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Ferrante C, Bancej C, Atchessi N. Disease burden attributable to respiratory syncytial virus outbreaks in long-term care. CANADA COMMUNICABLE DISEASE REPORT = RELEVE DES MALADIES TRANSMISSIBLES AU CANADA 2024; 50:25-34. [PMID: 38655245 PMCID: PMC11037883 DOI: 10.14745/ccdr.v50i12a03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Background Respiratory syncytial virus (RSV) disease burden is significant among children; however, RSV can also cause excess morbidity and mortality among older adults. Populations in long-term care homes (LTCHs) may be at greater risk of exposure and increased infection severity. The objectives of this article are to identify evidence regarding disease burden and outcome severity attributable to RSV outbreaks among residents and staff in LTCHs; and to highlight reported population and outbreak characteristics. Methods All types of evidence were eligible for inclusion. Data utilized by included studies was between the end of the 2010 H1N1 influenza pandemic and the beginning of the coronavirus disease 2019 (COVID-19) pandemic. Evidence from the following countries was considered: G7, the European Union, Australia and New Zealand. A total of 167 articles were identified; 58 full texts were analyzed and four sources of evidence were eligible for inclusion. Data related to population characteristics, outbreak type and resident and staff outcomes were manually charted. Results There is a paucity of evidence sources pertaining to RSV outbreak burden among residents and staff in LTCHs. Outbreak duration ranged from 13 to 21 days. For each outbreak, 4-7 residents had confirmed RSV infection. Attack rates ranged from 12% to 38%. A spectrum of disease attributable to RSV outbreaks in LTCHs was identified, ranging from mild cold-like symptoms to death. Conclusion Integration of RSV into existing respiratory pathogen surveillance programs is important to characterize susceptibility, transmissibility and virulence of RSV in at-risk populations. There is a need for public health organizations to publish the findings from outbreak investigations to provide evidence to inform RSV outbreak prevention and response in LTCH settings.
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Affiliation(s)
- Christina Ferrante
- Centre for Emerging and Respiratory Infections and Pandemic Preparedness, Public Health Agency of Canada, Ottawa, ON
| | - Christina Bancej
- Centre for Emerging and Respiratory Infections and Pandemic Preparedness, Public Health Agency of Canada, Ottawa, ON
| | - Nicole Atchessi
- Centre for Emerging and Respiratory Infections and Pandemic Preparedness, Public Health Agency of Canada, Ottawa, ON
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Hanna M, Shah R, Marquez L, Barzegar R, Gordon A, Pammi M. Infant isolation and cohorting for preventing or reducing transmission of healthcare-associated infections in neonatal units. Cochrane Database Syst Rev 2023; 6:CD012458. [PMID: 37368649 PMCID: PMC10297826 DOI: 10.1002/14651858.cd012458.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
BACKGROUND Neonatal healthcare-associated infections (HAIs) result in increased morbidity and mortality, as well as increased healthcare costs. Patient isolation measures, i.e. single-room isolation or the cohorting of patients with similar infections, remain a recommended and commonly used practice for preventing horizontal spread of infections in the neonatal intensive care unit (NICU). OBJECTIVES: Our primary objective was to assess the effect of single-room isolation or cohorting, or both for preventing transmission of HAIs or colonization with HAI-causing pathogens in newborn infants less than six months of age admitted to the neonatal intensive care unit (NICU). Our secondary objective was to assess the effect of single-room isolation or cohorting, or both on neonatal mortality and perceived or documented adverse effects in newborn infants admitted to the NICU. