Safety Council Research Articles

Four-year evaluation of drug-impaired driving drug concentrations.

Drug-impaired driving is a significant public health and safety concern in the USA. To help assess current patterns of drug use in drivers, we evaluated 4 years of drug positivity in a large cohort of suspected impaired drivers. Samples collected between January 2017 and December 2020 were tested via a method compliant with the National Safety Council's Alcohol, Drugs, and Impairment Division's Tier I scope of recommended drugs. In 2017, NMS Labs received 17 346 driving under the influence of drugs cases, 17 471 in 2018, 19 050 in 2019, and 16 539 in 2020. The most common drug class detected was cannabinoids in ∼50% of the cases each year. The most common drugs detected over the 4 years were delta-9 tetrahydrocannabinol (delta-9 THC), ethanol, amphetamine/methamphetamine, fentanyl, and alprazolam. Delta-9 THC increased in positivity over the study, having been identified in 45% of cases in 2017, 46% in 2018, 46% in 2019, and 49% in 2020. Ethanol was found in 59% of cases in 2017, 59% in 2018, 61% in 2019, and 53% in 2020. Delta-9 THC and ethanol were the most common drug combination, found together in ∼19% of the cases every year of the study. Statistically significant increases in the average concentration of the following drugs were observed: fentanyl (5.7 ng/mL in 2017 to 9.6 ng/mL in 2020), methamphetamine (301 ng/mL in 2017 to 381 ng/mL in 2020), and delta-9-THC (6.4 ng/mL in 2017 to 7.3 ng/mL in 2020). Other findings included increases in the maximum reported concentrations between 2017 and 2020 for amphetamine (1400 to 2700 ng/mL), methamphetamine (5550 to 13 000 ng/mL), and fentanyl (56 to 310 ng/mL). Statistically significant concentration decreases were noted for several central nervous system depressants, notably prescription benzodiazepines, and several prescription narcotic analgesics.

Huge urgency and consummate skill: an interview with Jim Pennington

ABSTRACT Jim Pennington is a printer and small press publisher who trained at London's North-Western Polytechnic and the London College of Printing. Over the course of his long career, he has worked as a print room and production manager first for the British Safety Council (1971–75) then for the anti-poverty charity War on Want (1975–79) and then for the Lithosphere Printing Co-operative (1979–1991), among others. In parallel, Pennington ran Aloes Books, the influential small press he established with the poets Allen Fisher and Dique Miller. Aloes Books has published key works by Kathy Acker, Thomas Pynchon and William Burroughs, among many others.

Foreign Body Aspiration in Children Clinical, Radiological, and Bronchoscopic Findings

Background: Inhalation of foreign bodies (FBs) is a frequent and adverse condition in the pediatric population. Foreign body aspiration (FBA) is a serious health problem that is sometimes fatal. According to the 2019 data of the National Safety Council (NSC), deaths associated with FBA are the fourth most common preventable accident between the ages of 0–4 years. Aim: The study aimed to retrospectively inspect foreign body aspiration (FBA) among children by focusing on symptoms, physical and radiological examination and complications. Method: This was a retrospective study (case series) conducted at Benghazi Children‘s Hospital in a period from1st. October 2020 to1st. October 2022 that included all children under 15 years old who underwent rigid bronchoscopy for suspected foreign body aspiration. Results: A total of 131 patients who underwent bronchoscopy were included in this study. The mean age of the studied group was (3.5±3.4 years) ranged from 2 months to 15 years. The FBA was most common (50, 38.17%) in the age group (1-3 years), followed by children aged <1 year (38, 29.01%), and less common in patients aged >10 years (8, 6.11%). The FBA was slightly higher in females (73, 55.73 %) than males (58, 44.27%). The history of FBA and the presence of FB in bronchoscopy were witnessed in the majority of cases: (108, 82.44%) and (117, 89.31%) respectively. The majority of removed FB were organic in nature (83, 70.94 %) with the predominance of peanuts (33, 39.76%), and seeds (21, 25.30%). Most of FB is located in the right main bronchus (46, 51.69%) followed by the left main bronchus (16, 17). A large number of cases (83, 72.82%) took more than two days (48 hours) between aspiration and the removal of a foreign body. Cough was the most common symptom (100, 77.5%), followed by chocking (88, 68.2%), then breathlessness (61, 47.3%), and the other cases presented the following symptoms in decreasing order: wheezing, cyanosis, fever, grunting, seizure, dysphagia, ........

