A survey of current practice in skeletal pin site management

The management of sites for external fixator pins and wires has been a matter of debate within orthopaedic and trauma nursing for decades. The literature outlining the conundrum goes as far back as the early 1980s. Sadly, none of this literature, to date, has resolved the question of how to most effectively prevent infection in these challenging wounds. This article reports on a UK survey that identifies current practice in pin and wire site wound management. It should help those planning to conduct research in this area to identify possible interventions, controls and variables that need to be taken into account when conducting randomised controlled studies.     

A health comparison of Alabama nurses versus US, UK, and Canadian normative populations

This article is one of a two part series examining the people and environment associated with patient handling. The approach used was that of an occupational injury investigation of a job class, which incorporates defining in the task, environment, tools, and worker health status. Hence, the objective of this portion of the research was to develop a method and use it to compare the physical and mental health of Alabama nurses with known normative populations to determine a baseline of overall health. For this purpose, the validated SF-36© survey was used to collect data on Alabama nurses who had been registered in the state for at least one year. The potential participant pool included 1000 nurses randomly selected from more than 49,000 registered. Physical mailers with a pre-paid return envelope and a follow-up reminder post-card were used. A return rate of 10% was expected based on nursing literature. One hundred and one surveys were returned with 87 being complete. Results confirmed that nursing in the US is a female dominated profession with the survey matching both the Alabama and US national average of 92%. Comparisons of the sample data to general populations yielded significant differences in 3 of the 8 outcome measures: social functioning; physical functioning; bodily pain. In each of these measures, Alabama nurses had a reduced health status compared to at least one comparative population. Additionally, data related to body mass index (BMI) for Alabama nurses were stratified by gender and age. Results indicated 28% had a “healthy” BMI with 37% and 35% of the nurses being “overweight” or “obese”, respectively. Consequently, results suggest Alabama nurses have a reduced health status compared to normative populations and show similar but not identical BMI trends to the general populations for the state of Alabama and the US, which warrants concerns about potential declines in health status among caregivers.

Significance to healthcare

Nurses constitute the largest proportion of the healthcare industry’s workforce. Understanding the perceptions of health status of this employee group is essential to gain further information about possible influences of health on nurses’ ability to continue to perform their jobs.     

医学生沉溺于网络的现状调查研究

目的探讨医学生网络成瘾的分布情况,找出其成瘾特点。方法采用个案分析法、问卷法,运用自编问卷、Y oung的网络成瘾调查问卷进行调查。结果大学生网龄3年以上的占57.3%,网络成瘾在城乡、网龄和学习成绩上没有显著性差异,而在上网目的这个影响因素下,网络成瘾呈现显著性差异(F=2.423,P<0.05)。结论大学生对网络成瘾的概念并不了解,以"看电影"和"聊天"为主要目的的上网,更容易产生网络成瘾。     

Developing a Framework for Pandemic COVID-19 Vaccine Allocation: a Modified Delphi Consensus Study in Korea

BackgroundThis study presents a framework for determining the allocation and distribution of the limited amount of vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).MethodsAfter analyzing the pandemic strategies of the major organizations and countries and with a literature review conducted by a core panel, a modified Delphi survey was administered to 13 experts in the fields of vaccination, infectious disease, and public health in the Republic of Korea. The following topics were discussed: 1) identifying the objectives of the vaccination strategy, 2) identifying allocation criteria, and 3) establishing a step-by-step vaccination framework and prioritization strategy based on the allocation criteria. Two rounds of surveys were conducted for each topic, with a structured questionnaire provided via e-mail in the first round. After analyzing the responses, a meeting with the experts was held to obtain consensus on how to prioritize the population groups.ResultsThe first objective of the vaccination strategy was maintenance of the integrity of the healthcare system and critical infrastructure, followed by reduction of morbidity and mortality and reduction of community transmission. In the initial phase, older adult residents in care homes, high-risk health and social care workers, and personal support workers who work in direct contact with coronavirus disease 2019 (COVID-19) patients would be prioritized. Expansion of vaccine supply would allow immunization of older adults not included in phase 1, followed by healthcare workers not previously included and individuals with comorbidities. Further widespread vaccine supply would ensure availability to the extended adult age groups (50–64 years old), critical workers outside the health sector, residents who cannot socially distance, and, eventually, the remaining populations.ConclusionThis survey provides the much needed insight into the decision-making process for vaccine allocation at the national level. However, flexibility in adapting to strategies will be essential, as new information is constantly emerging.     

