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Neurosurgical Focus Jul 2024Few large studies have investigated the factors and outcomes related to concomitant injuries occurring alongside mild traumatic brain injury (mTBI) after motor vehicle...
OBJECTIVE
Few large studies have investigated the factors and outcomes related to concomitant injuries occurring alongside mild traumatic brain injury (mTBI) after motor vehicle collisions (MVCs). Thus, the objective of this study was to assess whether MVC characteristics predict which patients with mTBI will have concomitant whiplash injury, and whether concomitant whiplash injury affects care utilization for these patients.
METHODS
This retrospective cohort study included 22,213 patients with mTBI after MVC identified from the American College of Surgeons Trauma Quality Programs dataset. A hierarchical logistic regression model was constructed to investigate patient and MVC factors associated with concomitant whiplash injury. Propensity score matching on whiplash status, in conjunction with a multivariable logistic regression model, assessed if concomitant whiplash affected odds of hospitalization. In the subgroup of patients who were hospitalized, associations with hospital length of stay (LOS) and discharge disposition were investigated.
RESULTS
The median (IQR) age was 34 (24-51) years, with a median Glasgow Coma Scale score at presentation of 15 (15-15). Patients with concomitant whiplash were older (median 36 years vs 34 years, p = 0.03) and had higher rates of hospitalization (75% vs 64%, p < 0.001). In the hierarchical model for associations with concomitant whiplash injury, patients with blood alcohol content (BAC) greater than the federal driving limit had lower odds of concomitant whiplash (OR 0.63, 95% CI 0.49-0.81) along with those who had airbag deployment (OR 0.80, 95% CI 0.68-0.95), but seatbelt use was associated with greater odds (OR 1.41, 95% CI 1.16-1.71). After matching, concomitant whiplash was independently associated with increased odds of hospitalization (OR 1.67, 95% CI 1.40-1.99) while seatbelt use was associated with decreased odds (OR 0.88, 95% CI 0.81-0.95). Among hospitalized patients, concomitant whiplash was not associated with hospital LOS or discharge disposition.
CONCLUSIONS
MVC characteristics such as alcohol consumption and airbag deployment were protective toward development of concomitant whiplash for mTBI patients, while seatbelt use was associated with higher risk. Concomitant whiplash increases the odds of hospitalization for mTBI patients but does not affect hospital LOS or discharge disposition, while seatbelt use is associated with lower rates of hospitalization and a more favorable hospital course. These findings provide context to injury patterns and care provision after a common mechanism of injury.
Topics: Humans; Accidents, Traffic; Male; Female; Adult; Whiplash Injuries; Hospitalization; Middle Aged; Retrospective Studies; Young Adult; Brain Concussion; Cohort Studies; Length of Stay; Glasgow Coma Scale
PubMed: 38950447
DOI: 10.3171/2024.4.FOCUS24146 -
Pediatric Emergency Care Jul 2024Bicycle helmet use has repeatedly been shown to protect riders from serious injury. Despite this, a majority of children and adolescents do not regularly wear helmets....
OBJECTIVE
Bicycle helmet use has repeatedly been shown to protect riders from serious injury. Despite this, a majority of children and adolescents do not regularly wear helmets. Our primary objective was to determine if an emergency department (ED)-based helmet distribution program could increase the amount of time children report wearing helmets.
METHODS
This was a prospective cohort study of children aged 3 to 17 years presenting to the ED of an urban, tertiary care hospital. Participants were surveyed on their helmet use habits and perceptions regarding the efficacy and importance of helmets. Participants then received a bicycle helmet along with safety counseling in the ED and bicycle safety handouts provided by the American Academy of Pediatrics. Participants were contacted for follow-up 8 weeks after enrollment.
