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1
Swenne, CL, und Katrin Alexandrén. „Surgical team members’ compliance with and knowledge of basic hand hygiene guidelines and intraoperative hygiene“. Journal of Infection Prevention 13, Nr. 4 (Juli 2012): 114–19. http://dx.doi.org/10.1177/1757177412448407.
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The aim of the present study was to observe surgical team members’ compliance with basic hand hygiene and intraoperative hygiene guidelines during the anaesthetic and surgical procedure. A secondary aim was to investigate the team members’ knowledge and attitudes toward these guidelines. A structured observation schedule was designed to capture observational data on compliance with hygiene guidelines. A questionnaire was also designed to elicit written responses on attitudes, beliefs and knowledge about hygiene routines. The results showed that the clinical procedures for basic hand hygiene and intraoperative hygiene were flawed in three areas. Hand disinfection before and after direct patient contact was incomplete. Secondly, the team members used gloves in an incorrect way. Thirdly, the scrub nurse did not always change sterile gloves after intraoperative skin disinfection before handling sterile instruments. The quantity of 0.5% chlorhexidine with 70% ethanol used varied and the mechanical performance of skin disinfection varied. Knowledge of hand hygiene routines and intraoperative hygiene routines among surgical team members is incomplete and adherence needs to improve. Regular routine observations and continuous feedback to all staff may be necessary to improve compliance and avoid deterioration of practice.
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Zhang, Chenyi, und Margaret F. Quinn. „Promoting Early Writing Skills through Morning Meeting Routines: Guidelines for Best Practices“. Early Childhood Education Journal 46, Nr. 5 (25.10.2017): 547–56. http://dx.doi.org/10.1007/s10643-017-0886-2.
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Shaw, Philip. „The intercultural validity of customer-complaint handling routines“. Document Design 2, Nr. 2 (17.08.2001): 180–93. http://dx.doi.org/10.1075/dd.2.2.08sha.
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Handbooks and consultants offer guidelines for customer-complaint reception which seem quite uniform across cultures. But one would expect different behavior patterns in different cultures. This paper describes a pilot investigation of this paradox. Four complaint-handling dialogues exhibiting different levels and types of politeness were written and shown to business students of various European nationalities, predominantly Danish and Spanish. The results showed that the Danes were much less tolerant of polite phrases and promotional language than the Spaniards, but that there was a ’concise, brief, sincere’ style acceptable to all cultural-national groups.
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Wahlström, Åsa, Andreas Hagnell, Birgitta Govén und Victoria Edenhofer. „Guidelines with routines and documentation for handling energy requirements within the building process“. IOP Conference Series: Earth and Environmental Science 588 (21.11.2020): 022021. http://dx.doi.org/10.1088/1755-1315/588/2/022021.
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Laska, Melissa N., Mary O. Hearst, Katherine Lust, Leslie A. Lytle und Mary Story. „How we eat what we eat: identifying meal routines and practices most strongly associated with healthy and unhealthy dietary factors among young adults“. Public Health Nutrition 18, Nr. 12 (02.12.2014): 2135–45. http://dx.doi.org/10.1017/s1368980014002717.
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AbstractObjective(i) To examine associations between young adults’ meal routines and practices (e.g. food preparation, meal skipping, eating on the run) and key dietary indicators (fruit/vegetable, fast-food and sugar-sweetened beverage intakes) and (ii) to develop indices of protective and risky meal practices most strongly associated with diet.DesignCross-sectional survey.SettingMinneapolis/St. Paul metropolitan area, Minnesota (USA).SubjectsA diverse sample of community college and public university students (n 1013).ResultsMeal routines and practices most strongly associated with healthy dietary patterns were related to home food preparation (i.e. preparing meals at home, preparing meals with vegetables) and meal regularity (i.e. routine consumption of evening meals and breakfast). In contrast, factors most strongly associated with poor dietary patterns included eating on the run, using media while eating and purchasing foods/beverages on campus. A Protective Factors Index, summing selected protective meal routines and practices, was positively associated with fruit/vegetable consumption and negatively associated with fast-food and sugar-sweetened beverage consumption (P<0·001). A Risky Factors Index yielded significant, positive associations with fast-food and sugar-sweetened beverage consumption (P<0·001). The probability test for the association between the Risky Factors Index and fruit/vegetable intake was P=0·05.ConclusionsMeal routines and practices were significantly associated with young adults’ dietary patterns, suggesting that ways in which individuals structure mealtimes and contextual characteristics of eating likely influence food choice. Thus, in addition to considering specific food choices, it also may be important to consider the context of mealtimes in developing dietary messaging and guidelines.
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Nassauer, Anne. „Effective crowd policing: empirical insights on avoiding protest violence“. Policing: An International Journal of Police Strategies & Management 38, Nr. 1 (16.03.2015): 3–23. http://dx.doi.org/10.1108/pijpsm-06-2014-0065.
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Purpose – The purpose of this paper is to connect sociology, criminology, and social psychology to identify specific factors that keep protests peaceful, discusses empirical examples of effective peacekeeping, and develops practical peacekeeping guidelines. Design/methodology/approach – The analysis systematically compared 30 peaceful and violent protests in the USA and Germany to identify peaceful interaction routines and how they are disrupted. It employed a triangulation of visual and document data on each demonstration, analyzing over 1,000 documents in total. The paper relies on qualitative analysis based on the principles of process tracing. Findings – Results show that specific interaction sequences and emotional dynamics can break peaceful interaction routines and trigger violence. Single interactions do not break these routines, but certain combinations do. Police forces and protesters need to avoid these interaction dynamics to keep protests peaceful. Communication between both sides and good police management are especially important. Research limitations/implications – The paper highlights the need to examine the role of situational interactions and emotional dynamics for the emergence and avoidance of protest violence more closely. Practical implications – Findings have implications for police practice and training and for officers’ and protesters’ safety. Originality/value – Employing recent data and an interdisciplinary approach, the study systematically analyzes peacekeeping in protests, developing guidelines for protest organizers and police.
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Christensen, K. Risager, C. Steenholdt, S. Schnoor Buhl, M. A. Ainsworth, O. Ø. Thomsen und J. Brynskov. „P300 Vaccination routines during anti-TNF treatment in IBD: Do patients adhere to ECCO's guidelines?“ Journal of Crohn's and Colitis 8 (Februar 2014): S189. http://dx.doi.org/10.1016/s1873-9946(14)60421-9.
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Knutsson, Susanne, Karin Enskär, Boel Andersson-Gäre und Marie Golsäter. „Children as relatives to a sick parent: Healthcare professionals’ approaches“. Nordic Journal of Nursing Research 37, Nr. 2 (18.08.2016): 61–69. http://dx.doi.org/10.1177/2057158516662538.
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An illness or injury sustained by a family member affects all family members. It is consequently important that a child’s need to be involved in a family member’s care is clearly recognized by healthcare professionals. The aim of this study was to describe healthcare professionals’ approaches to children as relatives of a parent being cared for in a clinical setting. A web-based study-specific questionnaire was sent and responded to by 1052 healthcare professionals in Sweden. Data were analysed using descriptive statistics and qualitative analysis. The results show that guidelines and routines are often lacking regarding involving children in the care of a parent. Compared to other areas, psychiatric units seem to have enacted routines and guidelines to a greater extent than other units. The results indicate that structured approaches based on an awareness of the children’s needs as well as a child-friendly environment are vital in family-focused care. These aspects need to be prioritized by managers in order to support children’s needs and promote health and wellbeing for the whole family.
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Bermejo-Martins, Elena, Elkin O. Luis, Ainize Sarrionandia, Martín Martínez, María Sol Garcés, Edwin Y. Oliveros, Cristian Cortés-Rivera, Maider Belintxon und Pablo Fernández-Berrocal. „Different Responses to Stress, Health Practices, and Self-Care during COVID-19 Lockdown: A Stratified Analysis“. International Journal of Environmental Research and Public Health 18, Nr. 5 (25.02.2021): 2253. http://dx.doi.org/10.3390/ijerph18052253.
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The aim of the present cross-sectional study was to analyze the differential impact of the first COVID-19 lockdown (3 April 2020) on stress, health practices, and self-care activities across different Hispanic countries, age range, and gender groups. One thousand and eighty-two participants from Spain, Chile, Colombia, and Ecuador took part in this study. Irrespective of the country, and controlling for income level, young people, especially females, suffered a greater level of stress, perceived the situation as more severe, showed less adherence to health guidelines, and reported lower levels of health consciousness, in comparison to their male peers and older groups. However, in the case of self-care, it seems that older and female groups are generally more involved in self-care activities and adopt more healthy daily routines. These results are mostly similar between Colombia, Ecuador, and Spain. However, Chile showed some different tendencies, as males reported higher levels of healthy daily routines and better adherence to health guidelines compared to females and people over the age of 60. Differences between countries, genders, and age ranges should be considered in order to improve health recommendations and adherence to guidelines. Moreover, developing community action and intersectoral strategies with a gender-based approach could help to reduce health inequalities and increase the success of people’s adherence to health guidelines and self-care-promoting interventions. Future studies should be addressed to explore the possible causations of such differences in more cultural-distant samples and at later stages of the current outbreak.
