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1.
BMC Health Serv Res ; 23(1): 96, 2023 Jan 28.
Article in English | MEDLINE | ID: mdl-36709274

ABSTRACT

BACKGROUND: There is a sharp contradiction between the supply and demand of medical resources in the provincial capitals of China. Understanding the spatial patterns of medical resources and identifying their spatial association and heterogeneity is a prerequisite to ensuring that limited resources are allocated fairly and optimally, which, along with improvements to urban residents' quality of life, is a key aim of healthy city planning. However, the existing studies on medical resources pattern mainly focus on their spatial distribution and evolution characteristics, and lack the analyses of the spatial co-location between medical resources from the global and local perspectives. It is worth noting that the research on the spatial relationship between medical resources is an important way to realize the spatial equity and operation efficiency of urban medical resources. METHODS: Localized colocation quotient (LCLQ) analysis has been used successfully to measure directional spatial associations and heterogeneity between categorical point data. Using point of interest (POI) data and the LCLQ method, this paper presents the first analysis of spatial patterns and directional spatial associations between six medical resources across Wuhan city. RESULTS: (1) Pharmacies, clinics and community hospitals show "multicentre + multicircle", "centre + axis + dot" and "banded" distribution characteristics, respectively, but specialized hospitals and general hospitals present "single core" and "double core" modes. (2) Overall, medical resources show agglomeration characteristics. The degrees of spatial agglomeration of the five medical resources, are ranked from high to low as follows: pharmacy, clinic, community hospital, special hospital, general hospital and 3A hospital. (3) Although pharmacies, clinics, and community hospitals of basic medical resources are interdependent, specialized hospitals, general hospitals and 3A hospitals of professional medical resources are also interdependent; furthermore, basic medical resources and professional medical resources are mutually exclusive. CONCLUSIONS: Government and urban planners should pay great attention to the spatial distribution characteristics and association intensity of medical resources when formulating relevant policies. The findings of this study contribute to health equity and health policy discussions around basic medical services and professional medical services.


Subject(s)
Hospitals, General , Quality of Life , Humans , Cities , Hospitals, Special , Hospitals, Community , China
2.
Rev Soc Bras Med Trop ; 562023.
Article in English | MEDLINE | ID: mdl-36700602

ABSTRACT

BACKGROUND: The spread of carbapenemase- and extended-spectrum ß-lactamase (ESBL)-producing gram-negative bacilli (GNB) represent a global public health threat that limits therapeutic options for hospitalized patients. This study aimed to evaluate the in-vitro susceptibility of ß-lactam-resistant GNB to ceftazidime-avibactam (C/A) and ceftolozane-tazobactam (C/T), and investigate the molecular determinants of resistance. METHODS: Overall, 101 clinical isolates of Enterobacterales and Pseudomonas aeruginosa collected from a general hospital in Brazil were analyzed. Susceptibility to the antimicrobial agents was evaluated using an automated method, and the minimum inhibitory concentrations (MIC50/90) of C/A and C/T were determined using Etest®. The ß-lactamase-encoding genes were investigated using polymerase chain reaction. RESULTS: High susceptibility to C/A and C/T was observed among ESBL-producing Enterobacterales (100% and 97.3% for CLSI and 83.8% for BRCAST, respectively) and carbapenem-resistant P. aeruginosa (92.3% and 87.2%, respectively). Carbapenemase-producing Klebsiella pneumoniae exhibited high resistance to C/T (80%- CLSI or 100%- BRCAST) but high susceptibility to C/A (93.4%). All carbapenem-resistant K. pneumoniae isolates were susceptible to C/A, whereas only one isolate was susceptible to C/T. Both antimicrobials were inactive against metallo-ß-lactamase-producing K. pneumoniae isolates. Resistance genes were concomitantly identified in 44 (44.9%) isolates, with bla CTX-M and bla SHV being the most common. CONCLUSIONS: C/A and C/T were active against microorganisms with ß-lactam-resistant phenotypes, except when resistance was mediated by metallo-ß-lactamases. Most C/A- and C/T-resistant isolates concomitantly carried two or more ß-lactamase-encoding genes (62.5% and 77.4%, respectively).