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, the WHO ICTRP and ClinicalTrials.gov trials registries. There were no restrictions to date, language or publication type. We also checked the reference lists of studies identified for full-text review. SELECTION CRITERIA: Types of studies: cluster-randomized or quasi-randomized trials at the level of the cluster (where clusters may be defined by NICU, hospital, ward, or other subunits of the hospital). We also included cross-over trials with a washout period of more than four months (arbitrarily defined). TYPES OF PARTICIPANTS newborn infants less than six months of age in neonatal units that implemented patient isolation or cohorting as infection control measures to prevent HAIs. Types of interventions: patient isolation measures (single-room isolation or cohorting, or both of infants with similar colonization or infections) compared to routine isolation measures. TYPES OF OUTCOME MEASURES the primary outcome was the rate of transmission of HAIs as estimated by the infection and colonization rates in the NICU. Secondary outcomes included all-cause mortality during hospital stay at 28 days of age, length of hospital stay, as well as potential adverse effects of isolation or cohorting measures, or both. DATA COLLECTION AND ANALYSIS The standard methods of Cochrane Neonatal were used to identify studies and assess the methodological quality of eligible cluster-randomized trials. The certainty of the evidence was to be assessed by the GRADE method as evidence of high, moderate, low, or very low certainty. Infection and colonization rates were to be expressed as rate ratios for each trial and if appropriate for meta-analysis, the generic inverse variance method in RevMan was to be used. MAIN RESULTS We did not identify any published or ongoing trials to include in the review. AUTHORS' CONCLUSIONS The review found no evidence from randomized trials to either support or refute the use of patient isolation measures (single-room isolation or cohorting) in neonates with HAIs. Risks secondary to infection control measures need to be balanced against the benefits of decreasing horizontal transmission in the neonatal unit for optimal neonatal outcomes. There is an urgent need to research the effectiveness of patient isolation measures for preventing the transmission of HAIs in neonatal units. Well-designed trials randomizing clusters of units or hospitals to a type of patient isolation method intervention are warranted.
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Affiliation(s)
- Morcos Hanna
- Section of Neonatology, Department of Pediatrics, Baylor College of Medicine, Houston, USA
| | - Rita Shah
- Section of Neonatology, Department of Pediatrics, Baylor College of Medicine, Houston, USA
| | - Lucila Marquez
- Department of Pediatric Infectious Diseases, Baylor College of Medicine, Houston, USA
| | - Rebecca Barzegar
- RPA Newborn Care, Sydney Local Health District, Sydney, Australia
| | - Adrienne Gordon
- RPA Newborn Care, Sydney Local Health District, Sydney, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Mohan Pammi
- Section of Neonatology, Department of Pediatrics, Baylor College of Medicine, Houston, USA
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Perception of Professionals from Different Healthcare Units Regarding the Use of Spray Technology for the Instantaneous Decontamination of Personal Protective Equipment during the Coronavirus Disease Pandemic: A Short Analysis. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12157771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Within the context of the coronavirus disease (COVID-19) pandemic, different disinfection technologies have been developed to efficiently exercise microbial control, especially to minimize the potential risks that are associated with transmission and infection among healthcare professionals. Thus, the aim of this work was to evaluate the perception of professionals regarding the use of a new technology (chamber) for the instantaneous decontamination of personal protective equipment before the doffing stage. This was a cross-sectional descriptive study where the study data were obtained by using a questionnaire with qualitative questions. In total, 245 professionals participated in the study in three hospitals. Healthcare professionals represented 72.24% (n = 177) of the investigated sample. Approximately 69% of the professionals considered the disinfection chamber as a safe technology, and 75.10% considered it as an important and effective protective barrier for healthcare professionals in view of its application before the doffing process. The results found in this study demonstrate that the use of spray technology in the stage prior to the doffing process is acceptable to professionals, and that it can be an important tool for ensuring the additional protection of the professionals who work directly with patients who are diagnosed with COVID-19.
