Extra Precautions Research Articles

What's Important: What Is Our Role in the COVID-19 Pandemic?

What's Important: What Is Our Role in the COVID-19 Pandemic?

COVID-19 and maternity care

African Journal of Midwifery and Women's HealthVol. 14, No. 2 EditorialCOVID-19 and maternity careUnice GoshomiUnice GoshomiCorrespondence to: E-mail Address: [email protected]Social Sciences, Women's University in Africa, Harare, ZimbabweSearch for more papers by this authorUnice GoshomiPublished Online:27 Jun 2020https://doi.org/10.12968/ajmw.2020.0018AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References International Confederation of Midwives. Women's rights in childbirth must be upheld during the coronavirus pandemic. 2020. https://www.internationalmidwives.org/assets/files/news-files/2020/03/icm-statement_upholding-womens-rights-during-covid19-5e83ae2ebfe59.pdf (accessed 10 April 2020) Google ScholarLuo Y, Yin K. Management of pregnant women infected with COVID-19. 2020. https://www.thelancet.com/action/showPdf?pii=S1473-3099%2820%2930191-2 (accessed 10 April 2020) Google ScholarNational Centre for Immunization and Respiratory Diseases. People who need extra precautions: if you are pregnant, breastfeeding, or caring for young children. 2020. https://www.cdc.gov/coronavirus/2019-ncov/hcp/pregnant-women-faq.html (accessed 10 April 2020) Google ScholarWorld Health Organization. Rational use of personal protective equipment for coronavirus disease 2019 (COVID-19). 2020. https://apps.who.int/iris/bitstream/handle/10665/331215/WHO-2019-nCov-IPCPPE_use-2020.1-eng.pdf (accessed 10 April 2020) Google Scholar FiguresReferencesRelatedDetails 2 April 2020Volume 14Issue 2ISSN (online): 2052-4293 Metrics History Published online 27 June 2020 Published in print 2 April 2020 Information© MA Healthcare LimitedPDF download

COVID-19, diabetes mellitus and ACE2: The conundrum

COVID-19, diabetes mellitus and ACE2: The conundrum

The COVID-19 pandemic and the use of MS disease-modifying therapies

The COVID-19 pandemic and the use of MS disease-modifying therapies

A Cross-sectional Study of Gender-related Differences in Reporting Fatigue and Pain among Latino/A Migrant Farmworkers

ABSTRACT Objectives: Migrant farmworkers face many hardships in both their working and living environments including dangerous and demanding tasks, long hours, and inadequate rest. This study sought to explore gender differences in the reporting of fatigue and pain and to identify predictors of fatigue and pain among migrant farmworkers in Nebraska (n = 241). Methods: Bivariate tests were used to assess associations among study variables. Linear and generalized linear mixed effect models were used to assess gender as a predictor of fatigue and pain respectively while controlling for covariates. Results: Females reported significantly higher levels of fatigue (M score = 15.5, SD = 6.1 compared to M score = 12.8, SD = 4.3) than their male counterparts. Females were also more likely to report pain (56.9% of females compared to 36.3% of males). Being female, pain, hours of sleep, and job demands were significant predictors of fatigue. Fatigue and job-related injury were the only significant predictors of pain. Conclusions: There are gender-related disparities in the reporting of fatigue and pain among Latino/a migrant farmworkers. Extra precautions need to be taken to protect worker health and safety and reduce fatigue, particularly for female workers. Implications for employers, supervisors, and healthcare providers are discussed.

Community eye-health and vision center guidelines during COVID-19 pandemic in India.

The severe acute respiratory syndrome coronavirus 2 (COVID-19) pandemic has disrupted our society on an unprecedented scale since its inception in December 2019. As the health-care system is finally re-organizing to mitigate the impact of the pandemic, it was necessary to re-structure primary eye care (PEC) activities as well on the same lines. A consensus meeting was held with leading eye-care experts on 2nd May 2020 to prepare a roadmap for PEC in the days to come. Guidelines are needed for PEC activities like vision testing, refraction, optical dispensing, counseling, etc., Some of the activities at vision centers (VCs) may be postponed or modified in light of the current pandemic situation. PEC workers need to strictly follow social distancing norms (minimum 3 feet) for minimizing risk of exposure and need access to appropriate personal protective equipment (PPE), like gloves, masks and shields while examining beneficiaries. For optometrists, sterilization of instruments and encouraging the people to remain silent during the examination is recommended. Because conjunctivitis may be an early sign which can present at VCs, extra precautions in the form of PPE has to be ensured while examining such patients. This is also an opportunity to start running telemedicine clinics for all emergent cases that cannot be managed at the primary level. The guidelines also need to be updated based on the context of the working environment and changes in government directives from time to time.