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Perez, Vinícius Pietta, Jéssica Karoliny Baptista Porto Carvalho, Marianne Schrader de Oliveira, Adriana Medianeira Rossato, Caroline Dani, Gertrudes Corção und Pedro Alves d’Azevedo. „Coagulase-negative staphylococci in outpatient routines: the implications of switching from CLSI to BrCAST/EUCAST guidelines“. Brazilian Journal of Microbiology 51, Nr. 3 (23.04.2020): 1071–78. http://dx.doi.org/10.1007/s42770-020-00278-1.
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Törmä, J., M. Sellgren, Y. Mattsson Sydner, B. Karlström, M. Carlsson, T. Cederholm und A. Saletti. „P040 DOES NUTRITIONAL GUIDELINES ENSURE GOOD ROUTINES IN NUTRITIONAL CARE OF ELDERLY SUBJECTS WITH COMMUNITY SUPPORT?“ Clinical Nutrition Supplements 4, Nr. 2 (Januar 2009): 41–42. http://dx.doi.org/10.1016/s1744-1161(09)70090-0.
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Styrke, Johan, Sven Resare, Karl-Johan Lundström, Patrick Masaba, Christofer Lagerros und Pär Stattin. „Current routines for antibiotic prophylaxis prior to transrectal prostate biopsy: a national survey to all urology clinics in Sweden“. F1000Research 9 (28.01.2020): 58. http://dx.doi.org/10.12688/f1000research.19260.1.
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Background: The risk of infection after transrectal ultrasound (TRUS)-guided prostate biopsies is increasing. The aim of the study was to assess the use of antibiotic prophylaxis for prostate biopsy in Sweden. Methods: All public and private urology clinics reporting to the National Prostate Cancer Register of Sweden received a survey on TRUS-biopsy prophylaxis. Results: Of the 84 clinics surveyed, 76 replied (90%). If no risk factors for infection were present, a single dose of ciprofloxacin 750 mg was used by 50 clinics (66%). Multiple doses of ciprofloxacin 500 or 750 mg (n=14; 18%) or a single dose of trimethoprim-sulfamethoxazole 160/800 mg (n=7; 9%) were other common prophylaxes. Most clinics gave the prophylaxes immediately before the biopsy (n=41; 54%). Urine dipstick was used by 30 clinics (39%) and rectal enema by six (8%). In patients with high risk of infection, the survey mirrors a large variety of regiments used. Conclusions: The preference to use a single dose of ciprofloxacin 750 mg is in accordance with the Swedish national guidelines for patients with a low risk of infection. Better compliance to the guideline recommendation to use a urine dipstick would probably increase the number of patients classified as having an increased risk of infection. Being classified as a high-risk patient should lead to an extended duration of antibiotic prophylaxis, however, the variety of regimens used in the high-risk group reflects an inability to treat these patients in a standardized fashion and also highlights a need for more clear-cut guidelines. Pre-biopsy identification of high-risk patients is an important issue to tackle for the urologic clinics in order to reduce the number of infections.
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Ehrlich, Carolyn, Steve Kisely, Elizabeth Kendall, David Crompton, Elizabeth Crowe und Ann Maree Liddy. „Active steps towards a healthier life for people with severe mental illness: a qualitative approach to understanding the potential for implementing change“. Australian Health Review 37, Nr. 4 (2013): 423. http://dx.doi.org/10.1071/ah13062.
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Objective. Our health systems are failing to provide optimal physical care for people with severe mental illness. To address this gap, Queensland Health and General Practice Queensland in partnership developed a comprehensive package of guidelines and health messages. However, guidelines alone are likely to be inadequate motivators of change. The objective of this research was to qualitatively explore key stakeholders’ expectations about the implementation of guidelines, with the purpose of identifying potential interventions to support practice change. Method. Participants were recruited from the partnership governance committee. A semistructured interview guide was used to gather data. Using grounded-theory techniques, the data were analysed to identify key themes. Results. All stakeholders agreed that the purpose of developing comprehensive guidelines and health messages was to achieve change through innovation and the promotion of early intervention, reduction of avoidable admissions and sectoral integration. However, existing structures within the system were considered to be insurmountable barriers. Conclusion. Key stakeholders sought broader change than just guidelines and health messages developed by the partnership focussed specifically on awareness-raising about the physical care of people with severe mental illness. However, there was no clear consensus as to what that change should be. This mismatch between the goals and actions of such a large-scale initiative is problematic. Suggestions are made about how to address change. What is known about the topic? The physical and oral health of people with severe mental illness is poor. One response that is frequently used to improve the health of this population is to develop and implement guidelines for practice. However, oral healthcare is frequently omitted from guidelines for care. Moreover, guidelines are not always adopted in everyday practice. What does this paper add? This paper outlines a process of guideline development and includes investigation of the short- and long-term goals that a governing committee held for the implementation of guidelines for both the physical and oral healthcare of people with severe mental illness. Additionally, we explore gaps between a short-term focus for guideline implementation and the longer-term goals of achieving improved healthcare. What are the implications for practitioners? Cultural change is required if the physical and oral health of people with severe mental illness is to be improved. However, a mismatch between the goals and actions of large-scale initiatives is problematic. Thus, clearly identified avenues for realising long-term culture change are required if new practices are to be embedded in everyday routines. -->
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Skodvin, Torbjørn Øygard, Roar Kloster, Wilhelm Sorteberg und Jørgen Gjernes Isaksen. „Survey of European neurosurgeons’ management of unruptured intracranial aneurysms: inconsistent practice and organization“. Acta Neurochirurgica 163, Nr. 1 (01.09.2020): 113–21. http://dx.doi.org/10.1007/s00701-020-04539-8.
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Abstract Background The discovery of an unruptured intracranial aneurysm creates a dilemma between observation and treatment. Neurosurgeons’ routines for risk assessment and treatment decision-making are unknown. The position of evidence-based medicine in European neurosurgery is considered to be weak, high-grade guidelines do not exist and variations between institutions are probable. We aimed to explore European neurosurgeons’ management routines for newly discovered unruptured intracranial aneurysms. Methods In cooperation with the European Association of Neurosurgical Societies (EANS), we conducted an online, cross-sectional survey of 420 European neurosurgeons during Spring/Summer 2016 (1533 non-Norwegians invited through the EANS, and 16 Norwegians invited through heads of departments because of the need for additional information for a separate study). We asked about demographic variables, routines for management and risk assessment of newly discovered unruptured intracranial aneurysms and presented a case. We collected information about gross domestic product (GDP) per capita from the International Monetary Fund. Results The response rate to the invite from the EANS was 26%, with respondents from 47 countries. More than half of the respondents (n = 226 [54%]) reported that their department treated less than 25 unruptured aneurysms yearly. Forty percent said their department used aneurysm size cut-off to guide treatment decisions, with a mean size of 6 mm. Presented with a case, respondents from countries with a lower GDP per capita recommended intervention more often than respondents from higher-income countries. Vascular neurosurgeons more commonly recommended observation. Conclusion The answers to this self-reported survey indicate that many centers have a treatment volume lower than recommended by international guidelines, and that there are socioeconomic differences in care. Better documentation of treatment and outcome, for example with clinical quality registries, is needed to drive improvements of care.
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Møller, Anders, Ole Weis Bjerrum und Arash Afshari. „Haemostasis and Safety Measures before Lumbar Puncture in the Haematology Ward: The Danish Routines“. Acta Haematologica 133, Nr. 1 (20.09.2014): 108–12. http://dx.doi.org/10.1159/000362357.
