Economic policy uncertainty and financial system efficiency.

Economic policy uncertainty (EPU) adversely affects financial system functioning with potentially critical repercussions for economies and corporations worldwide. Financial system efficiency (FSE) has a vital influence on fostering optimal economic growth and development; however, the impact of EPU on FSE remains under-explored. This study investigates the effect of EPU on FSE along with its components financial institution efficiency (FIE) and financial market efficiency (FME). Using data from 22 countries over a 20-year period (2002-2021), our analysis reveals a significant negative effect of EPU on FSE, FIE and FME. Notably, our split-sample analysis highlights the accentuated adverse effects of EPU in high-EPU regimes, emphasising the importance of vigilance during periods of elevated policy uncertainty. We conduct a series of sensitivity tests, including alternative measures of EPU, FSE, FIE and FME, and apply two-stage least squares and two-step dynamic system generalised method of moments estimators and introduce additional control variables. These tests consistently reaffirm the core conclusions of our study. Finally, we discuss the implications of our findings for policymakers.

Love yourself as a therapist, doubt yourself as an institution? Therapist and institution effects on outcome, treatment length, and dropout.

OBJECTIVE: Research suggests that some therapists achieve better outcomes than others. However, an overlooked area of study is how institution differences impact patient outcomes independent of therapist variance. This study aimed to examine the role of institution and therapist differences in adult outpatient psychotherapy. METHOD: The study included 1428 patients who were treated by 196 therapists at 10 clinics. Two- and three-level hierarchical linear regression models were employed to investigate the effects of therapists and institutions on three dependent patient variables: (1) symptom change, (2) treatment duration, and (3) dropout. Level three explanatory variables were tested. RESULTS: The results showed that therapist effects (TE) were significant for all three types of treatment outcome (7.8%-18.2%). When a third level (institution) was added to the model, the differences between therapists decreased, and significant institution effects (IE) were found: 6.3% for symptom change, 10.6% for treatment duration, and 6.5% for dropout. The exploratory analyses found no predictors able to explain the systematic variation at the institution level. DISCUSSION: TE on psychotherapy outcomes remain a relevant factor but may have been overestimated in previous studies due to not properly distinguishing them from differences at the institution level.

Sustainability in radiography education: A case study of a tertiary institution in Zimbabwe.

INTRODUCTION: To equip radiographers to tackle the negative impacts of climate change, it is crucial to offer in-depth education on planetary health and sustainability. This study aimed to use a tertiary institution in Zimbabwe as a case study to assess radiography students' views on the integration of sustainability into their curriculum. METHODS: A quantitative cross-sectional study using a questionnaire took place at a tertiary institution in Harare, Zimbabwe, where students were sampled consecutively. Categorical variables were described using frequencies and percentages. Data analysis was carried out using Stata 13.1. RESULTS: A total of 96 out of 111 students participated, with an 86% response rate. The majority of students believed in the importance of environmentally friendly radiography practices (90.62%) and felt that sustainability is crucial for better patient care. While sustainability teaching was acknowledged in the curriculum, many students were not confident about the topic in exams. There was no consensus on the preferred methods of teaching sustainability. University lecturers specializing in climate-related fields were seen as the most suitable teachers for sustainability education. CONCLUSIONS: The curriculum reflects efforts in sustainability education, but student confidence and awareness of climate-focused research units require improvement. Continuous education is crucial to link sustainability awareness with practical implications in radiography. Future studies should investigate tailored teaching methods to engage students effectively in sustainable radiography practices. IMPLICATIONS FOR PRACTICE: The findings highlight the importance of ongoing education and awareness campaigns to address the disconnect between understanding the importance of sustainability and implementing it effectively in radiography practice.

Challenges to the operation of Brazilian LTCIs and changes in oversight.

