Effect of chronic exposure to biomass fuel smoke on pulmonary function test parameters

Background: Life in a typical Indian household revolves around the cooking area, and Indian women spend much of their time there. Cooking stoves in most households are nothing more than a pit, a chulha (a U-shaped construction made from mud), or three pieces of brick. Cooking under these conditions entails high levels of exposure to cooking smoke. Aim of this study was to evaluate the effect of Chronic Exposure to Biomass Fuel Smoke on Pulmonary Function Test Parameters.Methods: 60 non-smoking women without any history of any major chronic illness in the past were selected for this study. The study group comprised of 30 rural female subjects who were chronically exposed to biomass fuel smoke combustion and 30 age matched urban female subjects exposed chronically to clean fuel combustion (Liquified Petroleum Gas–LPG) in Haryana (India). All the subjects were evaluated for pulmonary function tests by RMS Medspiror.Results: Biomass exposure index came out to be 85.68±3.69 for women cooking on biomass and LPG index was 64.17±6.97 for women cooking on LPG. This implies significant chronic exposure of women to biomass fuel smoke. The lung function parameters were significantly lesser in biomass exposed rural women [FEV1 (p<0.01), FVC (p<0.01), FEF25-75 (p<0.01), FEV1/FVC ratio (p<0.01), PEFR (p<0.01), MVV (p<0.01)] than the LPG exposed urban women. The evaluation of PFT suggested obstructive type of pulmonary disease.Conclusion: The derangement in pulmonary function parameters in women exposed to biomass smoke pollutants could be due to chronic significant exposure as suggested by high Biomass exposure Index. Inadequate ventilation in cooking area without chimney/vent also contributed to pulmonary function derangement and COPD.

Shah rukh khan the king of bollywood/ Chopra

xxi, 351 hal.: ill.; 21 cm

Support opportunities for second victims lessons learned: a qualitative study of the top 20 US News and World Report Honor Roll Hospitals

Abstract Background Second Victim Programs (SVPs) provide support for healthcare providers involved in a near-miss, medical error, or adverse patient outcomes. Little is known about existence and structure of SVPs in top performing US hospitals. Methods We performed a prospective study and interviewed individuals representing SVPs from 20 US News and World Report (USNWR) Honor Roll Hospitals. Telephone interviews were recorded, transcribed, and de-identified. To allow identification of both quantitative and qualitative themes that unified or distinguished programs with SVPs from each other, a content analysis approach was used. Results Of the Top 20 UNSWR hospitals, nineteen individuals with knowledge of or involvement in SVPs were identified. One individual represented two hospital systems for the same institution. Thirteen representatives agreed to participate, 12 declined, and 5 did not respond. One individual who initially agreed to participate did not attend the interview. Among twelve representatives interviewed, 10 reported establishment of SVPs at their hospitals between 2011 and 2016. Most program representatives reported that participants sought support voluntarily. Four domains were identified in the qualitative analysis: (a) identification of need for Second Victim Program (SVP); (b) challenges to program viability; (c) structural changes following SVP creation, and (d) insights for success. Driving SVP creation was the need support medical providers following a traumatic patient event. Poor physician participation due to the stigma associated with seeking support was commonly reported as a challenge. However, acceptance of the mission of SVPs, growing recognition of the value of the program across hospital departments, and systematic safety enhancements were cited as key advantages. To ensure success, participants suggested training a variety of volunteers and incorporating SVPs within quality improvement processes. Conclusions In this convenience sample, programs for healthcare providers that experience psychosocial or emotional trauma from clinical care were uncommon. Variation in structure, performance, and measures of success among SVPs was observed. A systematic approach to evaluating SVPs is needed to help inform institutions of how to best serve their second victims.http://deepblue.lib.umich.edu/bitstream/2027.42/173783/1/12913_2021_Article_7315.pd

Cryogenic treatment: Processing segment to tailor the interface and improve mechanical performance of impact modified PET/PBT blends

Cryogenic treatment of polymers is a well-known area of research these days. Many reports confirm the fact that, similar to metals, polymeric materials also undergo some structural changes that ultimately enhance mechanical properties like wear performance, tensile strength, impact strength, elongation, hardness, etc. The cryogenic treatment has proven an advantage for improving the properties of both virgin polymers and polymer micro- and nanocomposites. The present study, the first of its kind, reports the effect of cryogenic treatment on polymeric blends. An attempt is made to explore the effect of the treatment parameters, like temperature and time, on the impact modified and unmodified PET/PBT blends. Similar to the polymers and composites, the blend systems studied here reflect significant improvement by ∼50% in wear performance, ∼16–19% in tensile strength, and ∼9% in impact strength after cryogenic treatment. Thus, after extensive analysis of the material properties, structure, and thermal behavior, cryogenic treatment of PET/PBT blends, both impact-modified and unmodified, is advocated as an effective tool for tailoring the interface and improving performance