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Wang X, Wang J, Shen J, Ji JS, Pan L, Liu H, Zhao K, Li L, Ying B, Fan L, Zhang L, Wang L, Shi X. Facilities for Centralized Isolation and Quarantine for the Observation and Treatment of Patients with COVID-19. ENGINEERING (BEIJING, CHINA) 2021; 7:908-913. [PMID: 33903828 PMCID: PMC8061092 DOI: 10.1016/j.eng.2021.03.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/25/2021] [Accepted: 04/22/2021] [Indexed: 05/26/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic increased the burden on many healthcare systems and in the process, exposed the need for medical resources and physical space. While few studies discussed the efficient utilization of medical resources and physical space so far. Therefore, this study aimed to summarize experiences related to facilities used for centralized isolation for medical observation and treatment during the COVID-19 pandemic in China and to provide suggestions to further improve the management of confirmed cases, suspected cases, and close contacts. In China, three types of facilities for centralized isolation (Fangcang shelter hospitals, refitted non-designated hospitals, and quarantine hotels) underwent retrofitting for the treatment and isolation of confirmed and suspected cases. These facilities mitigated the immediate high demand for space. Moreover, in order to minimize infection risks in these facilities, regulators and governmental agencies implemented new designs, management measures, and precautionary measures to minimize infection risk. Other countries and regions could refer to China's experience in optimally allocating social resources in response to the COVID-19 pandemic. As a conclusion, government should allocate social resources and construct centralized isolation and quarantine facilities for an emergency response, health authorities should issue regulations for centralized isolation facilities and pay strict attention to the daily management of these facilities, a multidisciplinary administration team is required to support the daily operation of a centralized isolation facility, in-depth studies and international collaboration on the centralized isolation policy are encouraged.
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Affiliation(s)
- Xianliang Wang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Jiao Wang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Jin Shen
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - John S Ji
- Environmental Research Center, Duke Kunshan University, Kunshan 215316, China
- Nicholas School of the Environment, Duke University, Durham, NC 27708, USA
| | - Lijun Pan
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Hang Liu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Kangfeng Zhao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Li Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Bo Ying
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Lin Fan
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Liubo Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Lin Wang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Xiaoming Shi
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China
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Clark LTS, Sanchez S, Phelan C, Sokol-Hessner L, Bruce K, DeSanto-Madeya S. COVID-19 inpatient cohorting team: Successes and lessons learned. Nurs Manag (Harrow) 2021; 52:38-45. [PMID: 33908921 DOI: 10.1097/01.numa.0000737624.29748.4e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Lauren T S Clark
- At Beth Israel Deaconess Medical Center in Boston, Mass., Lauren T.S. Clark is a cardiac surgery clinical nurse and lead quality improvement management system fellow, Sandra Sanchez is the office of bed management and transfer center nursing director, Cynthia Phelan is an associate chief nurse, Lauge Sokol-Hessner is the patient safety medical director, Kendra Bruce is a cardiac medicine unit-based educator, and Susan DeSanto-Madeya is a nurse scientist and an associate professor at the University of Rhode Island College of Nursing in Kingston, R.I
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Izzo L, Santonastaso A, Cotticelli G, Federico A, Pacifico S, Castaldo L, Colao A, Ritieni A. An Italian Survey on Dietary Habits and Changes during the COVID-19 Lockdown. Nutrients 2021; 13:1197. [PMID: 33916384 PMCID: PMC8065756 DOI: 10.3390/nu13041197] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/26/2021] [Accepted: 04/02/2021] [Indexed: 02/07/2023] Open
Abstract
The World Health Organization has declared the coronavirus outbreak a Public Health Emergency of International Concern; the outbreak has led to lockdowns in several parts of the world, and sudden changes in people's lifestyles. This study explores the impact of the first coronavirus disease 2019 (COVID-19) pandemic period on dietary habits, lifestyle changes, and adherence to the Mediterranean diet among the Italian population, through an online questionnaire, conducted from April to May 2020, involving 1519 participants. The 14-point Mediterranean Diet Adherence Screener (MEDAS) highlighted a medium Mediterranean diet adherence in 73.5% of responders, which principally included the younger population, aged 18-30 years (p < 0.05). In regards to changes in eating habits, 33.5% of responders declared an influence of the pandemic period on nutritional practice. A decrease in alcohol consumption was reported by 81% of responders, while an increase in frozen food consumption was reported by 81.3% of responders. In addition, 58.8% reported positive weight modification (40.8%, +1-3 kg); physical activity reduction was reported for 70.5% of responders. Our study contributes toward amplifying the investigation on the dietary habits and changes of the Italian population during the COVID-19 lockdown, although the pandemic is ongoing. Similar studies should be performed around the world to understand how the emergency has impacted people's habits.