BACKGROUND: Despite 18 years since health surveillance regulations were promulgated in Brazil to govern Long-Term Care Institutions for Older Adults (LTCIs), many institutions fail to comply with the Differentiated Regime for Public Procurement (Resolution No. 502/2021) due to structural and operational conditions. This study aimed to investigate Brazilian LTCI managers' understanding of challenges that significantly impact institutional operation and gather suggestions for enhancing RDC No. 502/21. METHODS: A cross-sectional, exploratory, and qualitative study was conducted, involving 90 managers or technical supervisors from Brazilian LTCIs. Data were collected using a self-administered Google Forms instrument and analyzed through Thematic Analysis based on the Organizing for Quality (OQ) framework. RESULTS: The most impactful challenges for LTCIs were healthcare, financing, human resources, relationship with oversight bodies, and family members. DISCUSSION: Proposed improvements for RDC No. 502/21 included enhanced professional training, infrastructure revision, increased financial support from the state, realistic oversight/regulations, and tailored monitoring approaches. CONCLUSION: LTCIs in Brazil face numerous challenges, and the suggested improvements aim to adapt regulations to institutional realities. However, considering the regulations' variability and purposes, further investigation is warranted.

Can therapeutic reassessment in ODF be based on management principles? / La réévaluation thérapeutique en ODF peut-elle s'appuyer sur les principes du management ?

Introduction: Re-evaluation of therapy is sometimes necessary during treatment. Rarely planned or desired, it is legitimate to look for a way to avoid it while carrying out the correction of the dysmorphosis as initially envisaged. Can the introduction of management into the therapeutic process, and particularly the principle of the feedback loop, make it possible to eliminate any therapeutic re-evaluation? Materials and Methods: After having defined management, cybernetics and the feedback loop as well as the framework for their application, we will look for ways to apply them to the dento-maxillo-facial orthopedics and will then study through historical practice the specific foundations of management and cybernetics in order to be able to conclude that these means are well adapted to our practice. We will rely on a set of historical, sociological and anthropological sources. Conclusions: Management is unsuitable for eliminating the need for therapeutic re-evaluation because, through the deployment of the organizational mode which is consubstantial with it, it is opposed to the institutional order of which any therapeutic approach is a part.

Introduction: La réévaluation de la thérapeutique est parfois nécessaire en cours de traitement ; rarement prévue, ni désirée, il est légitime de chercher un moyen de s'y soustraire tout en menant à bien la correction de la dysmorphose telle qu'initialement envisagée. L'introduction du management dans le processus thérapeutique, et en particulier le principe de la boucle de rétroaction, peut-il permettre de supprimer toute réévaluation thérapeutique ? Matériels et méthodes: Après avoir défini le management, la cybernétique et la boucle de rétroaction, ainsi que le cadre de leur application, nous chercherons les moyens de les appliquer à l'orthopédie dento-maxillo-faciale, puis nous étudierons à travers la pratique historique les fondements propres du management et de la cybernétique afin de pouvoir conclure à la bonne adaptation de ces moyens avec les fins de notre pratique. Nous nous appuierons sur un ensemble de sources historiques, sociologiques et anthropologiques. Conclusion: Le management est impropre à supprimer la nécessité de la réévaluation thérapeutique car, de par le déploiement du mode organisationnel qui lui est consubstantiel, il s'oppose à l'ordre institutionnel dont fait partie toute démarche thérapeutique.

Before and during COVID-19: the roles of transformational leadership, organizational culture and work-life balance in healthcare.

PURPOSE: This research aims to investigate the role of transformational leadership and organizational culture - encompassing Clan, Adhocracy, Hierarchical and Market Cultures - in the context of work-life balance for healthcare workers. It aims to present a comparison of observations made pre and mid-pandemic. DESIGN/METHODOLOGY/APPROACH: A structured questionnaire was utilized to collect data from a varied sample of 355 employees (258 before and 97 during the pandemic) representing multiple sectors and positions within a hospital. The interpretation of the data was accomplished using Partial Least Squares Structural Equation Modeling (PLS-SEM). FINDINGS: Findings reveal that prior to the pandemic, transformational leadership significantly influenced all forms of organizational culture perceptions, with a strong influence on Clan Culture. Clan Culture displayed a consistent positive correlation with WLB both before and during the pandemic. During the pandemic, Market Culture exhibited a negative effect on WLB and Adhocracy Culture demonstrated a positive effect, impacts which were absent before the pandemic. Transformational leadership had a positive impact on WLB before the pandemic, but no discernible effect during the pandemic was observed. ORIGINALITY/VALUE: The results indicate that the dynamics between transformational leadership, organizational culture and work-life balance are susceptible to alterations in the face of external crisis events. This study offers a unique exploration of these dynamics in the healthcare sector during the ongoing global pandemic.

