally. Previous studies have noted gaps in our understanding regarding the unique challenges which paramedics face during this form of pre-hospital emergency care. The aim of this study is to explore and describe the ways in which paramedics experience overdose response, specifically within a community markedly affected by the overdose crisis. METHODS: Ten participants were recruited from a single ambulance station located in an urban center in Western Canada. Two rounds of semi-structured individual interviews were conducted, and data saturation was found to have been reached. Verbatim transcripts were produced and subject to two rounds of descriptive and pattern coding. A second researcher reviewed all of the codes, with disagreements being handled by discussion until agreement was obtained. Themes were identified, along with a Core Category which seeks to describe the underlying dynamics of overdose response represented in our data. The concept of a Core Category was borrowed from Grounded Theory methodology. FINDINGS: Five major themes were identified: Connecting with patients' lived experiences; Occupying roles as clinicians and patient advocates; Navigating on-scene hazards; Difficulties with transitions of care; and Emotional burden of the overdose crisis. A core category was identified as One's capacity to help. CONCLUSIONS: This research contributes to existing literature on overdose response by specifically examining paramedic experiences during this form of emergency care. While paramedics felt highly confident in providing clinical care, their capacity to address underlying causes of drug use was understood as much more limited. Participants found ways to address this lack of control, along with feelings of frustration, by trying to understand patient perspectives and adopting empathetic attitudes.


Assuntos
Pessoal Técnico de Saúde/estatística & dados numéricos , Overdose de Drogas/diagnóstico , Ambulâncias/estatística & dados numéricos , Canadá , Serviços Médicos de Emergência/estatística & dados numéricos , Auxiliares de Emergência/estatística & dados numéricos , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Profissionalismo , Pesquisa Qualitativa , Transtornos Relacionados ao Uso de Substâncias/diagnóstico
20.
J Interprof Care ; 34(5): 668-671, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32990118

RESUMO

Loneliness and isolation are concerning consequences of social distancing and other stay-at-home orders for older adults globally, amidst the COVID-19 pandemic. To combat loneliness and isolation among older adults residing in California, the Keck School of Medicine collaborated with other health profession schools at the University of Southern California (USC) to create the Age-Friendly Student Senior Connection (AFSSC). A total of 115 interprofessional graduate students were linked with older adults. Students engaged in 30 to 60 minute phone calls with older adults 2 to 5 times per week for 6 weeks. Student preparation included asynchronous video and web-based learning, weekly synchronous de-briefing sessions with a participating faculty member via Zoom, phone, and e-mail support from faculty, and information about resources for older adults. Faculty held weekly meetings throughout the pilot and developed new resources to respond to older adult needs, as reported by students. A total of 102 students completed pre-program and post-program surveys. Preliminary results show statistically significant changes in the reported benefits and outcomes from students participating in the program.


Assuntos
Pessoal Técnico de Saúde , Relações Interpessoais , Solidão , Isolamento Social , Apoio Social , Idoso , Betacoronavirus , California , Infecções por Coronavirus , Humanos , Pandemias , Projetos Piloto , Pneumonia Viral , Avaliação de Programas e Projetos de Saúde , Inquéritos e Questionários
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