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1.
Tao Ran Tursynbek Nurmagambetov Kanta Sircar 《The American journal of emergency medicine》2018,36(3):414-419
Background
Unintentional non-fire-related (UNFR) carbon monoxide (CO) poisoning has been among the leading causes of poisoning in the United States. Current estimation of its economic burden is important for an optimal allocation of resources for UNFR CO poisoning prevention.Objective
This study was to estimate the morbidity costs of UNFR CO poisoning. We also compared the costs and benefits of installing CO detectors in residences.Methods
We used 2010–2014 charges and cost data from Healthcare Cost and Utilization Project (HCUP), and Truven© Health MarketScan Commercial Claims and Encounters and Medicare Supplemental data. We directly measured the morbidity cost as the summation of costs for different healthcare services. Benefit of installing CO detector was estimated by summing up the avoidable morbidity cost and mortality cost (value of life). Cost of CO detectors was calculated using the average market price of CO detectors. We also calculated the benefit-to-cost ratio by dividing the benefit by its cost. All expenditures were converted into 2013 U.S. dollars.Results
For UNFR CO poisoning, total annual medical cost ranged from $33.6 to $37.7 million. Annual non-health-sector costs varied from $3.7 to almost $4.4 million. The benefit-to-cost ratio can be as high as 7.2 to 1.Conclusion
UNFR CO poisoning causes substantial economic burden in the U.S. The benefit of using CO detectors in homes to prevent UNFR CO poisoning can considerably exceed the cost of installation. Public health programs could use these findings to promote broad installation of CO detectors in homes. 相似文献2.
Sutapa Mukhopadhyay Annie Hirsch Suze Etienne Natalia Melnikova Jennifer Wu Kanta Sircar Maureen Orr 《The American journal of emergency medicine》2018,36(10):1837-1844
Background
Carbon monoxide (CO) is an insidious gas responsible for approximately 21,000 emergency department visits, 2300 hospitalizations, and 500 deaths in the United States annually. We analyzed 10 combined years of data from two Agency for Toxic Substances and Disease Registry acute hazardous substance release surveillance programs to evaluate CO incident-related injuries.Methods
Seventeen states participated in these programs during 2005–2014.Results
In those 10 years, the states identified 1795 CO incidents. Our analysis focused on 897 CO incidents having injured persons. Of the 3414 CO injured people, 61.0% were classified as general public, 27.7% were employees, 7.6% were students, and 2.2% were first responders. More than 78% of CO injured people required hospital or pre-hospital treatment and 4.3% died. The location for most injured people (39.9%) were homes or apartments, followed by educational facilities (10.0%). Educational services had a high number of people injured per incident (16.3%). The three most common sources of CO were heating, ventilation, and air conditioning systems; generators; and motor vehicles. Equipment failure was the primary contributing factor for most CO incidents.Conclusions
States have used the data to evaluate trends in CO poisoning and develop targeted public health outreach. Surveillance data are useful for setting new policies or supporting existing policy such as making CO poisoning a reportable condition at the state level and requiring CO alarms in all schools and housing. Public health needs to remain vigilant to the sources and causes of CO to help reduce this injury and death. 相似文献3.
Yasuhiko Kaita Takehiko Tarui Takahiro Shoji Hiroshi Miyauchi Yoshihiro Yamaguchi 《The American journal of emergency medicine》2018,36(5):851-853
Background
Carbon monoxide and cyanide poisoning are important causes of death due to fire. Carbon monoxide is more regularly assessed than cyanide at the site of burn or smoke inhalation treatment due to its ease in assessment and simplicity to treat. Although several forensic studies have demonstrated the significance of cyanide poisoning in fire victims using blood cyanide levels, the association between the cause of cardiac arrest and the concentration of cyanide among fire victims has not been sufficiently investigated. This study aimed to investigate the frequency of cyanide-induced cardiac arrest in fire victims and to assess the necessity of early empiric treatment for cyanide poisoning.Methods
This study was a retrospective analysis of fire victims with cardiac arrest at the scene who were transported to a trauma and critical care center, Kyorin University Hospital, from January 2014 to June 2017. Patients whose concentration of cyanide was measured were included.Results
Five patients were included in the study; all died despite cardiopulmonary resuscitation. Three of these victims were later found to have lethal cyanide levels (>3?μg/ml). Two of the patients had non-lethal carboxyhemoglobin levels under 50% and might have been saved if hydroxocobalamin had been administered during resuscitation.Conclusion
According to our results, cyanide-induced cardiac arrest may be more frequently present among fire victims than previously believed, and early empiric treatment with hydroxocobalamin may improve outcomes for these victims in cases where cardiac arrest is of short duration. 相似文献4.