Experiences of pregnant and parenting students at a university in Gauteng province.

Background: Pregnancy and parenting in tertiary institutions is a worldwide concern. The number of pregnancies among tertiary students is increasing globally. About 16 million young women between the ages of 15 years and 19 years around the world became mothers and two million girls under the age of 15 years are reported to be pregnant every year. South African universities continue to report high rates of student pregnancies, and are looking for solutions to the crisis that female students are facing. Aim: The purpose of the study was to explore the experiences of pregnant and parenting students. Setting: At a university in Gauteng province, South Africa. Methods: A qualitative, exploratory and descriptive design was used in a study that was conducted at a university in Gauteng province, South Africa. Undergraduate pregnant and parenting students were sampled purposively, and the sample size was 15 participants. Semi-structured interviews were used to collect data and data were analysed using thematic analysis. Results: The findings of the study produced four themes, namely emotional experience during pregnancy, academic challenges during parenting, experiences during antenatal care, and students' resilience during pregnancy and parenting. Conclusion: Pregnant and parenting students require emotional, academic and social support from the university and other stakeholders. The university should offer on-campus medical services such as antenatal care and provide academic support for pregnant and parenting students to help them achieve their academic objectives. Contribution: This study highlights the importance of developing support programmes that focus on pregnant and parenting students in universities.

Nurses' practice of metabolic monitoring for patients on antipsychotics in Lesotho.

Background: Severe mental illness is associated with higher physical health morbidities and reduced life expectancy, with an estimated 14.3% of global deaths attributed to mental disorders. Antipsychotic medications (APs) used in treatment contribute to physical health issues, including metabolic and cardiovascular effects. Aim: The aim of this study was to assess nurses' practices regarding metabolic monitoring for patients prescribed antipsychotic medications at Mohlomi Hospital in Lesotho. Setting: The study was conducted at Mohlomi Hospital, the primary psychiatric facility in Lesotho. Methods: Using a cross-sectional design, 44 nurses from Mohlomi Hospital participated in the study. A structured questionnaire assessed nurses' metabolic monitoring practices. Results: Most of the respondents were female (n = 30, 75%), and minority were male (n = 10, 25%). The academic qualifications of respondents were distributed as follows: 40% (16) held a nursing assistant certificate and 22.5% (9) held an advanced nursing diploma, among others. The average age of all respondents was 39.05 (s.d. 8.9), with an average of 8 years of experience in psychiatry (s.d. 7.6). The overall rate of nurses' practices of metabolic monitoring for patients taking antipsychotic medications showed variability, with a mean score of 2.83 (s.d. 0.524). However, only 20% performed ECG tests, 22.5% measured blood pressure, 27.5% tested for glucose abnormalities and 17.5% conducted lipid profile testing. Conclusion: Results revealed a significant gap in the practice of metabolic monitoring among nurses with various aspects of metabolic monitoring, not being adequately monitored. Contribution: The study's findings shall inform policy and guidelines for monitoring patients on antipsychotic medications while guiding future research.

Trust in Acquaintances, Strangers and Institutions among Individuals of Different Socioeconomic Statuses during Public Health Emergencies: The Moderation of Family Structure and Policy Perception.