SECURE DATA STORAGE SYSTEM

As we are entering into the digital era, people will have to learn to adapt to the change of digitizing most of the things in life. One of the limitation is the insufficient knowledge on multi-factor authentication method and the implementation method of it. This limitation will eventually lead to the researcher needing to spend more time and effort to research, analyse data and to develop the system. It is advisable that the researcher approach IT Security related specialists when conducting interview sessions to gather the opinions of the professionals. Another limitation is the understanding of encryption method to be used in the development of the system. As there are a lot of types of different encryption algorithms, the researcher needs to compare and justify the encryption methods available to be used and select the most suitable encryption method to implement in the system. The proposed system will be beneficial for users that preferred to take extra precautions when it comes to saving data in digital media format. As it is a security focused data storage system, privacy and integrity of the data in the system is crucial which became the goal of the system. Therefore, users who will be using the system can comfortably use the system without worrying of data leaks.

The COVID-19 pandemic and diabetes mellitus.

COVID-19, a disease caused by a novel coronavirus, SARS-CoV-2, has reached the proportion of a pandemic and presents with either mild and moderate symptoms or in severe cases with acute respiratory distress syndrome, multiple organ dysfunction syndrome and even death. Older age, hypertension, cardiovascular disease, diabetes mellitus and obesity significantly increase morbidity and mortality in COVID-19 patients. In the present review we summarize the existing, and daily growing, data on the impact of COVID-19 infection on patients with diabetes, their antidiabetic therapy as well as the extra precautions, apart from good glucose control, they have to take in order not to contract the virus. Social distancing and strict hand hygiene are of great importance in order to help the global goal of eradication of the disease.

A memory-recall checklist for dental services during the COVID-19 outbreak: A clinical recommendation

The epidemic coronavirus disease 2019 (COVID-19) has infected millions of people and put a huge amount of stress on the health-care system. Health-care professionals, including dental professionals, are at a high risk of acquiring COVID-19. Therefore, extra precautions need to be implemented for routine dental infection control procedures. It is encouraged to have a written reminder in the form of a checklist to recall these crucial steps, especially when nonroutine procedures must be followed. The aim of this special communication is to present a proposed mnemonic or memory-recall, user-friendly checklist to be used in the dental clinic during the COVID-19 outbreak. The checklist was created following the guidelines for reopening dental services in governmental and private sectors during the COVID-19 pandemic that were published by the Ministry of Health on June 5, 2020. Based on the patient's score and the urgency of the dental situation, specific steps should be followed. When the patient's score is ≥ 4 and needs an emergency aerosol-generating procedure, REDS steps should be recalled. Further, MRS steps must be followed if the patient's score is < 4. For both groups, GAMES can be followed when personal protective equipment is needed before the patient examination and HD steps should be applied after finishing the dental procedure. In conclusion, this written reminder in the form of a checklist can be helpful for a safe dental practice during pandemics to recall the crucial nonroutine steps. We recommend that the dental staff place those steps as a written reminder in an accessible, visible place.

Understanding the impact of isolation due to COVID-19 on employment for Kentuckians with spinal cord injuries

BACKGROUND: Obtaining and retaining employment for persons with spinal cord injury (SCI) is frequently a greater challenge than it is for the non-SCI population. It is particularly difficult during COVID-19 because all the barriers to employment are compounded for people with SCI as they have to take extra precaution to protect their health and wellbeing. OBJECTIVE: The objective of the study was to understand how isolation related to COVID-19 has had an effect on the employment experiences for persons living with SCI. METHODS: Three virtual focus groups were conducted with Kentuckians who had SCI. RESULTS: The major themes were: the impact of disruption in routine on physical and mental health, importance of having the right accommodations, working from home as an accommodation, and the uncertainty of work. CONCLUSIONS: Accommodations are a critical component for people with SCI to be retained in the workforce. Employers should be proactive in offering various inclusive and accessible accommodations to employees so that people do not have to bear the additional burden of asking for accommodations. Rehabilitation professionals would serve the SCI population well by finding ways to help clients better advocate for themselves, provide adaptive home therapeutic equipment, and help identify diverse employment skill sets.