Associations Between Korean Adolescents' Energy Drink Consumption and Suicidal Ideation and Attempts
Purpose
This study examined associations between caffeinated energy drink consumption patterns and (1) participant characteristics and health-risk behaviors and (2) suicidal ideation and attempts in Korean adolescents.Methods
Participants included 8961 adolescents who consumed the drinks more than once weekly. Data were analyzed via logistic regression.Results
Rates of suicidal ideation and attempts in participants who consumed the drinks more than once daily were higher relative to those for participants who consumed the drinks 3–6 and 1–2 times weekly.Conclusions
Further research is required to establish causality in these relationships. 相似文献5.
Background
This study was conducted to assess and clarify the predictive risk factor of neurologic outcome in patients with acute carbon monoxide (CO) poisoning.Methods
A total of 453 patients with acute CO poisoning were admitted to the emergency department of Samsung Changwon Hospital from January 2010 to June 2017. Patients with acute CO poisoning who were followed for >6?months were studied. Initial Glasgow Coma Score (GCS), serum neuron-specific enolase (NSE), and lactate were measured after emergency department arrival. Patients were divided into two groups (good vs poor neurologic outcome).Results
A total of 432 patients (median age: 55?years, range: 17–91?years) were enrolled. There was a statistical difference between the good neurologic outcome group and the poor neurologic outcome group in terms of Exposure time, WBC, aspartate aminotransferase (AST), CK-MB, Troponin-I, creatinine kinase, NSE, lactate, CO-Hb, and GCS. NSE, lactate, and GCS were the early predictors of development of poor neurologic outcome. The areas under the curve in the ROC curve analysis for the GCS, NSE, and lactate were 0.842, 0.795, and 0.894, respectively.Conclusion
Initial serum lactate level may correlate with the patient neurologic outcomes and prove to be a useful prognostic factor. Also NSE, and GCS might be a useful additional parameters that could predict the neurologic outcome on acute CO poisoned patients. 相似文献6.
Objective
To evaluate the impact of a rivaroxaban discharge initiative on the efficacy and safety of acute venous thromboembolism treatment in emergency department patients.Practice innovation
Patients discharged on rivaroxaban from the emergency department were provided extensive counseling along with a commercially-available medication dose pack by the ED pharmacist. Patients were contacted by phone until they had obtained outpatient follow-up and remained adherent to anticoagulation beyond the initial first month of treatment.Methods
In this retrospective chart review over a thirteen month period, efficacy and safety outcomes were compared between patients with intervention versus those who received usual care. Efficacy was defined by reduced 90-day readmission rates due to nonadherence or treatment failure, and improved medication adherence beyond the first month from discharge. Safety was determined by comparing 90-day readmission rates due to bleeding or adverse event.Results
41 patients received intervention with rivaroxaban, and 34 patients received usual care, with 76% prescribed rivaroxaban and remaining patients started on enoxaparin alone (6%) or enoxaparin plus warfarin (18%). Improved treatment efficacy in the intervention group was not found to be statistically significant. Safety outcomes were similar between the two groups.Conclusion
Home treatment of acute VTE, facilitated by medication dose pack, is a promising tactic to ensure both immediate and long-term treatment efficacy and safety. Further studies are warranted to demonstrate clinical superiority of this intervention. 相似文献7.