Subject(s)
Anti-Bacterial Agents , Lactams , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Brazil , Hospitals, General , Ceftazidime/pharmacology , Cephalosporins/pharmacology , Tazobactam/pharmacology , Drug Combinations , Gram-Negative Bacteria/genetics , Pseudomonas aeruginosa , Klebsiella pneumoniae , Carbapenems , beta-Lactamases/genetics , Microbial Sensitivity Tests
3.
BMJ Open ; 13(1): e059013, 2023 Jan 23.
Article in English | MEDLINE | ID: mdl-36690403

ABSTRACT

OBJECTIVES: Since the new medical reform in 2009, county-level hospitals in China have achieved rapid development, but health resource waste and shortage issues still exist. DESIGN: We applied the meta-frontier and slacks-based measurement-undesirable data envelopment analysis model to measure the medical service efficiency with or without medical quality constraints of the county-level public general hospitals (CPGHs). The assessment includes four inputs, three desirable outputs and one undesirable output. We conducted the assessment via Max-DEA V.8.19 software. Moreover, we analyse the factors affecting CPGHs' medical service efficiency based on the fractional response model. SETTING: A total of 77 sample CPGHs were selected from Shanxi province in China from 2013 to 2018. RESULTS: The results of this study showed that the efficiency level of county-level public hospitals in Shanxi Province is relatively low overall (the mean value of efficiency is 0.61 without quality constraints and 0.63 under quality constraints). This showed that ignoring medical quality constraints will result in lower efficiency and lower health resource usage for high medical quality hospitals. The medical service efficiency of CPGHs differs greatly among different regions. Under the meta-frontier, the hospitals in the central region had the highest efficiency (efficiency score 0.70), followed by those in the south (efficiency score 0.63) and the hospitals in the north had the lowest efficiency (efficiency score 0.54). Factors that have larger impacts on the service efficiency of county public hospitals are the average length of hospital stay, per capita disposable income and financial subsidy income. CONCLUSIONS: To improve CPGHs' medical service efficiency, the government should increase investment in the northern region, and hospitals should improve the management level and allocate human resources rationally.


Subject(s)
Efficiency, Organizational , Hospitals, General , Humans , Cross-Sectional Studies , Hospitals, Public , Efficiency , China
4.
Front Public Health ; 10: 1075146, 2022.
Article in English | MEDLINE | ID: mdl-36684861

ABSTRACT

Background: Internet hospitals are multiplying with solid support from the Chinese government. In internet hospitals, specialist outpatient online consultations (SOOC) are the primary services. However, the acceptance and utilization rates of this service are still low. Thus, the study of patients' choice preferences for SOOC is needed. Objective: To analyze the choice preference of patients' SOOC via a discrete choice experiment, understand the influence of each factor and promote the development of internet hospitals. Methods: Via a discrete selection experiment, a total of 162 patients from two general hospitals and three specialized hospitals in Beijing were selected for the questionnaire survey. The choice preferences were analyzed by conditional logit regression. Results: From high to low, patients' willingness to pay (WTP) for the attributes of SOOC is as follows: doctors' recommendation rate (ß highly recommend = 0.999), the convenience of applying SOOC services (ß Convenient = 0.760), the increasing ratio of medical insurance payment for online services compared to offline (ß Increase by 10% = 0.545), and the disease's severity (ß severe = -3.024). The results of the subgroup analysis showed differences in patient choice preference by age, whether the patients had chronic diseases, income, and medical insurance types. Conclusion: Both price and nonprice attributes influence the choice preference of SOOC for patients. Among them, patients are more inclined to choose SOOC when doctors highly recommend it, when it is convenient to apply, when medical insurance increases by 10%, and when disease severity is mild. The current findings show the government and medical institutions formulate auxiliary policies and welfare strategies by clarifying core attributes and adjusting the levels of different attributes to improve patients' acceptance of SOOC. The utility of SOOC and the further development of internet hospitals are radically promoted.


Subject(s)
Outpatients , Patient Preference , Humans , Surveys and Questionnaires , Chronic Disease , Hospitals, General
5.
Arch Prev Riesgos Labor ; 26(1): 51-53, 2022 Dec 08.
Article in Spanish | MEDLINE | ID: mdl-36655892