From the Journal Editor

Haere mai! Welcome to volume 1, edition 1 of the New Zealand Journal of Health and Safety Practice! The Journal is open access and online and subscriptions are free. Although published in New Zealand we hope it will be read by workers everywhere who work in the field of health, safety and wellbeing. This edition is published at the time of International Workers' Memorial Day and the 29th anniversary of the New Zealand Cave Creek tragedy. I hope the Journal will grow to share practical, research-based knowledge that will help every worker (and visitors to workplaces) to go home physically and mentally unharmed. Much work went into the development of the Journal and I thank: the authors who spent time writing and revising the articles our anonymous reviewers who spent their time reading the submissions and making comments: you have helped set the standard for the Journal. Nik Crombie and Max Sullivan in the Victoria University of Wellington Library who helped with the backroom work and technology making the Journal free to publish. The editorial team also thanks HASANZ, Engineering New Zealand, Faculty of Asbestos Management of Australia & New Zealand, Human Factors and Ergonomics Society of New Zealand, Institute of Organisational Psychology, New Zealand Institute of Safety Management, New Zealand Occupational Health Nurses Association, New Zealand Occupational Hygiene Society, New Zealand Safety Council, AVID Plus Limited and Risk Management Ltd for financial and other support to help establish the Journal. Terje Aven, a Norwegian academic, wrote that “safety science is multidisciplinary. Its contributors and its audience range from psychologists to chemical engineers”; that safety science “covers the physics and engineering of safety; its social, policy and organisational aspects; the management of risks; the effectiveness of control techniques for safety; standardization, legislation, inspection, insurance, costing aspects, human behaviour and safety and the like.” The founding organisations of NZJHSP are similarly drawn from those disciplines. A call for papers for the July 2024 edition will go out shortly. I look forward to submissions for future editions of this Journal those focused on the practice of workplace health and safety through implementing the broad subject area of safety science to help protect workers and others and achieve good work conditions. References Aven, T. (2014). What is safety science? Safety Science, 67, 15-20. https://doi.org/10.1016/j.ssci.2013.07.026

Digital resilience in Chinese adolescents: a portrayal of the current condition, influencing factors, and improvement strategies.

Digital resilience is an important skill for adolescents in the digital age, but there is a lack of valid and reliable assessment methods. This study aimed to develop and validate a digital resilience questionnaire for Chinese adolescents based on the Digital Resilience Framework proposed by the UK Children's Internet Safety Council. This study employed a mixed research design, combining quantitative and qualitative data collected and analyzed. Over a six-month period (January to June 2023), a questionnaire was distributed to 12,208 adolescents from 10 high schools and 16 middle schools, with in-depth interviews performed with 10 of the participants. The study revealed that Chinese adolescents digital resilience levels are slightly higher than average (M = 3.5038 > 3.5), but there is still potential for development, particularly in active learning. Additionally, a variety of characteristics influencing adolescents digital resilience were discovered, including gender, family residency, whether they are only children, grade level, the number of digital devices used per week, and the length of hours spent online daily. This study developed and verified a digital resilience questionnaire for Chinese adolescents, which may be used to assess and improve their digital skills and well-being in the digital age. The study also identified various variables and themes that influence digital resilience, which can be used to navigate educational initiatives and policy. However, this study's shortcomings included a cross-sectional design, self-reported data, and cultural distinctiveness. Future research could address these limitations by undertaking a longitudinal study, utilizing numerous data sources, and contrasting different cultural contexts.

Oops, I Did It Again! The Humour of Incongruity, Risk-Taking and Creativity in Art Practice and Everyday Life

This article explores the incongruous results of creativity and risk-taking within art practice and everyday life as encountered through the photographic image. The impetus for this study was a humorous experience that took place during health and safety training that raised questions about the role of humour within everyday life. Research was conducted into two forms of visual media, including pamphlets and guides from the British Safety Council (BSC) archives and viral images that demonstrate accidents (tagged with an ‘epic fail’ hashtag). This led to a practice-based approach to research involving the production of photographic works for an exhibition that tested the role of risk-taking and improvisation within the creative process. This article uses humour theory including superiority, incongruity and relief theory in relation to Louise Peacock’s model for the analysis of slapstick, to analyse these different types of photographs and draws comparisons between the risk-taking creative behaviours of both employees and artists. These creative approaches are considered in relation to Michel de Certeau’s notion of tactics within everyday life. Ordinary thinking and improvisational tactics are present within both art and work, and improvisation heightens the potential for risk-taking. This may lead to incongruities represented through a photograph which can impact the viewer’s engagement through humour, fascination or self-reflexivity. It is proposed that the viewer response to images containing risk is made up of a balance between an embodied understanding of the dangers and an awareness of the artifice, which can shift depending on the conditions of the photograph’s production and display. The peculiarities of the photograph are seen as conducive to a humour response because of the photograph’s ambiguous relationship with the reality that it represents.

