Ultraviolet-C (UV-C) Effectiveness for Bacterial Decontamination in The Hospital Setting: A Systematic Review

Introduction: Bacteria are the most common agent reported to cause hospital-acquired infection (HAI) and nurses play a key role in achieving optimal decontamination. Ultraviolet-C (UV-C) is a promising candidate to reduce the bacteria infection burden. Therefore, this review aims to explore the UV-C application and its effectiveness in reducing bacteria contamination on various objects that can act as sources of HAI transmission. Methods: Searches were conducted on the PubMed, ScienceDirect, Scopus, and Cumulative Index to Nursing and Allied Health Literature databases. The inclusion criteria were randomized clinical trials, and non-randomized clinical intervention studies, written in English and published between January 2018 and March 2023. The search strategy used a population (P), intervention (I), comparator (C), and outcome (O) approach. Results: A total of 21 eligible studies were included in this review with four being related to decontaminating medical devices, two to personal equipment, nine to communication devices, and the remaining six to the environment. The exposure to UV-C radiation varies ranging from 24 s to 24 h (continuously) and it reduced the level of bacteria even up to 100%. Meanwhile, previously the objects were detected to be contaminated with pathogenic and resistant bacteria. Conclusion: UV-C exposure can be effectively used to decontaminate various objects in hospitals. However, special consideration should be given to semi-critical devices due to contact with mucosal tissue. Further studies are needed regarding the application of doses and duration of UV-C exposure to eliminate bacteria completely

Measurement of palliative care competencies using PALCOM instrument

Introduction: An essential component of any profession is competent and confident staff. In palliative care, a wellrounded approach and versatile knowledge of staff and students are of great importance. Measuring these competencies is very important for the development of palliative care and health care. Methods: Measurement of competencies in palliative care by analyzing existing instruments and questions in palliative care. Process of developing a new instrument for measurement of competencies in palliative care PALCOM, using cross-sectional methodology with nurses from Bosnia and Herzegovina. Results: The results are presenting findings of research done with nurses from BIH using two main variables: Years of work experience and level of education of the participants. Main difference is between the two competencies: Pain assessment and management, education, and care for the patient’s family regarding the level of education. Conclusion: The need for measuring competencies is evident in the daily evolution of palliative care, community-based palliative care, hospice care, and subspecialized palliative care. There is no questionnaire that can measure all competencies, but the use of the general competencies in the PALCOM questionnaire can cover this area with the measurement of different domains and the competencies specific to these domains

Optimisation of the bone single photon emission computed tomography in oncology patients

Introduction: The introduction of hybrid imaging systems such as Single Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) has completely changed the scanning procedure of conventional diagnostic nuclear medicine protocols. Modern bone scintigraphy protocols include SUV quanitification and Whole Body (WB) SPECT/CT scanning modality. The major limitation of these new technologies is relatively long scanning time. New detector systems with modern reconstruction softwares have been developed for fast scanning SPECT protocolos. These new technologies can produce images of reduced acquisition with same quality as full scanning acquisition. As a result new studies suggest that planar WB scintigraphy should be replaced with WB SPECT/CT. Methods: One hundred oncology patients performed SPECT/CT as a part as their clinical follow-up. Three different scanning and three reconstruction protocols have been evaluated. Two nuclear medicine physicians evaluated with Likert scale image sharpness, lesion visibility, and lesion background detectability. The overall image quality was determined as the sum of these three parameters. Results: In terms of scan duration reduction on image quality, Volumetrix Evolution for Bone performed during ultra-fast SPECT acquisition achieved the highest score, which is superior compared to the standard SPECT acquisition protocol. The overall image quality was the best with the Volumetrix MI Evolution for Bone protocol for ultra-fast acquisition Conclusion: The Evolution for Bone protocol for ultra-fast acquisition showed best results compared to other protocols. The adoption of new acquisition SPECT protocol may offer more comfortable exams, resulting in higher patient satisfaction. The implementation of this new protocol can lead to an improvement in SPECT sensitivity, primarily due to the reduction of SPECT motion artifacts

