Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 9.450
Filtrar
1.
J Nurs Care Qual ; 37(1): 68-74, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34261088

RESUMO

BACKGROUND: Mobility is a vital function of human life. Nurses have an essential role in preventing hospitalized patient complications through movement and ambulation. PURPOSE: This study examined the integration, accuracy, and precision of a paper-based mobility/ambulation tool into an electronic health record (EHR) to assess inpatient mobility/ambulation status. METHODS: This multisite mixed-methods study was a time-series correlational evaluation of a mobility/ambulation tool into the EHR. RESULTS: Sustainability data revealed strong correlations between nurse responses and EHR levels (r = 0.602; scores r = 0.624). Cronbach's α values were 0.737 and 0.761. Nurses' anecdotes supported the findings. CONCLUSION: Findings revealed that the EHR-Mobility Ambulation Tool is a valid, reliable, and stable tool. EHR-generated scores can assist in reducing charting burden, care planning, and inform the interdisciplinary health team at all patient care stages. Tool adoption could potentially assist nurses plan interventions suitable to maintain or increase hospitalized patients' mobility status and contribute to discharge planning.


Assuntos
Registros Eletrônicos de Saúde , Caminhada , Atenção à Saúde , Eletrônica , Corpo Humano , Humanos
2.
Spectrochim Acta A Mol Biomol Spectrosc ; 264: 120233, 2022 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-34358780

RESUMO

Investigation of the adsorption properties croconic acid (CCA) with metal clusters (mC: Ag, Au and Cu) are reported using DFT method. CCA is found to form stable cluster with transition metal clusters of copper, silver and gold. The drug-cluster complexaton energy is slightly more for the copper nanocluster-drug complex. Non-covalent interaction analysis indicated that strong interactions and weak van der Waal interaction is present between drug and metal clusters. Dipole moment of the drug-gold cluster is found to be higher than that of the other systems. SERS studies demonstrates improved Raman signals for multiple wavenumbers of all CCA-metal cluster complexes. Mulliken charge analysis show that all CCA oxygen atom's charge changes due to the interactions with the mCs. Clustering of CCA with metal cages enhances the medicinal properties and the metal nanoclusters will act as a drug carrier of CCA.


Assuntos
Complexos de Coordenação , Prata , Cobre , Eletrônica , Ouro
3.
Spectrochim Acta A Mol Biomol Spectrosc ; 264: 120268, 2022 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-34450573

RESUMO

The computational simulation of the photoelectron spectrum of active form of vitamin B2 is reported in the gas phase. In this work, we determine relative stability of eight riboflavin conformers by conformational search first with molecular mechanics AMMP potential in VEGA software at 553 K. Relative abundance of conformers was deduced from Boltzmann population weighting method (BPW). The three most stable conformers were then selected for computing valence, vertical ionization energies. We used high-level Equation-of-Motion Coupled-Cluster (EOM-IP-CCSD) method to obtain valence ionization energies (IP). In order to characterize the nature of ionization processes pertaining to different spectral bands, natural bonding orbital (NBO) method and molecular electrostatic potentials (MEP) were used to obtain orbital electron densities. The influence of the electronic structure of riboflavin on its biological activity is manifested via reduction of ionization energies of outermost orbitals which makes electron densities of these orbitals more readily available to participate in ligand-receptor bonding.


Assuntos
Eletrônica , Riboflavina , Simulação por Computador , Conformação Molecular
4.
Biosens Bioelectron ; 195: 113683, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34619484

RESUMO

To understand the physio-pathological state of patients suffering from chronic diseases, scientists and clinicians need sensors to track chemical signals in real-time. However, the lack of stable, safe, and scalable biochemical sensing platforms capable of continuous operation in liquid environments imposes significant challenges in the timely diagnosis, intervention, and treatment of chronic conditions. This work reports a novel strategy for fabricating waterproof and flexible biochemical sensors with active electronic components, which feature a submicron encapsulation layer derived from monocrystalline Si nanomembranes with a high structural integrity due to the high formation temperature (>1000 °C). The ultrathin, yet dense and low-defect encapsulation enables continuous operation of field-effect transistors in biofluids for chemical sensing. The excellent stability in liquid environment and pH sensing performance of such transistors suggest their great potential as the foundation of waterproof and scalable biochemical sensors with active functionalities in the future. The understandings, knowledge base, and demonstrations for pH sensing reported here set the stage for the next generation long-term biosensing with a broad applicability in biomedical research, food science, and advanced healthcare.