Food Safety: A Developing Country Perspective

Abstract Developing countries, trying to achieve an acceptable level of food safety at the least possible cost (efficiency objective) and facilitation of market access to the large and lucrative developed country food markets (market access objective), could follow the multilateral, regional, unilateral or the independent approach. The paper studying the pros and cons of these approaches aims to determine the most appropriate food safety reform package. It shows that the best approach is the unilateral. Under this approach the achievement of efficiency objective requires the adoption and implementation of the multilateral approach. The achievement of market access objective requires the adoption and implementation of the regulatory regime of the developed country whose markets the developing country is intending to penetrate. Instead, the paper proposes that the developing country adopts and implements the developed countries‘ regulatory regime only in agricultural sub-sectors with highest comparative advantage scores, and that in all other agricultural sub-sectors the country should adopt and implement the regulatory regime as developed by multilateral approach. Since the tasks associated with designing and implementing the food safety policy reform are challenging, the paper advocates that this task should be left to a new institution, the ‘Food Safety Council‘, which needs to be formed as an autonomous public institution with sufficient financial and technical resources.

Rail integrity control system with closed loop approach

Rail systems have been used for transportation and carriage purposes since the beginning of the 19th century and are still an important means of transportation today. This transportation method is actively used in densely populated Asian countries, especially in America and European countries. According to data from the National Safety Council (NSC) in the United States, rail travel is indeed one of the safest modes of transportation, second only to air travel. NSC reported that in 2019 rail fatality rates were 0.31 deaths per billion passenger miles, while the death rate for air travel was only 0.061 deaths per billion passenger miles. However, this does not mean that serious accidents do not occur. Moreover, the cause of the majority of these accidents is derailment caused by line deterioration and breaking of rails. According to technical data from the Federal Railroad Administration (FRA), in 2020 there were 1,601 accidents caused by track issues, including rail cracks and deterioration. These statistics highlight the importance of regular road maintenance and inspection to ensure the integrity of the railway and prevent accidents caused by road problems. To date, many studies have been carried out to control and ensure the integrity of the rails. In our study, the main aim is to provide a system that will verify that there is no crack in the rails, and otherwise inform the machinist. Furthermore, this study does this verification by dividing the rail structure into small blocks and checking whether the circuit is completed with the electric current it provides over the train. Thanks to this easy-to-apply system, the deformations on the rails can be easily detected pointwise and the number of fatal accidents can be reduced.

Road safety and alcohol consumption by drivers

The subject of this article is the issue of road safety and road accidents caused by drunk drivers. Road safety is an important issue in Poland and in all EU Member States. That is why the European Commission adopts appropriate legal regulations, action plans and long-term strategies to increase road safety. For this purpose, the European Road Safety Council was established in 1993. An analysis of statistical data on road accidents in general and those involving drunk drivers indicates that this is still a serious problem of modern society.

Recent radiation protection activities related to nuclear facilities on the Iberian Peninsula

Part of the radiation protection in Spain and Portugal is focused on the protection of workers, public and environment due to the influence of nuclear facilities present in their territory (Spanish case) or nearby. Radiation protection is in a process of continuous improvement, with the participation of nuclear facilities, companies and researchers in numerous research projects funded in Spain by the Nuclear Safety Council or other international organizations. This article presents some of the projects in which Spanish working groups have participated. In addition, specific examples of activities related to radiation protection and environmental radiological monitoring carried out in Spain in recent years are shown. Among them are: the development of methods of analysis of environmental samples in case of emergency, real-time monitoring networks for measuring radiation, environmental dosimetry in the environment of nuclear facilities, programs and models of radiation dispersion in case of accident, and the treatment and management of radioactive waste for its clearance.