The effect of a six-week home physiotherapy program on symptoms and activities of daily living in post-COVID-19 patients following hospital discharge

Introduction: Patients following the acute stage of Severe Acute Respiratory Syndrome Coronavirus 2 were shown to present with persisting symptoms including fatigue, dyspnea, joint pain, and chest pain. The aim of this study was to investigate the effect of a 6-week home physiotherapy program on the psychological and physical symptoms, as well as the physical abilities to perform activities of daily living in post-COVID-19 patients. Methods: The subjects were 39 adult patients who had been diagnosed with COVID-19 and had been hospitalized at the University Clinical Center of Kosovo. Patients initially underwent a physiotherapy assessment 2-3 weeks after discharge from the hospital, including sociodemographic data, psychological and physical symptoms, and functional performance in daily activities using the Patient-Specific Functional Scale (PSFS). Based on their functional capacity, the patients received two types of brochures for a home physiotherapy program that was carried out over the next 6 weeks. Upon the completion of the physiotherapy program, 23 patients reported for the second physiotherapy assessment. The Mann–Whitney Wilcoxon test was used for comparison of the variables obtained during the first and second assessments. Results: Pre–post analysis showed that the symptoms including excessive fatigue, difficulty breathing, and insomnia were significantly less present following the home physiotherapy program (p = 0.005; p = 0.008; p = 0.034). On the PSFS scale, the mean score increased from 5.2 (2.1) to 7.8 (0.5) for stair climbing, from 5.5 (1.8) to 8.8 (1.6) for walking longer distances, and from 3.7 (3.2) to 4.0 (5.6) for running. Conclusion: Although limited by the absence of a control group, the findings from this study indicate that home physiotherapy intervention can be feasible and effective in enhancing psychological and physical symptoms, as well as activities of daily living in post-COVID-19 patients following hospitalization

Public health challenges in households - Food safety

Introduction: Most foodborne illnesses can be prevented by proper food preparation. The estimated prevalence of these diseases is 300-350 times higher than the data available today, which represents only the “tip of the iceberg.” Although restaurants are cited as the most common sites for food poisoning, these cases are three times more likely to occur in households. Therefore, assessing food consumer knowledge and practices provides a basis for formulating and designing programs to promote food safety in households. Methods: Representatives of 384 households in six urban and rural municipalities in Sarajevo Canton participated in the survey. A previously designed and validated household food safety questionnaire was used to explore the knowledge and practices of the population regarding household food safety. Respondents’ knowledge and practices were assessed by the score they achieved, with one point awarded for each correct answer. The range of scores for knowledge and practices was divided into quartiles. The Chi-square test was used to examine whether there was a difference between expected and observed scores in one or more categories in contingency tables. Results: In the assessment of food safety knowledge, 62% of the respondents had good knowledge, 33.1% had average knowledge, and 4.9% had poor knowledge. The results showed that 59.4% of the respondents had average practices and 22.4% had poor practices regarding food safety in their households. It was confirmed that various socioeconomic factors had a significant influence on consumers’ knowledge and practice regarding food safety in their households (p < 0.05). Conclusions: Nowadays, the topic of food safety is rarely discussed in households, and the public is not aware of the risks they face. Urgent action should be taken to raise collective awareness of the importance of household food safety to public health

Basic biochemical and hematological parameters in COVID-19 deceased: Analysis of potential mortality predictors