ABSTRACT

Estimada Sra. Directora: Agradecemos a los doctores Rujittika Mungmunpuntipantip y Viroj Wiwanitkit su interés por nuestra publicación(1) en la carta en la que se subrayan la importancia de los casos asintomáticos de COVID-19 en la evaluación de los efectos de la vacunación anti-SARS-CoV-2(2). Compartimos con ellos que las personas asintomáticas al COVID-19 pueden presentar unos niveles de anticuerpos anti-SARS-CoV-2 IgG-S mayores que las personas sin historia previa de COVID-19, y que pueden diferir en las reacciones a la vacunación, considerando que la prevalencia de COVID-19 asintomáticos se ha descrito como elevada(3).  En nuestra cohorte de trabajadores del Hospital General Universitario de Castellón, se detectaron 5 casos de COVID-19 asintomáticos (CA), incluyendo los dos seguimientos realizados(1,4), y 20 casos presentaron síntomas de COVID-19 (CS), con un total de 25 casos con confirmación por el laboratorio, 20 % tasa de asintomáticos (5/25). En la tabla 1 se recogen las características de los CA, CS, y de los participantes que no habían sufrido la enfermedad. Los CA eran más jóvenes que los otros 2 grupos, y la proporción de varones era significativamente mayor (p=0,027). En cuanto a los anticuerpos Anti-SARS-CoV-2 IgG-S al mes de la vacunación, los niveles de los CS fueron mayores que los de CA, y de los no casos, siendo estos últimos los que tuvieron significativamente menores niveles (p<0,001). Sin embargo, a los 8 meses de la vacunación la caída de IgG-S fue general, y los niveles de IgG-S eran mayores en los CA que en los CS y en los no casos (p<0,001). Los niveles de IgG-S considerados como protectores ? 4160 UA/ml, eran mayores en los CA y CS que el de los no casos (p=0,001). Si bien, el declive era similar en los tres grupos (p=0,084). Los síntomas y los efectos secundarios de las dos dosis de vacuna Pfizer-BioNTech no presentaron diferencias significativas entre los grupos. Estos resultados son coincidentes con númerosos estudios, en los que se constata que los casos de COVID-19 presentan niveles más elevados de IgG-S que las personas que no han sufrido la enfermedad(5), y se apreció que en valores medio no se alcanzaron los niveles de IgG-S protectores. De aquí la importancia de disponer de marcadores más efectivos de la situación de protección de la personas vacunadas tanto si han sufrido la enfermedad como sino. Además de los anticuerpos neutralizantes, la determinación de la inmunidad celular podría ser muy conveniente para conocer los niveles de protección.


Subject(s)
COVID-19 , SARS-CoV-2 , Humans , COVID-19/prevention & control , Hospitals, General , Personnel, Hospital , Antibodies , Health Personnel
8.
BMC Womens Health ; 23(1): 24, 2023 Jan 18.
Article in English | MEDLINE | ID: mdl-36650492

ABSTRACT

BACKGROUND: In Ghana, only 52% of mothers exclusively breastfeed their babies and the rate of increase has been steadily slow across all geographical areas of Ghana. The purpose of this study was to determine the various factors that influence exclusive breastfeeding (EBF) among mothers who visited the child welfare clinic at the Tema General Hospital, Accra, Ghana. METHODOLOGY: This descriptive cross-sectional study was carried out at the Child Welfare Clinic of the Tema General Hospital, Accra, Ghana. A random sampling technique was used to recruit mothers with children between the ages of 6 months and 24 months attending the Child Welfare Clinic. Mothers were interviewed with the aid of a structured questionnaire. RESULTS: Out of the 222 of mothers interviewed, 68.8% of them exclusively breastfed their infants up to 6 months. Mothers who have good knowledge were more than 3 times (AOR = 3.484, 95% CI 1.200, 10.122, P = 0.022) likely to breastfeed their children exclusively. Those who had positive attitudes towards EBF were about 4 times (COR: 4.018, 95% = 1.444, 11.181, P = 0.008) more likely to exclusively breastfeed than those who had poor attitudes towards EBF. Also, mothers whose spouses complained about EBF were about 3 times (AOR: 2.655, 95% CI 0.620, 11.365, P = 0.018) at increased odds of not exclusively breastfeeding their babies. CONCLUSIONS: High rate of EBF among mothers who visited the child welfare clinic was found. The mothers' level of knowledge and attitude towards EBF significantly influenced the 6 months of EBF. Spouses also showed a high influence on whether or not mothers should exclusively breastfeed their babies.


