Effectiveness of oolong tea and simethicone solution for lens cleansing during colonoscopy: A double-blinded randomized study.

BACKGROUND AND AIMS: water is an imperfect agent for lens cleansing during endoscopy due to its incompetence to clean hydrophobic dirt, whereas amphiphilic surfactants have the potential to overcome the limitation of water. The trial was aimed to evaluate the cleansing effectiveness of 2 typical surfactants (simethicone solution and oolong tea) for colonoscopic lens. METHODS: Oolong tea (O-), low concentration simethicone solution (S1-), high concentration simethicone solution (S2-) and distilled water (D-) were used as washing solutions for colonoscopic lens. Study I: The tip of the colonoscope was immersed in lard oil in order to simulate the blur, and photographs were taken toward a standard colonoscopy image in-vitro pre- and post- each cleansing procedure. The blurred areas of each image were quantified and compared. Study II: 395 consecutive patients who were due to colonoscopy examination were enrolled and randomized into O-, S2-, D-group. The volume of washing solution used and cleansing level during the examination procedure, adenoma and polyp detected per colonoscopy, insertion time and withdraw time were analyzed. RESULTS: Study I: There were no differences in 4 groups for the blurred areas on images before lens cleansing. The blurred areas after lens cleansing were significantly smaller in 3 groups (O- 8.47 ±â€Š20.91 vs S1- 13.06 ±â€Š10.71 vs S2- 6.76 ±â€Š8.49 vs D- 38.24 ±â€Š29.69, P < .05) than water. The decline range of blurred areas after lens cleansing in oolong tea, low concentration simethicone solution, high concentration simethicone solution groups were significantly higher than that in distilled water group (O- 87.35 ±â€Š20.81 vs S1- 78.12 ±â€Š19.24 vs S2- 89.57 ±â€Š8.50 vs D- 53.39 ±â€Š28.45, P < .05). Study II: The volume of washing solution used in S2-group was significantly smaller than that in O-group and D-group. The cleansing level of the colonoscopic lens of O-group was significantly superior than that of S2-group and D-group. CONCLUSIONS: The in-vitro test showed oolong tea and simethicone solution can effectively cleans the colonoscopic lens. The clinical trial demonstrated that oolong tea instead of water is effective to provide better visualization during colonoscopy.Registration: Chictr.org.cn No: ChiCTR1900025606.

Hair Maintenance and Chemical Hair Product Usage as Barriers to Physical Activity in Childhood and Adulthood among African American Women.

Qualitative studies have identified haircare practices as important culturally specific barriers to physical activity (PA) among Black/African American (AA) women, but quantitative investigations are lacking. Using the Study of Environment, Lifestyle and Fibroids data among 1558 Black/AA women, we investigated associations between hair product usage/hair maintenance behaviors and PA during childhood and adulthood. Participants reported childhood and current chemical relaxer and leave-in conditioner use. Self-reported PA included childhood recreational sports participation, leisure-time PA engagement during adulthood, and, at each life stage, minutes of and intensity of PA. Adjusting for socioeconomic and health characteristics, we used Poisson regression with robust variance to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for each PA measure for more vs. less frequent hair product use/hair maintenance. Thirty-four percent reported ≥twice/year chemical relaxer use and 22% reported ≥once/week leave-in conditioner use at age 10 years, and neither were associated with PA at age 10 years. In adulthood, ≥twice/year chemical relaxer users (30%) were less likely (PR = 0.90 [95% CI: 0.79-1.02]) and ≥once/week leave-in conditioner users (24%) were more likely (PR = 1.09 [95% CI: 0.99-1.20]) to report intense PA compared to counterparts reporting rarely/never use. Hair product use/maintenance may influence PA among Black/AA women and impact cardiometabolic health disparities.

High Proportion of Asymptomatic SARS-CoV-2 Infections in 9 Long-Term Care Facilities, Pasadena, California, USA, April 2020.