RESULTS
We enrolled a total of 94 patients. Post-intervention surveys were obtained from 47% of participants. Our helmet program resulted in a statistically significant increase in the amount of time children reported wearing bicycle helmets. Prior to ED intervention, 48% of participants reported wearing a helmet "most of the time" or "all of the time." After participating, 86% of participants indicated that they wore a helmet "most of the time" or "all of the time." Participants indicated a variety of reasons for not wearing helmets. Of all patients contacted for follow-up, 16% indicated that they were involved in an accident after participating where the helmet they were given prevented a head injury.
CONCLUSIONS
Helmet distribution programs based in the pediatric ED increase rates of bicycle helmet usage among pediatric patients. Additional study is needed to determine effect on head injury prevention.
PubMed: 38950378
DOI: 10.1097/PEC.0000000000003233 -
Oncology Nursing Forum Jun 2024To update the American Society of Clinical Oncology (ASCO)-Oncology Nursing Society (ONS) standards for antineoplastic therapy administration safety in adult and...
PURPOSE
To update the American Society of Clinical Oncology (ASCO)-Oncology Nursing Society (ONS) standards for antineoplastic therapy administration safety in adult and pediatric oncology and highlight current standards for antineoplastic therapy for adult and pediatric populations with various routes of administration and location.
METHODS
ASCO and ONS convened a multidisciplinary Expert Panel with representation of multiple organizations to conduct literature reviews and add to the standards as needed. The evidence base was combined with the opinion of the ASCO-ONS Expert Panel to develop antineoplastic safety standards and guidance. Public comments were solicited and considered in preparation of the final manuscript.
RESULTS
The standards presented here include clarification and expansion of existing standards to include home administration and other changes in processes of ordering, preparing, and administering antineoplastic therapy; the advent of immune effector cellular therapy; the importance of social determinants of health; fertility preservation; and pregnancy avoidance. In addition, the standards have added a fourth verification.
STANDARDS
Standards are provided for which health care organizations and those involved in all aspects of patient care can safely deliver antineoplastic therapy, increase the quality of care, and reduce medical errors.
Topics: Humans; Antineoplastic Agents; Adult; Child; Oncology Nursing; Neoplasms; Patient Safety; Female; United States; Male; Societies, Nursing
PubMed: 38950089
DOI: 10.1188/24.ONF.297-320 -
PloS One 2024To analyze the psychometric properties of the cross-culturally adapted version of the Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC)...
OBJECTIVE
To analyze the psychometric properties of the cross-culturally adapted version of the Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) Compact Form Brazil.
METHODS
A methodological study was conducted with 281 adult Primary Health Care users. Data collection took place online. Confirmatory Factor Analysis (CFA) was used to evaluate the psychometric properties of the PREOS-PC after the process of cross-cultural adaptation to the Brazilian context. Internal consistency was evaluated through Cronbach's alpha coefficient (α) and McDonald's omega coefficient (ω).
RESULTS
The sample consisted of 73.3% women. The mean age was 36.1 years (SD = 12.2). Of the 23 items of the PREOS-PC that were eligible for CFA, a model with four correlated domains and 16 items presented satisfactory fit indexes. The domains were Practice Activation (PrA) (four items), Patient Activation (PaA) (two items), Experiences of patient safety events (EPaS) (five items) and Outcomes of patient safety (OPaS) (six items). One domain (GPeS) presented one question with a 0 to 10 response scale and two open questions, which cannot be inserted in the CPA due to the nature of the items, but can be included in the application of the scale, being evaluated individually. In this factorial model, five items (EPaS2, EPaS3, EPaS4, EPaS5, EPaS6 and EPaS8) presented factor loadings ≤ 0.30. The α and ω values demonstrated good internal consistency for all domains of the PREOS-PC.
CONCLUSIONS
The Brazilian version of the PREOS-PC Compact Form Brazil composed of four domains (PrA, PA, EPaS and OPaS) and 16 items presented evidence of validation of its psychometric properties and can be used to evaluate the experiences and results of patient safety in Primary Health Care in the Brazilian context.