Assuntos
Técnicas Biossensoriais , Eletrônica , Humanos , Concentração de Íons de Hidrogênio , Transistores Eletrônicos
5.
J Assoc Physicians India ; 69(11): 11-12, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34781611

RESUMO

BACKGROUND: Exposure to blue light has been found to affect sleep. Reduced sleep has been found to affect academic performance. However, electronic gadget screen time, sleep quality and quantity and academic performance in undergraduate medical students has not been explored so far. The primary objective of this study was to explore Electronic Gadget Screen time, sleep quality, and sleep quantity and academic performance in Medical students. METHODS: The study was done in JSS Medical College, Mysuru. 400 students fromunder graduate course were selected through clustered random sampling. Data of electronic gadget usage was collected using a pre-tested proforma. Data of sleep quality, quantity was collected using Pittsburg Sleep Quality Index. Data of academic performance was collected from the marks sheet provided by the college authorities. RESULTS: Average screen time overall was 5.13 hours per day. On the whole, total Screen time does not have a direct relationship with sleep quantity or quality or academic performance. Rather than the total screen time, bed time gadget use seems to have a more significant relationship with academic performance. A non-significant relationship has been identified between screen time and quality of sleep with a p value= 0.2. Higher academic performance correlated with better sleep quality and better global PSQI scores. CONCLUSION: Bed time screen exposure plays a significant role in determining sleep quality, quantity and in turn academic performance.


Assuntos
Desempenho Acadêmico , Estudantes de Medicina , Estudos Transversais , Eletrônica , Humanos , Tempo de Tela , Sono , Inquéritos e Questionários
6.
BMC Med Inform Decis Mak ; 21(1): 307, 2021 11 03.
Artigo em Inglês | MEDLINE | ID: mdl-34732176

RESUMO

BACKGROUND: Medication reconciliation (MedRec), a process to reduce medication error at care transitions, is labour- and resource-intensive and time-consuming. Use of Personal Electronic Records of Medications (PERMs) in health information systems to support MedRec have proven challenging. Relatively little is known about the design, use or implementation of PERMs at care transitions that impacts on MedRec in the 'real world'. To respond to this gap in knowledge we undertook a rapid realist review (RRR). The aim was to develop theories to explain how, why, when, where and for whom PERMs are designed, implemented or used in practice at care transitions that impacts on MedRec. METHODOLOGY: We used realist methodology and undertook the RRR between August 2020 and February 2021. We collaborated with experts in the field to identify key themes. Articles were sourced from four databases (Pubmed, Embase, CINAHL Complete and OpenGrey) to contribute to the theory development. Quality assessment, screening and data extraction using NVivo was completed. Contexts, mechanisms and outcomes configurations were identified and synthesised. The experts considered these theories for relevance and practicality and suggested refinements. RESULTS: Ten provisional theories were identified from 19 articles. Some theories relate to the design (T2 Inclusive design, T3 PERMs complement existing good processes, T7 Interoperability), some relate to the implementation (T5 Tailored training, T9 Positive impact of legislation or governance), some relate to use (T6 Support and on-demand training) and others relate iteratively to all stages of the process (T1 Engage stakeholders, T4 Build trust, T8 Resource investment, T10 Patients as users of PERMs). CONCLUSIONS: This RRR has allowed additional valuable data to be extracted from existing primary research, with minimal resources, that may impact positively on future developments in this area. The theories are interdependent to a greater or lesser extent; several or all of the theories may need to be in play to collectively impact on the design, implementation or use of PERMs for MedRec at care transitions. These theories should now be incorporated into an intervention and evaluated to further test their validity.