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Affiliation(s)
- Luana Izzo
- Department of Pharmacy, University of Naples “Federico II”, Via Domenico Montesano 49, 80131 Naples, Italy;
| | - Antonio Santonastaso
- Department of Precision Medicine, Hepatogastroenterology Division, University of Campania “Luigi Vanvitelli”, Via Pansini 5, 80131 Naples, Italy; (A.S.); (G.C.); (A.F.)
| | - Gaetano Cotticelli
- Department of Precision Medicine, Hepatogastroenterology Division, University of Campania “Luigi Vanvitelli”, Via Pansini 5, 80131 Naples, Italy; (A.S.); (G.C.); (A.F.)
| | - Alessandro Federico
- Department of Precision Medicine, Hepatogastroenterology Division, University of Campania “Luigi Vanvitelli”, Via Pansini 5, 80131 Naples, Italy; (A.S.); (G.C.); (A.F.)
| | - Severina Pacifico
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania “Luigi Vanvitelli”, Via Vivaldi 43, 81100 Caserta, Italy;
| | - Luigi Castaldo
- Department of Pharmacy, University of Naples “Federico II”, Via Domenico Montesano 49, 80131 Naples, Italy;
| | - Annamaria Colao
- Department of Clinical Medicine and Surgery, Unit of Endocrinology, University Federico II, Via Sergio Pansini 5, 80131 Naples, Italy;
- UNESCO Chair on Health Education and Sustainable Development, “Federico II” University, 80131 Naples, Italy
| | - Alberto Ritieni
- Department of Pharmacy, University of Naples “Federico II”, Via Domenico Montesano 49, 80131 Naples, Italy;
- UNESCO Chair on Health Education and Sustainable Development, “Federico II” University, 80131 Naples, Italy
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Hall A, Qureshi I, Glaser J, Auchincloss P, Wilson R. Cost and benefit of military quarantine policies. Prev Med 2021; 143:106371. [PMID: 33321121 PMCID: PMC7834415 DOI: 10.1016/j.ypmed.2020.106371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/05/2020] [Accepted: 12/10/2020] [Indexed: 12/03/2022]
Abstract
The initial response to COVID-19 included quarantine policies. This study aims to determine the infection containment proportions and cost of two variations of quarantine policies based on geographic travel and close contact with infected individuals within deployed US military populations. Special Operations Command Africa (SOCAF) records of individuals quarantined between March 1, 2020 and June 1, 2020 were examined. The infection containment proportion and cost in containment hours were compared between types of quarantine and between geographic areas. Geographic quarantine contained 2 cases out of 63 quarantined individuals in West Africa (3.2%) compared to 0 out of 221 in East Africa (p = 0.0486). Close contact quarantine contained 3 cases out of 31 quarantined individuals in West Africa compared to 4 out of 55 in East Africa (7.3%, p = 0.6989). Total confinement was 42,048 h for each contained infection using geographic quarantine compared to 4076 h using close contact quarantine. In the US military population deployed to Africa for COVID-19, quarantining based on geographic movement is an order of magnitude more costly in terms of time for each contained infection then quarantining based on close contact with infected individuals. There is not a statistical difference between East and West Africa. The associated costs of quarantine must be carefully weighed against the risk of disease spread.