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Background/Aims: Thrombocytopenia and the increasing use and variety of antithrombotic drugs is a challenge prior to lumbar puncture. This study examined the Danish haematology practice regarding drug pausation, assessment of haemostasis and whether fundoscopy is a routine safety measure. Methods: An online survey with questions pertaining to precautions of haemostasis and application of fundoscopy was sent by e-mail to all 12 haematology wards in Denmark. Results: Eleven sites participated. Five (45%) reported no pausation of antiplatelet drugs at all. The mean platelet limit prior to lumbar puncture was 50 × 109/l (range 10-50 × 109/l). Seven (64%) sites had an international normalised ratio limit of 1.5, and the remaining 4 had values between 1.0 and 2.5. Two (18%) reported occasional use of thromboelastography or platelet analysis to assess the bleeding risk. Fundoscopy is routinely performed in 4 (36%) departments. Conclusion: We report considerable variation in the routine handling of antithrombotics and thrombocytopenia in patients set for lumbar puncture in Danish haematology departments. The diversity may be explained by and related to different opinions in the literature. Common national guidelines are warranted and there is a need for studies to establish an evidence-based approach for the management of patients at risk of bleeding when lumbar puncture or another invasive procedure is indicated.
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Yeung, David C. M., Ronald Lai, Eddy W. Y. Wong und Jason Y. K. Chan. „Care of Patients With a Laryngectomy During the COVID-19 Pandemic“. Otolaryngology–Head and Neck Surgery 163, Nr. 4 (02.06.2020): 695–98. http://dx.doi.org/10.1177/0194599820933185.
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Patients with a laryngectomy are at increased risk for droplet-transmitted diseases and, therefore, COVID-19, which has now caused a worldwide pandemic. Adaptive measures to protect patients with a laryngectomy and their families were designed and implemented in the Hong Kong SAR (HK). Driven by the fear of severe acute respiratory syndrome in 2003, hospitals in HK have since modified infection control routines to prevent a repeat public health nightmare. To face COVID-19, caused by SARS-CoV-2, we have adapted guidelines for our patients with a laryngectomy. Contact precautions, droplet precautions with physical barriers, and hand and equipment hygiene are our mainstays of prevention against COVID-19, and sharing these routines is the aim of this article. The COVID-19 pandemic is still roaring ahead. Awareness and precautions for patients with a laryngectomy who may be at higher risk are outlined here and should be maintained during the current pandemic.
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Goldberg, Stuart, und Luke Akard. „Why Don't Hematologists Follow Chronic Myeloid Leukemia Monitoring Guidelines? A Survey Of Practioners In New Jersey and Indiana“. Blood 122, Nr. 21 (15.11.2013): 5187. http://dx.doi.org/10.1182/blood.v122.21.5187.5187.
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Background Successful treatment of chronic myeloid leukemia (CML) requires monitoring of cytogenetic/molecular responses during tyrosine kinase inhibitor therapy.Both the National Comprehensive Cancer Network and European LeukemiaNet have published monitoring guidelines. However our group has reported <30% of 1200 CML ptsin 2 insurance databases underwent polymerase chain reaction (pcr) monitoring during their 1st year as recommended (Chen ASCO 2013). These inadequately monitored pts experienced inferior outcomes, more hospitalizations and higher costs. We have also conducted a >400 pt chart review from 38 practices and noted over half did not undergo appropriate molecular monitoring, leading to higher rates of progression and mortality (Goldberg Curr Med Res Opin 2013). Barriers to physician adherence with CML guidelines have not been previously explored. Methods An anonymous 3 page survey was mailed to 515 hematologist-oncologists in New Jersey (n=359) and Indiana (n=156) in June 2013. Questions about barriers to guidelines were taken from a prior validated general guideline study (Taba, BMC Health Services Research 2012). Results 96 physicians (19%) responded [NJ=68 (19%); IN=28 (18%)]. Respondents worked 11% in academic centers and 89%community practice; 18% solo practice, 65% heme/onc group, 17% multi-specialty. Physicians were in practice 6% <5, 11% 6-10, and 83% >10 years. 17% saw primarily hematology pts, 8% solid tumors, 75% mixed heme/onc. 92% saw pts with CML and 19% referred. For new CML pts, respondents felt the following tests should be done: CBC 100%,spleen measurement byhand 100%, spleen imaging 37%, flow cytometry peripheral blood (PB) 54%, bone marrow (BM) biopsy or aspirate for morphology 73%, PB karyotype 25%, PB FISH 42%, PB pcr bcr-abl 73%, PB abl kinase mutation 15%, BM karyotype 73%,BM FISH 56%, BM pcr bcr-abl 44%, BM abl kinase mutation 10%, (italic items recommended by NCCN). 77% correctly identified routine PB pcr testing as quarterly (6 % biannual, 2% at one year). PB FISH was chosen 38% quarterly. The 3 month evaluation was queried: 73% recommended obtaining a PB pcr which is a treatment decision point by NCCN guidelines, 38% recommended a PB FISH. 79% utilized a lab performing pcr testing by International Standard, 6% used non-IS lab, 15% did not know what their lab reported and 2% were unfamiliar with IS. 77% stated they were familiar with NCCN guidelines and used them, 19% were familiar but did not use, and 4% were not familiar. Using 5-point Likert scale, 98% strongly or somewhat agreed “treatment guidelines are evidenced based”, 98% agreed “guidelines are useful in daily clinical work and improve quality of treatment”, 90% agreed “guidelines include different aspects of the disease and are a good tool for confirming diagnoses, starting initial treatment and managing complications” and 92% agreed “guidelines are convenient and the information is easy to find.” Barriers to guidelines: 56% disagreed “guidelines are hard to implement due to lack of medical resources”, 48% disagreed “guidelines are hard to implement due to lack of patient resources”, 65% disagreed “there is no time to search for information’, 77% disagreed “guidelines are not accessible”, 92% disagreed “guidelines are too complicated and it is difficult to find the information”, 71% disagreed “guidelines reduce doctors autonomy”, 77% disagreed “guidelines limit treatment options”, 67% disagreed “guidelines limit flexibility and individual approach’, 85% disagreed “there is no need for guidelines as treatment routines exist”, and 83% disagreed “patients do not want doctors to conform to treatment guidelines.” Facilitators included: 90% agreed “an easy to find online database”, 46% agreed “special training courses”, 77% agreed “published materials”, 52% agreed “information through professional societies”, and 67% agreed “available consultation to answer questions about the guidelines.” Conclusions This survey, the 1st onCML guidelines barriers, suggests that guidelines are considered useful (especially on-line or published) without major system, resource or attitudinal barriers. The low response ratecautions firm conclusions, especially since >70% respondents correctly identified pcr monitoring practices (indicating a more motivated physician cohort).Given that outcomes improve when CML pts are monitored per published guidelines, efforts to encourage usage are needed. Disclosures: No relevant conflicts of interest to declare.
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Montalvão, Silmara Aparecida de Lima, Ana Paula Francisco, Bittar Letícia Queiroz da Silva, Stephany Cares Huber, Helder José Aguiari, Maria Carmem Gonçalves Lopes Fernandes, Priscila Soares Elidio et al. „From Hemophilia to Deep Venous Thrombosis Patient Samples: How to Perform an Easy Coagulometer Validation Process According to Available Guidelines“. Clinical and Applied Thrombosis/Hemostasis 26 (01.01.2020): 107602962091551. http://dx.doi.org/10.1177/1076029620915512.
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Validation protocols for the evaluation of coagulometers are needed to help professionals select the most suitable system for their regular laboratory routines. The objective of this study was to show how high standard protocols for the coagulometer validation process can fit into the daily laboratory routine. For this study, 45 healthy individuals and 112 patient samples were analyzed. From the patient samples, 51 were investigated for deep venous thrombosis, 27 for coagulopathy, 19 for antivitamin K therapy, and 15 for hemophilia. For the assessment, the performance of the 3 coagulometers and 1 point-of-care device was considered. One of the coagulometers was a new acquisition evaluated for precision, linearity, throughput, and carryover in the first moment, and the new coagulometer was then compared with the other well-established equipment in the laboratory. In normal plasma, coefficient of variation was ≤1.8% for total precision in screening tests and ≤3.5% for within-run precision in specific assays. For prothrombin time/international normalized ratio, no significant difference was found when comparing methods. Our study showed how to compare the capacity of a reagent in order to discriminate patients with severe hemophilia from patients with moderated hemophilia, and the κ coefficient agreement was 0.669 (95% confidence interval: 0.3-1.0; P < .001). d-dimer evaluated in patients with deep venous thrombosis and controls showed a 20% discrepancy between the methods. In our experience across Latin America, the number of laboratories that has performed this process is limited. In this study, we demonstrated how to adapt the validation process for the hemostasis laboratory routine to help the professional chose the best and more suitable option.
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Sobotka, Anna, und Agata Czarnigowska. „ANALYSIS OF SUPPLY SYSTEM MODELS FOR PLANNING CONSTRUCTION PROJECT LOGISTICS“. JOURNAL OF CIVIL ENGINEERING AND MANAGEMENT 11, Nr. 1 (31.03.2005): 73–82. http://dx.doi.org/10.3846/13923730.2005.9636335.