Introduction: As a result of research conducted globally, experts continue to extensively study the long-term consequences that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections can have on patients, as well as the factors contributing to severe outcomes. The aim of this study was to investigate the values of basic biochemical and hematological parameters in patients with fatal outcomes of SARS-CoV-2 infection, as well as to determine the combination of hematological and biochemical parameters that contribute to the progression of SARS-CoV-2 infection. The examined parameters were correlated with the age and gender distribution of patients with fatal outcomes from the SARS-CoV-2 infection. Methods: The study represents a retrospective study of patients hospitalized at the Cantonal Hospital Zenica from February to April 2021, focusing on the biochemical and hematological parameters of subjects with confirmed presence of the SARS-CoV-2 virus using the reverse transcription-polymerase chain reaction methods who were hospitalized at the Cantonal Hospital Zenica. Results: Of the 250 deceased subjects in the sample, females comprised the relative majority at 53.6%. Among the examined parameters, hemoglobin, mean corpuscular hemoglobin (MCH), and MCH were significantly lower in females compared to males, while males had significantly higher values of urea, creatinine, and troponin. The average age of the patients was 74 years, and with aging, the values of erythrocytes, hemoglobin, and troponin increased. Troponin showed a statistically significant positive correlation with age, as well as with urea and creatinine. Conclusion: We can conclude that hemoglobin, urea, creatinine, and troponin are parameters that can be considered to contribute to the progression of SARS-CoV-2 infection. These parameters can be useful for assessing disease severity and prognosis in patients infected with the SARS-CoV-2 virus

The effect of the ergonomic intervention program on work-related musculoskeletal disorders in healthcare professionals

Introduction: Work-related musculoskeletal disorders (WRMSDs) are the most common work-related disorders and describe a wide range of degenerative and inflammatory states that affect blood vessels, peripheral nerves, bones, joints, ligaments, tendons, and muscles. Healthcare as a special sector has almost the highest prevalence of WRMSDs in the world, far ahead of construction, mining, and manufacturing. Studies conducted in the EU and the USA indicate that health-care professionals most often have a problem with the lower back between 50% and 57% of cases, resulting in an average loss of more than 7 working days during 1 year. Methods: This study included 177 health professionals of both genders who are actively involved in the provision of health-care services. The study was conducted in the Public Health Center of Sarajevo Canton, which provides primary and specialist consultative healthcare services. The study was designed as a prospective, longitudinal, interventional, and descriptive-analytical that included all respondents who met the inclusion criteria. The instruments used in the study are the standardized Dutch Musculoskeletal Discomfort Questionnaire, modified according to our study, the standardized work ability index, and the ergonomic intervention program (EIP). Results: The highest frequency of work-related MKDs in health-care professionals before and after implementation of the EIP was in the neck area (83.1% before, 64.9% after), in the upper back region (71.8% before, 56.5 % after) and in the lower back region (68.4% before, 55.9% after). The average score of the working ability index before the introduction of the EIP was 35.44 ± 8.59, while after the implementation of the EIP it increased statistically significantly and amounted to 38.40 ± 7.30. Conclusion: The EIP influenced the reduction of the MKDs frequency caused by work, and increased the working capacity of health-care professionals

Gender-related epidemiological characteristics of cauda equina syndrome caused by disc herniation: a 10-year study in Zenica-Doboj Canton, Bosnia and Herzegovina

Introduction: Aim of this study is to analyze gender-related epidemiological characteristics of cauda equina syndrome (CES) in Zenica-Doboj Canton in 10 years period. Methods: The study was conducted in the Zenica-Doboj Canton, and data were obtained from the time period between 2012 to 2022. The study included a total sample of 1709 patients diagnosed with disc herniation who underwent surgical decompression. In total, 48 patients developed cauda equine syndrome (CES). Results: The analysis unveiled noteworthy gender disparities, with male predominance (79.2% vs. 20.8%, p<0.001) and varying employment distributions (males: 23.7% unemployed, 63.2% employed, 13.1% retired; females: 40.0% unemployed, 20.0% employed, 40.0% retired, p<0.001). The calculated OR for 2012-2022 was 2.969 (95% CI: 1.576-5.593, p=xxx), signifying a substantial gender-incidence relationship for CES. CES-I incidence ranged 0.80-1.60/100,000 and CES-R ranged 0.25-0.83/100,000. Highest CES incidence was 4.17/100,000 (2015); the lowest was in 2019 with no CES-R cases reported. Male incidence peaked at 2.64/100,000 (2018), and the lowest was 1.06/100,000 (2013, 2017). For females, the highest was 1.17/100,000 (2018, 2021), with no cases reported in certain years. The affected level demonstrated gender differences, with L4/L5 prevalence in males (47.4%) and L3/L4 in females (50%, p=0.165). Conclusion: This study revealed a higher incidence of CES in males compared to females in the Zenica-Doboj Canton. The heterogenicity of data regarding CES occurring due to the lumbar disc herniation is significant. This indicates a clear need for additional research and epidemiological studies that would highlight the population of patients that have higher risk of CES onset