Our analysis of coronavirus disease prevalence in 9 long-term care facilities demonstrated a high proportion (40.7%) of asymptomatic infections among residents and staff members. Infection control measures in congregate settings should include mass testing-based strategies in concert with symptom screening for greater effectiveness in preventing the spread of severe acute respiratory syndrome coronavirus 2.

Implementation of an Anaesthesia Quality Improvement Programme to Reduce Fibreoptic Bronchoscope Repair Incidents.

BACKGROUND: This study was aimed at investigating the effectiveness of the implementation of a comprehensive quality improvement programme (QIP) for reducing the repair rate of the fibreoptic bronchoscope (FOB). METHODS: A three-stage improvement strategy was implemented between January 2013 and December 2016. Stage one is the acquisition of information on violations of practice guidelines, repair rate, cost of repair, and incidence of unavailability of FOB during anaesthesia induction of the previous year through auditing. Stage two is the implementation of a quality improvement campaign (QIC) based on the results of stage one. Stage three is the programme perpetuation through monitoring compliance with policy on FOB use by regular internal audits. The effectiveness was retrospectively analyzed on a yearly basis. RESULTS: The annual repair rate, repair cost, and incidence of FOB unavailability before the QIP implementation were 1%, 18,757 USD, and 1.4%, respectively. After QIC, the repair rate in 2013 dropped by 81% (from 1% in 2012 to 0.19% in 2013, p < 0.05). The annual repair cost fell by 32% from 18,758 USD (2012) to 12,820 USD (2013). Besides, the incidence of FOB unavailability plummeted by 71% from 1.4% to 0.4% during the same period. The annual repair rates and incidence of FOB unavailability remained lower in subsequent three years than those before QIP implementation. CONCLUSION: Implementation of a quality improvement programme was effective for reducing the rate and cost of FOB repair as well as unavailability rate, highlighting its beneficial impact on cost-effectiveness and patient safety in a tertiary referral center setting.

Gender Discrepancies Related to Pediatrician Work-Life Balance and Household Responsibilities.

BACKGROUND: Physicians must balance career and home responsibilities, yet previous studies on work-life balance are focused primarily on work-based tasks. We examined gender discrepancies and factors related to household responsibilities and work-life balance among pediatricians. METHODS: We used 2015 data from the American Academy of Pediatrics Pediatrician Life and Career Experience Study, a longitudinal study of early-career pediatricians. χ2 tests and multivariable logistic regression were used to examine the effects of gender on household responsibilities, satisfaction, and work-life balance attainment. We formally reviewed responses from 2 open-ended questions on work-life balance challenges and strategies for common themes. RESULTS: Seventy-two percent of participants completed the survey (1293 of 1801). Women were more likely than men to report having primary responsibility for 13 of 16 household responsibilities, such as cleaning, cooking, and routine care of children (all P < .001). All gender differences except budget management remained significant when controlling for part-time work status and spouse or partner work status (P < .05). Women were less satisfied with their share of responsibilities relative to others (52% vs 62%; P < .001), and few women and men report being very successful at achieving balance between their job and other life areas (15% vs 19%, respectively; P = .05). Open-ended responses (n = 1145) revealed many barriers to achieving work-life balance. Strategies to increase work-life balance included reducing work hours, outsourcing household-related work, and adjustments to personal responsibilities and relationships. CONCLUSIONS: Female pediatricians spend more time on household responsibilities than male pediatricians, and gender is a key factor associated with work-life balance satisfaction.

Occupational accidents and human errors in apartment custodians' work.

BACKGROUND: According to a survey of the economically active elderly population in South Korea, most of them are employed in the service sector, with many men working as custodians. OBJECTIVE: This study investigates the characteristics of injuries affecting apartment custodians, one of the representative jobs for older male workers, as well as the characteristics of accident causes based on human errors. METHODS: The study used information processing as a framework to identify the cause of accidents that affected 831 male apartment custodians. This study investigated the characteristics of injured persons and features of accidents. RESULTS: The majority of accidents were caused by human errors, in particular perceptual (45.5%) and action (26.9%) errors. The rate of accidents caused by human errors rose from 85.3% among those aged below 60 to 91.4% among those aged 70 or above. Furthermore, the rate of accidents caused by perceptual errors was higher among those aged 60 or above (45.0%) than those aged below 60 (31.4%). CONCLUSIONS: The findings of this study imply that accident prevention measures must be customized to older workers according to the different employment conditions.

