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1.
《Journal of the Academy of Nutrition and Dietetics》2022,122(11):2060-2071
BackgroundVoices for Food was a longitudinal community, food pantry–based intervention informed by the social ecological model, and designed to improve food security, dietary intake, and quality among clients, which was carried out in 24 rural food pantries across 6 Midwestern states.ObjectiveOur objective was to evaluate changes in adult food security, dietary intake, and quality from baseline (2014) to follow-up (2016), and to assess the role of adult food security on dietary outcomes.DesignA multistate, longitudinal, quasi-experimental intervention with matched treatment and comparison design was used to evaluate treatment vs comparison group changes over time and changes in both groups over time.Participants/settingAdult food pantry clients (n = 617) completed a demographic food security survey, and up to three 24-hour dietary recalls at baseline (n = 590) and follow-up (n = 160).InterventionCommunity coaching served as the experimental component, which only “treatment” communities received, and a food council guide and food pantry toolkit were provided to both “treatment” and matched “comparison” communities.Main outcome measuresChange in adult food security status, mean usual intakes of nutrients and food groups, and Healthy Eating Index-2010 scores were the main outcome measures.Statistical analyses performedLinear mixed models estimated changes in outcomes by intervention group and by adult food security status over time.ResultsImprovements in adult food security score (–0.7 ± 0.3; P = .01), Healthy Eating Index-2010 total score (4.2 ± 1.1; P < .0001), and empty calories component score (3.4 ± 0.5; P <.0001) from baseline to follow-up were observed in treatment and comparison groups, but no statistically significant changes were found for adult food security status, dietary quality, and usual intakes of nutrients and food groups between the 2 groups over time. The intervention effect on dietary quality and usual intake changes over time by adult food security status were also not observed.ConclusionsFood pantry clients in treatment and comparison groups had higher food security and dietary quality at the follow-up evaluation of the Voices for Food intervention trial compared with baseline, despite the lack of difference among the groups as a result of the experimental coaching component. 相似文献
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《Journal of emergency nursing》2022,48(2):202-210.e1
IntroductionA sexual assault nurse examiner role exemplifies the high-stress and highly emotional patient interactions that are often associated with burnout. The purpose of this study was to examine the frequency of burnout among sexual assault nurse examiners in North Carolina.MethodsThis cross-sectional study was an anonymous survey of practicing sexual assault nurse examiners within North Carolina using the Maslach Burnout Inventory and additional demographics. Results were analyzed with odds ratios, confidence intervals, Fisher exact, chi-square, and Kruskal Wallis tests as appropriate.ResultsAmong 95 respondents, burnout was more frequent in sexual assault nurse examiners who stopped both emergency and nurse examiner work (55.6%, odds ratio 4.41, 95% confidence interval 1.07-18.06) and in dual function nurses (both emergency and nurse examiner work, 35.7%, odds ratio 2.71, 95% confidence interval 1.04-7.06). Sexual assault nurse examiners who had a high percentage of pediatric cases (above the median of 40%) were more likely to meet burnout thresholds for emotional exhaustion scores > 26 (48.78% vs 25.93%, χ2 = 5.30, P = .02) and more likely to meet burnout thresholds for depersonalization scores > 9 (48.78% vs 24.07%, χ2 = 6.28, P = .01).DiscussionHigher frequency of burnout threshold criteria was found in those people who worked concurrently as a sexual assault nurse examiner and an emergency nurse and in those who had retired from both specialties. We also found that sexual assault nurse examiners with a higher case mix of pediatric cases had higher emotional exhaustion scores and higher depersonalization scores. 相似文献
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Heather L. Brown 《Journal of emergency nursing》2021,47(2):321-325