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The paper discusses a number of construction project logistics problems, with focus on supply systems, and presents the results of recent survey of Polish contractors’ supply routines. On the basis of the survey, patterns of development of logistic systems have been described. The enclosed results of cost simulations indicate that outsourcing supply logistic processes, considering the current state of Polish construction market, may reduce costs. The paper emphasises that creating logistic guidelines of a project at its early stages of planning and then a design of integrated logistic service to the project may help find ways of making a construction project more effective.
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Schachat, Sandra R., S. Augusta Maccracken und Conrad C. Labandeira. „Sampling fossil floras for the study of insect herbivory: how many leaves is enough?“ Fossil Record 23, Nr. 1 (21.02.2020): 15–32. http://dx.doi.org/10.5194/fr-23-15-2020.
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Abstract. Despite the great importance of plant–insect interactions to the functioning of terrestrial ecosystems, many temporal gaps exist in our knowledge of insect herbivory in deep time. Subsampling of fossil leaves, and subsequent extrapolation of results to the entire flora from which they came, is practiced inconsistently and according to inconsistent, often arbitrary criteria. Here we compare herbivory data from three exhaustively sampled fossil floras to establish guidelines for subsampling in future studies. The impact of various subsampling routines is evaluated for three of the most common metrics of insect herbivory: damage type diversity, nonmetric multidimensional scaling, and the herbivory index. The findings presented here suggest that a minimum fragment size threshold of 1 cm2 always yields accurate results and that a higher threshold of 2 cm2 should yield accurate results for plant hosts that are not polyphyletic form taxa. Due to the structural variability of the plant hosts examined here, no other a priori subsampling strategy yields consistently accurate results. The best approach may be a sequential sampling routine in which sampling continues until the 100 most recently sampled leaves have caused no change to the mean value or confidence interval for damage type diversity and have caused minimal or no change to the herbivory index. For nonmetric multidimensional scaling, at least 1000 cm2 of leaf surface area should be examined and prediction intervals should be generated to verify the relative positions of all points. Future studies should evaluate the impact of subsampling routines on floras that are collected based on different criteria, such as angiosperm floras for which the only specimens collected are those that are at least 50 % complete.
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Yaqub, Michael Mead, Randal A. Beam und Sue Lockett John. „‘We report the world as it is, not as we want it to be’: Journalists’ negotiation of professional practices and responsibilities when reporting on suicide“. Journalism 21, Nr. 9 (17.09.2017): 1283–99. http://dx.doi.org/10.1177/1464884917731957.
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Media coverage of suicide can play a pivotal role in raising public awareness of an important public health issue. But research suggests that reporting on suicide can potentially trigger suicidal behavior in vulnerable individuals. To encourage the responsible reporting of suicide as a public health issue, media recommendations have been developed. Based on interviews with 50 US journalists, this study explores journalists’ awareness of and attitudes toward suicide reporting risks and US media recommendations. Through the lens of suicide news reporting, this is a study examining how journalists view their professional roles and sense of social responsibility when reporting on issues, like suicide, with potential public health consequences. We find that while the journalists interviewed want to cover suicide responsibly, and as a public health issue, they often deviate from recommendations. In many cases, professional conventions and routines conflict with or hinder guideline compliance. Moreover, many journalists deliberately disregard suicide reporting guidelines because they clash with their professional values and perceived responsibility of serving the public via truth-telling and full disclosure of information.
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Valencia-Peris, Alexandra, Jorge Lizandra, Irene Moya-Mata, Fernando Gómez-Gonzalvo, Silvia Castillo-Corullón und Amparo Escribano. „Comparison of Physical Activity and Sedentary Behaviour between Schoolchildren with Cystic Fibrosis and Healthy Controls: A Gender Analysis“. International Journal of Environmental Research and Public Health 18, Nr. 10 (18.05.2021): 5375. http://dx.doi.org/10.3390/ijerph18105375.
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The purpose of this study was to examine differences in sports participation and the levels of physical activity (PA) and sedentary behaviour (SB) between schoolchildren with cystic fibrosis (CF) and a healthy control group (CG) taking into account the gender variable. PA and SB were measured with an accelerometer for 7 consecutive days in 44 children (24 girls; 11.0 (3.2) years) with CF and 45 age-, sex-, and socioeconomic status-matched controls (24 girls; 11.1 (3.0) years). CF patients and CG did not differ in moderate-to-vigorous PA (54 (31) vs. 59 (27) min/day respectively) or in SB (558 (106) vs. 553 (92) min/day respectively). There were no differences in meeting the PA guidelines between both groups (CF: 36.4% vs. CG: 42.4%). Gender analysis revealed that boys were more active and met more PA guidelines than girls regardless of the group (CF or CG), girls with CF being the least active group (only 16.7% met PA guidelines). A possible compensatory effect was found between SB and PA only in the CF sample, as for each minute/day spent in SB the odds of meeting PA guidelines decreased by 34%. These findings suggest that promoting a reduction in SB is as important as promoting PA in the CF population, especially in girls. Health caregivers, coaches, teachers, or parents could offer appealing supervised and unsupervised physical activities, foster the adoption of active lifestyles, or incorporate PA into daily routines to improve the health of CF schoolchildren.
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Garcia, Bianca Harumi Yamaguti, Ricardo Alves de Olinda, Domingos Sávio Barbosa und Camila Leonardo Mioto. „Substantive audit testing of sewer systems using Brazilian open database: stat methods for compliance screening“. Revista Ibero-Americana de Ciências Ambientais 11, Nr. 6 (06.07.2020): 716–24. http://dx.doi.org/10.6008/cbpc2179-6858.2020.006.0057.
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The monitoring of data and the management of information are important tools for the decision-making and guidance of investments, which is a crucial procedure for the effective capital opening of the sanitation sector. The research aims at analyzing the correlation of urban population growth with the variables of importance for evaluating the overall performance of sanitary sewage systems. The study was developed based on raw data and indicators, in the long term period (1999 to 2017), with the information provided by the service providers themselves to the SNIS (national system of information on sanitation). The methodology consists of an application of a substantive test, following the guidelines of ISO 19.011 :2018, NBC TI 01 and, NBC PI 01: 2012, where the structure is presented in the format of the analytical review. For the validation of the test, statistical routines were used. Scores were elaborated to determine the probable inconsistencies found during the statistical routine, where the results, denominated evidence by the audit, were divided into conformities and non-conformities, being indicated 19 conformities and seven non-conformities. It is concluded that the methodology used can help evaluate public domain data and generate subsidies for sector managers and investors.
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Caetano, Juliana Denicoli Silvestre, Selma Rodrigues de Castilho und Vania dos Santos. „Perspective of pharmaceutical practice in adrenal insufficiency: An integrative review“. Research, Society and Development 10, Nr. 7 (13.06.2021): e5610716197. http://dx.doi.org/10.33448/rsd-v10i7.16197.
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An integrating review of the literature about the perspectives of the pharmaceutical practices in Adrenal Insufficiency (AI) was carried out. Researches were done on the LILACS database, Medline (Pubmed), and Scientific Electronic Library OnLine-SCIELO. Articles published between January 2007 and February 2021, written in Portuguese, English, and Spanish, were included. A total of 43 articles were selected to compose the review. A great deal of the studies considers patient education fundamental for the treatment and AI control. Among the education measures found in these studies, which can subside the service routines are: guidelines on the precipitating factors, signs and disease symptoms, dose adjustment, drug interaction, and condition identification cards. Relevant interventions of clinic management reported hospital discharge plans, management of AI acute and chronic phases, home care management, and routine outpatient follow-up. For an effective self-care support system, patient-centered assistance must be the core of the health care standards model. The review establishes that the AI patient follow-up must be performed regularly by a multidisciplinary team. It also allowed the identification of health measures that a pharmacist integrated with the healthcare team should perform.
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Thorstad, M., I. Sie und B. M. Andersen. „MRSA: A Challenge to Norwegian Nursing Home Personnel“. Interdisciplinary Perspectives on Infectious Diseases 2011 (2011): 1–6. http://dx.doi.org/10.1155/2011/197683.
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In Norway, methicillin-resistantStaphylococcus aureus(MRSA) is increasing in primary healthcare, associated with imported cases and outbreaks in long-term care. According to Norwegian national guidelines, MRSA-exposed healthcare workers (HCWs) and patients are tested. Carriage of MRSA leads to exclusion from work in healthcare institutions. In this study, 388 staff members in 42 nursing homes in Oslo County responded to questions about personal experience with MRSA and of own attitudes to challenges associated with the control and treatment of MRSA patients. Half (52%) of the nursing staff were concerned of becoming infected with MRSA and the consequences of this would be for own social life, family, economy, and work restriction. The concern was associated with risk factors like old buildings not suitable for modern infection control work, low staffing rate (70% without specific training in healthcare and 32% without formal healthcare education), defective cleaning and decolonization, and lack of formal routines and capacity for isolation of MRSA patients. Since the Norwegian MRSA guideline permits patients with persistent MRSA infections to move freely around in nursing homes, the anxiety of the staff to become infected and excluded from job was real.