Subject(s)
Breast Feeding , Hospitals, General , Infant , Child , Female , Humans , Cross-Sectional Studies , Ghana , Health Knowledge, Attitudes, Practice
9.
Langenbecks Arch Surg ; 408(1): 32, 2023 Jan 16.
Article in English | MEDLINE | ID: mdl-36645510

ABSTRACT

BACKGROUND: Laparoscopic common bile duct exploration (LCBDE) is relatively a new approach for clearing choledocholithiasis. The aim of this study is to assess the safety of this approach to clearing common bile duct (CBD) stones on an index admission including emergency setting. METHODS: Retrospective data collection and analysis were carried out for 207 consecutive cases of LCBDE performed in Royal Cornwall Hospital over 6 years (2015-2020). Patients were divided into two groups (Index admission vs elective) then both groups compared. RESULTS: A total of 207 cases of LCBDE were performed in our unit during the time period. One hundred twenty-two operations were performed on the index admission and 85 on a subsequent elective list. Mean operative time was 146 ± 64 min in the index admission group and 145 ± 65 min in the elective group (p = 0.913). Length of stay post-operatively was 3.3 ± 6.3 days in the index admission cases and 3.5 ± 4.6 days after elective cases. Successful clearance was achieved at the end of the operation in 116 patients in the index admission group, clearance failed in one case and negative exploration in 5 patients. In the elective group 83 patients had a successful clearance at the end of the operation, and 2 patients has had a negative exploration. Twelve patients (index admission group) and 8 patients of the elective cases required post-operative Endoscopic Retrograde Cholangiopancreatography (ERCP) to manage retained stones, recurrent stones and bile leak (p = 0.921). Three patients required re-operation for post-operative complications in each group. CONCLUSION: Common bile duct exploration in index admission is safe with high success rate if performed by well-trained surgeons with advanced laparoscopic skills.


Subject(s)
Cholecystectomy, Laparoscopic , Choledocholithiasis , Gallstones , Laparoscopy , Humans , Common Bile Duct/surgery , Retrospective Studies , Hospitals, General , Choledocholithiasis/surgery , Gallstones/surgery , Cholangiopancreatography, Endoscopic Retrograde , Length of Stay
10.
BMC Health Serv Res ; 23(1): 32, 2023 Jan 14.
Article in English | MEDLINE | ID: mdl-36641474

ABSTRACT

BACKGROUND: Patient safety culture concerns the values, beliefs and standards shared by an organisation's health staff and other personnel which influence their care provision actions and conduct. Several countries have made a priority of strengthening patient safety culture to improve the quality and safety of health care. In this direction, measuring the patient safety culture through validated instruments is a strategy applied worldwide. The purpose of this study was to adapt transculturally and validate the HSOPSC 2.0 to Brazilian Portuguese and the hospital context in Brazil. METHODS: Of the various validated scales for measuring safety culture, the instrument most used internationally is the Hospital Survey on Patient Safety Culture (HSOPSC) developed by the United States Agency for Healthcare Research and Quality in 2004 and revised in 2019, when version 2.0 was released. Adaptation was conducted on a universalist approach and the adapted instrument was then applied to a sample of 2,702 respondents (56% response rate) comprising staff of a large general hospital in the city of São Paulo. Construct validity was investigated by Exploratory Structural Equation Modelling-within-Confirmatory Factor Analysis (ESEM-within-CFA) and reliability was measured in each dimension by means of Cronbach alpha coefficients. RESULTS: ESEM fit indexes showed good data fit with the proposed model: χ2 = 634.425 df = 221 χ2/df ratio = 2.9 p-value < 0.0000; RMSEA = 0.045 (90% C.I. = 0.041-0.050) and probability RMSEA < = .05 = 0.963; CFI = 0.986; TLI = 0.968. However, ten items had loads lower than 0.4. Cronbach alpha values were 0.6 or more for all dimensions, except Handoffs and information exchange ([Formula: see text]= 0.50) and Staffing and work pace ([Formula: see text] = 0.41). CONCLUSION: The psychometric properties of the Brazilian version were found to be satisfactory, demonstrating good internal consistency and construct validity as expressed by estimates of reliability and indexes of model fit. However, given factor loadings smaller than 0.4 observed in ten items and considering that the scale translated and adapted to Portuguese was tested on a single sample during the Covid-19 pandemic, the authors recognize the need for it to be tested on other samples in Brazil to investigate its validity.