The coronavirus 2019 pandemic has affected almost every aspect of health care delivery in the United States, and the emergency medicine system has been hit particularly hard while dealing with this public health crisis. In an unprecedented time in our history, medical systems and clinicians have been asked to be creative, flexible, and innovative, all while continuing to uphold the important standards in the US health care system. To continue providing quality services to patients during this extraordinary time, care providers, organizations, administrators, and insurers have needed to alter longstanding models and procedures to respond to the dynamics of a pandemic. The Emergency Medicine Treatment and Active Labor Act of 1986, or EMTALA, is 1 example of where these alterations have allowed health care facilities and clinicians to continue their work of caring for patients while protecting both the patients and the clinicians themselves from infectious exposures at the same time. 相似文献
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Itay Zmora Yonit Wiener-Well Evan Avraham Alpert 《The American journal of emergency medicine》2019,37(5):1006.e5-1006.e7
Background
Purulent bacterial pericarditis is a rare and potentially fatal disease. The course may be fulminant, and the presentation may pose a diagnostic challenge.Case report
An otherwise healthy 75-year-old male was brought to the emergency department in a state of general deterioration, confusion, and shock. Bedside ultrasound showed a significant pericardial effusion. His condition quickly deteriorated and the resuscitation included emergent bedside pericardiocentesis. The drainage was purulent and later cultures grew out Streptococcus pneumoniae.Why should an emergency physician be aware of this?
Purulent pericarditis is extremely rare but should be considered in the patient with a fulminant infectious process (particularly pneumonia) and signs of pericardial effusion. Treatment should include appropriate antibiotics and early drainage. 相似文献7.
8.
《Vaccine》2016,34(43):5175-5180
IntroductionThe continuous deployments of polio resources, infrastructures and systems for responding to other disease outbreaks in many African countries has led to a number of lessons considered as best practice that need to be documented for strengthening preparedness and response activities in future outbreaks.MethodsWe reviewed and documented the influence of polio best practices in outbreak preparedness and response in Angola, Nigeria and Ethiopia. Data from relevant programmes of the WHO African Region were also analyzed to demonstrate clearly the relative contributions of PEI resources and infrastructure to effective disease outbreak preparedness and response.ResultsPolio resources including, human, financial, and logistic, tool and strategies have tremendously contributed to responding to diseases outbreaks across the African region. In Angola, Nigeria and Ethiopia, many disease epidemics including Marburg Hemorrhagic fever, Dengue fever, Ebola Virus Diseases (EVD), Measles, Anthrax and Shigella have been controlled using existing polio Eradication Initiatives resources. Polio staffs are usually deployed in occasions to supports outbreak response activities (coordination, surveillance, contact tracing, case investigation, finance, data management, etc.). Polio logistics such vehicles, laboratories were also used in the response activities to other infectious diseases. Many polio tools including micro planning, dashboard, guidelines, SOPs on preparedness and response have also benefited to other epidemic-prone diseases. The Countries’ preparedness and response plan to WPV importation as well as the Polio Emergency Operation Center models were successfully used to develop, strengthen and respond to many other diseases outbreak with the implication of partners and the strong leadership and ownership of governments. This review has important implications for WHO/AFRO initiative to strengthening and improving disease outbreak preparedness and responses in the African Region in respect to the international health regulations core capacities. 相似文献
9.
目的 研究新型冠状病毒肺炎常态化疫情防控下应急梯队护士的真实体验。提出针对性改善护士的心理状况的方法和建议。方法 于2021年10月选取上海市静安区闸北中心医院应急梯队的护士11名为研究对象,对其进行半结构式面对面谈话,并采用Colaizzi七步分析法进行资料分析。结果 进入应急梯队的护士普遍存在着紧张焦虑,情绪低落,身心疲惫等心理问题。而执行完应急任务后的成就感,社会的认同,多方的理解支持,有利缓解心理压力。结论 通过对新型冠状病毒肺炎常态化疫情防控下应急梯队护士的真实体验的了解,护士普遍存在各种心理问题,需要给予针对性的干预措施,提高应急梯队成员的心理素质和应急能力。 相似文献
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