Triage education in rural remote settings: A scoping review.

BACKGROUND: Triage is a complex nursing task to prioritise patient care, based on acuity. Triage decisions can affect patient safety and must employ critical thinking. Graduate registered nurses are expected to triage in rural facilities, which is in contrast to current guidelines. The purpose of this review was; to discover how effective education support programs were in developing clinical decision-making skills for graduates at triage; and to determine what is known about triage education support programs for graduate or novice registered nurses undertaking triage in rural and remote settings. METHOD: A scoping review was undertaken to identify and analyse primary research articles following PRISMA guidelines, sourced from four electronic databases. RESULTS: 6158 retrieved articles were found, after duplicate removal and screening against inclusion/exclusion criteria; fourteen articles were included. Themes included 'variability of triage accuracy and assessment'; 'education qualifications and experience'; and 'training and supervision'. CONCLUSION: This review demonstrates significant gaps in the literature reporting on this topic area, particularly in the rural context. Common recommendations include standardised triage education strategies, and strategies that account for differences in resourcing levels. Further research is required to attempt to link education strategies in rural contexts to acceptable triage outcomes like triage accuracy.

Heavy metal content and mobility in urban soils of public playgrounds and sport facility areas, Poland.

Among the threats to air, soil, and water posed by urbanization, heavy metals appear particularly hazardous. Playgrounds and sport facilities are unique urban places, widely used by children and youth. The aim of this research was to evaluate heavy metal pollution in urban soils, identify relationships among topsoil metal distributions, and assess related health risks in two Polish cities - Warsaw and Bydgoszcz. According to the Regulation of the Polish Minister of the Environment guidelines for total content of Pb, Cu, Zn, Ni, Cd and Co our study sites were classified as uncontaminated. Applied Geoaccumulation Index (Igeo; Müller, 1969) largely confirmed this classification, with only two of the investigated Warsaw areas "moderately polluted" with Pb. Generally, only Pb and Zn concentrations exceeded reference background levels for Polish soils. The highest concentrations of Pb and Zn were found in the city centers, the oldest areas where pollution risk is potentially the highest. Metal mobility and solubility were mainly correlated with total content, indicating potential risk from lead and zinc. At some sites in Warsaw, where mean Pb concentration was 87.25 mg kg-1 and Zn 207.25 mg kg-1, health risks from ingestion and inhalation seemed significant, particularly for children. In Bydgoszcz use of the studied playgrounds and sport facility areas did not pose a risk to human health. Finally, the study (especially in Warsaw) indicates the need for continued monitoring and suggests lowering permissible limits of these metals in soils, especially in recreational areas, may decrease childrens' exposure risk to these pollutants.

Examining Changes in Prevention Guidelines in Maternal and Child Health: Development of a Teaching Activity.

Purpose Recent changes in preventive guidelines (e.g., pap testing, mammography) have resulted in confusion for both providers and patients. These changes have occurred either because new research has been introduced or because evidence for the practice is not established. Public health has the responsibility to promote the dissemination and implementation of changing guidelines into practice to improve the public's health. Health literacy may facilitate this process. The purpose of this study is to describe a teaching tool applying principles of health literacy to changes in prevention guidelines. The objectives of the teaching activity were to: (1) understand the development of evidence-informed prevention guidelines; and (2) use health literacy to evaluate the target population's perspectives on the guideline change using a health literacy approach. Description An interactive lecture and a practice-based assignment were created; the assignment was pilot-tested in graduate Women's Health classes. Multiple final products were developed in order to facilitate the lecture and assignment: (1) lesson plan; (2) slide presentation; (3) health literacy interview guide worksheet; and (4) grading rubric. After the presentation, students interviewed women from the guideline target population using health literacy constructs and synthesized their findings to create an overall assessment report. Assessment Feedback from the pilot test informed the revision of the teaching activity. Conclusions This teaching tool can be applied in a wide variety of settings in higher education, such as courses in public health, nursing, or medicine. As health literacy continues to be an important determinant of health status, integrating this determinant into the dissemination and communication of preventive guideline changes is needed.

Impact of highway traffic and the acoustic screen on the content and spatial distribution of heavy metals in soils.

Recent years have witnessed intensification of road traffic and, with it, the amount of substances emitted by vehicles. Such emissions need to be monitored for public health purposes. The aim of this study was to evaluate the impact of the highway traffic on the total content and bioavailability of Zn, Cu, Ni, Cd, Cr and Pb in nearby soils as well as influence of an acoustic screen on spatial distribution of the metals. The material included 40 soil samples collected from 15 research points located 5, 10, 25 and 50 m away from the road acoustic screen and from 4 points between the screen and the highway. Additionally, 5 research points were located next to the metal barrier. Selected physicochemical properties of soils were determined: soil texture, soil pH, TOC and CaCO3 content. The total content of heavy metals in the soils was determined by AAS after digestion in aqua regia and bioavailable forms in 1 M diethylenetriaminepentaacetic acid. The research found low impact of the highway traffic on the content of heavy metals in soils; however, due to a very short period of this potential impact (5 years), the moderately polluted category of geo-accumulation index of cadmium and high bioavailability of lead indicate the need of repeating the research within the next several years. Furthermore, the road acoustic screen significantly influenced spatial distribution of the metals in soils.