Assuntos
Reconciliação de Medicamentos , Transferência de Pacientes , Eletrônica , Humanos , Erros de Medicação
7.
Ann Card Anaesth ; 24(4): 447-451, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34747752

RESUMO

Background: Cardiac implantable electronic devices (CIED) are becoming more common for the management of underlying of cardiac dysrhythmias, and more patients with these devices are presenting for cardiac and noncardiac procedures. Methods: We performed a retrospective, cohort, single-center study at a tertiary teaching medical center, gathering 151 patients with CIED undergoing elective and emergent surgeries for the time period between November 2013 and December 2016. We aimed to determine whether patients with CIED had the device interrogated before surgery as recommended by the Heart Rhythm Society (HRS)/American Society of Anesthesiologists (ASA) consensus, whether this lack of compliance led to delay in the holding area before surgery and determine the presence of intra- or postoperative cardiac events in these patients. Results: A total of 76% of patients had interrogation of the device before surgery. Emergent cases were not interrogated as much as elective cases preoperatively (43% vs. 18%, respectively; P < 0.05). In total, 6% of cases had a CIED-related average holding area delay time of 54 minutes. Patients without preoperative device interrogation had more perioperative cardiac events than those who had the device checked (25% vs. 8%, respectively; odds ratio [OR] 0.26; 95% CI, 0.09-0.7, P < 0.013). Conclusions: Our findings suggest that preoperative interrogation of the device plays a significant role to minimize the incidence of perioperative cardiac adverse events. Institutional providers show a lack of compliance with HRS/ASA recommendations for preoperative CIED management. Further research is required to determine if improved compliance to recommendations will lead to enhanced outcomes.


Assuntos
Desfibriladores Implantáveis , Arritmias Cardíacas , Estudos de Coortes , Eletrônica , Humanos , Estudos Retrospectivos
8.
Zhongguo Gu Shang ; 34(11): 1020-4, 2021 Jul 25.
Artigo em Chinês | MEDLINE | ID: mdl-34812018

RESUMO

OBJECTIVE: To observe the progress of disease activity and sacroiliac joint imaging in patients with ankylosing spondylitis treated by extracorporeal shockwave combined with conventional oral medicine, and find a new safe and effective therapeutic method. METHODS: The clinical data of 30 patients with ankylosing spondylitis treated from January 2018 to December 2018 were retrospectively analyzed. Including 20 males and 10 females, aged from 18 to 50 years with an average of (34.50±9.60) years. All 30 patients had different degrees of sacroiliac joint bone marrow edema on MRI before treatment. Thirty patients were divided into treatment group and control group according to different treatment methods. Among them, 15 cases in control group were treated with non-steroidal anti-inflammatory drugs and sulfasalazine enteric-coated tablets, for the 15 cases in treatment group, in addition to oral medicine in line with control group, electronic focusing high-energy extracorporeal shockwave therapy was added. The course of disease, age, pre- and post-treatment erythrocyte sedimentation rate, C-reactive protein in the two groups were analyzed; and visual analogue scale (VAS) and spondyloarthritis research consortium Canada (SPARCC) scoring system were used to evaluate the pain of the sacroiliac joint and the structural damage of the sacroiliac joint;Bath ankylosing spondylitis disease activity index (BASDAI) was calculated. RESULTS: All patients were followed up for at least 3 months. One month after treatment, VAS, and SPARCC scores in treatment group were significantly better than in control group (P<0.05). After 1 month of treatment, there was no significant difference in BASDAI, erythrocyte sedimentation rate and C-reactive protein between two groups(P>0.05). VAS, BASDAI, SPARCC, erythrocyte sedimentation rate, and C-reactive protein of all patients after treatment were significantly improved compared with those before treatment (P< 0.01). CONCLUSION: Electronic focusing high-energy extracorporeal shockwave combined with conventional oral medicine in the treatment of ankylosing spondylitis has a good clinical effect in rapidly relieving pain, improving disease activity, and preventing imaging progress. In addition, it is safe and non-invasive, which is worthy of clinical application.