Case Study: Developing an In-House Magnetic Resonance Imaging Maintenance Program.

In 2015, the Children's Hospital of Eastern Ontario (CHEO) developed an in-house magnetic resonance imaging service team. Within two years, the team achieved substantial savings in operational costs, generated new revenue, improved uptime and response time, and improved customer satisfaction within the hospital. Through careful planning and collaboration, the Clinical Engineering Department at CHEO was able to bring imaging services in house successfully, demonstrating improvements over historical original equipment manufacturer performance thresholds.

Occupation and Thyroid Cancer: A Population-Based, Case-Control Study in Connecticut.

OBJECTIVE: The study aims to explore the associations between various occupations and thyroid cancer risk. METHODS: A population-based, case-control study involving 462 histologically confirmed incident cases and 498 controls was conducted in Connecticut in 2010 to 2011. RESULTS: A significantly increased risk of thyroid cancer, particularly papillary microcarcinoma, was observed for those working as the health care practitioners and technical workers, health diagnosing and treating practitioners, and registered nurses. Those working in building and grounds cleaning, maintenance occupations, pest control, retail sales, and customer service also had increased risk for papillary thyroid cancer. Subjects who worked as cooks, janitors, cleaners, and customer service representatives were at an increased risk of papillary thyroid cancer with tumor size more than 1 cm. CONCLUSION: Certain occupations were associated with an increased risk of thyroid cancer, with some tumor size and subtype specificity.

Work-related back discomfort and associated factors among automotive maintenance mechanics in Eastern Nigeria: A cross sectional study.

BACKGROUND: Back pain has been identified as a common cause of disability in the working population. Automotive mechanics habitually use awkward back posture in their course of manual activity and hence may be at risk of work-related back pain. OBJECTIVE: To investigate the prevalence, pattern and severity of back pain among automotive maintenance mechanics, as well as the personal and job variables associated with or predicting occurrence of back pain. METHOD: Using a cross-sectional design, information about self-reported back pain and the associated variables were collected among 684 randomly recruited automotive mechanics. RESULT: Prevalence of back pain was 76.02%; with the majority experiencing low back pain. 63.3% of the workers reported they limited their activity due to the back pain. Older workers (>50 years), daily work lasting ≥5 hours duration, no more than primary education, being normal weight, frequent use of kneeling and sustained postures, and lack of knowledge of ergonomic postures were associated with increased prevalence of back pain. Lack of job autonomy, inadequate task clarity, heavy physical work load, manual material handling, strenuous posture, noisy environment, vibrations, work schedule and inadequate auxiliary support were also associated with increased prevalence of back pain among the mechanics. CONCLUSION: Work-related back pain is prevalent among automotive maintenance mechanics. Work-related back pain is high among automotive maintenance mechanics. Workstation policy and legislation on reduction of risks with combined health literacy and ergonomic education programs in this occupational group are imperative.

Identifying the hazard characteristics of powder byproducts generated from semiconductor fabrication processes.

Semiconductor manufacturing processes generate powder particles as byproducts which potentially could affect workers' health. The chemical composition, size, shape, and crystal structure of these powder particles were investigated by scanning electron microscopy equipped with an energy dispersive spectrometer, Fourier transform infrared spectrometry, and X-ray diffractometry. The powders generated in diffusion and chemical mechanical polishing processes were amorphous silica. The particles in the chemical vapor deposition (CVD) and etch processes were TiO(2) and Al(2)O(3), and Al(2)O(3) particles, respectively. As for metallization, WO(3), TiO(2), and Al(2)O(3) particles were generated from equipment used for tungsten and barrier metal (TiN) operations. In photolithography, the size and shape of the powder particles showed 1-10 µm and were of spherical shape. In addition, the powders generated from high-current and medium-current processes for ion implantation included arsenic (As), whereas the high-energy process did not include As. For all samples collected using a personal air sampler during preventive maintenance of process equipment, the mass concentrations of total airborne particles were < 1 µg, which is the detection limit of the microbalance. In addition, the mean mass concentrations of airborne PM10 (particles less than 10 µm in diameter) using direct-reading aerosol monitor by area sampling were between 0.00 and 0.02 µg/m(3). Although the exposure concentration of airborne particles during preventive maintenance is extremely low, it is necessary to make continuous improvements to the process and work environment, because the influence of chronic low-level exposure cannot be excluded.

