Cirurgia segura: validação de checklist pré e pós-operatório

Objective: to develop, evaluate and validate a surgical safety checklist for patients in the pre and postoperative periods in surgical hospitalization units. Method: methodological research carried out in a large public teaching hospital in the South of Brazil, with application of the principles of the Safe Surgery Saves Lives Programme of the World Health Organization. The checklist was applied to 16 nurses of 8 surgical units and submitted for validation by a group of eight experts using the Delphi method online. Results: the instrument was validated and it was achieved a mean score ≥1, level of agreement ≥75% and Cronbach’s alpha >;0.90. The final version included 97 safety indicators organized into six categories: identification, preoperative, immediate postoperative, immediate postoperative, other surgical complications, and hospital discharge. Conclusion: the Surgical Safety Checklist in the Pre and Postoperative periods is another strategy to promote patient safety, as it allows the monitoring of predictive signs and symptoms of surgical complications and the early detection of adverse events.Objetivo: desarrollar, evaluar y validar un checklist de seguridad quirúrgica para los períodos pre y postoperatorio de unidades de hospitalización quirúrgica.. Método: investigación metodológica llevada a cabo en un amplio hospital público de enseñanza del Sur de Brasil, con aplicación de los principios del Programa de Cirugía Segura Salva Vidas de la Organización Mundial de la Salud. El checklist se aplicó a 16 enfermeros de 8 unidades quirúrgicas y fue sometida a validación por ocho expertos utilizando el método Delphi en línea. Resultados: el instrumento fue validado y se logró una puntuación media ≥1, grado de acuerdo ≥75% y alfa de Cronbach >;0.90. La versión final incluyó 97 indicadores de seguridad organizados en seis categorías: identificación, preoperatorio, postoperatorio inmediato, postoperatorio inmediato, otras complicaciones quirúrgicas y alta hospitalaria. Conclusión: el Checklist de Seguridad Quirúrgica en el Período Pre y Postoperatorio es otra estrategia más para promover la seguridad del paciente, ya que permite monitorear los signos y síntomas predictivos de las complicaciones quirúrgicas y la detección temprana de eventos adversos.Objetivo: elaborar, avaliar e validar um checklist de segurança cirúrgica para os períodos pré e pós-operatório de unidades de internação cirúrgica. Método: pesquisa metodológica, realizada em hospital de ensino público de grande porte do Sul do Brasil, com aplicação dos fundamentos do Programa Cirurgias Seguras Salvam Vidas da Organização Mundial da Saúde. O checklist foi aplicado a 16 enfermeiros de oito unidades cirúrgicas, e submetido à validação por meio da técnica Delphi on-line com oito especialistas. Resultados: o instrumento foi validado, obtendo-se ranking médio ≥1, grau de concordância ≥75% e Alfa de Cronbach >;0,90. A versão final contemplou 97 indicadores de segurança organizados em seis categorias: identificação, pré-operatório, pós-operatório imediato, pós-operatório mediato, outras complicações cirúrgicas, e alta hospitalar. Conclusão: o Checklist de Segurança Cirúrgica Pré e Pós-Operatório é mais uma estratégia na promoção da segurança do paciente, pois possibilita monitorar sinais e sintomas preditivos de complicações cirúrgicas e detecção precoce de eventos adversos

Peasant settlers and the ‘civilizing mission’ in Russian Turkestan, 1865-1917

This article provides an introduction to one of the lesser-known examples of European settler colonialism, the settlement of European (mainly Russian and Ukrainian) peasants in Southern Central Asia (Turkestan) in the late nineteenth and early twentieth centuries. It establishes the legal background and demographic impact of peasant settlement, and the role played by the state in organising and encouraging it. It explores official attitudes towards the settlers (which were often very negative), and their relations with the local Kazakh and Kyrgyz population. The article adopts a comparative framework, looking at Turkestan alongside Algeria and Southern Africa, and seeking to establish whether paradigms developed in the study of other settler societies (such as the ‘poor white’) are of any relevance in understanding Slavic peasant settlement in Turkestan. It concludes that there are many close parallels with European settlement in other regions with large indigenous populations, but that racial ideology played a much less important role in the Russian case compared to religious divisions and fears of cultural backsliding. This did not prevent relations between settlers and the ‘native’ population deteriorating markedly in the years before the First World War, resulting in large-scale rebellion in 1916

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

A study of the effectiveness of MP3 players to support family carers of people living with dementia at home

Background: Music can be therapeutic to people with dementia; however, little is known about its effect on the family carers. This project aimed to (1) assess the effects of MP3 player use by a person with dementia on caregivers’ mental health and wellbeing, including their self-care and health-promoting behavior and (2) determine whether MP3 player use increases caregivers’ self-reported capacity to cope with their role. Methods: A pre–post quantitative and qualitative design was used. Carers completed a survey prior to commencing and four weeks after using the player. The survey included validated measures to assess the level of stress and coping among carers. Carers also kept a diary of the way they used the MP3 player. Half of the carers were interviewed about their experiences at the end of the study. Results: Of 59 people who started using the MP3 player, 51 carers completed the four-week study period and surveys. Use of the MP3 player significantly decreased psychological distress, significantly improved the mental health and wellbeing of carers, significantly increased caregiver self-efficacy to manage symptoms of dementia, and was reported to provide valued respite from the high level of vigilance required for caring for a person with dementia. Conclusion: An MP3 player loaded with music can be a low cost and relatively simple and effective additional strategy to support families caring for people with dementia in the community. (PsycINFO Database Record (c) 2016 APA, all rights reserved

Design for Wearability

Digital Technology is constantly improving as information becomes wireless. These advances demand more wearable and mobile form factors for products that access information. A product that is wearable should have wear- ability. This paper explores the concept of dynamic wearability through design research. Wearability is defined as the interaction between the human body and the wearable object. Dynamic wearability extends that definition to include the human body in motion. Our research has been to locate, understand, and define the spaces on the human body where solid and flexible forms can rest -- without interfering with fluid human movement. The result is a set of design guidelines embodied in a set of wearable forms. These wearable forms describe the three dimensional spaces on the body best suited for comfortable and unobtrusive wearability by design

Nitrogen enrichment alters carbon fluxes in a New England salt marsh

Introduction: Nitrogen enrichment of coastal salt marshes can induce feedbacks that alter ecosystem-level processes including primary production and carbon sequestration. Despite the rising interest in coastal blue carbon, the effects of chronic nutrient enrichment on blue carbon processes have rarely been measured in the context of experimental fertilization. Here, we examined the ecosystem-level effects of nitrate (NO3−) enrichment on the greenhouse gas dynamics of a Spartina alterniflora-dominated salt marsh. We measured CO2 and CH4 fluxes using static chambers through two growing seasons in a salt marsh that was nitrogen-enriched for 13 years and compared fluxes to those from a reference marsh. Outcomes: We found that nitrogen enrichment increased gross primary productivity (GPP) by 7.7% and increased ecosystem respiration (Reco) by 20.8%. However, nitrogen enrichment had no discernible effect on net ecosystem exchange (NEE). Taken together, these results suggest that nitrogen-induced stimulation of Reco could transform this salt marsh from a carbon sink into a source of carbon to the atmosphere. Conclusion: Our results complement prior findings of nitrogen enrichment weakening soil structure and organic matter stability in tidal salt marshes, suggesting that increased nutrient inputs have the potential to alter the carbon storage function of these ecosystems through enhanced microbial respiration of previously sequestered carbon