RELATIONSHIP ATTITUDE AND NURSE KNOWLEDGE ABOUT THE COMPLIANCE OF THE USE OF PERSONAL PROTECTIVE EQUIPMENT (PPE) IN OUTPATIENT INSTALLATION AT TANGERANG SELATAN HOSPITAL

Results from the National Safety Council report show that the incidence of workplace accidents in hospitals is 41% higher compared to other industrial workers. Frequent cases are needle needles, scratches, and infectious diseases. The implementation of K3RS is of course determined by policy by the hospital by applicable laws and regulations. The purpose of this study was to see that there is a relationship between knowledge and attitudes with adherence to PPE use. This study used quantitative analysis methods with a cross-sectional study design. This study was conducted in November-January at South Tangerang Hospital. The population of this research source is all South Tangerang Hospital Workers, the target population is nurses at South Tangerang Hospital. The sample size of this study was 100 samples. Take samples using random sampling techniques. Analysis of research data using chi-square. Based on the analysis, it was found that all independent variables are related to dependent variables. Including, knowledge p-value 0.000 and attitude with p-value 0.000. It is estimated that the hospital will conduct routine socialization of the use of PPE for nurses. Nurses should be more compliant with the use of PPE.

Psychische Belastungen und berufliche Mobilitätsunfälle

Mental stress and occupational mobility accidents – What can organisations and employees do about the number one cause of death in the workplace? Mobility accidents are the most frequent cause of death in the work context. With regard to participation in road traffic, numerous risk factors in terms of technology and environment, organisation, the person and the situation are known to be psychological strains which exercise an influence on the probability of accidents. Nevertheless, traffic participation as part of the occupational activity is little considered in risk assessments and the issue of road safety plays almost no role in the organisational context. After a classification of the relevance, therefore, this overview presents a framework model for the systematic observation of hazards and the resulting mental stress in the context of occupational mobility. This is followed by an overview of the most relevant empirically proven risk factors in the context of traffic participation. Finally, a free and proven instrument of the accident insurance institutions and the German Road Safety Council for hazard assessment and the risk evaluation of organisational mobility (GUROM) is presented, as well as other measures for organisations that have been empirically proven to be successful. It is very much hoped that many readers and managerial staff in companies will be inspired and take the opportunity to do something about the number one killer in the working world. Keywords: mental stress – occupational mobility – road safety – risk assessment – GUROM

Health profile of workers from different industries in Singapore.

Workplace safety and health are interrelated - a worker who is not healthy may cause safety lapses at the workplace; conversely, safety lapses could affect the health of the workers. This study was part of a larger Total Workplace Safety and Health (WSH) programme run by the Workplace Safety and Health Council, Singapore. The objectives were to obtain a baseline health profile of workers across four major industries and identify important health risks for targeted workplace interventions. Five service providers (SPs) were appointed to run the Total WSH programme. As part of the programme, SPs conducted an anonymous basic health survey among workers of participating companies. The responses of 6,373 respondents from the cleaning, construction, manufacturing, and transport and storage industries were studied. The overall response rate was 62%. Key health issues identified were high rates of obesity (22%) and smoking (24%) and low prevalence of regular exercise and healthy dietary habits. Chronic disease rates were similar to population self-reported rates (hypertension 15%, high lipid 12% and diabetes mellitus 6%). The workers reported high work stress (13%). Health issues are prevalent in the workforce and may affect work and employee safety. It is increasingly important for employees' health to be considered in risk assessments and prioritised in workplace safety and health management systems and strategies. Health promotion interventions should be targeted, and multilevel and multicomponent initiatives should be integrated with pre-existing occupational safety programmes.

Analysis of Occupational Health and Safety Risks in the Surgical Inpatient Room at Hospital

According to the latest report from the International Labor Organization, more than 1.8 million people died in Asia-Pacific. At the Asian level, as many as two-thirds of the global population of more than 2.78 million people die every year due to work accidents or occupational diseases. Meanwhile, based on the National Safety Council (NSC) report, it shows that 41% of accidents in hospitals are greater than in other industries. . The purpose of this study was to determine the level of occupational safety and health risks in the surgical inpatient room of X Hospital Bandar Lampung. This study uses a semi-quantitative method that refers to AS/NZS: 2004 and a method for identifying risk using job hazard analysis (JHA) and multiplying the values​​of consequence, likelihood, exposure to determine the level of risk. The research results obtained with a substantial risk level of 1 risk and an acceptable level of 10 risks.

Implementation of the First Comprehensive State Oral Fluid Drug Testing Program for Roadside Screening and Laboratory Testing in DUID Cases - A Five-Year Review.