Subject(s)
COVID-19 , Cross-Cultural Comparison , Humans , Brazil , Reproducibility of Results , Pandemics , Safety Management , Surveys and Questionnaires , Patient Safety , Hospitals, General , Psychometrics
11.
J Frailty Aging ; 12(1): 59-62, 2023.
Article in English | MEDLINE | ID: mdl-36629085

ABSTRACT

An observational, cross-sectional study is conducted to compare elevated risk scores of four geriatric syndromes (falls, malnutrition, physical impairment, delirium) in older hospitalized psychiatric patients (n=178) with patients hospitalized in a general hospital (n=687). The median age of all patients was 78 years (IQR 73.3-83.3), 53% were female. After correction for age and gender, we found significantly more often an elevated risk in the mental health care group, compared to the general hospital group of falls (Odds Ratio (OR) = 1.75; 95% Confidence Interval (CI) 1.18-2.57), malnutrition (OR = 4.12; 95% CI 2.67-6.36) and delirium (OR = 6.45; 95% CI 4.23-9.85). The risk on physical impairment was not statistically significantly different in both groups (OR = 1.36; 95% CI .90-2.07). Older mental health care patients have a higher risk to develop geriatric syndromes compared to general hospital patients with the same age and gender, which might be explained by a higher level of frailty.


Subject(s)
Delirium , Malnutrition , Humans , Female , Aged , Aged, 80 and over , Male , Inpatients , Hospitals, General , Mental Health , Cross-Sectional Studies , Frail Elderly , Malnutrition/epidemiology , Delirium/epidemiology , Geriatric Assessment
12.
Vertex ; 33(158, oct.-dic.): 6-19, 2022 12 30.
Article in Spanish | MEDLINE | ID: mdl-36626610

ABSTRACT

Objectives: To explore the frequency of sociodemographic, clinical, and therapeutic variables of the Inpatient Psychiatric Unit at the Italian Hospital of Buenos. Introduction: Considering that the Inpatient Psychiatric Unit functions within a General Metropolitan Community Hospital, referent both at the local and the international level, we deem it relevant to perform an updated characterization of the population admitted into our Unit. This is especially important given the changes presented since the approval of the National Mental Health Law N° 26.657. Materials and Methods: We performed an observational descriptive and analytic cross-sectional study, studying the patients admitted into the Inpatient Psychiatric Unit for a period of 12 consecutive months (from October 1st, 2018, to September 30th, 2019). Results: During the study period a total of 254 hospitalizations were registered. Mean Age: 51,85 years (S.D.=21,23), Median hospitalization time 22 days [IQR=14.00, 34.00], 31.5% of the admissions were involuntary. The most frequent cause of hospitalization was due to depressive episodes (32.7%), psychosis (22.8%), and dementia/behavioral symptoms (13%). 10.6% of the patients were admitted into our Unit after a suicide attempt. Discussion: The present study provides an updated analysis of the hospitalized population. It contributes to outlining the changes that have taken place over the last years, because of the new legislation. Conclusions: The description of the epidemiologic characteristics of the inpatient population in our setting is crucial to have a current situation diagnosis that allows us to develop health-policy strategies and an adequate allocation of resources.


Objetivo: Explorar la frecuencia de diferentes variables sociodemográficas, clínicas y terapéuticas en los pacientes internados en la Sala de Psiquiatría del Hospital Italiano de Buenos Aires (HIBA). Introducción: Considerando que la Sala de Psiquiatría del HIBA se encuentra emplazada en un hospital general privado metropolitano de comunidad, referente a nivel nacional e internacional, resulta relevante realizar una descripción actualizada de la población usuaria de dicho dispositivo a la luz de los cambios producto de la sanción de la Ley Nacional de Salud Mental N° 26.657. Materiales y métodos: Se realizó  un estudio observacional descriptivo y analítico de corte transversal de pacientes que fueron internados en la Sala de Psiquiatría del HIBA durante el período comprendido entre el 1 de octubre de 2018 hasta el 30 de septiembre de 2019 inclusive. Resultados: Durante el período del estudio se valoraron 254 internaciones. Edad promedio de 51,85 años (D.E.=21,23), Mediana de la duración de internación correspondió a 22 días [IQR=14.00, 34.00], siendo el 31.5% de las mismas de carácter involuntario. Los motivos de ingreso más frecuentes fueron: cuadros depresivos (32.7%), descompensación psicótica (22.8%) y demencia/síntomas conductuales (13%). El 10.6% de los pacientes ingresaron tras haber realizado una tentativa suicida. Discusión: El presente trabajo permite tener una noción actualizada de las características de los pacientes que atendemos en la Sala de Internación teniendo en cuenta los cambios en la legislación vigente y en la sociedad en su conjunto. Conclusiones: Caracterizar los determinantes epidemiológicos del patrón de internaciones psiquiátricas permite realizar diagnóstico de situación local y actualizado que favorecerá el desarrollar y repensar estrategias de planificación y gestión informadas.