Assuntos
Ondas de Choque de Alta Energia , Espondilite Anquilosante , Eletrônica , Feminino , Humanos , Masculino , Estudos Retrospectivos , Índice de Gravidade de Doença , Espondilite Anquilosante/terapia
9.
Sensors (Basel) ; 21(21)2021 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-34770271

RESUMO

The effects of a static magnetic field on systems with chaotic dynamical behavior have attracted little attention so far. Here, Chua's electronic circuit with an inductor placed in a static uniform magnetic field operating in a chaotic double-scroll regime is studied experimentally. The effect of the magnetic field on the duty cycle factor and the spike count rate, with spikes defined by crossings between the scrolls of the double-scroll attractor, is described. A slow monotonic variation in the duty cycle factor and constant spike count rate is observed for magnetic field intensities up to the threshold, where both these metrics change severely; the dynamic trajectory remains on one scroll and spikes disappear. The dependence of the static magnetic field intensity on Chua's circuit resistivity at the threshold is given. Two biomimetic magnetic chaotic sensors are proposed: one based on one Chua's circuit and another that can have various transfer functions and is composed of several independent Chua's circuits.


Assuntos
Biomimética , Dinâmica não Linear , Eletrônica , Campos Magnéticos , Fenômenos Físicos
10.
Sensors (Basel) ; 21(21)2021 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-34770346

RESUMO

Signcryption schemes leveraging chaotic constructions have garnered significant research interest in recent years. These schemes have proffered practical solutions towards addressing the vast security vulnerabilities in Electronic Cash Systems (ECS). The schemes can seamlessly perform message confidentiality and authentication simultaneously. Still, their applications in emerging electronic cash platforms require a higher degree of complexity in design and robustness, especially as billions of online transactions are conducted globally. Consequently, several security issues arise from using open wireless channels for online business transactions. In order to guarantee the security of user information over these safety-limited channels, sophisticated security schemes are solely desired. However, the existing signcryption schemes cannot provide the required confidentiality and authentication for user information on these online platforms. Therefore, the need for certificateless group signcryption schemes (CGSS) becomes imperative. This paper presents an efficient electronic cash system based on CGSS using conformable chaotic maps (CCM). In our design, any group signcrypter would encrypt information/data with the group manager (GM) and send it to the verifier, who confirms the authenticity of the signcrypted information/data using the public criteria of the group. Additionally, the traceability, unforgeability, unlinkability, and robust security of the proposed CGSS-CCM ECS scheme have been built leveraging computationally difficult problems. Performance evaluation of the proposed CGSS-CCM ECS scheme shows that it is secure from the Indistinguishably Chosen Ciphertext Attack. Finally, the security analysis of the proposed technique shows high efficiency in security-vulnerable applications. Overall, the scheme gave superior security features compared to the existing methods in the preliminaries.


Assuntos
Segurança Computacional , Telemedicina , Algoritmos , Confidencialidade , Eletrônica
11.
Sensors (Basel) ; 21(21)2021 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-34770372

RESUMO

The design of the Controller Area Network (CAN bus) did not account for security issues and, consequently, attacks often use external mobile communication interfaces to conduct eavesdropping, replay, spoofing, and denial-of-service attacks on a CAN bus, posing a risk to driving safety. Numerous studies have proposed CAN bus safety improvement techniques that emphasize modifying the original CAN bus method of transmitting frames. These changes place additional computational burdens on electronic control units cause the CAN bus to lose the delay guarantee feature. Consequently, we proposed a method that solves these compatibility and security issues. Simple and efficient frame authentication algorithms were used to prevent spoofing and replay attacks. This method is compatible with both CAN bus and CAN-FD protocols and has a lower operand when compared with other methods.