Prospective evaluation of refurbished flexible ureteroscope durability seen in a large public tertiary care center with multiple surgeons.

OBJECTIVE: To evaluate the durability and cost of maintenance for outsourced, refurbished flexible ureteroscopes. MATERIALS AND METHODS: Ureteroscope usage and repair were prospectively recorded over a 365-day period at a large 836-bed public hospital. Cases were performed by 14 different urologists using either refurbished DUR-8 or DUR-8 Elite model ureteroscopes. Retrograde cases involving calculi, urothelial carcinoma, stricture, and diagnostic evaluations were included. Ureteroscope repairs were performed by a single outsourced repair vendor, not the original manufacturer. RESULTS: A total of 501 ureteroscopic cases involving 550 ureteroscope usages were performed over a 365-day period. Semirigid ureteroscopes were used for 281 (56.1%) cases and refurbished flexible ureteroscopes for 220 (43.9%). The reason for the ureteroscopy was calculi in 386 (77.0%) cases, urothelial carcinoma in 32 (6.4%), stricture in 36 (7.2%), and diagnostic in 47 (9.4%). No repairs were needed during this period for semirigid scopes. Ureteral access sheaths were used in 82 (37.7%) of the cases. A total of 32 instances of catastrophic breakage occurred. Each newly refurbished ureteroscope was used for an average of 6.9 times before incurring further damage requiring repair. CONCLUSION: Refurbished flexible ureteroscopes that have undergone comprehensive repair are extremely fragile in the setting of multiple surgeon users in a large public hospital that uses central processing for sterilization and storage. This poor durability results in significant maintenance, repair, and administrative inconvenience that should be considered along with the purchase price.

The use of fault reporting of medical equipment to identify latent design flaws.

BACKGROUND AND PURPOSE: Poor device design that fails to adequately account for user needs, cognition, and behavior is often responsible for use errors resulting in adverse events. This poor device design is also often latent, and could be responsible for "No Fault Found" (NFF) reporting, in which medical devices sent for repair by clinical users are found to be operating as intended. Unresolved NFF reports may contribute to incident under reporting, clinical user frustration, and biomedical engineering technologist inefficacy. This study uses human factors engineering methods to investigate the relationship between NFF reporting frequency and device usability. MATERIAL AND METHODS: An analysis of medical equipment maintenance data was conducted to identify devices with a high NFF reporting frequency. Subsequently, semi-structured interviews and heuristic evaluations were performed in order to identify potential usability issues. Finally, usability testing was conducted in order to validate that latent usability related design faults result in a higher frequency of NFF reporting. RESULTS: The analysis of medical equipment maintenance data identified six devices with a high NFF reporting frequency. Semi-structured interviews, heuristic evaluations and usability testing revealed that usability issues caused a significant portion of the NFF reports. Other factors suspected to contribute to increased NFF reporting include accessory issues, intermittent faults and environmental issues. Usability testing conducted on three of the devices revealed 23 latent usability related design faults. CONCLUSIONS: These findings demonstrate that latent usability related design faults manifest themselves as an increase in NFF reporting and that devices containing usability related design faults can be identified through an analysis of medical equipment maintenance data.

Prepared for sudden cardiac arrest? A cross-sectional study of automated external defibrillators in amateur sport.