Trust plays a crucial role in effectively responding to public health emergencies. Drawing on COVID-19 survey data conducted in Hubei, China, during August 2020 with a sample size of 5494, this study investigated the influence of individuals' socioeconomic status on trust in acquaintances, strangers and institutions, and how this relationship is moderated by epidemic prevention, policy perception and family structure. The findings showed that individuals with higher socioeconomic status tend to have higher levels of trust. Those with higher income but being married demonstrate higher trust. When perceiving epidemic prevention policies as stringent, those with higher income display increased trust in acquaintances and institutions; similarly, those with lower education levels exhibit heightened trust in acquaintances and strangers. Individuals working in social organizations express higher trust in strangers; however, their trust is compromised under stringent epidemic prevention policies due to potentially heavier work burdens.

Transforming leisure time physical activity into a habit through social institutions.

Physical activity is a positive health behavior that has been shown to reduce the risk of physical and mental illnesses; There's strong evidence suggesting that Physical activity, as one of the components of a healthy lifestyle, if transformed into a consistent behavior or habit early in life, becomes easier to sustain throughout the lifecycle and leads to valuable outcomes for the society's health in various physical, mental, and social dimensions. Each social institution, considering its unique role and characteristics, can contribute to shaping individuals' behaviors in societies. Consequently, identifying the role of social institutions in the development of leisure-time physical activity (LTPA) as a regular activity and a behavioral habit can result in the selection and implementation of highly effective intervention strategies. Therefore, this research aimed to present a model of the role of social institutions in institutionalizing leisure-time physical activity among Iranian adolescent girls. To collect data, the questionnaires were employed, and for presenting the model, structural equation modeling was utilized. Data analysis showed that the role of three social institutions in the institutionalization of physical activities including habituation, objectification and sedimentation was confirmed, although sedimentation was confirmed in all three institutions at the 0.05 level, which indicates that factors in this area can be investigated. Examining the role of social institutions in institutionalizing behaviors may vary across different ages and genders, which is open to investigation in future studies.

A lightweight framework for cyber risk management in Western Balkan higher education institutions.

Higher education institutions (HEIs) have a significant presence in cyberspace. Data breaches in academic institutions are becoming prevalent. Online platforms in HEIs are a new learning mode, particularly in the post-COVID era. Recent studies on information security indicate a substantial increase in cybersecurity attacks in HEIs, because of their decentralized e-learning structure and diversity of users. In Western Balkans, there is a notable absence of incident response plans in universities, colleges, and academic institutions. Moreover, e-learning management systems have been implemented without considering security. This study proposes a cybersecurity methodology called a lightweight framework with proactive controls to address these challenges. The framework aims to identify cybersecurity vulnerabilities in learning management systems in Western Balkan countries and suggest proactive controls based on a penetration test approach.

A framework for leveraging network course-based undergraduate research experience (CURE) faculty to develop, validate, and administer an assessment instrument.

Over the last several years, nationally disseminated course-based undergraduate research experiences (CUREs) have emerged as an alternative to developing a novel CURE from scratch, but objective assessment of these multi-institution (network) CUREs across institutions is challenging due to differences in student populations, instructors, and fidelity of implementation. The time, money, and skills required to develop and validate a CURE-specific assessment instrument can be prohibitive. Here, we describe a co-design process for assessing a network CURE [the Prevalence of Antibiotic Resistance in the Environment (PARE)] that did not require support through external funding, was a relatively low time commitment for participating instructors, and resulted in a validated instrument that is usable across diverse PARE network institution types and implementation styles. Data collection efforts have involved over two dozen unique institutions, 42 course offerings, and over 1,300 pre-/post-matched assessment record data points. We demonstrated significant student learning gains but with small effect size in both content and science process skills after participation in the two laboratory sessions associated with the core PARE module. These results show promise for the efficacy of short-duration CUREs, an educational research area ripe for further investigation, and may support efforts to lower barriers for instructor adoption by leveraging a CURE network for developing and validating assessment tools.

A Multidisciplinary Assessment of ChatGPT's Knowledge of Amyloidosis: Observational Study.

