The continue increase of interventions during labour in low risk population is a controversial issue of the current obstetric literature, given the lack of evidence demonstrating the benefits of ...unnecessary interventions for women or infants' health. This makes it important to have approaches to assess the burden of all medical interventions performed.
Exploiting the nature of childbirth intervention as a staged process, we proposed graphic representations allowing to generate alternative formulas for the simplest measures of the intervention intensity namely, the overall and type-specific treatment ratios. We applied the approach to quantify the change in interventions following a protocol termed Comprehensive Management (CM), using data from Robson classification, collected in a prospective longitudinal cohort study carried out at the Obstetric Unit of the Cà Granda Niguarda Hospital in Milan, Italy.
Following CM a substantial reduction was observed in the Overall Treatment Ratio, as well as in the ratios for augmentation (amniotomy and synthetic oxytocin use) and for caesarean section ratio, without any increase in neonatal and maternal adverse outcomes. The key component of this reduction was the dramatic decline in the proportion of women progressing to augmentation, which resulted not only the most practiced intervention, but also the main door towards further treatments.
The proposed framework, once combined with Robson Classification, provides useful tools to make medical interventions performed during childbirth quantitatively measurable and comparable. The framework allowed to identifying the key components of interventions reduction following CM. In its turn, CM proved useful to reduce the number of medical interventions carried out during childbirth, without worsening neonatal and maternal outcomes.
Malaria is an important vector-borne disease which is widespread in tropical and subtropical areas worldwide as well as in south China. Previous research has separately focused on the association ...between malaria incidence and meteorological variables or between malaria incidence and anti-malaria intervention measures in China, especially in Yunnan Province. Therefore, a typical county, Tengchong County, in Yunnan Province with high malaria incidence was selected as the study area to investigate the integrated influence of climate variance and anti-malaria intervention measures. Malaria incidence and meteorological variables were analyzed with a 2-month lag. The variables include average monthly temperature, minimum temperature, maximum temperature, cumulative precipitation, wind speed, maximum wind speed, relative humidity and minimum relative humidity. First, the principal component analysis was introduced to investigate the relationship between malaria incidence and meteorological variables; classification and regression trees were used to clarify contributions of key meteorological variables to malaria incidence afterwards. Second, based on existing anti-malaria intervention measures and above results, the integrated impact of climate variance and anti-malaria interventions on interannual trends of malaria incidence was analyzed. High malaria incidence occurred under one of the two meteorological conditions: 1) high minimum temperature combined with high minimum relative humidity or both precipitation and minimum relative humidity above middle level; 2) middle minimum temperature combined with both precipitation and minimum relative humidity below middle levels. Moreover, the steep interannual decline of malaria incidence in Tengchong was determined by slight climate variance and persistent anti-malaria intervention measures during malaria epidemics, predominantly by the latter. These findings will provide evidence data for developing malaria surveillance strategies in China.
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•Malaria incidence shows a steeply interannual decline and an obvious seasonality.•Malaria incidence highly correlates to temperature, precipitation and humidity.•Two favorable climate conditions are determined for high incidence of malaria.•There is good agreement between a decreasing malaria incidence and slightly declined climate variance in epidemic months.•Malaria incidence is declined rapidly because of the persistent progress of anti-malaria interventions.
Numerous studies point out that at present, a complete elimination of Campylobacter species in the poultry food chain is not feasible. Thus, the current aim should be to establish control measures ...and intervention strategies to minimize the occurrence of Campylobacter spp. in livestock (esp. poultry flocks) and to reduce the quantitative Campylobacter burden along the food chain in animals and subsequently in foods. The most effective measures to mitigate Campylobacter focus on the primary production stage. Nevertheless, measures applied during slaughter and processing complement the general meat hygiene approaches by reducing fecal contamination during slaughtering and processing and as a consequence help to reduce Campylobacter in poultry meat. Such intervention measures at slaughter and processing level would include general hygienic improvements, technological innovations and/or decontamination measures that are applied at single slaughter or processing steps. In particular, approaches that do not focus on a single intervention measure would need to be based on a thorough process of evaluation, and potential combinatory effects have to be modeled and tested. Finally, the education of all stakeholders (including retailers, food handlers and consumers) is required and will help to increase awareness for the presence of foodborne pathogens in raw meat and meat products and can thus aid in the development of the required good kitchen hygiene.