Oral fluid (OF) is a valuable specimen for Driving under the influence of drugs (DUID) applications. This study demonstrates the implementation of the first comprehensive OF drug testing program in the United States, including approved roadside screening OF devices for law enforcement and validated LC-MS-MS confirmation methods. Three roadside OF screening devices were evaluated: the Dräger DrugTest® 5000, Abbott SoToxa®, and Randox Evidence MultiSTAT™. Two qualitative LC-MS-MS confirmation methods were validated per ASB Standard 036. The first method utilized an automated Dispersive Pipette Extraction (DPX) extraction using Integra and Hamilton STARlet platforms for drugs of abuse. The second method used a liquid-liquid extraction to detect cannabinoids. The prevalence of drugs in blood and OF was monitored over five years of casework. Calibration curves were analyzed with each batch to monitor OF concentrations for research purposes. Three roadside OF screening devices were deemed fit for purpose. Devices demonstrated appropriate sensitivity, specificity, positive and negative predictive values, and accuracy above 80% for targeted drugs except for benzodiazepines (DrugTest® 5000) and amphetamine (SoToxa®). The validated LC-MS-MS OF confirmation methods met the National Safety Council recommended cutoffs for 18/21 (86%) of the targets. Over five years of casework, THC and cocaine were detected at a positivity rate of 90% and 97% in OF versus 75% and 44% in blood, respectively. OF: blood ratios exceeded unity for parent drugs. Median concentrations of THC in OF and blood were 31 and 3.5 ng/mL, respectively. OF is a viable alternative or supplemental specimen for DUID investigations. Collecting OF close to the driving event increases the opportunity to identify pharmacologically active substances, and when combined with blood analysis results, an elevated OF: blood ratio provides valuable information for DUID investigation purposes.

On the role of simulation codes in regulatory activities. Challenges and R&D needs

Simulation codes are essential tools in Nuclear Safety. Calculations are needed to assess the safety of nuclear power plants and to verify compliance with safety requirements. Nuclear regulatory bodies must assess the codes, the methodologies for their use, and the calculations performed with them by licensees in support of their safety analyses. One important way for assessing the validity, quality, consistency, and conclusions of licensee assessments is for regulators and Technical Support Organizations (TSO) alike to resort to independent analysis, including detailed TH calculations. This regulatory task requires high technical expertise and capabilities, such as the ones needed for the development of simulation codes and computerized diagnostic tools specific for regulatory assessment. These tools are not to have the same focus and scope as their industry counterparts, since the objective is shifted from design (for the licensees) to verification of safety requirements. (for regulators/TSOs). This paper has been written by members of the technical staff of Spain’s Nuclear Safety Council, with a double purpose:-To review challenges and needs for Regulatory Bodies concerning the licensing processes where thermohydraulic system codes and related methodologies and calculations are involved.-To review new and advanced methodologies, mainly related to Risk-Informed Regulations, where TH simulation codes are used.

QI/PI: POSNA Safe Surgery Program (PSSP)—First-Year Results Implementing Quality Metrics

