The new back-to-school basics: COVID-19 hygiene education for elementary students.

Context: In the midst of the COVID-19 pandemic- with undulating statistics of new cases and deaths and with schools set to reopen in the fall of 2020 after a long hiatus- the objective was to address the needs and methods of preparing children for a safe return to school. Objective: To educate 1st - 5th grade elementary school children about proper health and safety precautions during the COVID-19 pandemic. Study Design and Setting: Three monthly virtual sessions via zoom were implemented with focuses on hygiene, physical activity, and healthy coping mechanisms during a pandemic. The hygiene lecture included interactive demonstrations on handwashing, coughing/sneezing precautions, and appropriate mask-wearing behavior. During the coping mechanisms session, children were asked to use art or free text to answer the question "How has COVID-19 changed my feelings?" The physical activity session discussed safe ways for children to stay active during the pandemic. Both quantitative (pre and post-knowledge assessment quizzes) and qualitative (free text, drawings) data were collected through electronic surveys. Quizzes were designed for the appropriate grade level and used a combination of multiple choice, free text, checkboxes, and pictures to address common themes. Population studied and Intervention: School-aged children (1st-5th grade) at the Raindrop Foundation of San Antonio participated in educational sessions about maintaining proper COVID-19 hygiene. Outcome Measures and Results: Final results show six 1st - 2nd graders and nine 3rd - 5th graders consistently participated in the project. The children involved could identify proper mask-wearing etiquette, safe coughing habits, and when and how to wash their hands. Emotions reported were both positive (ex. happy) and negative (ex. Sad, bored). Reported activities were indoor electronic games and work. Children reported missing friends and going to parks. Conclusions: These educational sessions were organized to teach children safe practices for their return to school, develop coping skills, and also help them adapt to physical activity while maintaining social distancing. Participant 1st - 5th graders answered most questions correctly and displayed the basics of COVID-19 safety knowledge. The children surveyed are experiencing mixed emotions during the pandemic due to feelings of social isolation.

[Development of the Patient-Centered Nursing Culture Scale for Hospitals].

PURPOSE: This study aimed to develop a scale measuring the Patient-Centered Nursing Culture (PCNC) and provide a basic tool to improve PCNC in Korea. METHODS: A conceptual framework and construct factors were extracted through extensive literature review and in-depth interviews with nursing professionals. In total, 59 items were derived based on the pilot survey. Data were collected from 357 nurses working at general hospitals and analyzed for verifying the reliability and validity of the scale. RESULTS: Nine factors containing 54 items were extracted from the exploratory factor analysis to verify the construct validity. The nine factors were top management leadership, policy and procedure, education and training, middle management leadership, supportive teamwork, nursing workplace environment, professional competence, patient-centered nursing activity, and nurses' values. These items were verified by convergent, discriminant, and concurrent validity testing. The internal consistency reliability was acceptable (Cronbach's α=.96). CONCLUSION: The developed PCNC scale is expected to be used as the tool for the development of theory and improvement of PCNC, the empirical testing for cause and effect of PCNC, the development of interventions, education and training programs for improving PCNC, and indicators for evaluation or accreditation of hospital service quality.

Analysis of YouTube as a Source of Information for Diabetic Foot Care.

BACKGROUND: Increasing amounts of diabetes-focused content is being posted to YouTube with little regulation as to the quality of the content. Diabetic education has been shown to reduce the risk of ulceration and amputation. YouTube is a frequently visited site for instructional and demonstrational videos posted by individuals, advertisers, companies, and health-care organizations. We sought to evaluate the usefulness of diabetic foot care video information on YouTube. METHODS: YouTube was queried using the keyword phrase diabetic foot care. Original videos in English, with audio, less than 10 min long within the first 100 video results were evaluated. Two reviewers classified each video as useful or nonuseful/misleading. A 14-point usefulness criteria checklist was used to further categorize videos as most useful, somewhat useful, or nonuseful/misleading. Video sources were categorized by user type, and additional video metrics were collected. RESULTS: Of 87 included videos, 56 (64.4%), were classified as useful and 31 (35.6%) as nonuseful/misleading. A significant difference in the mean length of useful videos vs nonuseful/misleading videos was observed (3.33 versus 1.73 min; P < .0001). There was no significant difference in terms of popularity metrics (likes, views, subscriptions, etc) between useful and nonuseful/misleading videos. CONCLUSIONS: This study demonstrates that although most diabetic foot care videos on YouTube are useful, many are still nonuseful/misleading. More concerning is the lack of difference in popularity between useful and nonuseful videos. Podiatric physicians should alert patients to possibly misleading information and offer a curated list of videos.

The impact of distractions and interruptions during Cesarean Sections: a prospective study in a London teaching hospital.