The relationship of limited mobility of the cervical spinewith postural and mental reactions of students

Introduction: Previous studies have found that, in addition to the general factors for the occurrence of pain and reduced mobility of the cervical spine, the use of electronic devices promotes these, the excessive use of which can also lead to the occurrence of depressive symptoms in students. The aim of this study was to determine the mobility limitation of the cervical spine in students with reported neck pain, to determine the degree of disability and depression due to neck pain, to determine the correlation of mobility limitation of the cervical spine with the degree of disability and depression of students, and to determine the correlation of the degree of disability with the degree of depression. Methods: The research was conducted as a cross-sectional study from May to July 2021 at the University of Zenica in four faculties. The study used the General Questionnaire and two standardized questionnaires to assess disability due to neck pain (Index of Disability due to Neck Pain) and the degree of depression (patient health questionnaire). Results: A total of 147 students with reported neck pain participated in the study. A limitation of mobility was found in 30.6% of the students in flexion, 25.2% in rotation, 23.8% in lateral flexion, and 20.4% on extension. Mild disability due to neck pain was found in 58.5% of students, moderate in 23.8%, and severe in 2.7%. 45.6% of the students had mild depression, 18.4% had moderate depression, and 5.4% had severe depression.Conclusion: Restricted flexion and rotation are more common than restricted lateral flexion and extension of the cervical spine. About half of the students who reported neck pain had a mild degree of disability and mild depression. A strong positive correlation was found between the degree of disability and depression in students with neck pain

The role of laboratory diagnostics in the assessment of occupational lead exposure

Introduction: Industrialization and urbanization led to a significant increase in the environment. Lead inhibits the activity of numerous enzymes, triggers oxidative stress, and causes protein biosynthesis dysregulation. Inhalation of lead particles is the most common route of intoxication associated with occupational exposure. This study aims to evaluate laboratory methods and biomarkers in the assessment of lead exposure. Methods: For non-experimental qualitative research, available scientific articles in English published in the relevant databases (MEDLINE and ScienceDirect) were used. The database search was performed using the keywords “Laboratory diagnostics”, “occupational exposure”, and “lead”. Results: Atomic absorption spectrometry (AAS) is the gold standard in laboratory monitoring of occupational lead exposure. Inductively coupled plasma with mass spectrometry is a commonly used method described as more sensitive than AAS due to its low detection limit. Lead concentrations can be determined in various samples, but blood and urine are the most commonly used in laboratory practice. The most important exposure biomarker is the enzyme δ-aminolevulinic acid dehydratase (ALAD) in the blood, which is characterized by progressive inactivation by lead and a negative correlation with its concentration. The concentration of urinary delta-aminolevulinic acid (δ-ALA-U) reflects the state of impaired enzyme function in heme biosynthesis. In addition, determining blood zinc protoporphyrin and urinary coproporphyrin levels significantly aids in assessing occupational lead exposure disorders. Conclusion: The availability of the laboratory methods used and the biomarker specificity and sensitivity play an important role in the adequacy of lead exposure monitoring. Accurate determination of ALAD and δ-ALA-U concentrations, along with other biomarkers, is critical for assessing individuals exposed to lead