INTRODUCTION: Sudden cardiac arrest (SCA) is a rare but tragic part of professional and amateur sport. Following multiple high profile deaths in professional sport over the past two decades, there has been a significant trend towards the widespread availability of automated external defibrillators (AEDs) at amateur sports grounds. OBJECTIVES: To examine the availability of AEDs in amateur sports clubs in Cork, Ireland, and to investigate club practices with respect to the purchase, accessibility, maintenance and use of AEDs. DESIGN: A cross-sectional survey of 218 amateur Gaelic Athletic Association (GAA), soccer and rugby clubs was conducted between July and September 2012. Club committee representatives answered a 22-point questionnaire. RESULTS: 126 GAA clubs and 28 soccer and 17 rugby (n=171) clubs were enrolled in this study. A total of 81.3% of amateur clubs own an AED. We estimate an AED-use rate of one AED use for every 54.5 years an AED is available. Almost 50% of club representatives thought the location of their club AED could be improved while 12.9% of clubs admitted to not maintaining their club AED on a regular basis. CONCLUSIONS: A large proportion of amateur clubs in Cork City and County own an AED. Many clubs engage in regular maintenance and storage of AEDs. However, this study identifies several areas for improvement in facilitating a secure chain of survival for players in the event of an SCA.

An analysis of the radiation field characteristics for extremity dose assessment during maintenance periods at nuclear power plants in Korea.

Workers who maintain the water chambers of steam generators during maintenance periods in nuclear power plants (NPPs) have a higher likelihood of high radiation exposure, even if they are exposed for a short period of time. In particular, it is expected that the hands of workers would receive the highest radiation exposure as a consequence of hand contact with radioactive materials. In this study, a characteristic analysis of inhomogeneous radiation fields for contact operations was conducted using thermoluminescent dosemeters for the whole body and extremities during maintenance periods at Korean NPPs. It was observed that inhomogeneous radiation fields for contact operations at NPPs were dominated by high-energy photons.

Increasing incidence of malignant mesothelioma after exposure to asbestos during home maintenance and renovation.

OBJECTIVE: To determine trends in incidence of malignant mesothelioma (MM) caused by exposure to asbestos during home maintenance and renovation. DESIGN, SETTING AND PARTICIPANTS: Using the Western Australian Mesothelioma Register, we reviewed all cases of MM diagnosed in WA from 1960 to the end of 2008, and determined the primary source of exposure to asbestos. Categories of exposure were collapsed into seven groups: asbestos miners and millers from Wittenoom; all other asbestos workers; residents from Wittenoom; home maintenance/renovators; other people exposed but not through their occupation; and people with unknown asbestos exposure; or no known asbestos exposure. Latency periods and age at diagnosis for each group were calculated and compared. RESULTS: In WA, 1631 people (1408 men, 223 women) were diagnosed with MM between 1960 and 2008. Since 1981, there have been 87 cases (55 in men) of MM attributed to asbestos exposure during home maintenance and renovation, and an increasing trend in such cases, in both men and women. In the last 4 years of the study (2005-2008), home renovators accounted for 8.4% of all men and 35.7% of all women diagnosed with MM. After controlling for sex and both year and age at diagnosis, the latency period for people exposed to asbestos during home renovation was significantly shorter than that for all other exposure groups, but the shorter follow-up and difficulty recalling when exposure first occurred in this group may partly explain this. CONCLUSIONS: MM after exposure to asbestos during home renovation is an increasing problem in WA, and these cases seem to have a shorter latency period than other types of exposure. MM cases related to renovation will probably continue to increase because of the many homes that have contained, and still contain, asbestos building products.

Psychosocial factors of work and mental disorders in electricians.

