Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

The effect of stress inoculation training on the medication error of nurses.

Background: Administration of medications is an important part of treatment and care provided by nurses. Medication errors in nursing profession is one of the most common health care mistakes.One of the factors in the incidence of medication errors, job stress, so stress management and efficient use of preventive methods necessary to appear. The aim of this study is to determine the effect of a Stress Inoculation training on the medication error of nurses. Materials and methods: The present research is, a field trial controlled study.The population included 100 nurses in medical, surgical and pediatric hospitals constitute Sabzevar University of Medical Sciences. Nurses are selected using quota sampling permutation blocks were divided into two groups.The intervention group, stress inoculation training (workshop 2 days 8 hours a week) was conducted.The data collecting by a researcher-made forms of occupational demographic information and registration forms medication errors,during the two stage, one months before and one and a half months after the intervention was completed by both groups. Data were analyzed by means of SPSS-11/5 and SAS 9.1 statistical software using descriptive statistics, Mann-Whitney, Chi-square, Fisher, T test and generalized estimation equations. Results:The mean and standard deviation of medication errors in the intervention group before stress inoculation training 5/65 ± 2/30 and a half months was 2/68 ± 1/57. Analysis of data between the mean medication errors samples before and after the intervention groups showed significant differences (P<0/05). Conclusion:Stress inoculation training can reduce the incidence of medication errors

Comparative study of SBOAs on the tuning procedure of the designed SMPI controller for MIMO VSP/HVDC interconnected model

This paper presents a new application of advanced SMPI controller for a newly introduced interconnected dynamic system with VSP based HVDC links for frequency control problem. This work presents an outgrowth of analysis about the Swarm – Based Optimization Algorithms (SBOAs) in the tuning process of Multivariable Proportional – Integral (MPI) controller, which is called swarm – based MPI (SMPI). PSO, GOA and GWO algorithms are used for tuning process of the designed SMPI. The VSP based HVDC model is added for mitigation of system frequency dynamics with emulating virtual inertia. The proposed SMPI controller are designed for enhancing the dynamic performance of this system's states during contingencies and they are compared with the conventional designed MPI controller. Deviation characteristics of the step function in MIMO transfer function of the VSP based HVDC model is considered as the common performance index in the proposed algorithms. On the other hand, the role of the proposed SMPI controller is to stabilize such interconnected system while minimizing the associated cost function. Matlab simulations next to the performed Nyquist's stability anslysis demonstrate how the tuned SMPI can remarkably improve the frequency deviations and the damping of the inter-area oscillations excited during a fault. This enhancement is more obvious especially when SMPI controller for a VSP based virtual inertia emulation is tuned using GWO method.</p

Development and Psychometric of Assessment Tool of Students\' Preventive Behaviors of Cutaneous Leishmaniosis Based on BASNEF Model

Introduction and Aims:  One of the important strategies to control cutaneous leishmaniasis is preventive behaviors and evaluation of preventive behaviors from leishmaniasis and detecting factors associated with the disorder is the first step in planning for training intervention. Since there is no standard questionnaire in this regard, this study aimed to design and psychometric native tools to evaluate the preventive behaviors of cutaneous leishmaniasis based on BASNEF Model in students of Neyshabur. Materials and Methods: In this sectional study, we designed a primary tool after investigated the scientific sources and Needs assessment beliefs Based on BASNEF Model on 25 people from the study population. For psychometric tools, we used artificial validity with the participation of 20 students and content validity (By measuring the ratio of the content validity and content validity index) through an expert panel with the participation of 10 health education experts and tool designed experts. Construct validity (using confirmatory factor analysis) was performed in LISREL software by selecting 226 high school students by using a multistage random sampling method. To determine the reliability of the tool, we used internal consistency and test-retest method. Results:  The basic questionnaire version was designed with 46 items then some items were modified by artificial and content validity.in artificial validity, 2 items were excluded because of having an impact score less than 1.5 and content validity by taking a cut-off point./79 to measure content validity index and cut-off point./62 for the credit test, the number of 8 items to be removed and items Number declined to 36 in artificial and content validity rate. In constructing validity, AGFI = 0.90, RMSEA = 0.040 were obtained by Confirmatory Factor Analysis, Respectively. The reliability of the tool was approved through internal consistency (0/864 = α) and retest test (0/993 =ICC) Conclusions: The results showed that prevention behavior questionnaire of skin, cutaneous Based on BASNEF Model is valid and reliable with 36 items, and because of the strength of suitable factor structure and psychometric properties, researchers can use it in the  related studies

An optimized LQG servo controller design using LQI tracker for VSP-based AC/DC interconnected systems

