Improving Code Response Time through Strategic Positioning of Nursing House Supervisors: Results of a Nurse-Led Intervention

Background: In many settings, the nursing house supervisors (NHS) are a critical part of the entity’s code response team. To date, much of the research on code response has focused on improving response times through staff-focused interventions such as simulation training. However, use of data to determine where to physically place NHS in the building to optimize code response times has received little attention, especially in an outpatient oncology setting. Purpose: To test whether using data on code frequency/location to strategically position NHS could reduce mean code response times in large (450,000-ft2) outpatient cancer center. Methods: Data on code volume, type, distance and estimated response time before and after strategic repositioning was collected by staff over a 238-day period occurring between September, 2019 and April, 2020. Results: Over an eight-month period, NHS staff responded to 64 codes. Prior to repositioning, 77.3% of codes required NHS to travel to a different building and through at least one floor and/or departments to arrive at the code. After strategic repositioning, mean code response times at our center fell from 3.4±0.7 min, on average, to 1.5 ± 0.6 min (p \u3c .000). Improvements in code response times and distance travelled were observed regardless of code type, time of day, or individual NHS responding to the code. Conclusions: Results suggest that a data-driven strategy for determining where to place NHS in the building based on code frequency and location may be a useful way for oncology centers to improve code response times

Calidad de la leche cruda para consumo humano en dos localidades de Sucre (Colombia)

Objective. To determine the physicochemical, microbiological and somatic cell count of raw milks marketed for human consumption in neighborhoods of Sincelejo and Corozal (Sucre). Materials and methods. A cross-sectional study was carried out in 97 samples of raw milk marketed for human consumption in different neighborhoods of Sincelejo and Corozal (Sucre). Physical-chemical, microbiological and somatic cell count parameters were determined. The data obtained were analyzed according to the regulations in normative measures in Colombia. Results. Most of the physical-chemical parameters of the raw milk samples analyzed were found within the normal range according to Colombian legislation. Mesophilic count and somatic cells count was found to be above what is allowed by the legislation. The presence of total and fecal coliforms, antibiotics and adulterants such as sucrose and starches were determined. Conclusions. Raw milks distributed for human consumption in Sincelejo and Corozal presents good physical-chemical quality but poor microbiological quality; it becomes necessary to increase surveillance and to demand the production of excellent quality milk in the primary sector in the dairy chain.Objetivo. Determinar la calidad fisicoquímica, microbiológica y recuento de células somáticas de leches crudas que se distribuyen para consumo humano en diferentes barrios de Sincelejo y Corozal (Sucre). Materiales y métodos. Mediante un estudio descriptivo de corte transversal, se tomaron 97 muestras de leche cruda; se determinaron algunos parámetros fisicoquímicos, microbiológicos y recuento de células somáticas. Los datos obtenidos se analizaron de acuerdo a la normatividad vigente en Colombia. Resultados. La mayoría de los parámetros fisicoquímicos de las muestras de leche cruda evaluadas se encontraron dentro de los parámetros normales de la legislación colombina. El recuento estándar en placa y el recuento de células somáticas se encontraron por encima de lo permitido por la legislación. Se demostró la presencia de coliformes totales, coliformes fecales, antibióticos y adulterantes como sacarosa y almidones. Conclusiones. La leche cruda que se distribuye para consumo humano en  Sincelejo y Corozal presenta  buena calidad fisicoquímica pero deficiente calidad microbiológica; se hace necesario incrementar la vigilancia y exigir al eslabón primario de la cadena láctea la producción de leche de excelente calidad

Normal Values Determination for High Resolution Esophageal Manometry Using Sitting Viscous Solution Swallows. Results of a Multicenter Study in Healthy Volunteers

Q1Q1Introduction: It has been suggested that a more physiologic esophageal manometry study protocol, including non-liquid solutions and a sitting position, could improve the test performance. For the specificity determination of putative findings it is necessary to determine normal values Aim: To determine normal values for sitting viscous solution swallows in healthy volunteers using high-resolution esophageal manometry.https://orcid.org/0000-0002-9219-4548Revista Nacional - Indexad

Contraction amplitude is a relevant predictor of bolus transit during sitting viscous solution swallows in healthy individuals : preliminary results of a multicenter study using high resolution impedance manometry (HRIM)

Q1Q1https://orcid.org/0000-0002-9219-4548https://orcid.org/0000-0003-1222-0636https://orcid.org/0000-0002-4523-7947Revista Internacional - Indexad

Su1876 Determination of normal esophageal pressure responses to a rapid multiple swallow challenge test. results of a multicenter study in healthy volunteers

Q1Q1https://orcid.org/0000-0002-9219-4548Revista Internacional - Indexad

Climate change, malaria and neglected tropical diseases: a scoping review

To explore the effects of climate change on malaria and 20 neglected tropical diseases (NTDs), and potential effect amelioration through mitigation and adaptation, we searched for papers published from January 2010 to October 2023. We descriptively synthesised extracted data. We analysed numbers of papers meeting our inclusion criteria by country and national disease burden, healthcare access and quality index (HAQI), as well as by climate vulnerability score. From 42 693 retrieved records, 1543 full-text papers were assessed. Of 511 papers meeting the inclusion criteria, 185 studied malaria, 181 dengue and chikungunya and 53 leishmaniasis; other NTDs were relatively understudied. Mitigation was considered in 174 papers (34%) and adaption strategies in 24 (5%). Amplitude and direction of effects of climate change on malaria and NTDs are likely to vary by disease and location, be non-linear and evolve over time. Available analyses do not allow confident prediction of the overall global impact of climate change on these diseases. For dengue and chikungunya and the group of non-vector-borne NTDs, the literature privileged consideration of current low-burden countries with a high HAQI. No leishmaniasis papers considered outcomes in East Africa. Comprehensive, collaborative and standardised modelling efforts are needed to better understand how climate change will directly and indirectly affect malaria and NTDs

Triple Co-Administration of Ivermectin, Albendazole and Praziquantel in Zanzibar: A Safety Study

This paper describes how the use of three drugs which are used separately in mass drug distribution programmes when given together appear safe for use in large populations which have been previously treated with the same drugs separately (Mectizan [ivermectin], albendazole and praziquantel). The target diseases—lymphatic filariasis, soil-transmitted worms and schistosomiasis—were prevalent in Zanzibar up to 2000 but have been largely controlled by mass drug administration. The Ministry of Health and Social Welfare, with the support of WHO, initiated a small scale trial in a population of triple therapy in over 5,000 people initially in two sites, and having found there were no severe adverse events associated with the combined treatment then upscaled to treat the whole of the eligible population of over 700,000. Similarly, there were no severe adverse events. This is the first time the three drugs have been used together at the same time at scale in Africa and provide a basis for expansion of integrated preventive chemotherapy of helminths (worms). The next steps need to be initiated in populations which have heavier worm loads and such interventions need to be subject to close monitoring and ethical review