OBJECTIVE: To identify psychosocial aspects of work associated with common mental disorders in workers who maintain electrical transmission lines and equipment. METHODS: A cross-sectional study was performed with 158 workers in the maintenance sector of an electric power company, in Northeastern Brazil. The main independent variable were the psychosocial aspects of work, measured according to the demand-control model (passive job, active job, low-strain job, and high-strain job), while the dependent variable was the prevalence of common mental disorders, measured by the Self-Reporting Questionnaire (SRQ-20). The relationships between variables were analyzed in multiple logistic regression models, considering a 5% significance level. RESULTS: The prevalence of common mental disorders was 20.3%, varying according to the four categories of the demand-control model. The high-strain job group showed a prevalence that was 2.7 times higher than that of the low-strain job group, after adjustment for the "physical activity practice", "leisure", "level of education" and "social support" covariables. CONCLUSIONS: The prevalence of common mental disorders was associated with psychosocial aspects present in the work of electricians, especially high-strain jobs, in addition to high psychological demand and low social support.

Fatores psicossociais do trabalho e transtornos mentais comuns em eletricitários / Factores psicosociales del trabajo y trastornos mentales comunes en electricistas / Psychosocial factors of work and mental disorders in electricians

OBJETIVO: Identificar aspectos psicossociais do trabalho associados a transtornos mentais comuns em trabalhadores da manutenção de equipamentos e linhas de transmissão de energia elétrica. MÉTODOS: Estudo transversal realizado com 158 trabalhadores do setor de manutenção de uma empresa de energia elétrica no Nordeste do Brasil. A variável independente principal foram os aspectos psicossociais do trabalho, medidos segundo o modelo demanda-controle (trabalho passivo, trabalho ativo, trabalho com baixa exigência e trabalho com alta exigência), e a variável dependente foi a prevalência dos transtornos mentais comuns, medida pelo Self-Reporting Questionnaire (SRQ-20). As relações entre as variáveis foram analisadas em modelos de regressão logística múltipla, considerando-se nível de significância de 5 por cento...

OBJECTIVE: To identify psychosocial aspects of work associated with common mental disorders in workers who maintain electrical transmission lines and equipment. METHODS: A cross-sectional study was performed with 158 workers in the maintenance sector of an electric power company, in Northeastern Brazil. The main independent variable were the psychosocial aspects of work, measured according to the demand-control model (passive job, active job, low-strain job, and high-strain job), while the dependent variable was the prevalence of common mental disorders, measured by the Self-Reporting Questionnaire (SRQ-20). The relationships between variables were analyzed in multiple logistic regression models, considering a 5 percent significance level...

OBJETIVO: Identificar aspectos psicosociales del trabajo asociados a trastornos mentales comunes en trabajadores del mantenimiento de equipos y líneas de transmisión de energía eléctrica. MÉTODOS: Estudio transversal realizado con 158 trabajadores del sector de mantenimiento de una empresa de energía eléctrica en el Noreste de Brasil. Las variables independientes principales fueron los aspectos psicosociales del trabajo, medidos según el modelo demanda- control (trabajo pasivo, trabajo activo, trabajo con baja exigencia y trabajo con alta exigencia), y la variable dependiente fue la prevalencia de los trastornos mentales comunes, medida por el Self-Reporting Questionnaire (SRQ-20). Las relaciones entre las variables fueron analizadas en modelos de regresión logística múltiple, considerándose un nivel de significancia de 5 por ciento...

Clustering techniques: measuring the performance of contract service providers.

This paper investigates the use of clustering technique to characterize the providers of maintenance services in a health-care institution according to their performance. A characterization of the inventory of equipment from seven pilot areas was carried out first (including 264 medical devices). The characterization study concluded that the inventory on a whole is old [exploitation time (ET)/useful life (UL) average is 0.78] and has high maintenance service costs relative to the original cost of acquisition (service cost /acquisition cost average 8.61%). A monitoring of the performance of maintenance service providers was then conducted. The variables monitored were response time (RT), service time (ST), availability, and turnaround time (TAT). Finally, the study grouped maintenance service providers into clusters according to performance. The study grouped maintenance service providers into the following clusters. Cluster 0: Identified with the best performance, the lowest values of TAT, RT, and ST, with an average TAT value of 1.46 days; Clusters 1 and 2: Identified with the poorest performance, highest values of TAT, RT, and ST, and an average TAT value of 9.79 days; and Cluster 3: Identified by medium-quality performance, intermediate values of TAT, RT, and ST, and an average TAT value of 2.56 days.