Objective
The aim of this study was to investigate the perceptions of patients with chronic heart failure regarding palliative care needs.Method
The study used a qualitative design. Five patients with chronic heart failure (New York Heart Association functional classes III or IV) were interviewed in inpatient unit at the main referral government hospital in Indonesia. Data was analyzed using content analysis.Results
Patients reported dyspnea and fatigue as the most common signs and symptoms of chronic heart failure. Psychologically, patients experience fear and believe that the disease is the most serious illness. Declining body functions and quality of life are the reasons chronic heart failure patients need palliative care. Professional treatment, end-of-life care, information, support, and motivation are identified as the needs of patients in palliative care.Conclusions
The findings provide valuable information for health care professionals about the needs of patients with chronic heart failure in relation to palliative care. 相似文献8.
María Elena Pileño Javier Morillo Andrea Morillo Marta Losa-Iglesias 《Archives of Psychiatric Nursing》2018,32(2):206-214
Background
Health care institutions include workers who must operate in accordance with the requirements of the position, even though there are psychosocial influences that can affect the stability of the worker.Aims
To analyze the organizational culture of the team of professionals who work in the mental health network.Method
A qualitative methodology was used to assess a sample of 55 mental health professionals who have been practicing for at least 5 years.Results
“Team” was the overall topic. The subtopics within “Team” were: getting along in the unit, getting along with the patient, personal resources for dealing with patients, adaptive resources of team members and, resources that the team uses in their group activities.Conclusion
It was observed that the team does not work with a common objective and needs an accepted leader to manage the group. The definition and acceptance of roles can result in conflict. By increasing the skill level of each worker, the multidisciplinary team would be more collaborative. 相似文献9.
Physical and mechanical restraint in psychiatric units: Perceptions and experiences of nursing staff
Kelly Graziani Giacchero Vedana Danielle Maria da Silva Carla Aparecida Arena Ventura Bianca Cristina Ciccone Giacon Ana Carolina Guidorizzi Zanetti Adriana Inocenti Miasso Tatiana Longo Borges 《Archives of Psychiatric Nursing》2018,32(3):367-372
Background
Physical restraint in psychiatric units is a common practice but extremely controversial and poorly evaluated by methodologically appropriate investigations. The cultural issues and professionals' perceptions and attitudes are substantial contributors to the frequency of restraint that tend to be elevated.AimIn this qualitative study, we aimed to understand the experiences and perceptions of nursing staff regarding physical restraint in psychiatric units.Method
Through theoretical sampling, 29 nurses from two Brazilian psychiatric units participated in the study. Data were collected from 2014 to 2016 from individual interviews and analyzed through thematic analysis, employing theoretical presuppositions of symbolic interactionism.Results
Physical restraint was considered unpleasant, challenging, risky, and associated with dilemmas and conflicts. The nursing staff was often exposed to the risks and injuries related to restraint. Professionals sought strategies to reduce restraint-related damages, but still considered it necessary due to the lack of effective options to control aggressive behavior.Conclusions
This study provides additional perspectives about physical restraint and reveals the need for safer, humanized and appropriate methods for the care of aggressive patients that consider the real needs and rights of these patients. 相似文献10.
Rosanna F. DeMarco Jacqueline Fawcett Julianne Mazzawi 《Journal of Professional Nursing》2018,34(4):253-258
Purpose
The purpose of this paper is to present a Neuman Systems Model-guided discussion of current knowledge associated with covert incivility in the nursing academic workplace.Organizing structure
The Neuman Systems Model provides a multiple discipline, systems perspective of the stressor covert incivility and levels of prevention interventions to counter it.Findings
Covert incivility is defined as a stressor that affects individual, group, community, and social systems' intrapersonal, interpersonal, and extrapersonal levels of function. Two prominent examples of expressing covert incivility in academic settings are identified—pluralistic ignorance and passive aggression.Conclusions
The Neuman Systems Model can guide development and testing of primary, secondary, and tertiary prevention interventions targeted to covert incivility in the nursing academic workplace, as well as outcomes of the interventions.Clinical relevance
The Neuman Systems Model is a useful multiple discipline conceptual model for identification and testing of the effects of covert incivility in the nursing academic workplace. 相似文献11.