Subject(s)
Mental Disorders , Humans , Argentina , Inpatients , Hospitals, Community , Hospitals, General , Hospitalization
13.
BMC Health Serv Res ; 23(1): 21, 2023 Jan 10.
Article in English | MEDLINE | ID: mdl-36627635

ABSTRACT

BACKGROUND: This study aimed to explore the location of acute mental health inpatient units in general hospitals by mapping their location relative to hospital facilities and community facilities and to compare their proximity to hospital facilities with that of general medical acute units. METHODS: We obtained Google maps and hospital site maps for all New Zealand public hospitals. Geographic data were analysed and mental health units' locations in relation to hospital facilities and public amenities were mapped. Radar plots were constructed comparing acute medical and mental health units' locations in relation to hospital facilities. RESULTS: Twenty-two mental health units were identified. They were located predominantly at the periphery of hospital campuses, but also at a distance from community facilities. Compared to acute medical units, mental health units were almost universally located further from shared hospital facilities - with distances approximately three times further to reach the main hospital entrance (2.7 times distance), the nearest public café (3.4 times), the emergency department (2.4 times), and medical imaging (3.3 times). CONCLUSION: Despite the reforms of the 20th Century, mental health units still appear to occupy a liminal space; neither fully integrated into the hospital, nor part of the community. The findings warrant further investigation to understand the impact of these structural factors on parity of health care provision between mental and physical health care and the ability of mental health care services to support recovery.


Subject(s)
Mental Disorders , Mental Health Services , Humans , Mental Health , New Zealand , Hospitals, General , Health Services Accessibility
14.
Front Public Health ; 10: 1049832, 2022.
Article in English | MEDLINE | ID: mdl-36589930

ABSTRACT

Objective: Workplace violence (WPV) not only affects workers' physical and mental health but also increases turnover rates and social costs. There are no studies that have consistently followed the prevalence of WPV and the effectiveness of anti-violence measures in cross-sectional studies of the same hospital. The main aim of this study was to understand the prevalence of WPV among medical staff in a hospital in China and the effectiveness of implemented anti-violence measures. Methods: A cross-sectional survey, which was conducted by using a questionnaire developed by the International Labor Organization and the World Health Organization, was administered in a tertiary hospital in China in 2022 to investigate the occurrence of violence in the past year. Valid data were collected from 1,195 respondents via cell phone. WPV was compared between this survey and a baseline survey conducted at the same hospital in 2017 using the same questionnaire. The relationship between years and gender and occupation was explored using the Cochran-Armitage trend test. Descriptive statistics and chi-square tests were used to respond to the effects of the anti-violence interventions. Results: After the implementation of anti-violence measures, the prevalence of WPV decreased from 48.47 in 2017 to 33.95% in 2021. The recognition of safety measures increased from 80.16 in 2017 to 87.70% in 2021(P < 0.001), improvement of the work environment increased from 56.57 in 2017 to 65.10% in 2021(P < 0.001), restricted of public access increased from 34.36 in 2017 to 55.60% in 2021(P < 0.001), the patient protocols increased from 37.42 in 2017 to 38.40% in 2021, patient screening increased from 32.11 in 2017 to 41.90% in 2021(P < 0.001), and strict restrictions on workplace cash activities from 29.65% in 2017 to 36.00% in 2021(P < 0.05). The percentage of health workers who felt that anti-violence measures were not at all helpful to their current work decreased from 2017 to 2021. Conclusions: The prevalence of workplace violence has decreased, recognition of interventions has increased, and the proportion of interventions that are perceived by HWs as not helpful at all has decreased. This study demonstrates that the 12 anti-violence measures recommended by the International Labor Organization are applicable in China. Based on this, hospitals should focus on the improvement of the intervention effect of the following measures to further prevent violence.