This paper reviewed the care experience and needs of family caregivers of patients with gastrointestinal cancer. The care experience of family caregivers of patients with gastrointestinal cancer ...mainly included three aspects: overloaded psychological load, decreased physiological function and limited social function; the needs of caregivers were mainly concentrated in the thirst for knowledge and skills in the care of patients with digestive tract cancer and the need for emotional and social support. The care support intervention measures for family caregivers of patients with digestive tract cancer are summarized, and it is suggested that nurses should pay attention to the negative psychological problems of the caregivers and give full play to their positive psychology. It can help caregivers strengthen the social support system and meet their psychological support needs, thereby improving the quality of their care. (本文综述消化道肿瘤患者家庭照护者照护体验及需求。消化道肿瘤患者家庭照护者照护体验主要包括心理负荷过重、生理功能减退及社交功能受限三个方面; 照护者需求主要集中表现为对消化道肿瘤患者照护知识和技能的渴求及情感和社会支持的需求。本文还梳理归纳了消化道肿瘤患者家庭照护者照护支持干预措施, 建议护理人员应重视照护者的消极心理问题, 发挥积极心理效应, 帮助照护者强化社会支持系统, 满足其心理支持需求, 从而提高照护质量。)
The Coronavirus disease 2019 (COVID-19) outbreak has been brought under control through a nationwide effort, and now it has become a global pandemic and the situation seems grim. We summarized the ...measures taken in Wuhan and analyzed the effects to comprehensively describe the factors involved in controlling the COVID-19 in China. In China, several measures such as the lockdown of Wuhan, restriction of traffic and communities, increasing hospital beds, nationwide support from medical staff, epidemic prevention equipment and supplies, and establishment of makeshift shelter hospitals have been taken. The lockdown of Wuhan reduced the propagation of cases to other cities in Hubei province and throughout China, traffic and community restrictions reduced the flow of population and the spread of disease, increasing wards and beds and medical personnel reduced the incidence of severe cases and mortality, the establishment of the Fangcang shelter hospitals provided a good isolation and monitoring environment, and further reduced the spread and fatality of the disease. The fact that China was able to control the spread of COVID-19 within three months without a specific drug or vaccine suggests that these measures are more adequate and effective.
In May 2021, the SARS-CoV-2 Delta variant led to the first local outbreak in China in Guangzhou City. We explored the epidemiological characteristics and spatial-temporal clustering of this outbreak.
...Based on the 153 cases in the SARS-CoV-2 Delta variant outbreak, the Knox test was used to analyze the spatial-temporal clustering of the outbreak. We further explored the spatial-temporal clustering by gender and age groups, as well as compared the changes of clustering strength (S) value between the two outbreaks in Guangzhou.
The result of the Knox analysis showed that the areas at short distances and brief periods presented a relatively high risk. The strength of clustering of male-male pairs was higher. Age groups showed that clustering was concentrated in cases aged ≤ 18 years matched to 18-59 years and cases aged 60+ years. The strength of clustering of the outbreak declined after the implementation of public health measures. The change of strength of clustering at time intervals of 1-5 days decreased greater in 2021 (S = 129.19, change rate 38.87%) than that in 2020 (S = 83.81, change rate 30.02%).
The outbreak of SARS-CoV-2 Delta VOC in Guangzhou has obvious spatial-temporal clustering. The timely intervention measures are essential role to contain this outbreak of high transmission.
Air filtration is frequently recommended as a component of environmental control measures for patients with allergic respiratory disease. Residential air filtration can be provided by whole house ...filtration via the home’s heating, ventilation, or air conditioning system, by portable room air cleaners, or a combination of the two. Appliances to filter the sleep breathing zone also have been developed. High-efficiency whole house filtration, high-efficiency particulate air sleep zone air filtration, and high-efficiency particulate air room air cleaners all appear to provide various degrees of benefit. Recent studies of various types of filtration, used alone or as part of more comprehensive environmental control measures, are reviewed.
The brain has a limited process of repair/regeneration linked to the restricted and localized activity of neuronal stem cells. Consequently, it shows a reduced capacity to counteract the age-related ...loss of neural and glial cells and to repair the consequent injuries/lesions of nervous system. This progressively determines nervous dysfunction and onset/progression of neurodegenerative diseases, which represent a serious social (and economic) problem of our populations. Thus, the research of efficient treatments is encouraged. Stem cell therapy might represent a solution. Today, it, indeed, represents the object of intensive research with the hope of using it, in a near future, as effective therapy for these diseases and preventive treatment in susceptible individuals. Here, we report and discuss the data of the recent studies on this field, underling the obstacles and benefits. We also illustrate alternative measures of intervention, which represent another parallel aim for the care of neurodegenerative pathology-affected individuals. Thus, the road for delaying or retarding these diseases appears hard and long, but the advances might be different.
Carbapenem-resistant Enterobacteriaceae (CRE) cause surgical site infections (SSIs) in intensive care units (ICUs). This study aimed to evaluate the impact of intervention and control measures to ...reduce CRE colonization and infection rates among patients in the ICU of a cardiac surgery hospital following a CRE outbreak.
An observational study of the pre- and postintervention status of a cohort of colonized or infected patients in the postoperative adult cardiac surgery ICU was performed between April 2013 and December 2014. As well as the usual measures of screening and cohort nursing, the control measures were enhanced during the intervention period by providing alcohol gel at the bedside, daily bathing with no-rinse 2% chlorhexidine-impregnated wash cloths, and disinfection of surfaces around the patient three times per day.
The rates of CRE colonization (P<0.001), primary central-line-associated bloodstream infections (P<0.002) and SSIs (P< 0.003) decreased significantly during the postintervention period.
The implemented measures were effective in controlling colonization and infection with CRE in the cardiac surgery ICU.
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