Assuntos
Segurança Computacional , Telemedicina , Algoritmos , Comunicação , Confidencialidade , Eletrônica
12.
Sensors (Basel) ; 21(21)2021 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-34770517

RESUMO

Smart sensors are an integral part of the Fourth Industrial Revolution and are widely used to add safety measures to human-robot interaction applications. With the advancement of machine learning methods in resource-constrained environments, smart sensor systems have become increasingly powerful. As more data-driven approaches are deployed on the sensors, it is of growing importance to monitor data quality at all times of system operation. We introduce a smart capacitive sensor system with an embedded data quality monitoring algorithm to enhance the safety of human-robot interaction scenarios. The smart capacitive skin sensor is capable of detecting the distance and angle of objects nearby by utilizing consumer-grade sensor electronics. To further acknowledge the safety aspect of the sensor, a dedicated layer to monitor data quality in real-time is added to the embedded software of the sensor. Two learning algorithms are used to implement the sensor functionality: (1) a fully connected neural network to infer the position and angle of objects nearby and (2) a one-class SVM to account for the data quality assessment based on out-of-distribution detection. We show that the sensor performs well under normal operating conditions within a range of 200 mm and also detects abnormal operating conditions in terms of poor data quality successfully. A mean absolute distance error of 11.6mm was achieved without data quality indication. The overall performance of the sensor system could be further improved to 7.5mm by monitoring the data quality, adding an additional layer of safety for human-robot interaction.


Assuntos
Robótica , Algoritmos , Confiabilidade dos Dados , Eletrônica , Humanos , Monitorização Fisiológica
13.
BMC Health Serv Res ; 21(1): 1240, 2021 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-34789234

RESUMO

BACKGROUND: The COVID-19 pandemic and the associated economic recession has increased parental psychosocial stress and mental health challenges. This has adversely impacted child development and wellbeing, particularly for children from priority populations (culturally and linguistically diverse (CALD) and rural/regional communities) who are at an already increased risk of health inequality. The increased mental health and psychosocial needs were compounded by the closure of in-person preventive and health promotion programs resulting in health organisations embracing technology and online services. Watch Me Grow- Electronic (WMG-E) - developmental surveillance platform- exemplifies one such service. WMG-E was developed to monitor child development and guide parents towards more detailed assessments when risk is identified. This Randomised Controlled Trial (RCT) aims to expand WMG-E as a digital navigation tool by also incorporating parents' mental health and psychosocial needs. Children and families needing additional assessments and supports will be electronically directed to relevant resources in the 'care-as-usual' group. In contrast, the intervention group will receive continuity of care, with additional in-person assessment and 'warm hand over' by a 'service navigator' to ensure their needs are met. METHODS: Using an RCT we will determine: (1) parental engagement with developmental surveillance; (2) access to services for those with mental health and social care needs; and (3) uptake of service recommendations. Three hundred parents/carers of children aged 6 months to 3 years (recruited from a culturally diverse, or rural/regional site) will be randomly allocated to the 'care-as-usual' or 'intervention' group. A mixed methods implementation evaluation will be completed, with semi-structured interviews to ascertain the acceptability, feasibility and impact of the WMG-E platform and service navigator. CONCLUSIONS: Using WMG-E is expected to: normalise and de-stigmatise mental health and psychosocial screening; increase parental engagement and service use; and result in the early identification and management of child developmental needs, parental mental health, and family psychosocial needs. If effective, digital solutions such as WMG-E to engage and empower parents alongside a service navigator for vulnerable families needing additional support, will have significant practice and policy implications in the pandemic/post pandemic period. TRIAL REGISTRATION: The trial (Protocol No. 1.0, Version 3.1) was registered with ANZCTR (registration number: ACTRN12621000766819 ) on July 21st, 2021 and reporting of the trial results will be according to recommendations in the CONSORT Statement.