NUMERICAL AND EXPERIMENTAL INVESTIGATION OF AIR-WATER SYSTEM TO SIMULATE BUBBLE DYNAMICS IN LIQUID SODIUM POOL

Abstract The dynamics of rising bubbles in a liquid sodium pool plays a significant role in the estimation of the radiological source term during anticipated transients and normal operation of a fast reactor. Sodium is chemically reactive with air and water. Therefore, carrying out experiments using sodium on a reactor scale level requires extra precautions. We report an in-house experimental technique to depict the bubble dynamics along with numerical support to establish similarity behavior between water and liquid sodium, to reduce the number of experiments in sodium systems for in-depth knowledge of bubble dynamics in the case of the fast breeder reactor. In the present work, 3-D bubble dynamics is studied in the OpenFOAM platform and the validated numerical model is used to study bubble dynamics in sodium to establish similitude between the water and sodium systems. The bubble aspect ratio of 0.9 cm diameter bubbles in the sodium system is found to be in close agreement with that of 0.5 cm bubbles in the water system. Experimental and numerical findings suggest similarity of the aspect ratio between water and scaled-up sodium systems. The similarity criteria established between water and sodium are found to be very useful in conducting water-based experiments to study bubble dynamics in sodium systems.

Radiological study of the Asian coracoid process and clavicle: Implications for coracoclavicular ligament reconstruction

PurposeIatrogenic coracoid and clavicle fracture is a known complication of drilling bone tunnels during anatomic coracoclavicular ligament reconstruction (ACCR). This study aims to measure the dimensions of coracoid process and clavicle in an Asian population to evaluate the suitability of drilling coracoid and clavicle tunnels for ACCR in Asians. MethodsWidth measurements of 196 coracoids and 189 clavicles were obtained after reviewing all computed tomography (CT) scans of the shoulder performed over a 6 years period. Coracoid measurements were made on the CT slice which showed the maximum cross sectional width of the coracoid base. Medial to lateral measurements of the coracoid width were taken on an axial view, 4 mm above the identified junction of the coracoid base and glenoid base. Antero-posterior clavicle width was measured through a point directly above the midpoint of the coracoid and perpendicular to the long axis of the clavicle. ResultsThe overall mean coracoid width was 14.8 mm ± 2.54 mm (range 9.2–23.3 mm) and clavicle width was 17.1 mm ± 2.72 mm (range 11.1–25.3 mm). ConclusionThe Asian coracoid process is smaller than its Western equivalent. More research is required to validate this conclusion as no cadaveric studies with equivalent measurement techniques have been performed on Asians. Given the potentially narrower dimensions of the Asian coracoid process, extra precautions are required to minimize the risk of iatrogenic coracoid and clavicle fractures.

Error in measurement of intraocular pressure with the Icare and IcarePRO.

We sought to determine whether changes in the measurement angle of the Icare TA01i and IcarePRO tonometers led to errors in the measurement of intraocular pressure (IOP). In this prospective, single-facility study, we analyzed 77 patients from November 2017 to September 2019. We measured IOP with the Icare TA01i and IcarePRO while changing the angle of the device with the cornea center and analyzed the associated changes in the measurement. IOP measured with the Icare tilted -30°, -15° vertically was significantly higher than that measured with the Icare tilted horizontally (p < 0.0001, p < 0.0001). The IOP measured with a + 10° vertical tilt was significantly lower than that measured horizontally (p < 0.0001). When the IcarePRO was tilted + 90° vertically, the IOP was significantly lower with the patient in the supine position than in the lateral position (p = 0.00058). IOP measured with the Icare and IcarePRO is affected by the measurement angle. The study results will direct the clinicians to exercise extra precautions in determining the measurement angle while measuring IOP.

Becoming a Character: Dissociation in Conservatory Acting Students

ABSTRACTActors must realistically portray imagined characters in imaginary circumstances by “becoming” their characters. What is it that allows them to do this? We suggest that acting is related to dissociation, a trait typically related to psychopathology. We measured dissociation in 53 conservatory acting students before and after six months of training, using the Dissociative Experiences Scale-II (DES-II). Although no significant changes occurred over time, acting students scored significantly higher than the general population on the DES-II. These scores were driven by just one of the subscales – absorption and imaginative involvement. We argue here that this subscale measures a trait central to the creative process. Furthermore, although the DES-II was designed to measure psychopathology, we found that it is also related to flow (a positive experience). Certain flow dimensions were predictive of dissociation and of its absorption and imaginative involvement subscale. We conclude that total DES-II scores may not necessarily indicate psychopathology in actors. At the very least, these results suggest that clinicians should take extra precaution when diagnosing dissociation in actors using the DES-II.