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Clarke, Channine, Caroline Stack und Marion Martin. „Lack of meaningful activity on acute physical hospital wards: Older people’s experiences“. British Journal of Occupational Therapy 81, Nr. 1 (12.10.2017): 15–23. http://dx.doi.org/10.1177/0308022617735047.
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Introduction Research suggests that older people on acute physical hospital wards are at increased risk of physical and mental health decline due to inactivity during their stay. Whilst studies have highlighted potential causes of such inactivity, there exists a paucity of occupational therapy research that explores engagement in meaningful occupation from patients’ perspectives in hospital settings. Method Interpretative phenomenological analysis was used to gain a deeper understanding of how 18 older people spent their time on hospital wards and the impact this had on their feelings of wellbeing. Interviews were carried out and analysed using interpretive phenomenological analysis guidelines. Findings Patients experienced a lack of meaningful activity on the wards which resulted in feelings of passivity, boredom and a sense of alienation from their normal roles, routines and sense of self. Despite a willingness to engage in activity, barriers were suggested as limited resources, hospital routines and personal limitations. Suggestions of potential meaningful activities were made. Conclusion Occupational therapy services need to review service provision and provide an occupation-focused service, ensuring that patients’ engagement in meaningful activities is seen as an integral part of their role in order to maintain patients’ mental and physical wellbeing. Recommendations for further research are highlighted.
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Machín, Leandro, Jessica Aschemann-Witzel, Angelina Patiño, Ximena Moratorio, Elisa Bandeira, María Rosa Curutchet, Joseline Martínez et al. „Barriers and Facilitators to Implementing the Uruguayan Dietary Guidelines in Everyday Life: A Citizen Perspective“. Health Education & Behavior 45, Nr. 4 (22.12.2017): 511–23. http://dx.doi.org/10.1177/1090198117744243.
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An in-depth understanding of the citizen’s perception and behavior is needed for the development of targeted public policies and interventions that can successfully encourage people to shift their dietary patterns and contribute to the prevention of non-communicable diseases. The present work aimed to identify barriers and facilitators for the adoption of the new Uruguayan dietary guidelines from a citizen perspective. Twelve semistructured focus groups were conducted with a total of 91 people (81% female, age 18-64 years) from 3 Uruguayan cities. Findings identified several multifaceted barriers, including lack of value given to food, meals and cooking, taste preferences for unhealthy foods, the unsupportive social context in terms of household preferences, customs and social norms, and lack of control of the situation through insufficient food capabilities, time scarcity, and an adverse food market environment. The potential facilitators discussed in the focus groups were mainly related to policies and regulations to discourage consumption of unhealthful products and the provision of more education and information. In addition, respondents acknowledged the need for own actions in terms of seeking greater cooking skills and enjoyment, incorporating changes in their daily routines and promoting a more supportive social environment. Results suggest that supportive actions are needed to support citizen’s adoption of the new Uruguayan dietary guidelines.
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SALEND, SPENCER J., und MEENAKSHI GAJRIA. „Increasing the Homework Completion Rates of Students with Mild Disabilities“. Remedial and Special Education 16, Nr. 5 (September 1995): 271–78. http://dx.doi.org/10.1177/074193259501600503.
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Whether students with mild disabilities are educated in mainstreamed general education classes or special education settings, it is likely that they will be assigned homework by their teacher(s). assignment of homework can affect their school performance and the grades they receive in their classes. however, because of a variety of factors, many students with mild disabilities experience difficulty completing their homework. this article presents educators with guidelines for increasing the homework completion rates of students with mild disabilities, including (a) varying the amount and type of homework assignments, (b) providing motivating acts so that students complete their homework, (c) using peermediated strategies, (d) establishing and following homework routines, (e) teaching strategies to improve students' study and organizational skills, and (f) involving parents in the homework process.
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Josendal, Anette Vik, Trine S. Bergmo und Anne Gerd Granas. „The Practice Guidelines for Multidose Drug Dispensing Need Revision—An Investigation of Prescription Problems and Interventions“. Pharmacy 9, Nr. 1 (06.01.2021): 13. http://dx.doi.org/10.3390/pharmacy9010013.
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Multidose drug dispensing (MDD) is an adherence aid used by one-third of patients receiving home care services in Norway. The system can increase patient safety by reducing dispensing errors and increase adherence, however it has also been criticised for unclear routines and distribution of responsibilities. We investigated prescription problems which pharmacists have detected, and the responsibilities they adopt regarding MDD. For two consecutive weeks, 11 pharmacies used a self-completion form to register prescription problems identified with MDD. Of the 4121 MDD prescriptions, problems were identified on 424 (11%). The most common issues were expired prescriptions (29%), drug shortages (19%), missing prescriber signatures (10%) and unclear/missing medication names or strengths (10%). Compared to ordinary prescriptions, the pharmacist took on additional responsibility for renewing MDD prescriptions. However, because these patients received their medications via the home care service, there was limited patient counselling during dispensing. To increase the efficiency and patient safety of the MDD system, the roles and responsibilities of the pharmacist, GP, and home care nurses in the MDD system should be clearly defined. This seems most urgent for the renewal of prescriptions and patient counselling, where the responsibilities and work practice seem to differ from ordinary prescriptions.
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Davies Forsman, Lina, Mats Öström, Mikael Svanström und Anders Eriksson. „Fatal bupivacaine overdose through intrathecally positioned epidural catheter“. Scandinavian Journal of Forensic Science 19, Nr. 1 (01.05.2013): 10–12. http://dx.doi.org/10.2478/sjfs-2013-0003.
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ABSTRACT We describe a fatality due to an intrathecally positioned epidural catheter and an infusion rate of bupivacaine set 10 times higher than planned. The undetected misplacement, despite safety routines, is discussed along with the toxicological findings and new information on the intrathecal distribution of bupivacaine. From a clinical point of view, the human factor, in combination with an indistinct decimal point on the pump, was considered as the reason for the unfortunate overdose. In continuous epidural infusion of local anesthetics, the importance of guidelines and informed staff in managing complications of epidural lumbar infusion as well as careful monitoring of the vital functions is essential. Guidelines are also vital during the procedure of insertion of epidural catheters. When using combined spinal and epidural anaesthesia, we believe that an epidural catheter should be inserted, and its position tested, prior to spinal anesthesia. The case also illustrates the need of innovative investigation techniques to confirm the suspicion of unusual manifestations of inadvertent drug effects. Segmental analysis, together with analyses in a control case, enabled us to elucidate the high and varying tissue concentrations in the central nervous system.
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Niepel, Dorothea, Thomas Klag, Nisar P. Malek und Jan Wehkamp. „Practical guidance for the management of iron deficiency in patients with inflammatory bowel disease“. Therapeutic Advances in Gastroenterology 11 (01.01.2018): 175628481876907. http://dx.doi.org/10.1177/1756284818769074.
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Iron deficiency or iron deficiency anemia (IDA) are some of the most common systemic complications of inflammatory bowel diseases (IBD). Symptoms such as fatigue, reduced ability to concentrate and reduced exercise tolerance can mimic common symptoms of IBD and can therefore easily be overseen. Furthermore, clinicians tend to see mild to moderate anemia as an inevitable accompaniment of IBD that is sufficiently explained by the underlying disease and does not require further workup. But in contrast to these clinical routines, current guidelines recommend that any degree of anemia in patients with IBD should be further evaluated and treated. Multiple studies have shown that anemia is a main factor for decreased quality of life (QoL) in patients with IBD. Correction of anemia, however, can significantly improve the QoL of patients with IBD. It is therefore recommended that every patient with IBD is regularly screened for iron deficiency and anemia. If detected, appropriate workup and treatment should be initiated. Over the last years, a number of new diagnostic tools and treatment options have been developed. Multiple studies have demonstrated the safety of newer formulations of intravenous iron in patients with IBD and have compared oral and intravenous iron in various situations. Treatment recommendations have changed and new evidence-based guidelines were developed. However, to date these guidelines are still not widely implemented in clinical practice. The aim of this review is to draw attention to the need for treatment for every level of anemia in patients with IBD and to provide some practical guidance for screening, diagnostics, treatment and follow up of IDA in patients with IBD following current international guidelines.