Do bedside whiteboards enhance communication in hospitals? An exploratory multimethod study of patient and nurse perspectives

Objective To understand patient and nurse views on usability, design, content, barriers and facilitators of hospital whiteboard utilisation in patient rooms. Design Multimethods study. Setting Adult medical-surgical units at a quaternary care academic centre. Participants Four hundred and thirty-eight adult patients admitted to inpatient units participated in bedside surveys. Two focus groups with a total of 13 nurses responsible for updating and maintaining the whiteboards were conducted. Results Most survey respondents were male (55%), ≥51 years of age (69%) and admitted to the hospital ≤4 times in the past 12 months (90%). Over 95% of patients found the whiteboard helpful and 92% read the information on the whiteboard frequently. Patients stated that nurses, not doctors, were the most frequent user of whiteboards (93% vs 9.4%, p<0.001, respectively). Patients indicated that the name of the team members (95%), current date (87%), upcoming tests/procedures (80%) and goals of care (63%) were most useful. While 60% of patients were aware that they could use the whiteboard for questions/comments for providers, those with ≥5 admissions in the past 12 months were significantly more likely to be aware of this aspect (p<0.001). In focus groups, nurses reported they maintained the content on the boards and cited lack of access to clinical information and limited use by doctors as barriers. Nurses suggested creating a curriculum to orient patients to whiteboards on admission, and educational programmes for physicians to increase whiteboard utilisation. Conclusion Bedside whiteboards are highly prevalent in hospitals. Orienting patients and their families to their purpose, encouraging daily use of the medium and nurse-physician engagement around this tool may help facilitate communication and information sharing.http://deepblue.lib.umich.edu/bitstream/2027.42/176331/2/Do bedside whiteboards ...explorator study.pdfPublished versio

How Often Are Healthcare Personnel Hands Colonized with Multi-Drug Resistant Organisms? A Systematic Review and Meta-Analysis

Background: Hands of health care personnel (HCP) can transmit multidrug-resistant organisms (MDROs), resulting in infections. Our aim was to determine MDRO prevalence on HCP hands in adult acute care and nursing facility settings. Methods: A systematic search of PubMed/MEDLINE, Web of Science, CINAHL, Embase, and Cochrane CENTRAL was performed. Studies were included if they reported microbiologic culture results following HCP hands sampling; included prevalent MDROs, such as methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus, Clostridium difficile, Acinetobacter baumannii, or Pseudomonas aeruginosa, and were conducted in acute care or nursing facility settings. Results: Fifty-nine articles comprising 6,840 hand cultures were included. Pooled prevalence for MRSA, P aeruginosa, A baumannii, and vancomycin-resistant Enterococcus were 4.26%, 4.59%, 6.18%, and 9.03%, respectively. Substantial heterogeneity in rates of pathogen isolation were observed across studies (I2 = 81%-95%). Only 4 of 59 studies sampled for C difficile, with 2 of 4 finding no growth. Subgroup analysis of MRSA revealed the highest HCP hand contamination rates in North America (8.28%). Sample collection methods used were comparable for MRSA isolation (4%-7%) except for agar direct contact (1.55%). Conclusions: Prevalence of common MDROs on HCP hands vary by pathogen, care setting, culture acquisition method, study design, and geography. When obtained at an institutional level, these prevalence data can be utilized to enhance knowledge, practice, and research to prevent health care–associated infections.http://deepblue.lib.umich.edu/bitstream/2027.42/176336/2/Americal Journal of Infection control. MDRO.pdfPublished versio

Do Bedside Visual Tools Improve Patient and Caregiver Satisfaction? A Systematic Review of the Literature.