BACKGROUND: Amyloidosis, a rare multisystem condition, often requires complex, multidisciplinary care. Its low prevalence underscores the importance of efforts to ensure the availability of high-quality patient education materials for better outcomes. ChatGPT (OpenAI) is a large language model powered by artificial intelligence that offers a potential avenue for disseminating accurate, reliable, and accessible educational resources for both patients and providers. Its user-friendly interface, engaging conversational responses, and the capability for users to ask follow-up questions make it a promising future tool in delivering accurate and tailored information to patients. OBJECTIVE: We performed a multidisciplinary assessment of the accuracy, reproducibility, and readability of ChatGPT in answering questions related to amyloidosis. METHODS: In total, 98 amyloidosis questions related to cardiology, gastroenterology, and neurology were curated from medical societies, institutions, and amyloidosis Facebook support groups and inputted into ChatGPT-3.5 and ChatGPT-4. Cardiology- and gastroenterology-related responses were independently graded by a board-certified cardiologist and gastroenterologist, respectively, who specialize in amyloidosis. These 2 reviewers (RG and DCK) also graded general questions for which disagreements were resolved with discussion. Neurology-related responses were graded by a board-certified neurologist (AAH) who specializes in amyloidosis. Reviewers used the following grading scale: (1) comprehensive, (2) correct but inadequate, (3) some correct and some incorrect, and (4) completely incorrect. Questions were stratified by categories for further analysis. Reproducibility was assessed by inputting each question twice into each model. The readability of ChatGPT-4 responses was also evaluated using the Textstat library in Python (Python Software Foundation) and the Textstat readability package in R software (R Foundation for Statistical Computing). RESULTS: ChatGPT-4 (n=98) provided 93 (95%) responses with accurate information, and 82 (84%) were comprehensive. ChatGPT-3.5 (n=83) provided 74 (89%) responses with accurate information, and 66 (79%) were comprehensive. When examined by question category, ChatGTP-4 and ChatGPT-3.5 provided 53 (95%) and 48 (86%) comprehensive responses, respectively, to "general questions" (n=56). When examined by subject, ChatGPT-4 and ChatGPT-3.5 performed best in response to cardiology questions (n=12) with both models producing 10 (83%) comprehensive responses. For gastroenterology (n=15), ChatGPT-4 received comprehensive grades for 9 (60%) responses, and ChatGPT-3.5 provided 8 (53%) responses. Overall, 96 of 98 (98%) responses for ChatGPT-4 and 73 of 83 (88%) for ChatGPT-3.5 were reproducible. The readability of ChatGPT-4's responses ranged from 10th to beyond graduate US grade levels with an average of 15.5 (SD 1.9). CONCLUSIONS: Large language models are a promising tool for accurate and reliable health information for patients living with amyloidosis. However, ChatGPT's responses exceeded the American Medical Association's recommended fifth- to sixth-grade reading level. Future studies focusing on improving response accuracy and readability are warranted. Prior to widespread implementation, the technology's limitations and ethical implications must be further explored to ensure patient safety and equitable implementation.

Receptive and expressive vocabulary performance in 2- to 5-year-olds in care: The role of different care types and temperament.

The detrimental role of institutionalization in children's development has prompted the introduction of alternative care types designed to offer more personalized care. The current study aimed to test whether children in alternative care types (care villages, care homes, and foster care) performed better on vocabulary than those in institutions. The role of temperament, specifically perceptual sensitivity and frustration, and the interaction between temperament and care types on vocabulary performance were also explored. The study involved 285 2- to 5-year-old children from different care types, and they were assessed through receptive and expressive vocabulary tests and temperament scales. The results of the linear mixed model revealed that children in alternative care types exhibited significantly higher vocabulary scores compared with those in institutions. Moreover, perceptual sensitivity showed a positive association with receptive and expressive vocabulary skills and seemed to act as a protective factor by mitigating the lower vocabulary scores in institutions. Frustration moderated vocabulary outcomes differently for children in institutions and foster care, aligning with the diathesis-stress model and vantage sensitivity theory, respectively. The findings emphasize the positive role of alternative care types in vocabulary performance and the importance of children's temperamental traits in this process.