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Affiliation(s)
- Andrew Hall
- Special Operations Command Africa, Unit 30401, APO AE 09107, B96 Medical Group, 307 Boatner Rd., Eglin AFB, FL 32542, USA; 96 Medical Group, 307 Boatner Rd. Eglin AFB, FL 32542, USA.
| | - Iram Qureshi
- Naval Medical Research Unit San Antonio, Department of Surgery, 3698 Chambers Rd., San Antonio, TX 78234, USA
| | - Jacob Glaser
- Naval Medical Research Unit San Antonio, Department of Surgery, 3698 Chambers Rd., San Antonio, TX 78234, USA
| | - Paul Auchincloss
- Special Operations Command Africa, Unit 30401, APO AE 09107, B96 Medical Group, 307 Boatner Rd., Eglin AFB, FL 32542, USA
| | - Ramey Wilson
- Special Operations Command Africa, Unit 30401, APO AE 09107, B96 Medical Group, 307 Boatner Rd., Eglin AFB, FL 32542, USA; Uniformed Services University, Department of Medicine, 4301 James Creek Road, Bethesda, MD 20814, USA
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Ngeh EN, Kuaban C. COVID-19: challenges and the impact on care in clinical settings in Cameroon. Pan Afr Med J 2020; 35:122. [PMID: 33282077 PMCID: PMC7687471 DOI: 10.11604/pamj.supp.2020.35.24929] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 07/14/2020] [Indexed: 12/24/2022] Open
Abstract
COVID-19 is a new disease of pandemic proportions. Since the announcement of the first confirmed case of COVID-19 in Cameroon early this year, there has been an increasing number of circulating videos and messages from families about the poor management of their loved ones in clinical care settings. This correspondence highlights the challenges posed by COVID-19 and its impact on clinical care of patients in Cameroon.
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Affiliation(s)
- Etienne Ngeh Ngeh
- Research Organisation for Health Education and Rehabilitation-Cameroon (ROHER-CAM)
- Regional Hospital Bamenda, North West Region-Cameroon
- Department of Physiotherapy, St. Louis University Douala-Cameroon
| | - Christopher Kuaban
- Research Organisation for Health Education and Rehabilitation-Cameroon (ROHER-CAM)
- Regional Hospital Bamenda, North West Region-Cameroon
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A Conceptual and Adaptable Approach to Hospital Preparedness for Acute Surge Events Due to Emerging Infectious Diseases. Crit Care Explor 2020; 2:e0110. [PMID: 32426752 PMCID: PMC7188427 DOI: 10.1097/cce.0000000000000110] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
At the time this article was written, the World Health Organization had declared a global pandemic due to the novel coronavirus disease 2019, the first pandemic since 2009 H1N1 influenza A. Emerging respiratory pathogens are a common trigger of acute surge events—the extreme end of the healthcare capacity strain spectrum in which there is a dramatic increase in care demands and/or decreases in care resources that trigger deviations from normal care delivery processes, reliance on contingencies and external resources, and, in the most extreme cases, nonroutine decisions about resource allocation. This article provides as follows: 1) a conceptual introduction and approach to healthcare capacity strain including the etiologies of patient volume, patient acuity, special patient care demands, and resource reduction; 2) a framework for considering key resources during an acute surge event—the “four Ss” of preparedness: space (beds), staff (clinicians and operations), stuff (physical equipment), and system (coordination); and 3) an adaptable approach to and discussion of the most common domains that should be addressed during preparation for and response to acute surge events, with an eye toward combating novel respiratory viral pathogens.