Topics: Humans; Female; Brazil; Primary Health Care; Adult; Male; Middle Aged; Psychometrics; Patient Safety; Patient Reported Outcome Measures; Surveys and Questionnaires; Factor Analysis, Statistical; Young Adult
PubMed: 38950012
DOI: 10.1371/journal.pone.0305414 -
Health Physics Jul 2024We had previously developed a measurement method using an imaging plate (IP) to evaluate and address surface contamination caused by the release of radioactive materials...
We had previously developed a measurement method using an imaging plate (IP) to evaluate and address surface contamination caused by the release of radioactive materials during the Fukushima nuclear accident. The measurement units for the surface contamination density were in relative values [described as relative luminescence levels measured in luminescence arbitrary units (LAU)], but the evaluation was required in absolute values, such as Bq cm-2, to enable appropriate control of exposure doses. This study establishes a method for converting the IP measurements of surface contamination density due to environmental radioactivity into absolute values. Soil contaminated with radioactive materials from the Fukushima nuclear accident was collected to create a working reference material (WRM). The conversion coefficient for surface contamination density was calculated using the WRM values measured with an IP and high-purity germanium detectors. The IP measurement values were converted into the surface contamination density using the conversion coefficient. The WRM values measured with the IP and high-purity germanium detectors were 324.1 LAU and 32.22 ± 2.27 Bq cm-2, respectively. The surface contamination density conversion factor was calculated as 0.0994. The surface contamination density on the roof of the Tsukuba City facility was re-evaluated using the conversion factor. The average value of 29,972 Bq m-2 matched the amount of radioactive material fallen in Tsukuba City. By standardizing the measurement conditions for surface contamination when using IPs, we successfully quantified the surface contamination density with an accuracy comparable to that of conventional methods. This method is expected to make a significant contribution to efficient radiation safety management.
PubMed: 38949861
DOI: 10.1097/HP.0000000000001818 -
Nephrology Nursing Journal : Journal of... 2024ANNA's Administration SPN created this proposal as a clinical practice project to re-evaluate how training and education are provided to individuals working in the...
ANNA's Administration SPN created this proposal as a clinical practice project to re-evaluate how training and education are provided to individuals working in the dialysis setting. This article describes an education initiative based on the escape room methodology to provide a fresh approach on dialysis curriculum.
Topics: Humans; Renal Dialysis; Patient Safety; Nephrology Nursing; Curriculum; United States
PubMed: 38949803
DOI: No ID Found -
Nephrology Nursing Journal : Journal of... 2024The importance of the Life Safety Code (LSC) cannot be understated. The LSC is composed of a set of components, measures, and protocols with the overarching goal of...
The importance of the Life Safety Code (LSC) cannot be understated. The LSC is composed of a set of components, measures, and protocols with the overarching goal of protecting and preserving human life. This article describes the LSC survey process in dialysis facilities. Ensuring the physical plant and its infrastructure is critical for patient safety. The survey tasks, provider, and building management responsibilities are reviewed. Implications for nephrology nursing regarding survey readiness and best practices for an LSC survey are discussed.
Topics: Renal Dialysis; Humans; Patient Safety; Nurse Administrators; Nephrology Nursing; Safety Management; United States
PubMed: 38949802
DOI: No ID Found -
Methods in Molecular Biology (Clifton,... 2024Mycobacterium tuberculosis is an infectious pathogen that requires biosafety level-3 laboratory for handling. The risk of transmission is high to laboratory staff, and...
Mycobacterium tuberculosis is an infectious pathogen that requires biosafety level-3 laboratory for handling. The risk of transmission is high to laboratory staff, and to manage the organism safely, it is necessary to construct high containment laboratory facilities at great expense. This limits the application of tuberculosis diagnostics to areas where there is insufficient capital to invest in laboratory infrastructure. In this method, we describe a process of inactivating sputum samples by either heat or guanidine thiocyanate (GTC) that renders them safe without affecting the quantification of viable bacteria. This method eliminates the need for level 3 containment laboratory for the tuberculosis molecular bacterial load assay (TB-MBLA) and is applicable in low- and middle-income countries.