Evaluation of quality of life in patients with schizophrenia: An inpatient social welfare institution-based cross-sectional study.

Schizophrenia is a chronic mental illness with a poor quality of life (QoL). The main aim of this study was to measure the QoL and factors that affect the QoL of patients with schizophrenia placed in a social welfare institution. This cross-sectional study included 287 patients with schizophrenia who were treated in a long-stay social care institution in which QoL was assessed using five different instruments: the World Health Organization Quality of Life scale, the EuroQoL Five-Dimension-Five-Level scale (including the visual analog scale), the Quality of Life Enjoyment and Satisfaction Questionnaire - Short Form, and the Brief Psychiatric Rating Scale. To determine the impact of patients' characteristics on score values, multiple linear regression using backward elimination was employed. Due to non-normality in the distribution of the dependent variables, a Box-Cox power transformation was applied to each dependent variable prior to conducting multiple linear regression analysis. Results revealed that patients with schizophrenia have lower QoL. Our study revealed that age, level of education, type of accommodation, type of pavilion, age of onset of the disease, number of prescribed antipsychotics, number of psychiatric comorbidities, duration of therapy, and the number of daily doses of antipsychotics are dominant contributors to the QoL in patients with schizophrenia who were treated in social welfare institution.

Bereavement and Grief Among Employees in an Arab University Setting: A Cross-Sectional Study.

BACKGROUND: Several mental health outcomes develop following bereavement. Little research has examined bereavement in the workplace and the associated risk factors, particularly in Arab populations. OBJECTIVES: The objectives of this cross-sectional study were to determine the sociodemographic characteristics of bereaved employees, measure the prevalence of their dysfunction, establish the type of closeness and conflict in their relationship with the deceased, determine the available resources to the bereaved, and determine the proportion of bereaved employees who needed help. METHODS: A study was conducted on Arabian Gulf University employees (91) in Bahrain. The revised Two Track Bereavement Questionnaire (TTBQ3-CG11) was utilized to assess bereavement outcomes. RESULTS: The response rate of the study was 28%. The composition of the study population was as follows: 51.6% males, 37.4% in the age range of 40-49 years, 86.8% married, 39.6% Bahraini, and 51.6% academicians. Over half of the participants had biopsychosocial dysfunction, 35.2% had active relational grief and trauma (ARGT), 36.3% had a conflict with the deceased, and half were close to the deceased. Total TTBQ3-CG11 scores showed that 28.6% of the bereaved had a low score (14-22), 61.5% medium (23-28), and 9.9% high (29 or more), with more females than males in the high category. The majority reported receiving adequate support from the administration and colleagues following their loss. CONCLUSION: There is a need to establish bereavement policies and procedures at tertiary educational institutes. This study may inform future policies to advance bereavement services in the educational institutions of the region.

The influence of COVID-19 on health seeking behaviors among students attending a minority-serving institution in the U.S.

Objective: The goal of this research was to examine the effects of COVID-19 on health seeking behaviors among students attending a minority-serving institution (MSI). Participants: Students [N = 580, Mage (SD) = 27.7 ± 9.1 years] from a midsized university in the U.S. Methods: Cross-sectional survey, distributed between February-March 2021, assessing visits with a healthcare professional before and during the pandemic. Comparison by time and between groups using McNemar's test and ordinal logistic regression. Results: In-person medical care decreased during the pandemic (p = 0.096). Higher frequency of doctor visits pre-pandemic resulted in less contact with students' healthcare providers during the pandemic (p < 0.001). Those that indicated their health status as Excellent were mostly likely to visit their healthcare provider in-person during the pandemic (p = 0.026). Virtual contacts with their healthcare provider increased during the pandemic (p < 0.001). Conclusions: The COVID-19 pandemic has changed health seeking behaviors among students attending an MSI.