BACKGROUND: Although common, the impact of low-cost bedside visual tools, such as whiteboards, on patient care is unclear. PURPOSE: To systematically review the literature and assess the influence of bedside visual tools on patient satisfaction. DATA SOURCES: Medline, Embase, SCOPUS, Web of Science, CINAHL, and CENTRAL. DATA EXTRACTION: Studies of adult or pediatric hospitalized patients reporting physician identification, understanding of provider roles, patient–provider communication, and satisfaction with care from the use of visual tools were included. Outcomes were categorized as positive, negative, or neutral based on survey responses for identification, communication, and satisfaction. Two reviewers screened studies, extracted data, and assessed the risk of study bias. DATA SYNTHESIS: Sixteen studies met the inclusion criteria. Visual tools included whiteboards (n = 4), physician pictures (n = 7), whiteboard and picture (n = 1), electronic medical record-based patient portals (n = 3), and formatted notepads (n = 1). Tools improved patients’ identification of providers (13/13 studies). The impact on understanding the providers’ roles was largely positive (8/10 studies). Visual tools improved patient–provider communication (4/5 studies) and satisfaction (6/8 studies). In adults, satisfaction varied between positive with the use of whiteboards (2/5 studies) and neutral with pictures (1/5 studies). Satisfaction related to pictures in pediatric patients was either positive (1/3 studies) or neutral (1/3 studies). Differences in tool format (individual pictures vs handouts with pictures of all providers) and study design (randomized vs cohort) may explain variable outcomes. CONCLUSION: The use of bedside visual tools appears to improve patient recognition of providers and patient–provider communication. Future studies that include better design and outcome assessment are necessary before widespread use can be recommended.http://deepblue.lib.umich.edu/bitstream/2027.42/176332/2/Goyal 1108e v4.pdfPublished versio

Brief Mindfulness Practices for Healthcare Providers – A Systematic Literature Review

Mindfulness practice, where an individual maintains openness, patience, and acceptance while focusing attention on a situation in a nonjudgmental way, can improve symptoms of anxiety, burnout, and depression. The practice is relevant for health care providers; however, the time commitment is a barrier to practice. For this reason, brief mindfulness interventions (eg, ≤ 4 hours) are being introduced. We systematically reviewed the literature from inception to January 2017 about the effects of brief mindfulness interventions on provider well-being and behavior. Studies that tested a brief mindfulness intervention with hospital providers and measured change in well-being (eg, stress) or behavior (eg, tasks of attention or reduction of clinical or diagnostic errors) were selected for narrative synthesis. Fourteen studies met inclusion criteria; 7 were randomized controlled trials. Nine of 14 studies reported positive changes in levels of stress, anxiety, mindfulness, resiliency, and burnout symptoms. No studies found an effect on provider behavior. Brief mindfulness interventions may be effective in improving provider well-being; however, larger studies are needed to assess an impact on clinical care.http://deepblue.lib.umich.edu/bitstream/2027.42/176333/2/Americal Journal of Infection control. MDRO.pdfPublished versio

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Not AvailableEnvironmental crises, declining factor productivity, and shrinking natural resource is a threat to global agricultural sustainability. The task is much more daunting in the Indo-Gangetic northern plains of India, where depletion of the underground water table and erratic rains due to the changing climate pose a major challenge to agriculture. To address these challenges a field investigation was carried out during 2016–2018 to test the efficacy of biopolymeric superabsorbent hydrogels namely Pusa Hydrogel (P-hydrogel: a semi-synthetic cellulose derivative-based product) and kaolin derivative of Pusa Hydrogel (K-hydrogel: semi-synthetic cellulose derivative) to assess their effect on crop and water productivity, soil moisture, root dynamics, and economics of soybean (Glycine max L.)–wheat (Triticum aestivum L.) system under three irrigation regimes namely full irrigation, limited irrigation and rainfed. The results revealed that the full irrigation along with P-hydrogel led to enhanced grain yield, biomass yield, and water productivity (WP) of soybean (1.61–10.5%, 2.2–9.5%, and 2.15– 21.8%, respectively) and wheat (11.1–18.3%, 12–54% and 11.1–13.1%, respectively) over control plots. Likewise, under water stressed plots of rainfed conditions with P-hydrogel exhibited 52.7 and 20.6% higher system yields (in terms of wheat equivalent yield) over control and other combinations during the respective study years. Whereas the magnitude of increase in system yield under limited irrigation with P-hydrogel was ~ 15.1% and under full irrigation with P-hydrogel was 8.0–19.4%. Plots treated with P-hydrogel retained 3.0–5.0% higher soil moisture compared to no-hydrogel plots, while K-hydrogel treated plots held the lower moisture (4.0–6.0%) than the control. In terms of profitability, full irrigation along with P-hydrogel plots registered 12.97% higher economic returns over control. The results suggested that P-hydrogel (2.5 kg ha− 1) reduces runoff water loss in full irrigation applied plots and retained more water, where loss of water is more thus reduces number of irrigations. Hence P-hydrogel with irrigation water is a viable option for sustainable production of soybean-wheat systems in the Indo-Gangetic plains of India and other similar eco-regions of the world.Not Availabl