PURPOSE: During Cesarean Sections, distractions which interrupt task specific activities include auditory, equipment, theatre traffic, and irrelevant communication. Aims of this study were to investigate frequency and types of distractions and to assess impact on patient safety and theatre efficiency. METHODS: Prospective observational study in a London hospital in women undergoing elective and emergency Cesarean Sections. Distractions were recorded prospectively in primiparous women having uncomplicated elective and emergency Cesarean Sections over a 4 week period. Level of distraction is categorized as I: no noticeable impact on surgical team; II: ≥ 1 team member affected; and III: all members affected. Safety outcomes assessed included perioperative complications such as postpartum hemorrhage, organ injury, postsurgical pyrexia (first 48 h), return to theatre, readmissions, and postdelivery anemia < 7 g/dl. RESULTS: Data from 33 elective and 23 emergency cases were collected. Mean number of level II/III distractions/case was 13.20 (± 6.93) and number of level II/III distracting events was greater during elective compared to emergency cases (mean 14.91 vs 12.00, p = 0.04). In total, 17.89% of distractions occurred during crucial part of surgery between skin incision and delivery of baby, while delays resulting from level II/III distractions accounted for 11.25% of total operating time. There were no intra- or postoperative complications observed in the cohort of cases. CONCLUSIONS: Distractions did not culminate in perioperative complications, but disrupted surgeons' task activity, prolonging mean procedure duration by 26.8%. Recognising sources and effects of distractions will enable measures to be taken to improve theatre productivity and patient safety.

Effects of the REMEEX System in Female Patients with Intrinsic Sphincteric Deficiency and Recurrent Urinary Incontinence: 3-Year Outcomes.

OBJECTIVES: To evaluate the long-term outcomes of the REMEEX system (EXternal MEchanical REgulation, Neomedic International, Terrassa, Barcelona, Spain) for the treatment of recurrent urinary incontinence (UI) and intrinsic sphincteric deficiency (ISD). METHODS: From August 2006 to September 2007, a total of 30 patients underwent REMEEX system. Patients were categorized into failed UI (Group A, 11 patients) and ISD (Group B, 19 patients). The success rate of patients after surgery was assessed by cure and satisfaction rates postoperatively at follow-up at 1, 12, and 36 months. Clinical, urodynamic, perioperative, and postoperative data of success rates were analyzed. RESULTS: Total cure rates with REMEEX system(Group A/Group B) were 100.0/94.7% at 1 month and 90.9/79.0% at 3 years. Satisfaction rates were 100.0/89.5% at 1 month and 81.8/68.4% at 3 years in groups A and B. Two patients (6.7%) experienced wound infections. Of these, one patient was treated using intravenous antibiotics and the other had their varitensor removed. Other minimal postoperative complications were immediately resolved. CONCLUSION: The REMEEX system may be an effective procedure regardless of previous incontinence surgical interventions and ISD. The correct sling tension is easily achieved during the early postoperative period, and when necessary, is able to convert late failures into cures. The problems of recurrent UI during the follow-up period were also resolved successfully in every case.

Bicycle riding: impact on lower urinary tract symptoms and erectile function in healthy men.

PURPOSE: Recently, reports in the mass media have implicated that bicycle riding increases the risk of erectile dysfunction and prostatic diseases. So, we evaluate the impact of bicycle riding on erectile function and lower urinary tract symptoms (LUTS) in healthy general men. METHODS: From 26 June 2010 to 20 July 2010, we investigate degree of LUTS (voiding and storage symptoms), using International Continence Society-male Questionnaire (ICS-mQ) and erectile function using International Index of Erectile Function-5 Questionnaire (IIEF-5) in 5 work places (personnel of public office, hospital, university, etc.) of which bicycle riding club members were doing active club activities. Respondents, who participated in club activities for 6 months and longer, were classified as the bicycle club (142 men; age, 44.02±8.56). Ones who do not ride bicycles were classified as the control group (83 men; age, 42.13±7.85). People who were having the history of urological and other chronic diseases (diabetes, vascular disease, heart disease, etc) were excluded from both groups. RESULTS: Bicycle club is not significantly associated with increased prevalence of LUTS (bicycle club, 2.1 to 57.7% control, 4.8 to 73.5%) and erectile dysfunction (bicycle club, 46.1% control, 55.4%). The total mean score (storage/voiding/erectile function) of bicycle club (13.93±1.95/11.14±3.49/20.46±5.30) were not significantly different from control (14.35±2.49/11.52±3.38/20.40±4.07) (P=0.190 to 0.968). CONCLUSIONS: These results suggested that bicycle riding as exercise or hobby has no negative effect on LUTS and erectile function in healthy general men, although this research data were limited to the questionnaire analysis.

Urethral erosion and perineal cellulitis after midurethral sling procedure.

Midurethral tension-free sling procedure has become one of the most popular techniques for the treatment of stress urinary incontinence. As the time elapsed, however, complications associated with a synthetic tape have been reported to occur. Recently, we experienced a rare case of urethral erosion with perineal cellulitis at anterior wall of vagina after midurethral sling procedure. So our experience was presented with a review of literature.