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Lin, Xiao, Yoshinari Nishiki und Lóránt A. Tavasszy. „Performance and Intrusiveness of Crowdshipping Systems: An Experiment with Commuting Cyclists in The Netherlands“. Sustainability 12, Nr. 17 (03.09.2020): 7208. http://dx.doi.org/10.3390/su12177208.
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Crowdshipping systems are receiving increasing attention in both industry and academia. Different aspects of crowdshipping (summarized as platform, supply, and demand) are investigated in research. To date, the mutual influence of crowdshipping platform design and its supply side (with participating crowdshippers) has not yet been thoroughly investigated. This paper addresses this mutual influence by investigating the relations between shipping performance and intrusiveness to daily trips of commuters who voluntarily act as cycle couriers. In an experiment in The Hague, cyclists were asked to transport small parcels during a simulated daily commuting routine. The grid of commuting trips acted as a relay network to move parcels to their individual destinations. All the movements of the parcels were recorded by GPS trackers. The analysis indicates that a higher degree of complexity of rules in crowdshipping systems can lead to better system performance. Meanwhile, it also imposes higher intrusiveness, as participants need to deviate more from their routines of daily, uninterrupted trips. The case also suggests that a well-designed crowdshipping system can increase system performance without having to ask too much from crowdshippers. This study provides reference to better design such systems, and opens up directions for further research that can be used to provide thorough guidelines for the implementation of crowdshipping platforms.
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Lian, Tom, Eva Dybvik, Jan-Erik Gjertsen, Håvard Dale, Marianne Westberg, Lars Nordsletten und Wender Figved. „Compliance with national guidelines for antibiotic prophylaxis in hip fracture patients: a quality assessment study of 13 329 patients in the Norwegian Hip Fracture Register“. BMJ Open 10, Nr. 5 (Mai 2020): e035598. http://dx.doi.org/10.1136/bmjopen-2019-035598.
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ObjectiveWe assessed compliance with new guidelines for prophylactic antibiotics in hip fracture surgery in Norway introduced in 2013.DesignThe data from the Norwegian Hip Fracture Register was used to assess the proportion of antibiotics given according to the national guidelines.SettingAll hospitals in Norway performing hip fracture surgery in the period from 2011 to 2016.ParticipantsWe studied 13 329 hemiarthroplasties (HAs) for acute hip fracture.Main outcome measureType and timing between first and last dose of prophylactic antibiotics compared with the national guidelines.ResultsBefore the guidelines were introduced, the recommended drugs cephalotin or clindamycin was used in only 86.2% of all HAs. In 2016, one of the two recommended drugs was administered in 99.2% of HAs. However, hospitals’ adaption of the recommended administration of the two drugs improved slowly, and by the end of the study period, only three out of five HAs were performed with the correct drug administered in the correct manner. We found major differences in compliance between hospitals.ConclusionsThe change towards correct administration of antibiotic prophylaxis was varied both when investigating university and non-university hospitals. We suggest that both hospital leaders and the national Directorate of Health need to investigate routines for better dissemination of information and education to involved parties. Strong leadership concerning evidence-based guidelines on antibiotic prophylaxis in surgery may take away some autonomy from executing healthcare professionals, but will result in better patient care and antibiotic stewardship.
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Oliveira, Wanderlei Abadio de, Jorge Luiz da Silva, Neire Aparecida Machado Scarpini, Susana Segura Munõz, Marta Angélica Iossi Silva und Marlene Fagundes Carvalho Gonçalves. „Professor training in health postgraduate studies: analysis of an experience“. Revista Brasileira de Enfermagem 71, Nr. 6 (Dezember 2018): 3115–20. http://dx.doi.org/10.1590/0034-7167-2017-0319.
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ABSTRACT Objective: To analyze a professor training experience for higher education. Method: This is a descriptive case report on the professor training process in the postgraduate course of the College of Nursing of Ribeirão Preto, University of São Paulo. An evaluative activity was performed to capture the perceptions and experiences of 21 graduate students who were interns of an educational improvement program. The data were analyzed following the thematic content analysis guidelines. Results: Three thematic categories were identified: 1) knowledge necessary for teaching practice; 2) teaching routines and practices; 3) the essentiality of mentoring. Final considerations: This article provides a critical approach on the formative process of human resources for higher education in health, identifying potentials and challenges. Its innovative character resides in understanding pedagogical work articulated with graduate research training.
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Wieczorek, Douglas, Brandon Clark und George Theoharis. „Principals' Perspectives of a Race to the Top-Style Teacher Evaluation System“. Journal of School Leadership 28, Nr. 5 (September 2018): 566–95. http://dx.doi.org/10.1177/105268461802800501.
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Set in a collective bargaining state in the Northeastern U.S., this exploratory case study investigated how a sample of 12 public school principals interpreted new teacher evaluation processes required by Race to the Top (RTTT). Principals reported that the RTTT evaluation system disrupted established routines and contractual guidelines for evaluating all their teachers and held principals more accountable for supervision and evaluation processes. The embedded evaluation protocols and rubrics established clearer expectations for teachers‘ performance, and aligned state-, district-, and school-level instructional goals. However, principals believed the RTTT policy emphasis on teachers’ ratings raised concerns about their teachers' employment status, professional growth, and instructional improvement. Our findings suggest that principals may have difficulty balancing instructional supervision and evaluation processes in these types of high-stakes policy systems.
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Venturini, Gabriela, und Betina Schuler. „pensamento, experiência e o tempo do ócio na educação infantil“. childhood & philosophy 16, Nr. 36 (21.12.2020): 01–27. http://dx.doi.org/10.12957/childphilo.2020.53797.
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This paper aims to examine the way that the concepts of thought and interest have been described in the three main documents that currently guide Brazilian Child Education – National Education Guidelines and Bases/1996, National Curriculum Guidelines for Child Education/2010, and National Curriculum Basis/2018 for Child Education – and their implications for relations between childhood and thinking. In order to do that, we have relied on studies in the philosophy of difference, considering authors such as Kohan, Larrosa, López and Ribeiro, among others, to problematize thought as linked to individual interest. We notice how much thought has been regarded as a problem-resolution tool in these documents, following a neoliberal logic that has been increasingly displaced from collective to individualized interest. Furthermore, the whole functioning of a disciplinary society is evident in the documents, as the latter moves towards a performance society, with greater emphasis on assessment practices and records of children’s “production.” We consider, both in the concept of childhood and the concept of experience, the possibility of experiencing other relationships with childhoods and temporalities in schools, and the power of both free time and play as open breathing spaces among routines that are both full of compulsory activities and empty of meaning.
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Shorey, Shefaly, Lydia Siew Tiang Lau, Jia Xuan Tan, Esperanza Debby Ng und Ramkumar Aishworiya. „Families With Children With Neurodevelopmental Disorders During COVID-19: A Scoping Review“. Journal of Pediatric Psychology 46, Nr. 5 (24.03.2021): 514–25. http://dx.doi.org/10.1093/jpepsy/jsab029.
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Abstract Objective Prolonged home isolation may lead to long-term negative consequences for both children and caregivers’ psychological wellbeing, especially in families with children with neurodevelopmental disorders. Therefore, a scoping review was conducted to identify challenges faced by caregivers of children with neurodevelopmental disorders during the coronavirus disease 2019 (COVID-19) pandemic and to consolidate parenting interventions and guidelines. Methods A systematic search was conducted on Embase, PsycInfo, PubMed, Scopus, and LitCovid. All article types published between December 2019 and November 2020 which reported on intervention guidelines and experiences of families with children with neurodevelopmental disorders during the COVID-19 pandemic were included. Qualitative themes, quantitative data, and article summaries were charted, and a thematic analysis was conducted. Results Twenty-nine articles were included in the review. Three themes were generated: (a) behavioral issues and health concerns, (b) disruptions of lifelines and daily routines, and (c) existing programs, models, and guidelines to support families. Additionally, a list of caregiver strategies such as scheduling regular online consultations, maintaining online therapy, educating a child on COVID-19, and preventive behaviors, creating a structured daily schedule and reinforcement system, and selecting child-appropriate activities was consolidated. Conclusion This review revealed a lack of evidence-based studies and articles on children with other neurodevelopmental disorders apart from autism and attention-deficit hyperactivity disorder. It also places emphasis on the importance of telehealth services as major lifelines to parents during this pandemic and urges healthcare organizations to provide funding to increase telehealth services to afflicted families.