Assuntos
COVID-19 , Desenvolvimento Infantil , Criança , Eletrônica , Humanos , Saúde Mental , Pais , Ensaios Clínicos Controlados Aleatórios como Assunto , SARS-CoV-2
14.
Addict Sci Clin Pract ; 16(1): 66, 2021 11 10.
Artigo em Inglês | MEDLINE | ID: mdl-34758881

RESUMO

BACKGROUND: The emergency department (ED) offers an important opportunity to identify patients with opioid use disorder (OUD) and initiate treatment. However, post-ED follow-up is challenging, and novel approaches to enhance care transitions are urgently needed. Outcomes following ED visits have traditionally focused on overdose, treatment engagement, and mortality with an absence of patient reported outcomes (PROs), for example patient ability to schedule follow-up OUD treatment appointments or pick up a prescription medication, that may better inform evaluation of treatment pathways and near-term outcomes after acute events. In the context of increasing novel secure mobile health (mHealth) platforms, we explored the feasibility and acceptability of electronically collecting PROs from ED patients with non-medical opioid use to enhance care in the ED and transitions of care. METHODS: ED patients with non-medical opioid use or opioid overdose who endorsed willingness and ability to complete electronic surveys after discharge were enrolled from a tertiary, urban academic ED. Participants were enrolled in an mHealth platform, shared electronic health records with researchers, and completed electronic surveys of PROs at baseline, three- and thirty-days post discharge from the hospital, including questions about ability to schedule a follow-up appointment, pick up a prescription medication and overdose risk behaviors. Primary outcomes were measures of feasibility and acceptability of electronic PRO collection among ED patients with non-medical opioid use. RESULTS: Among 1,808 patients assessed for eligibility between June-December 2019, 101 of 130 (78%) eligible adult patients consented to participate. Ninety-six (95%) of 101 patients completed registration in the mHealth platform, and 77/96 (80%) were successful in sharing their electronic health data. Completion rates for the baseline, three-day and thirty-day surveys were 97% (93/96), 49% (47/96) and 42% (40/96). Implementation challenges included short engagement window during ED visit, limited access to smartphones/computers, insufficient battery life of participant phone to access email and password, forgotten emails and passwords, multi-step verification processes for account set-up, and complaints about hospital care, most of which were effectively addressed by study personnel. CONCLUSIONS: ED patients with OUD were willing to share electronic health information and PROs, although implementation challenges were common, and more than half of participants were lost-to-follow-up after hospital discharge at 30 days. Efforts to streamline communication and remove barriers to engagement are needed to improve the collection of PROs and pathways of care in ED patients with OUD. Clinical Trial Registration ClinicalTrials.gov (NCT03985163). Date of Registration: June 10, 2019, Retrospectively registered (First enrollment June 8, 2019). https://clinicaltrials.gov/ct2/show/record/NCT03985163.


Assuntos
Transtornos Relacionados ao Uso de Opioides , Telemedicina , Adulto , Assistência ao Convalescente , Analgésicos Opioides/uso terapêutico , Eletrônica , Serviço Hospitalar de Emergência , Estudos de Viabilidade , Humanos , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Alta do Paciente , Medidas de Resultados Relatados pelo Paciente
15.
BMC Med Educ ; 21(1): 578, 2021 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-34781930

RESUMO

BACKGROUND: Surgical logbooks are a commonly used tool for quality assurance of surgical training. Electronic logbooks are increasingly applied in low-resource settings, but there is limited research on their quality. The aim of this study is to evaluate the quality of an app-based surgical e-logbook system shortly after its implementation in a low-income country and to identify potential areas of improvement for the system. METHODS: Entries in the e-logbook system were cross-checked with hospital records and categorized as matched or overreported. Moreover, the hospital records were checked for underreported procedures. Additionally, semi-structured interviews were conducted with users of the e-logbook system. RESULTS: A total of 278 e-logbook database entries and 379 procedures in the hospital records from 14 users were analyzed. Matches were found in the hospital records for 67.3% of the database entries. Moreover, 32.7% of the database entries were overreported and 50.7% of the procedures in the hospital records were underreported. A previous study of an analog surgical logbook system in the same setting estimated that 73.1% of the entries were matches or close matches. Interviews with 12 e-logbook users found overall satisfaction but also identified potential areas of improvement, including the need for more training in the use of the system, modifications to improve user-friendliness, and better access to the necessary technology. CONCLUSIONS: A reliable documentation system is necessary to evaluate the quality of health workforce training. The early evaluation of a surgical e-logbook system in a low-income country showed that the collected data should be approached with caution. The quantitative analysis suggests that the e-logbook system needs to be improved in terms of accuracy. In interviews, users reported that digitalization of the logbook system was a much-needed innovation but also identified important areas of improvement. Recognition of these aspects at an early stage facilitates guidance and adjustment of further implementation and might improve the accuracy of the system.