Background: Ranking of orthopaedic programs by external organizations is expanding to pediatric orthopaedics. These external organizations rarely consult pediatric orthopaedists themselves; therefore, POSNA members strongly supported the creation of a new performance evaluation. As a result, POSNA developed a member-driven process for driving quality improvements in pediatric orthopaedics: the POSNA Safe Surgery Program (PSSP). The PSSP aims to develop key quality metrics that members believe improve outcomes in pediatric orthopaedics. This paper aims to summarize the first year of implementing the PSSP quality metrics.Methods: The POSNA Quality, Safety, and Value Initiative (QSVI) Council developed 20 PSSP quality metrics for five domains: sports medicine, trauma, spine, hip/lower extremity (LE), and hand/upper extremity (UE). The quality metrics were integrated into five online surveys (one per domain) and distributed to POSNA member orthopaedic centers across North America.Results: Thirty-three POSNA member orthopaedic centers responded to at least one domain-specific survey. Spine had the highest response rate (88%), while hand/UE and hip/LE had the lowest (70% and 73%, respectively). Centers meeting each quality metric ranged from 65% to 92% in sports medicine, 62% to 100% in trauma, 79% to 100% in spine, 83% to 96% in hip/LE, and 83% to 100% in hand/UE. Large and very large centers, as well as specialized children's hospitals, provided more detailed protocols and procedures, likely due to greater resources and specialization. There was nearly 100% agreement between centers on protocols with well-known, easy-to-follow checklists for fulfilling a quality metric.Conclusions: The primary goal of the PSSP is to create internally developed, surgeon-driven quality metrics that determine high-quality care. By using these quality metrics and reports, we hope surgeons can gain institutional resources to drive improvements in their centers. In its first year, the PSSP demonstrated that these quality metrics can be successfully distributed and reviewed by POSNA members. Our future work will focus on expanding the PSSP to more pediatric orthopaedic centers, iteratively evaluating and modifying the metrics, and adding metrics for additional domains.Level of Evidence: Level IVKey Concepts•Ranking of orthopaedic programs by external organizations is expanding to pediatric orthopaedics which will have important clinical and financial implications.•Pediatric orthopaedists are rarely consulted in quality evaluations by external organizations; therefore, POSNA created a member-driven performance evaluation system—the POSNA Safe Surgery Program (PSSP)—to develop surgeon-driven quality metrics to improve high-quality care.•Twenty PSSP quality metrics were developed by the POSNA Quality, Safety, and Value Initiative (QSVI) Council across five domains: sports medicine, trauma, spine, hip/lower extremity (LE), and hand/upper extremity (UE).•Our first year distributing the PSSP quality metrics to POSNA member centers revealed (1) high engagement rates and (2) diverse ranges of quality metric fulfillment by centers.•In the future, we will expand the PSSP to more pediatric orthopaedic centers, iteratively evaluate and modify the PSSP quality metrics, and develop metrics for additional domains.

Measuring the Distance between Trees and Power Lines under Wind Loads to Assess the Heightened Potential Risk of Wildfire

The incidence of wildfires caused by tree contact with high-voltage power lines has become an increasingly pressing issue in the United States. To prevent such incidents, local safety councils have established minimum clearance regulations between trees and power lines. While most studies have focused on the tree encroachment around power lines during normal weather conditions, recent catastrophic fires have been caused by strong winds. To address this gap in knowledge, we investigated the critical wind speed that heightens the risk of wildfires by calculating the distance between trees and wires. To conduct this study, we used airborne LiDAR data collected from Sonoma County in northern California and analyzed the behavior of a sample tree having a height of 19.2 m under wind loads. Our analysis showed that the main factor determining tree deflection is the ratio of the tree height to the trunk diameter. We also found that, although the probability of fire ignition is typically low under normal conditions, it is likely to increase at a wind speed of approximately 40.3 m/s. In conclusion, this research demonstrates the utility of point cloud data in identifying potentially dangerous trees and reducing the risk of fires.

Implementing Guide Imagery for Elderly with Diabetes Mellitus Post Covid-19 who Experiencing Respiratory Disorders

The success of health development in Indonesia has had an impact, among others, on increasing the life expectancy of the elderly. One of the health problems that often occur in the elderly is diabetes mellitus. Various complications from diabetes mellitus can very easily occur, especially during the current Covid-19 pandemic. Preliminary studies conducted by WHO on the relationship between diabetes and Covid-19 showed that around 25 percent of Covid-19 patient s in hospitals with poor conditions had diabetes. With advanced age, of course it is very risky if you depend only on drugs, therefore non-pharmacological therapy is needed, one of which is relaxation techniques. The National Safety Council says guided imagery is a distraction technique that can be used to reduce stress and increase feelings of calm and peace and is a sedative for difficult situations in life. Purpose: to determine the effectiveness of guided imagery therapy in the elderly with post-covid-19 diabetes mellitus who experience respiratory tract disorders. Method: case study conducted by observation. Results: After 7 days, 2 hours after the intervention, the authors measured blood pressure, checked SPO2 and calculated the respiratory system back to Mr.A. The results obtained were 120/80 mmHg, SPO2 95% and respiration 20x/minute. Patient said he was not short of breath, Patient looks no longer limp pale like the first day the assessment was carried out. Conclusion: there is an effect of guided imagery therapy in the elderly with post-covid-19 diabetes mellitus who experience respiratory tract disorders

Addressing gaps in our understanding of the drowning patient: a protocol for the retrospective development of an Utstein style database and multicentre collaboration

IntroductionThis retrospective observational study aims to create a comprehensive database of the circumstances of drowning (including care provided and outcomes of care) to report against the Utstein style for drowning...