This paper proposes a novel application for the optimal Linear Quadratic Gaussian (LQG) servo controller to enable a proper coordination of the AC/HVDC interconnected system with Virtual Synchronous Power (VSP) based inertia emulation. Particularly, the proposed control design takes the process disturbances and measurement noise of the studied VSP-HVDC system into account, while few studies have focused on this perspective. The proposed LQG controller with modifications is designed by means of a combination of Kalman Filter (state estimator) and an added Linear Quadratic Integrator (LQI) to observe the system model's states and track the reference commands while rejecting the effects of system noise. Besides, we utilize a swarm-based optimization algorithm to operate as the search process for the tuning of the elements in the weighting matrices involved in the controller design. The role of the proposed optimal LQG controller is to stabilize such AC/DC interconnected system with VSP-based inertia emulator while minimizing the associated performance index. According to the obtained simulation results, in addition to the advancement from the VSP-based approach for damping frequency oscillations excited by faults, application of the proposed LQG servo controller can achieve the targets on both estimating the state variables and tracking the reference signals with satisfactory performance, comparing with the conventional LQG regulator.</p

Nursing students and nurses attitude toward spirituality and spiritual care

مقدمه: سلامت معنوی یک بعد از ابعاد سلامتی انسان و مراقبت معنوی بخشی از وظایف مهم پرستاران است. پژوهش حاضر با هدف تعیین دیدگاه پرستاران و دانشجویان پرستاری نسبت به معنویت و مراقبت معنوی بیماران، در سال 94 انجام شده است. روش: این مطالعه از نوع توصیفی ـ مقطعی است که جامعه پژوهش آن را کلیه پرستاران شاغل و دانشجویان سال آخر شاغل به تحصیل در دانشگاه علوم پزشکی سبزوار تشکیل می‌دادند. نمونه‌گیری از دانشجویان به صورت سرشماری و از پرستاران به صورت تصادفی انجام شد. ابزار گردآوری داده‌ها، پرسشنامه سنجش معنویت و مراقبت معنوی (Spirituality and Spiritual Care Rating Scale-SSCRS) بود که روایی و پایایی آن سنجیده شد. داده‌ها با استفاده از نرم‌افزار SPSS 16 تحلیل شد. یافته‌ها: میانگین نمره کل نگرش نسبت به معنویت و مراقبت معنوی در پرستاران شرکت‌کننده 0/88±52/44 و در دانشجویان 1/74±54/57 بود، ولی این میانگین در بین پرستاران و دانشجویان از نظر آماری اختلاف معنی‌داری نداشت. بین میانگین نمره نگرش نسبت به معنویت و مراقبت معنوی با ویژگی‌های جمعیت‌شناختی افراد شرکت کننده ارتباط آماری معنی‌دار مشاهده نشد. بحث و نتیجه‌گیری: نگرش شرکت‌کنندگان در مطالعه نسبت به موضوع معنویت و مراقبت معنوی مطلوب بود که می‌تواند به عنوان یک سرمایه مورد توجه برنامه‌ریزان حوزه سلامت قرار گیرد. انجام مطالعات بیشتر در مورد عوامل اثرگذار بر این نگرش در کارکنان پرستاری و دانشجویان پیشنهاد می‌شود.Background:&nbsp;Spiritual health is a component of human health. Despite of its importance in recent years the concept of spirituality and spiritual care in nursing as a nurses duties, there are few studies in this field especially in our country Iran. Aim: This study was aimed to investigate nurses and nursing students’ viewpoints about spirituality and spiritual care of patients. Method:&nbsp;This cross-sectional study conducted in hospitals affiliated with the Sabzevar University of Medical Sciences. Sampling performed for students by census and for nurses by two-stage sampling. Study instrument was Spirituality and Spiritual Care Rating Scale- SSCRS. Data was analyzed by SPSS software ver.16. Results:&nbsp;The mean total score of attitude towards spirituality and spiritual care in nursing students participating in the study was 54.57±1.74 and 52.44±0.88 in nurses. The mean score differences in nurses and students were not statistically significant and by demographic characteristics. Conclusion:&nbsp;Participants' attitude toward spirituality and spiritual care was desirable and this could be considered as an asset for health managers. Further studies about factors affected their attitude were offered. Please cite this article as: Tofighian, T. Kooshki, A. Borhani, F. Rakhshani, MH. Mohsenpour, M. (2017). Nursing students and nurses attitude toward spirituality and spiritual care.&nbsp;Med History J. 8(29): 45-62

Quality control of sterilization in the hospitals of Sabzevar in 2014

Background and Purpose:Â The important role of proper sterilization of surgical instruments and accessories of patient safety and infection control in hospitals to hygiene standards is a proven fact. Therefore, evaluating the quality control of sterilization in hospitals in Sabzevar is the aim of this study. Â Methods: This investigation cross-sectional was studied in the 2014-2015 on the three hospitals Vasei, Emdad and Mobini. In this study, a questionnaire workplace health center of the Ministry of Health and Medical Education was used by using a check list of the sterilization units were survey and compared in four dimensions: personnel, physical condition, devices and equipment, and packs features reviews. Then the results were analyzed using SPSS 11. Â Result:Â The results showed that the sterilization unit in Sabzevar hospitals, as then staff is the highest with 96.66 and then sterilization equipment with a 76.66 had the lowest quality. Conclusion:Â Sterilization and infertile can reduce hospital infection rate, increase efficiency indicators, and avoid imposing additional financial burden. Therefore, considering the health centers to provide management, credit systems and equipment, increased physical space, and workshops for staff seem necessary for sterilization units