Subject(s)
Workplace Violence , Humans , Workplace Violence/psychology , Hospitals, General , Prevalence , Cross-Sectional Studies , China/epidemiology
16.
BMJ Open ; 12(12): e066296, 2022 12 30.
Article in English | MEDLINE | ID: mdl-36585129

ABSTRACT

OBJECTIVES: To explore genetic/genomic nursing competency and associated factors among nurses from tertiary general and specialist cancer hospitals in mainland China and compare the competencies of nurses from the two types of hospitals. DESIGN AND SETTING: A cross-sectional survey was conducted from November 2019 to January 2020, wherein 2118 nurses were recruited from 8 tertiary general hospitals and 4 cancer hospitals in mainland China. We distributed electronic questionnaires to collect data on nurses' demographics, work-related variables and genomic nursing competency. PARTICIPANTS: 2118 nurses were recruited via a three-stage stratified cluster sampling method. RESULTS: More than half (59.1%, 1252/2118) of the participants reported that their curriculum included genetics/genomics content. The mean nurses' genomic knowledge score was 8.30/12 (95% CI=8.21 to 8.39). Only 5.4% had always collected a complete family history in the past 3 months. Compared with general hospital nurses, slightly more cancer hospital nurses (75.6% vs 70.6%, p=0.010) recognised the importance of genomics, while there was no significant difference in the knowledge scores (8.38 vs 8.21, p>0.05). Gender (ß=0.06, p=0.005), years of clinical nursing (ß=-0.07, p=0.002), initial level of nursing education (ß=0.10, p<0.001), membership of the Chinese Nursing Association (ß=0.06, p=0.004), whether their curriculum included genetics/genomics content (ß=0.08, p=0.001) and attitude towards becoming more educated in genetics/genomics (ß=0.25, p<0.001) were significantly associated with the nurses' genomic knowledge score. CONCLUSION: The levels of genomic knowledge among mainland Chinese nurses in tertiary hospitals were moderate. The overall genomic competency of cancer hospital nurses was comparable to that of general hospital nurses. Further genomic training is needed for nurses in China to increase their genomic competency and accelerate the integration of genomics into nursing practice.


Subject(s)
Neoplasms , Nurses , Humans , Hospitals, General , Cancer Care Facilities , Cross-Sectional Studies , Tertiary Care Centers , China , Genomics/education , Surveys and Questionnaires , Clinical Competence , Neoplasms/genetics
17.
PLoS One ; 17(12): e0279622, 2022.
Article in English | MEDLINE | ID: mdl-36584129

ABSTRACT

INTRODUCTION: Neonatal sepsis can be either early (<7 Days) or late-onset ≥7days) neonatal sepsis depending on the day of the occurrence. Despite the decrement in early onset neonatal sepsis, there is still an increment in late-onset neonatal sepsis. Ethiopian demography and health survey report showed an increment in neonatal mortality in 2019/20. OBJECTIVE: The objective of this study was to assess the determinants of late-onset neonatal sepsis among neonates admitted to the neonatal intensive care unit at Arba-Minch general hospital, southern Ethiopia. METHODS: An institution based study was conducted from March 1, 2021, to June 30, 2021 in Arba-Minch general hospital. Cases were neonates diagnosed with late-onset neonatal sepsis with their index mother chart and controls were neonates admitted with other diagnoses at the same period. Cases and controls were selected consecutively. Data extraction tool and interview which was developed by reviewing different kinds of literature was used to collect data. Data were entered by using Epi data version 3.1software and transformed to Statistical Package for Social Sciences version 25 software for analysis. The binary logistic regression model was used to assess determinants and variables with a p-value <0.2 were transformed to multivariable logistic regression then, a p-value < 0.05 with 95% confidence interval were used to declare significant association with the outcome variable. RESULT: A total of 180 subjects (60 cases and 120 controls) were included in this study. The mean age of neonates was 12.1 days with standard deviations of 4.3. Multivariable logistic regression analysis showed that; history of either sexually transmitted disease /urinary tract infection [AOR = 9.4; 95%CI(3.1-28.5)], being preterm (gestational age of <37 weeks) [AOR = 4.9; 95%CI (1.7-13.7)], use of endotracheal intubation/mechanical intubation [AOR = 8.3; 95%CI (1.8-26.4)]and either mixed types of infant feeding option or formula feeding before admission [AOR = 12.7; 95%CI(3.7-42.8)]were significantly associated with late-onset neonatal sepsis. CONCLUSION AND RECOMMENDATIONS: This study revealed that antenatal, intrapartum and postpartum factors have shown an association with late-onset neonatal sepsis. It is recommended to strengthen counseling and advice to mothers with specific risk factors of late-onset neonatal sepsis.