Assuntos
Documentação , Hospitais , Coleta de Dados , Eletrônica , Serra Leoa
16.
Stud Health Technol Inform ; 286: 72-76, 2021 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-34755693

RESUMO

Electronic medication management (eMM) systems can have a significant impact on efficiency and safety. There is limited evidence on the effects of eMM implementation on the physical location of work. The objective of this study was to evaluate the impact of eMM and associated hardware implementation on the location of tasks performed by doctors and nurses. 41.5 hours of observation were conducted in the oncology ward of a paediatric hospital. Tasks, locations and resources used were recorded pre and post eMM implementation. Results showed that a wider variety of locations were used to conduct tasks following eMM implementation. Post-eMM, more tasks were performed in the hallway, where medication trolleys with attached laptops were situated, and in patient rooms where additional computers were installed, providing more opportunities for patient/carer and clinician interaction. The findings from this study reveal the impact that computer placement has on the location of work for doctors and nurses, and the importance of planning hardware placement for eMM implementation.


Assuntos
Sistemas de Medicação , Conduta do Tratamento Medicamentoso , Criança , Eletrônica , Hospitais Pediátricos , Humanos , Quartos de Pacientes
17.
Trials ; 22(1): 763, 2021 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-34727956

RESUMO

BACKGROUND: Medication overload or problematic polypharmacy is a major problem causing widespread harm, particularly to older adults. Taking multiple medications increases the risk of potentially inappropriate medications (PIMs), and residents in long-term care (LTC) are frequently prescribed 10 or more medications at once. One strategy to address this problem is for the physician and/or pharmacist to perform regular medication reviews; however, this process can be complicated and time-consuming. With a prescription review, medications may be decreased, changed, or stopped altogether. MedReviewRx is a software that runs an analysis using deprescribing rules to produce a report to guide medication reviews addressing medication overload for residents in LTC. METHODS: This study will employ a mixed methods effectiveness-implementation hybrid type 2 study design. To measure effectiveness, a stepped wedge cluster randomized trial design is planned, which allows us to approximate a randomized clinical trial. Approximately 1000 residents living in LTC will be recruited from five facilities in New Brunswick. The study will begin with 3 months of baseline data on rates of deprescribing. Thereafter, every 3 months a new cluster will enter the intervention mode. The intervention consists of medication reviews augmented with the MedReviewRx software, which will be used by staff and clinicians in the facilities. The estimated study duration is 18 months and the main outcome will be the proportion of patients with one or more PIMs deprescribed (reduced/stopped or changed to a safer alternative) in the 90 days following a prescription review. The goal is to study the impact of MedReviewRx on medication overload among older adults living in LTC. In typical fashion of a stepped wedge cluster randomized trial, each cluster acts as an internal control (before and after) as well as a control for the other clusters (external control). Qualitative data collected will include resident/caregiver attitudes towards deprescribing and semi-structured interviews with staff working in the long-term care homes. DISCUSSION: This study design addresses issues with seasonality and allows all clusters to participate in the intervention, which is an advantage when the intervention is related to quality improvement. This study will provide valuable information on PIM use, cost savings, and facilitators and challenges associated with medication reviews and deprescribing. This study represents an important step towards understanding and promoting tools to guide safe and rational reduction of PIM use among older adults. TRIAL REGISTRATION: NCT04762303 , Registered February 21, 2021.