Topics: Mycobacterium tuberculosis; Humans; Thiocyanates; Containment of Biohazards; Sputum; Bacterial Load; Tuberculosis; Guanidines; Hot Temperature; Microbial Viability
PubMed: 38949708
DOI: 10.1007/978-1-0716-3981-8_14 -
International Maritime Health 2024In confined waters, ships run a high risk of groundings, contact, sinkings and near misses. In such waters the maritime traffic is dense, the waterway is narrow, the...
BACKGROUND
In confined waters, ships run a high risk of groundings, contact, sinkings and near misses. In such waters the maritime traffic is dense, the waterway is narrow, the depth is limited, and tides and currents are constantly changing.
MATERIALS AND METHODS
From 2009-2019, 75 accidents were investigated in the estuary of the Seine. Weather conditions and perceived fatigue were studied. From May to June 2020, 114 seafarers, 34 pilots and 80 captains, responded to a questionnaire focusing on the use of Pilot Portable Units (PPU) and Electronic Chart Display Information Systems (ECDIS).
RESULTS
The 75 accidents corresponded to an average of 6.8 ± 3.2 accidents per year. Groundings were the most frequent accidents (35%, n = 26) followed by contact accidents with the quayside (25%, n = 19), between ships or tugs while manoeuvring (8%, n = 6) or while sailing (1%, n = 1). There was no loss of vessels nor fatalities of crew members. In poor weather conditions, there were 76% more accidents than in normal conditions (4.4 ± 2.5 accidents/10,000 movements versus 2.5 ± 1.9 accidents/10,000 movements, p < 0.03). Almost all the accidents (96%) were related to human errors of judgment (81%), or negligence (53%), or both (39). Perceived fatigue was probably in cause in 6 accidents. Only 3 accidents were related to mechanical causes. Through the questionnaires, 69% of the pilots complained of difficulties in mastering the devices and software. They felt distracted by alarms which affected their attention while navigating. They requested training on a simulator. Concerning ship captains, 83% felt comfortable with ECDIS devices yet only 20% were able to configure the ECDIS correctly.
CONCLUSIONS
In the Seine estuary, 75 accidents occurred within the 11 year-study. Risk factors were poor weather conditions and human error. PPU and ECDIS were considered as useful tools in the prevention of accidents. However, pilots and captains requested more thorough training in their use.
Topics: Humans; Ships; Accidents, Occupational; France; Adult; Surveys and Questionnaires; Weather; Male; Estuaries; Pilots; Naval Medicine; Fatigue; Female; Middle Aged
PubMed: 38949220
DOI: 10.5603/imh.99407 -
EFORT Open Reviews Jul 2024This systematic review aims to investigate the management and outcomes of pelvic ring fractures (PRFs) during pregnancy, emphasizing maternal and fetal mortality rates,...
PURPOSE
This systematic review aims to investigate the management and outcomes of pelvic ring fractures (PRFs) during pregnancy, emphasizing maternal and fetal mortality rates, mechanisms of injury, and treatment modalities.
METHODS
Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a comprehensive search of databases from 2000 to 2023, identifying 33 relevant studies. Data extraction included demographics, fracture types, treatment methods, and outcomes. Risk of bias was assessed using the JBI criteria.
RESULTS
Maternal mortality stood at 9.1%, with fetal mortality at 42.4%. Maternal factors impacting mortality included head trauma and hemodynamic instability. Fetal mortality correlated with mechanisms like motor vehicle accidents and maternal vital signs. Surgical and conservative treatments were applied, with a majority of pelvic surgeries performed before delivery. External fixators proved effective in fracture stabilization.
CONCLUSION
Pelvic ring fractures during pregnancy present significant risks to maternal and fetal health. Early stabilization and vigilant monitoring of maternal vital signs are crucial. Vaginal bleeding/discharge serves as a critical fetal risk indicator. The choice between surgical and conservative treatment minimally influenced outcomes. Multidisciplinary collaboration and tailored interventions are essential in managing these complex cases.
PubMed: 38949162
DOI: 10.1530/EOR-23-0164