Social Comparison Processes of Hispanic Students at Hispanic Majority Institutions.

This paper describes the types of social comparison used by Hispanic students at a Hispanic Majority Institution through two studies (N = 406). We found that students engaged in upward identification more often than downward identification, downward contrast, and upward contrast. However, when comparing themselves on an academic measure, downward identification and upward contrast became relatively more frequent. Additionally, downward identification tended to predict higher self-reported confidence about academic abilities than other types of social comparison.

Educational interventions to prevent urinary infections in institutionalized elderly people. Quasi-experimental Study / Intervención educativa para prevenir las infecciones urinarias en ancianos institucionalizados. Estudio cuasi-experimental / Intervenção educativa para prevenção de infecções urinárias de idosos institucionalizados. Estudo quase-experimental

Objective. To analyze the effectiveness of an educational intervention among nursing professionals and caregivers to prevent urinary tract infections in institutionalized elderly people. Methods. this is a quasi-experimental study carried out with 20 people (7 nurses and 13 formal caregivers). A questionnaire was applied during the pre-intervention stage, then professional training was carried out and finally, the questionnaire was reapplied 6 months after the intervention. The prevalence profile and factors associated with urinary infections in 116 elderly people was evaluated before and after the educational interventions. Statistical analysis was performed using association and correlation tests, logistic regression model comparison and prevalence rates. Results. The average number of correct answers by the nursing professionals Invest Educ Enferm. 2024; 42(1): e05Educational interventions to prevent urinary infections in institutionalized elderly people. Quasi-experimental Studyand caregivers after the educational intervention increased from the pre to the post-test by 52% regarding signs of urinary infection, 32% regarding its symptoms, 72.5% regarding its treatment, 40% regarding personal/behavioral and morbidity-related risk factors, 59% regarding conditional factors and 43.8% regarding its preventive measures. The team of caregivers showed a greater gain in knowledge compared to the nursing team in almost every question (p<0.05). The length of time working in elderly care showed no positive correlation with any variable (R<1; p>0.05). The prevalence of urinary tract infection in the pre-intervention period was 33.62%, and 20% in the post-intervention period. Conclusion.The educational intervention was effective in preventing urinary tract infections in the elderly. The increased knowledge acquired by nurses and caregivers was associated with a reduction in the infection rate and an improvement in the most prevalent modifiable factors for the development of this type of pathology

Objetivo. Analizar la eficacia de una intervención educativa con profesionales de enfermería y cuidadores para prevenir las infecciones urinarias en ancianos institucionalizados. Métodos. Estudio cuasi-experimental realizado con 20 personas (7 enfermeros y 13 cuidadores formales). Se aplicó un cuestionario antes de la intervención, se llevó a cabo la capacitación de los enfermeros y se volvió a aplicar el cuestionario 6 meses después de la intervención. Se evaluó el perfil de prevalencia de las infecciones urinarias y los factores asociados de 116 ancianos antes y después de las intervenciones educativas. En el análisis estadístico se utilizaron pruebas de asociación y correlación, comparación de modelos de regresión logística y tasas de prevalencia. Resultados. El promedio de respuestas correctas del equipo de enfermería y de los cuidadores tras la intervención educativa aumentó del pre al post-test en un 52% con los signos de infección urinaria, un 32% con los síntomas, un 72.5% con el tratamiento, y un 40% con los factores de riesgo personales/conductuales y los relacionados con la morbilidad, un 59% con los factores condicionales y un 43.8% con las medidas preventivas. El equipo de cuidadores mostró una mayor aprehensión de conocimientos en relación al equipo de enfermería en casi todas las preguntas (p<0.05). El tiempo dedicado al cuidado de ancianos no mostró correlación positiva con ninguna variable (R<1; p>0.05). La prevalencia de infección urinaria en el período pre-intervención fue del 33.62% y en el post-intervención del 20%. Conclusión. La intervención educativa fue eficaz en la prevención de las infecciones urinarias en ancianos. El aumento de conocimientos adquiridos por los enfermeros y por los cuidadores se relacionó con la reducción de la tasa de infecciones y el mejoramiento de los factores modificables más prevalentes para desarrollar este tipo de patología.