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Chao, Chien-Chung, Zhiwen Zhang, Tatyana Belinskaya, Le Jiang, Brian J. Morrison, Jose Garcia Rivera, Hua-Wei Chen und Wei-Mei Ching. „Investigation of the Sterility of Diluent in Prefilled Syringes Used for Vaccine Reconstitution at Department of Defense Recruit Training Sites“. Military Medicine 185, Nr. 9-10 (13.08.2020): e1440-e1446. http://dx.doi.org/10.1093/milmed/usaa181.
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Abstract Introduction Measles, mumps, and rubella (MMR) and varicella (VAR) vaccines are the two vaccines administered in large recruit training sites (RTS) that require a single-use syringe to be prefilled with the diluent (ie water) before vaccine reconstitution. Since there are no preservatives in either MMR or VAR vaccines, it is critical to maintain the diluent sterile to ensure the sterility of the reconstituted vaccine. The Department of Defense/Defense Health Agency has instructions on reconstitution of lyophilized vaccines and guidelines for their storage. Vaccine manufacturers provide instructions on how to properly store the diluent. However, there is no clear guidance or standard operating procedures regarding the best practice for preparation and storage of the syringes prefilled with diluent. Various RTS across all four services have their respective routines to best fit their vaccination requirements. Currently, there are no available data on the sterility status of the diluent prepared using these various routines before they are used to reconstitute vaccines. Materials and Methods We investigated the sterility of the diluent (ie water) in prefilled syringes prepared using routines practiced at various RTS. Diluent was drawn up into single syringes and was kept under various conditions (4 °C or room temperature for overnight up to 24 hours) used by various RTS. At indicated time, diluent was injected into sterile vials and the sterility of the diluent was determined by monitoring the presence/growth of bacteria (including aerobic bacteria, mycoplasma, and an obligate intracellular bacterium, Coxiella burnetii), fungi, and viruses for up to 21 days after inoculation into proper and specific culture media. Both traditional cell culture and molecular assays were used to demonstrate the presence or absence of contamination that may compromise the sterility of the diluent. Results Our results demonstrate that the diluent, after being drawn up to fill the syringe, maintains sterility after storage for overnight up to 24 hours at room temperature or 4 °C with or without recapping the syringes, suggesting that current vaccine reconstitution routines practiced at large military RTS are safe. Conclusions Our results demonstrate that in spite of variations in current practices used in various RTS, the diluent in the prefilled syringe tested from each site maintains its sterility and was determined to be safe for use in military health system-wide vaccine reconstitution.
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Lima, José Jayme Galvão de. „Practical ways to deal with the high burden of cardiovascular disease in hemodialysis patients“. Sao Paulo Medical Journal 124, Nr. 1 (Februar 2006): 36–41. http://dx.doi.org/10.1590/s1516-31802006000100008.
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Cardiovascular disease is the main cause of death among hemodialysis patients. Although uremia by itself may be considered to be a cardiovascular risk factor, a significant proportion of dialysis patients die because of cardiovascular disease not directly attributable to uremia. Indeed, many of the cardiovascular diseases and cardiovascular risk factors in these patients are common to those occurring in the general population and are amenable to intervention. Lack of proper medical care during the early stages of renal insufficiency and present-day dialysis routines, by failing to correct hypertension, hypervolemia and left ventricular hypertrophy in many patients, may also add to the cardiovascular burden. The author suggests that, in addition to early treatment and referral to a specialist, chronic renal failure patients should undergo intensive cardiovascular screening and treatment, and correction of cardiovascular risk factors based on guidelines established for the general population.
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Moreira, Sonia Virgínia, und Cláudia Lago. „Journalism Education in Brazil: Developments and Neglected Issues“. Journalism & Mass Communication Educator 72, Nr. 3 (22.07.2017): 263–73. http://dx.doi.org/10.1177/1077695817719609.
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Journalism education started in Brazil in 1947. Today, it comes under the field of Social Communication, along with Advertising, Public Relations, Film, and Radio & TV. For almost 40 years, from 1970 to 2009, a journalism diploma was mandatory to work in a newsroom. As part of the field of Applied Social Sciences, journalism remains popular among the young generation: The demand for undergraduate bachelor’s programs has attracted fairly high levels of enrollment in the last three decades. For the purposes of this article, we analyze the application of the 2013 Guidelines for Journalism Education to verify whether bachelor’s programs in journalism include or neglect an important axis in the process of instruction: knowledge of the world and the intellectual challenges of journalistic routines, as suggested in the United Nations Educational, Scientific and Cultural Organization’s (UNESCO) Model Curricula for Journalism Education.
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Juul, Anne, Raelene Wilding und Loretta Baldassar. „The Best Day of the Week: New Technology Enhancing Quality of Life in a Care Home“. International Journal of Environmental Research and Public Health 16, Nr. 6 (19.03.2019): 1000. http://dx.doi.org/10.3390/ijerph16061000.
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Older people living in residential aged care facilities tend to be physically as well as socially inactive, which leads to poorer health and reduced wellbeing. A lack of recognition of the importance of social support, limited resources, lack of training and task-oriented work routines leave little time for staff to meet the social needs of residents. Through qualitative ethnographic fieldwork, this study investigates the potential for new technologies to enhance quality of life and facilitate meaningful engagement in physical and social activities among culturally and linguistically diverse residents and staff in care facilities. A continuum from nonparticipation to full participation among residents was observed when Touch Screen Technology activities were implemented. Data indicate that resident’s engagement is impacted by five interdependent factors, including environmental, organisational, caregiver, patient, and management- &government-related. Findings show that new technologies can be used to increase meaningful physical and social engagement, including transcending language and cultural barriers. However, the successful application of new technologies to enhance quality of life is dependent on their integration into the daily routine and social relationships of staff and residents, with the full support of management. Guidelines governing the use of new technologies to support meaningful engagement of older people in residential care are lacking: this project highlights the importance of attention to the social relational dimensions of technology interventions to support best practice in their use.
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Jepkemoi, Gladys, C. Gichunge und P. Masibo. „Determinants of adherence to dietary guidelines among Type 2 Diabetes Mellitus patients at Moi Teaching and Referral Hospital-Kenya“. African Journal of Food, Agriculture, Nutrition and Development 21, Nr. 03 (05.05.2021): 17752–63. http://dx.doi.org/10.18697/ajfand.98.19370.
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Diabetes is one of the major non-communicable diseases and an important public health problem not only in Kenya but all over the world. It is estimated that the prevalence of diabetes in Kenya is at 5% among adults. Although the care regimen is complex, patients with good diabetes self-care behaviors can attain excellent glycemic control. It is vital that patients adhere to their stipulated routines to minimize the burden of the disease on the healthcare systems. The objective of this study was to determine the association between socio-economic and demographic factors with adherence to dietary guidelines among Type 2 diabetes mellitus (DM) patients in Moi Teaching and Referral Hospital (MTRH), Eldoret. A cross-sectional study with mixed methods was conducted among 313 Type 2 DM patients at MTRH. Systematic random sampling was used to select the participants,while purposive sampling was used to select 6 key informants and 50 patients who participated in a Focus Group Discussion (FGD). Data were analyzed using descriptive and inferential statistics. Adherence to dietary guidelines was significantly associated with income (p< 0.001) and the frequency of attending clinics (p=0.001).Education levels (p= 0.634), Occupation(p=0.358) and Age (p=0.737) had no significant association with dietary adherence. Better ways should be explored in enhancing adherence to dietary guidelines for Type 2 DM patients with high income levels. The study findings are useful in informing implementation and evaluation of nutrition strategies for the control and management of Type 2 DM. This includes nutrition counseling and education,which would inform decisions leading to optimal quality care and cost-effectiveness in the management of Type 2DM.
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Clayton, D. G., L. Barker und W. B. Runciman. „Evaluation of Safety Procedures in Anaesthesia and Intensive Care“. Anaesthesia and Intensive Care 21, Nr. 5 (Oktober 1993): 670–72. http://dx.doi.org/10.1177/0310057x9302100532.
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A study was conducted to determine the ability of junior anaesthetists to check the anaesthetic machine, demonstrate a knowledge of a multifunction monitor and a defibrillator, and know the hospital fire drill. The subjects were 38 junior anaesthetists working in a large multi-disciplinary teaching hospital. 45% were able to check the anaesthetic machine according to the guidelines of the Australian and New Zealand College of Anaesthetists, and 16% had a complete working knowledge of the monitor. All subjects could use the defibrillator but only 24% could adequately solve the problem of malfunction. Only one subject had a working knowledge of the fire drill; excluding knowledge of the fire drill only 3 subjects (8%) satisfactorily completed all aspects of the assessment. As a result of this study structured checking routines are being introduced into anaesthetic teaching and practice and a similar multi-center study of specialist anaesthetists is being planned.