Subject(s)
Hospitals, General , Neonatal Sepsis , Infant , Infant, Newborn , Humans , Female , Pregnancy , Ethiopia/epidemiology , Neonatal Sepsis/epidemiology , Intensive Care Units, Neonatal , Infant Mortality
18.
PLoS One ; 17(12): e0279887, 2022.
Article in English | MEDLINE | ID: mdl-36584225

ABSTRACT

The emergence of drug-resistant Gram-negative bacterial uropathogens poses a grave threat worldwide, howbeit studies on their magnitude are limited in most African countries, including Ethiopia. Therefore, measuring the extent of their drug resistance is essential for developing strategies to confine the spread. A cross-sectional study was conducted at title hospital from 01 June to 31 August 2020. Midstream urine specimens were collected and inoculated onto MacConkey agar. Positive urine cultures showing significant bacteriuria as per the Kass count (>105 CFU/mL) were further subjected to biochemical tests to identify the type of uropathogens. Antimicrobial susceptibility testing was performed by the Kirby-Bauer disk diffusion technique, and potential carbapenemase producers were phenotypically determined by the modified carbapenem inactivation method as per the CLSI guidelines. Data were analyzed using SPSS version 26; P-value <0.05 was considered statistically significant. Totally, 422 patients were included, and the majority were females (54.7%). The prevalence of carbapenem-resistant Gram-negative uropathogens was 12.9%, and 64.7% of them were carbapenemase producers. Klebsiella pneumoniae (n = 5) was the predominant carbapenemase producer, followed by Pseudomonas aeruginosa (n = 4). Consumption of antibiotics prior to six months of commencement of the study, the presence of chronic diseases and hospitalizations were statistically associated with UTI caused by carbapenem-resistant Gram-negative uropathogens. Carbapenemase producers were resistant to most of the antibiotics tested. Our findings highlight the need for periodic regional bacteriological surveillance programs to guide empirical antibiotic therapy of UTI.


Subject(s)
Hospitals, General , Urinary Tract Infections , Female , Humans , Male , Ethiopia/epidemiology , Cross-Sectional Studies , Urinary Tract Infections/drug therapy , Urinary Tract Infections/epidemiology , Urinary Tract Infections/microbiology , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Gram-Negative Bacteria , Carbapenems/therapeutic use , Microbial Sensitivity Tests
19.
PLoS One ; 17(12): e0267868, 2022.
Article in English | MEDLINE | ID: mdl-36548275

ABSTRACT

BACKGROUND: The first few minutes after birth are the most dangerous for the survival of an infant. Babies in neonatal intensive care units are either under heated or overheated, and hypothermic infants remain hypothermic or develop a fever. As a result, special attention must be paid to monitoring and maintaining the time of recovery from hypothermia states. Despite numerous studies, only a few have examined the transition from neonatal hypothermia and associated risk factors in depth. METHOD: A retrospective observational study was conducted to track axillary temperatures taken at the time of neonatal intensive care unit admission, which were then tracked every 30 minutes until the newborn's temperature stabilized. All hypothermic neonates admitted to the neonatal intensive care unit between January 2018 and December 2020 was included in the study. Temperature data were available at birth and within the first three hours of admission for 391 eligible hypothermic neonates. The effect of factors on the transition rate in different states of hypothermia was estimated using a multi-state Markov model. RESULT: The likelihood of progressing from mild to severe hypothermia was 5%, while the likelihood of progressing to normal was 34%. The average time spent in a severe hypothermia state was 48, 35, and 24 minutes for three different levels of birth weight, and 53, 41, and 31 minutes for low, moderate, and normal Apgar scores, respectively. Furthermore, the mean sojourn time in a severe hypothermia state was 48, 39, and 31 minutes for three different levels of high, normal, and low pulse rate, respectively. CONCLUSION: For hypothermic survivors within the first three hours of life, very low birth weight, low Apgar, and high pulse rate had the strongest association with hypothermia and took the longest time to improve/recover. As a result, there is an urgent need to train all levels of staff dealing with maintaining the time of recovery from neonatal hypothermia.


Subject(s)
Hypothermia , Infant, Newborn , Humans , Hypothermia/etiology , Hypothermia/complications , Hospitals, General , Ethiopia/epidemiology , Body Temperature , Intensive Care Units, Neonatal , Risk Factors
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