Objetivo. Analisar a efetividade de intervenção educativa com profissionais de enfermagem e cuidadores para prevenção de infecções do trato urinário de idosos institucionalizados. Métodos. Estudo quase experimental realizado com 20 pessoas (7 enfermeiros e 13 cuidadores formais). Aplicou-se questionário na pré-intervenção, realizou-se capacitação dos profissionais e reaplicação do questionário 6 meses pós-intervenção. O perfil de prevalência de infecções urinárias e fatores associados de 116 idosos foi avaliado antes e após as intervenções educativas. Na análise estatística utilizou-se testes de associação e de correlação, comparação de modelos de regressão logística e de taxas de prevalência. Resultados. A média de acertos da equipe de enfermagem e de cuidadores, após intervenção educativa, aumentou do pré para o pós-teste em 52% com relação aos sinais de infecção urinária, 32% a sintomas, 72.5% tratamento, e 40% sobre fatores de risco pessoais/comportamentais e relacionados a morbidade, 59% a fatores condicionais e 43,8% sobre medidas preventivas. A equipe de cuidadores apresentou maior ganho de conhecimento em relação à equipe de enfermagem em quase todas as questões (p<0.05). O tempo de cuidado com idoso não apresentou correlação positiva com nenhuma variável (R<1; p>0.05). A prevalência de infecção do trato urinário no período pré-intervenção foi de 33.62% e pós intervenção 20%. Conclusão. A intervenção educativa foi efetiva na prevenção às infecções do trato urinário dos idosos. O aumento do conhecimento adquirido por enfermeiros e cuidadores foi associado à redução da taxa de infecções e à melhoria dos fatores modificáveis mais prevalentes para o desenvolvimento desse tipo de patologia.

The Impact of Acute Peri-operative Particulate Matter Exposure on Endoscopic Sinus Surgery Outcomes: A Preliminary Multi-site Investigation.

BACKGROUND: Environmental exposures have been postulated to play an important role in the pathophysiology of chronic rhinosinusitis (CRS). Particulate matter (PM) is one of the most widely studied ambient air pollutants, but its peri-operative impact on CRS is unknown. OBJECTIVE: To determine the effect of acute, peri-operative PM exposure on outcomes after endoscopic sinus surgery (ESS). METHODS: Participants with CRS who self-selected ESS were prospectively enrolled. The 22-item SinoNasal Outcome Test (SNOT-22) and Medical Outcomes Study Questionnaire Short-Form 6-D (SF-6D) health utility values scores were recorded. Using residence zip codes, a secondary analysis of patient exposure to PM <2.5 µm and <10 µm (PM2.5 and PM10, respectively) was performed for the month of surgery utilizing data from Environmental Protection Agency air quality monitors. Spearman's correlation coefficients (ρ), 95% confidence intervals (CIs), and effect estimates (ß) were used to determine the magnitudes of association. Simple, multivariate regression analysis was also completed. RESULTS: One hundred and seven patients from four geographically unique institutions across the US were enrolled with a follow-up of 6 months. Patients with higher peri-operative PM2.5 exposure had less improvement in their SNOT-22 scores after ESS compared to those with less exposure using both univariate analysis (ρ = 0.26, 95% CI: 0.08, 0.43; P = .01) and after covariate adjustment with multivariate analysis (B = 1.06, 95% CI: 0.001, 2.14, P = .05). Similar associations were not found with SF-6D outcomes or with PM10 as an exposure of interest. No significant correlations were found between peri-operative PM levels and Lund-Kennedy endoscopy scores post-operatively. CONCLUSION: Preliminary data from this pilot study reveal that PM exposure at the time of ESS may negatively associate with post-operative improvement in sinonasal quality-of-life. Larger, population-based studies with more standardized PM exposure windows are needed to confirm the clinical significance of the present findings.