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Pain, Matthew A., Chris Harwood und Rich Anderson. „Pre-Competition Imagery and Music: The Impact on Flow and Performance in Competitive Soccer“. Sport Psychologist 25, Nr. 2 (Juni 2011): 212–32. http://dx.doi.org/10.1123/tsp.25.2.212.
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This article describes an intervention on the precompetition routines of soccer players during a 19-week phase of a competitive season. Specifically, we worked with players to develop an enhanced understanding of the effectiveness of personalized preperformance music and imagery scripts in facilitating flow states and performance. Five male players (M age = 20.5; S.D = 1.6) participated in a single-subject multiple baseline across individuals design with multiple treatments and without reversal. Following a preintervention phase, participants undertook the intervention during their prematch warm-up. Flow and perceived performance were assessed immediately after each match. Results indicated that asynchronous music and MG-M imagery when combined had a facilitative effect on flow and perceived performance. Postexperimental player comments supported these findings and suggest that the intervention strategy has great potential for athletes during precompetition. Consultancy guidelines for the use of music and imagery within competitive soccer are presented in the discussion.
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Carvalho, Liliana I., und Rute C. Sofia. „A Review on Scaling Mobile Sensing Platforms for Human Activity Recognition: Challenges and Recommendations for Future Research“. IoT 1, Nr. 2 (29.11.2020): 451–73. http://dx.doi.org/10.3390/iot1020025.
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Mobile sensing has been gaining ground due to the increasing capabilities of mobile and personal devices that are carried around by citizens, giving access to a large variety of data and services based on the way humans interact. Mobile sensing brings several advantages in terms of the richness of available data, particularly for human activity recognition. Nevertheless, the infrastructure required to support large-scale mobile sensing requires an interoperable design, which is still hard to achieve today. This review paper contributes to raising awareness of challenges faced today by mobile sensing platforms that perform learning and behavior inference with respect to human routines: how current solutions perform activity recognition, which classification models they consider, and which types of behavior inferences can be seamlessly provided. The paper provides a set of guidelines that contribute to a better functional design of mobile sensing infrastructures, keeping scalability as well as interoperability in mind.
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Dos Santos, Tiago Jeronimo, Caroline Gouvêa Buff Passone, Marina Ybarra, Simone Sakura Ito, Milena Gurgel Teles, Thais Della Manna und Durval Damiani. „Pitfalls in the diagnosis of insulin autoimmune syndrome (Hirata’s disease) in a hypoglycemic child: a case report and review of the literature“. Journal of Pediatric Endocrinology and Metabolism 32, Nr. 4 (24.04.2019): 421–28. http://dx.doi.org/10.1515/jpem-2018-0441.
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Abstract Background Insulin autoimmune syndrome (IAS) is a rare cause of hyperinsulinemic hypoglycemia (HH) not addressed as a potential differential diagnosis in current pediatric guidelines. We present a case of IAS in a child with no previous history of autoimmune disease, no previous intake of triggering medications and absence of genetic predisposition. Case presentation A 6-year-old boy presented with recurrent HH (blood glucose of 26 mg/dL [1.4 mmol/L] and insulin of 686 μU/mL). Abdominal imaging was normal. After multiple therapeutic failures, we hypothesized misuse of exogenous insulin and factitious hypoglycemia. Council of Guardianship had the child separated from his mother, but insulin levels remained high. A chromatography test was then performed which showed high titers of endogenous insulin autoantibody (IAA) with early dissociation from the insulin molecule. The human leukocyte antigen (HLA) test showed a DRB1 *13:01/*08:02 genotype. The patient was advised to control food intake and physical activity routines. During a 5-year follow-up, hypoglycemic episodes were sparse, despite high insulin levels. Conclusions Misdiagnosis of IAS with factitious hypoglycemia may happen if IAS is not considered as a differential diagnosis, leading to potential traumatic consequences. Further efforts should be made to increase awareness of IAS as a differential diagnosis of hypoglycemia and to include it in pediatric guidelines.
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Bojic-Milicevic, Gordana, Momir Mikov und Radomir Dautovic. „Common errors in diagnosis and management of urinary tract infections: Microbiological aspects“. Medical review 58, Nr. 7-8 (2005): 380–87. http://dx.doi.org/10.2298/mpns0508380b.
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Introduction Urinary tract infections (UTI) are among the most common infectious diseases affecting all age groups, from infants to the elderly. The majority of these infections occur in otherwise healthy individuals who present with symptoms of acute uncomplicated bacterial cystitis or pyelonephritis. Certain patient populations with complicated conditions are at increased risk for acquiring infection or failing therapy. Forty to 50% of adult women have a history of at least one urinary tract infection. Diagnosis and classification of UTI Although there are general guidelines concerning diagnosis and classification of urinary tract infections, there are wide variations in clinical practice. There are both errors which are frequently committed and mysteries that are still unsolved. Active management is important because under some circumstances urinary tract infections may cause permanent renal scarring. Imaging procedures are a cornerstone for critical evaluation of urinary tract infections, but avoidance of investigative routines will allow a marked saving in terms of costs and in terms of unnecessary radiation and psychological stress to the patient.
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Cerqueira, Ana Carolina Dantas Rocha, Maria Vera Lúcia Moreira Leitão Cardoso, Tamires Rebeca Forte Viana und Márcia Maria Coelho Oliveira Lopes. „Integrative literature review: sleep patterns in infants attending nurseries“. Revista Brasileira de Enfermagem 71, Nr. 2 (April 2018): 424–30. http://dx.doi.org/10.1590/0034-7167-2016-0480.
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ABSTRACT Objective: To identify evidence available in the literature about sleep patterns of infants attending nurseries. Method: An integrative review of studies published in Portuguese, English or Spanish available in full text on LILACS, CINAHL, and PubMed databases. The following descriptors sono, lactente and creches or berçários (in Portuguese) and sleep, infant and childcare or nurseries were used for LILACS, CINAHL and Pubmed, respectively. Nine studies were selected and analyzed. Results: The main component explored in the studies about sleep pattern is the sleep position of the infants, due to its association with sudden infant death syndrome. The results pointed to the need to promote and develop written guidelines regarding behavioral practices to reduce the risk of this phenomenon. Conclusion: Evidence has identified sleep issues, mainly regarding the sleep position of the infant and the environment where the infant sleeps, showing that it is critical to set routines and interventions to improve the quality of sleep care of infants attending nurseries.
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Nordholm, Daniel, und Mette Liljenberg. „Educational infrastructures and organisational memory: Observations from a Swedish perspective“. Improving Schools 21, Nr. 3 (21.03.2018): 255–68. http://dx.doi.org/10.1177/1365480218763669.
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This article focuses on the interplay between the concepts of ‘educational infrastructure’ and ‘organisational memory’. Using data from collaboration between a Swedish university and a local municipality, the article draws attention to the interplay between three nation-wide improvement programmes and their educational infrastructures, and the knowledge developed and stored in the local schools. The data analysis is supported by the theoretical concept of organisational memory built up by ‘soft’ and ‘hard’ forms of knowledge. The findings show that primarily soft types of knowledge were developed and stored in organisational memory in the local schools. The programmes, therefore, became highly dependent on leaders’ and teachers’ personal knowledge and commitment, in-job training, imitation and socialisation. Regarding hard types of knowledge, for example, clear guidelines, organisational routines, processes and roles for improvement work, the programmes and their infrastructures were, generally, less supportive. These findings illuminate the importance of an organisational learning perspective in successful school system improvement.
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Gamrot-Wrzoł, Marta, Paweł Sowa, Grażyna Lisowska, Wojciech Ścierski und Maciej Misiołek. „Risk Factors of Recurrence and Malignant Transformation of Sinonasal Inverted Papilloma“. BioMed Research International 2017 (2017): 1–7. http://dx.doi.org/10.1155/2017/9195163.
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Sinonasal inverted papilloma is a relatively rare disease; however, it is prevalent enough for every ENT practitioner to encounter it several times throughout medical routines. Despite the developments in experimental and clinical medicine as well as surgical techniques, our knowledge of this disease is still inadequate. With improved imaging and better diagnostic techniques, proper diagnosis and qualification for surgical approaches leave no doubt. Although the endoscopic approach seems to be the gold standard for such condition, some cases may additionally require an external approach. Regardless of the type of surgery, postoperative management is crucial for both healing and long-term follow-up. Unfortunately, the procedures are still lacking in explicit and standardized postoperative management guidelines. Moreover, an important issue is still the need for a biomarker indicative of inverted papilloma and its malignant transformation. Several particles, within the spotlight of the researchers, have been SCCA, Ki-67, Bcl-2, Wnt proteins, and many more. Nevertheless, the topic requires further investigations.