Angie Docherty Patti Warkentin Judy Borgen KellyAnn Garthe Katherine L. Fischer Rana Halabi Najjar 《Journal of Professional Nursing》2018,34(6):470-474
Aim
This paper presents four innovative teaching modalities conceptually designed and adherent to National Survey of Student Engagement (NSSE) indicators.Background
Nurse education has received ‘calls’ for transformation, demanding a pedagogical refocus that better equips the future workforce. A key aspect is the need to actively engage students in learning, an approach shown to improve outcomes.Method
Four innovative teaching modalities were incorporated into a baccalaureate curriculum, aligned to the NSSE indicators, and targeted an area of the curriculum where active student participation had the potential to improve the learning experience.Results
The four modalities: Theater of the Oppressed; Simulation as a Clinical Site for Active Engagement; Legal Simulation; and Creating Student Researchers were introduced at key stages in the curriculum and covered sophomore to senior levels.Conclusion
NSSE can be utilized to provide a robust framework on which to plan and deliver educational opportunities that support meaningful, student-centered participation. 相似文献12.
Ana Carolina G. Zanetti Tais Milena Pantaleão de Souza Larissa de Souza Tressoldi João Mazzoncini de Azevedo-Marques Gabriel Elias Corrêa-Oliveira Amanda Heloisa Santana da Silva Isabela dos Santos Martin Kelly Graziani Giacchero Vedana Lucilene Cardoso Sueli Aparecida Frari Galera Edilaine Cristina da Silva Gherardi-Donato 《Archives of Psychiatric Nursing》2018,32(3):390-395
BACKGROUND
Evidence suggests that expressed emotion (EE) and family burden (FB) are phenomena that interact, but there is a lack of studies that analyze this association in patients in first-episode psychosis.AIM
This study evaluated the relationship between EE and FB in relatives of patients in first-episode psychosis.METHOD
A convenience sample of 71 family members of patients being assisted in an outpatient care unit participated in the study. We used a form with sociodemographic and clinical variables of family members and patients, the Family Questionnaire-Brazilian Portuguese Version and the Brazilian version of the Burden Interview. The data were obtained via semi-structured interviews. Statistical analyses included Fisher's exact tests, Mann Whitney tests, Spearman correlations, and Student's t-tests.RESULTS
Our results showed high levels of EE and its component emotional over-involvement (EOI) among relatives, and a strong correlation between critical comments (CC) and EOI and FB measurements. In addition, family members with elevated EE levels showed higher means for FB and this difference was significant.CONCLUSIONS
Mental health nurses are expected to consider these concepts for proposing nursing interventions to first-episode psychosis patients and their relatives. 相似文献13.
Hong Jun Zeng Gui Ying Zhou Hui Hong Yan Xiu Hong Yang Hui Min Jin 《Archives of Psychiatric Nursing》2018,32(6):896-900
Objective
This study summarized the cases of Chinese nurses' suicide during 2007–2016.Methods
We reviewed public reports on local media, and medical websites.Result
A total of 46 cases of nurse suicide reported or published from 2007 to 2016. In these 46 cases, the proportion of female suicide is 98%. Most cases of suicide occurred in nurses aged 18–50?years. The most common way of suicide was jump from building. Nurse suicide occurred more often in full-service tertiary hospitals.Conclusion
The Chinese Government and medical organization should be aware of severity of suicide, and take action to be avoided of more suicide in Chinese nurses. 相似文献14.
Objective
Stress is one of the responses experienced by families with child victims of sexual violence. The purpose of this study was to explore in depth the stress experienced by families dealing with child victims of sexual violence.Method
This qualitative study employed the phenomenology approach. A purposive sample of six families participated in the study. Data were analyzed using Colaizzi's method.Results
This study discussed the experience of family with children who are victims of sexual violence. This study generated the following 5 themes: 1) sexual violence and the subsequent behavior changes in children as a source of family stress; 2) Family stress as a response to changes in the family process; 3) social support as sources of the family's strengths; 4) spiritual activities for coping with stress, and 5) parenting changes as a family learning and evaluation.Conclusions
Results suggested the development of the School Mental Health Unit to help families, and the community, identify and prevent sexual violence. In addition, the School Mental Health Unit would be a useful source for students who experience sexual violence to function well at school. 相似文献15.