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Datta R. COVID-2019: Experience of setting up quarantine center. J Anaesthesiol Clin Pharmacol 2020; 36:S14-S18. [PMID: 33100640 PMCID: PMC7574001 DOI: 10.4103/joacp.joacp_315_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 06/16/2020] [Indexed: 12/03/2022] Open
Abstract
Indians stranded in countries reporting widespread transmission of COVID-19 in Jan to Mar 2020 were evacuated at short notice. Unclear and evolving evidence on COVID-19, risk of transmission of the disease from pre-symptomatic, asymptomatic and known cases of COVID-19 has put the spotlight back on the practice of quarantine. The article describes the processes, inter-sectoral coordination and methodology adopted for putting in place all measures for a successful evacuation and subsequent quarantine of the evacuees at the first Quarantine camp set up in India at Manesar, Gurugram near New Delhi by the Armed Forces. No health care worker or support staff contracted any infection with SARS-Cov-2 during the period of care and contact with those quarantined. The archaic practice of quarantine has yet again proven to be a robust and effective Public Health tool with great relevance in the ongoing Pandemic of COVID-19.
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Cohorting Trauma Patients in a Medical/Surgical Unit at a Level I Pediatric Trauma Center to Enhance Interdisciplinary Collaboration and Documentation. J Trauma Nurs 2019; 26:17-25. [PMID: 30624378 DOI: 10.1097/jtn.0000000000000418] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Medical errors are a significant issue in health care that may be avoided through enhanced communication and documentation. This study examines interdisciplinary communication and compliance with trauma standards of care demonstrated through following the implementation of cohorting trauma patients to one medical/surgical unit and instituting daily interdisciplinary trauma patient rounds. Potential benefits include enhanced communication, improved nursing satisfaction, and increased compliance with trauma standards of care demonstrated through documentation, which the literature suggests improves quality of care. Pre- and postcohorting surveys related to safety attitudes, comfort with caring for trauma patients, and the efficacy of cohorting were administered to the nursing staff. As a marker for increased compliance with trauma standards of care, medical records were reviewed for completion of substance abuse screening upon admission and Functional Independence Measure screening at discharge. The results were compared after the cohorting initiative with 2 years prior. The rate of compliance with substance abuse screening increased from an average of 62.5% in 2015 and 2016 to 84% in 2017. Functional Independence Measure compliance increased from an average of 72.5% in 2015 and 2016 to 94% in 2017 following the cohorting intervention. Nursing perceptions of teamwork, safety climate, and staff support significantly improved (p < .05) from pre- to postcohorting surveys. Improvements were noted in comfort with performing tasks associated with caring for trauma patients but were not statistically significant. Cohorting trauma patients to one medical/surgical unit resulted in positive perceptions of professional relationships, improved communication, and compliance with trauma standards of care for documentation.
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12
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Park JM, Cho HM, Kim JM, Ghim SY. New procedures for food handlers under infectious gastrointestinal disease: To control emerging microbial problems. J Food Saf 2018. [DOI: 10.1111/jfs.12481] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Jong Myong Park
- Department of Infectious Disease Diagnosis; Incheon Institute of Public Health and Environment; Incheon Republic of Korea
- School of Life Sciences; BK21 Plus KNU Creative BioResearch Group, Institute for Microorganisms, Kyungpook National University; Daegu Republic of Korea
| | - Hyun Min Cho
- Food Safety Center; LOTTE group R&D Center; Seoul Republic of Korea
| | - Jong Mun Kim
- Food Safety Center; LOTTE group R&D Center; Seoul Republic of Korea
| | - Sa-Youl Ghim
- School of Life Sciences; BK21 Plus KNU Creative BioResearch Group, Institute for Microorganisms, Kyungpook National University; Daegu Republic of Korea
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Piper GL, Kaplan LJ. Antibiotic heterogeneity optimizes antimicrobial prescription and enables resistant pathogen control in the intensive care unit. Surg Infect (Larchmt) 2012; 13:194-202. [PMID: 22913313 DOI: 10.1089/sur.2012.121] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Multi-drug-resistant organisms (MDRO) complicate care increasingly on the general ward and in the emergency department, operating room, and intensive care unit (ICU). Whereas barrier precautions are important in limiting transmission of MDRO between patients, few tactics have been defined that reduce the genesis of MDRO. METHOD Review of pertinent English-language literature. RESULTS Antibiotic heterogeneity practices, as part of an overall antimicrobial drug stewardship program, offer one readily deployable means to reduce selection pressure for MDRO development in the ICU. The data underpinning this approach and data derived from its use indicate that, especially in surgical ICUs, heterogeneity of antibiotic prescribing can preserve or restore microbial ecology, reduce the prevalence of MDRO and the incidence of infections caused thereby, and facilitate the implementation and effectiveness of other antibiotic-sparing tactics, such as de-escalation. CONCLUSION Heterogeneity of antibiotic prescribing is effective in preventing the dissemination of MDRO pathogens.