阻塞性睡眠呼吸暂停低通气综合征患者疾病认知的调查及对策

目的了解阻塞性睡眠呼吸暂停低通气综合征患者对疾病的认知情况,针对问题提出对策。方法自行设计调查问卷,对924例阻塞性睡眠呼吸暂停低通气综合征患者进行就诊原因、疾病严重度、疾病认知情况调查;以50岁为界分为A组和B组,对不同年龄组进行比较分析。结果患者主要就诊原因是影响家人休息及有临床症状,不同年龄疾病严重度分布无统计学意义,不同年龄患者疾病相关知识认知比较有统计学意义。结论阻塞性睡眠呼吸暂停低通气综合征患者总体疾病认知较低,对不同年龄患者进行针对性健康宣教,可提高其防范意识及健康水平。     

Both allergic and nonallergic asthma are associated with increased FENO levels, but only in never-smokers

Background:  Allergic asthma is consistently associated with increased FE_NO levels whereas divergence exists regarding the use of exhaled nitric oxide (NO) as marker of inflammation in nonallergic asthma and in asthmatic smokers. The aim of this study is to analyze the effect of having allergic or nonallergic asthma on exhaled nitric oxide levels, with special regard to smoking history.
Methods:  Exhaled NO measurements were performed in 695 subjects from Turin (Italy), Gothenburg and Uppsala (both Sweden). Current asthma was defined as self-reported physician-diagnosed asthma with at least one asthma symptom or attack recorded during the last year. Allergic status was defined by using measurements of specific immunoglobulin E (IgE). Smoking history was questionnaire-assessed.
Results:  Allergic asthma was associated with 91 (60, 128) % [mean (95% CI)] increase of FE_NO while no significant association was found for nonallergic asthma [6 (–17, 35) %] in univariate analysis, when compared to nonatopic healthy subjects. In a multivariate analysis for never-smokers, subjects with allergic asthma had 77 (27, 145) % higher FE_NO levels than atopic healthy subjects while subjects with nonallergic asthma had 97 (46, 166) % higher FE_NO levels than nonatopic healthy subjects. No significant asthma-related FE_NO increases were noted for ex- and current smokers in multivariate analysis.
Conclusions:  Both allergic and nonallergic asthma are related to increased FE_NO levels, but only in never-smoking subjects. The limited value of FE_NO to detect subjects with asthma among ex- and current smokers suggests the predominance of a noneosinophilic inflammatory phenotype of asthma among ever-smokers.     

Awareness of lifestyle risk factors for cancer and heart disease among adults in the UK

Objective

To examine and compare awareness of lifestyle risk factors for cancer and heart disease in a single UK representative sample.

Methods

Two open-ended questions about cancer and heart disease risk factors were included in a population-based survey of 1747 adults. Responses were coded for four lifestyles with established links to both diseases: smoking, eating an unhealthy diet, drinking excessive alcohol and physical inactivity.

Results

Awareness of lifestyle risk factors was low for both diseases, although higher for heart disease than cancer. The average number identified by respondents was 2.1 (heart disease) and 1.4 (cancer). The strongest predictor was education (both p < 0.001). Awareness that physical inactivity is a cancer risk factor was particularly low at 7%.

Conclusion

These findings suggest that public awareness of the impact of lifestyle on commonly feared diseases, especially cancer, is low.

Practice implications

Unhealthy lifestyles make a significant contribution to ill health and mortality. Increased public awareness of the links between lifestyles and commonly feared diseases might help people understand the potential health consequences of their actions and encourage them to make much-needed lifestyle changes. Efforts are needed to improve public health messages about how lifestyle risk factors impact on the chances of developing these important diseases.     

商都县农村5岁以下儿童营养状况调查分析

目的：为了了解商都县农村贫困地区儿童营养状况,以便进一步开展有针对性的营养干预工作。方法按照中国疾控中心《建立贫困地区6岁以下儿童营养健康状况相关危险因素监测及数据信息系统工作手册》统一方法进行监测及评价分析。结果两组低出生体重率皆为6%,贫血患病率分别为23%和4%,营养不良发生率分别为33%和18%,远高于全国农村儿童平均水平。结论商都县贫困地区农村儿童营养状况问题严重,应采取综合措施加以防控。