16.
Mariane Altomare Andréa Monte-Alto-Costa 《Journal of manipulative and physiological therapeutics》2018,41(5):359-362
Objective
The aim of this study was to induce the remodeling of subcutaneous fibrosis in mice by the manual mobilization of skin and subcutaneous tissue.Methods
Seven days after the induction of subcutaneous fibrosis, mice were divided into 3 groups: control, stretch, and manual mobilization. Stretch was achieved by elongating the trunk, and manual mobilization was achieved by using the indicator fingertip of both hands, side by side, touching the back and performing a brief stretch. Stretch or manual mobilization was performed once a day for 7 days.Results
Fibrosis was present in the subcutaneous tissue of control animals, whereas brief stretch and manual mobilization were found to reduce fibrosis.Conclusions
Mechanical stimulation through manual mobilization, or brief stretching, reduced subcutaneous fibrosis after tissue injury. 相似文献17.
Lorna Jane Moxham Ritin Fernandez Bora Kim Samuel Lapkin Wilma ten Ham-Baloyi Abbas Al Mutair 《Journal of Professional Nursing》2018,34(6):502-506
Background
Caring for self by maintaining emotional well-being is important for pre-registration nursing students if they are to graduate as confident and competent health professionals.Purpose
The purpose of this cross-sectional study was to identify the predictors of emotional well-being of pre-registration nursing students by measuring their levels of anxiety, depression, behavioural control, positive affect and general distress.Method
A cross-sectional study designed facilitated an examination of the level of emotional well-being of pre-registration nursing students (enrolled in their first, second and third year) in an Australian university across five campuses using the Mental Health Index (MHI). Purposive, all-inclusive sampling was used to recruit 920 nursing students. Data was collecting during a two month period (August to October 2016). Regression analyses were used to identify predictors of emotional well-being.Results
Results indicate that employment status was one of the major predictors of students' emotional well-being.Conclusion
Given this finding, and the importance that paid employment appears to have as a protective factor nurse education programs need to support these students to effectively balance their academic performance and employment. Innovative ways to structure course curriculum and modes of delivery to support work and study demands should be a focus of future research. 相似文献18.
Objective
The research identified the influence of assertiveness training against teenage depression in high scholars in Kepahiang Regency, Bengkulu, Indonesia.Method
This study used a quasi-experiment approach with pre-test and post-test design and a control group. Eighty students were engaged through simple random sampling.Results
The study found the frequency of depression in teenagers and considered the effect of assertiveness training. 14.10 teens were counted as depressed before assertiveness training provision, while the post-training average was 7.98 (p = .000). Assertiveness training had a significant effect on the prevalence of depression in the intervention group.Conclusions
The study recommends schools to cooperate with health services to increase mental health programs such as building peer groups, delivering assertiveness training, and teaching stress management to prevent depression in teenagers. 相似文献19.
Allison Tadros Melinda Sharon Nicholas Chill Shane Dragan Jeremy Rowell Shelley Hoffman 《The American journal of emergency medicine》2018,36(8):1455-1458
Background
Work-related injuries are commonly seen in the emergency department (ED). This study sought to analyze characteristics of ED patient visits that were billed under workers' compensation.Methods
This was a retrospective chart review of visits during 2015 that were billed under workers' compensation at an academic ED. The following variables were collected: age, gender, mechanism of injury/exposure, diagnoses, imaging performed, specialty consultation, operative requirement, follow-up specialty, and ED disposition.Results
In 2015, 377 patients presented to the ED for work-related injuries. The most common mechanism of injury was fall. Frequent diagnoses included lower extremity injuries and hand/finger injuries. The most common consulting service was orthopedics. Only five patients were referred to occupational medicine for follow up.Conclusion
Knowledge of the types of occupational injuries and subsequent care required may help guide both workers and employers how to best triage patients within the healthcare system. Alternative settings such as occupational medicine or primary care services may be appropriate for some patients. 相似文献20.