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Affiliation(s)
- Greta L Piper
- Section of Trauma, Surgical Critical Care, and Surgical Emergencies, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut 06520, USA
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Abstract
BACKGROUND In the aftermath of a devastating earthquake in early 2011, Haiti fell victim to an outbreak of cholera that claimed thousands of lives and affected populations in nearby Dominican Republic, Venezuela, and even the United States. This was the first time cholera had been reported in Haiti in more than 100 years. The sudden appearance of cholera, a pathogen with no known non-human host, raised the question of how it was introduced to an island that has long been spared this disease. The purpose of this review is to provide an overview of the history of cholera, its pathophysiology and virulence factors, and current recommendations for treatment. METHODS Articles published in the past 10 years were identified by a search of the medical literature using PUBMED and reviewed. Bibliographies of each article also were reviewed for additional pertinent articles. RESULTS The recent epidemic was caused by a strain that has been responsible for disease in South Asia since 1961, the seventh and most recent strain identified since 1900. It is transmitted by the fecal-oral route. Once infected, the patient develops a rapidly dehydrating diarrheal illness caused by the cholera toxin, which activates cytoplasmic adenylate cyclase of the intestinal epithelial cells by adenosine diphosphate (ADP)-ribosylation of the stimulatory G protein. The high cyclic adenosine monophosphate (cAMP) concentrations activate the cystic fibrosis transmembrane conductance regulator, causing a dramatic efflux of ions and water from infected enterocytes and leading to watery diarrhea. The first line of therapy is oral hydration with intravenous fluids; antibiotics are reserved for patients with severe dehydration. Spread of cholera is preventable with simple modifications of hygiene and water preparation. CONCLUSIONS Cholera has re-emerged as a major infectious disease in the recent past, with a global increase in its incidence. Vaccination should be considered as an adjunct for controlling the epidemics and also for volunteer health care workers who provide services to underdeveloped nations. During an epidemic such as occurred in Haiti, use of antibiotics should be considered for all hospitalized patients. These endeavors should proceed in concert with much-needed improvements in sanitation and accessibility of potable water.
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Affiliation(s)
- Michael Sigman
- Division of General Surgery, Department of Surgery, Stritch School of Medicine of Loyola University, Maywood, Illinois 60153, USA
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Attard K, Burrows E, Kotiranta-Harris K, Hedlefs R, Ketheesan N, Govan B. Veterinary infection control in Australia: is there control? Aust Vet J 2012; 90:438-41. [DOI: 10.1111/j.1751-0813.2012.00971.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2012] [Indexed: 11/30/2022]
Affiliation(s)
- K Attard
- School of Veterinary and Biomedical Sciences; James Cook University; Townsville; Queensland; Australia
| | - E Burrows
- School of Veterinary and Biomedical Sciences; James Cook University; Townsville; Queensland; Australia
| | - K Kotiranta-Harris
- School of Veterinary and Biomedical Sciences; James Cook University; Townsville; Queensland; Australia
| | - R Hedlefs
- School of Veterinary and Biomedical Sciences; James Cook University; Townsville; Queensland; Australia
| | - N Ketheesan
- School of Veterinary and Biomedical Sciences; James Cook University; Townsville; Queensland; Australia
| | - B Govan
- School of Veterinary and Biomedical Sciences; James Cook University; Townsville; Queensland; Australia
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