Assuntos
Desprescrições , Idoso , Eletrônica , Humanos , Casas de Saúde , Avaliação de Resultados em Cuidados de Saúde , Polimedicação , Ensaios Clínicos Controlados Aleatórios como Assunto , Software
18.
BMC Public Health ; 21(1): 1970, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34724921

RESUMO

BACKGROUND: College students are leading an evolution of device use both in the type of device and the frequency of use. They have transitioned from desktop stations to laptops, tablets, and especially smartphones and use them throughout the day and into the night. METHODS: Using a 35-min online survey, we sought to understand how technology daily usage patterns, device types, and postures affect pain and discomfort to understand how knowledge of that pain might help students avoid it. Data were analyzed from 515 students (69.5% male) who completed an internet-delivered survey (81.3% response rate). RESULTS: Participants ranked smartphones as their most frequently used technology (64.0%), followed by laptops and tablets (both 53.2%), and desktop computers (46.4%). Time spent using smartphones averaged over 4.4 h per day. When using their devices, students were more likely to adopt non-traditional workplace postures as they used these devices primarily on the couch or at a chair with no desk. CONCLUSION: Recent trends in wireless academic access points along with the portability of small handheld devices, have made smartphones the most common link to educational materials despite having the least favorable control and display scenario from an ergonomic perspective. Further, the potential impact of transitions in work environments due to COVID-19 may further exacerbate ergonomic issues among millions highlighting the need for such work to be carried out.


Assuntos
COVID-19 , Eletrônica , Feminino , Humanos , Masculino , SARS-CoV-2 , Smartphone , Estudantes
19.
J Synchrotron Radiat ; 28(Pt 6): 1825-1838, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34738936

RESUMO

Sulfur K-edge X-ray absorption spectroscopy (XAS) was employed to experimentally characterize the coordinative bond between the thiourea (TU) or thiocarbamide ligand and transition metal (TM) ions Zn2+, Co2+ and Ni2+ in distorted tetrahedral and octahedral homoleptic coordination environments. Comparisons of XAS spectra of the free TU ligand and [Zn(TU)4]2+, [Co(TU)4]2+ and [Ni(TU)6]2+ complexes clearly identify spectral features unique to TM2+-S(TU) bonding. Quantitative analysis of pre-edge intensities describes the covalency of Ni2+-S(TU) and Co2+-S(TU) bonding to be at most 21% and 9% as expressed by the S 3p contributions per TM 3d electron hole. Using relevant Ni2+ complexes with dithiocarbamate and thioether ligands, we evaluated the empirical S 1s → 3p transition dipole integrals developed for S-donor ligands and their dependence on heteroatom substitutions. With the aid of density functional theory-based ground electronic state calculations, we found evidence for the need of using a transition dipole that is dependent on the presence of conjugated heteroatom (N) substitution in these S-donor ligands.


Assuntos
Compostos Organometálicos , Tioureia , Eletrônica , Enxofre , Espectroscopia por Absorção de Raios X , Zinco
20.
Artigo em Inglês | MEDLINE | ID: mdl-34769926

RESUMO

Oral ingestion is the predominant pathway of metal(loid)s exposure. In this study, the health risks of typical metal(loid)s (including Mn, As, Cr, Cd, and Pb) via multi-source, oral pathways for children aged 3-12 years, living in an area of China dominated by the electronic manufacturing industry, were studied based on the field sampling of duplicated diet, soil, and drinking water. Child-specific ingestion parameters were measured (except the soil ingestion rates, which were from a previous study of the same population), and a Monte Carlo method was applied to determine the uncertainty of the risk assessment. It was observed that children living in such environments were at risk of metal(loid)s exposure, with the accumulative carcinogenic risk exceeding the maximum acceptable level. Food intake was identified to be the primary exposure pathway. Moreover, Pb and Cr were the major risk elements to local children's health. Compared with primary school students, kindergarten children experienced a higher risk. This study highlights that high attention should be paid to children living in suburban areas dominated by the electronic manufacturing industry, and that priority should be given to studies on metal(loid)s exposure deriving from different types of food and their corresponding bioavailability, in order to further discern the precise risk sources to protect children's health.


Assuntos
Metais Pesados , Poluentes do Solo , China/epidemiologia , Eletrônica , Monitoramento Ambiental , Humanos , Metais Pesados/análise , Medição de Risco , Solo , Poluentes do Solo/análise
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...