CN46 - HIV positive and treated for cancer: A qualitative study exploring the experiences of HIV related stigma in the cancer clinical setting

BackgroundAn increasing number of people living with HIV are living longer and experiencing a dual diagnosis of HIV and cancer. Little is known of their experience and quality of care. Here we present the findings of a study exploring patient experiences of cancer care, with a focus on the impact of HIV related stigma in the cancer clinical setting. MethodsAn interpretive approach, utilising qualitative research methods was adopted to explore the complexity of experiences. Thematic analysis of participant narratives provided in longitudinal, semi-structured interviews with 17 people, recruited from three London sites between 2015 and 2017. Focused ethnography comprising 27hours of participant observation and seven semi-structured interviews with healthcare professionals. ResultsBoth HIV and cancer have a powerful, combined impact on individuals with a dual diagnosis; in cancer the impact is visible; in HIV it is generally hidden. Patients reported feeling a sense of difference within cancer services. The combination of marginalising features such as age, ethnicity and sexuality with reported experiences such as exclusion from clinical trials, extra infection control precautions and tensions about the involvement of the GP led to a powerful felt stigma. Inadequate knowledge about HIV amongst healthcare staff who were unfamiliar with the latest changes in the HIV field led to patients feeling isolated and dependent on their own resources to navigate care. The management of information relating to HIV status was experienced as an additional emotional burden on top of a physically debilitating and disruptive cancer diagnosis. Issues around disclosure were often framed by healthcare professionals as inconvenient and potentially unsafe, but they did not always demonstrate empathy for the potentially devastating implications for those patients for whom secrecy was integral to continued social support. ConclusionsDual diagnosis of cancer and HIV can have a profound and negative effect on patients’ experiences and potentially outcomes. Improvement depends on interventions that acknowledge the shared social narrative and impact of HIV-related stigma so that this burden is not carried by the patient alone. Legal entity responsible for the studyUCL. FundingHas not received any funding. DisclosureAll authors have declared no conflicts of interest.

Seismic Effect on Multi Storey Building with Different Positioning Of Floating Column

Modern multi storied buildings are being constructed with floating column at the ground floor to meet the requirements of parking or other aesthetic or utility value. Masonry buildings have proved to be most vulnerable when earthquakes strike in any part of the world. The damage caused by the earthquake cannot be eliminated but it could be mitigated by taking extra precaution. Floating columns can be constructed at any level or storey, at any point in the construction area. Seismic analysis is a major tool in earthquake engineering; this is used to understand the response of buildings due to seismic excitations in a simpler manner. Response Spectrum Analysis was used. Assumptions were made to study the seismic effect on different position of floating column for a six storied RC framed building.

Effects of Quarry Blasting Towards the Residential Area at Kangkar Pulai, Johor, Malaysia

The drill and blast technique have been widely used recently due to demand for natural building materials like rock aggregates. However, the intensity of blasting effects has been questioned on its validity towards the nearby residential areas. In this study, the blasting effects from Quarry A and B has been assessed based on constant location of the residential areas (Taman Pulai Hijauan and Taman Bandar Baru Kangkar Pulai, respectively) using the empirical formulations only. The blasting effects are highly dependent on the maximum instantaneous charge in blast holes (Q) which are dependent on parameters like number of blast holes, charge per column, Powder Factor and number of blast per delay. This study was able to show that with an increase of the independent variables, the Q value rises significantly. The average Q value from Quarry A (181.07 kg) was slightly higher than Quarry B (180.22 kg). The correlations made for each quarry showed that Quarry A had a better regression line with lower standard error due to the high number of blast data obtained during the monitoring period of about 1 year and 8 months. Meanwhile, the impact assessments showed higher PPV (Peak Particle Velocity) value at higher Q holding blast holes in Quarry A compared to Quarry B and decreases with increasing distance. The similar relationship was observed for the air blast assessments. Yet, all of the blasts produced are relatively within safe limits which are less than 5 mm/s Mineral & Geosciences Department (JMG) and less than 125 dBL United States Bureau of Mining (USBM). Thus, extra precaution can be taken by estimating the suitable Q value such as A (97.66 kg) and B (271.68 to 495.01 kg) to maintain safe blasting operations and prevent damages to the nearby residential areas.

First trimester termination of pregnancy.

First trimester termination of pregnancy (TOP) is a safe and effective procedure. The complete abortion rates of surgical and medical abortion are approximately 97% and 95%, respectively. Vacuum aspiration (VA) either by electrical suction or manual aspiration is the method of choice for surgical TOP. Risk of significant bleeding is≤5% in VA, while major complications occur in <1%. The risk of infection after VA can be reduced significantly by using prophylactic antibiotics or by the screen-and-treat strategy. Pre-operative administration of misoprostol can also reduce the risk of complications. The combination of 200mg mifepristone followed by 800μg misoprostol 24-48h later is recommended for first trimester medical TOP. If mifepristone is not available, misoprostol can also be used alone, but repeated doses may be required and the complete abortion rate may be lower. Due to the reduced efficacy in more advanced gestation, repeated doses of misoprostol may be required for medical TOP over 9 weeks of gestation. The complete abortion rate with this regimen is 95% or more. Gastrointestinal upsets can occur in up to 50% of women, but major complications are rare. There was no lower limit of gestational week for TOP, although extra precaution is required for the confirmation of completion of procedures and exclusion of ectopic pregnancy.

Safety measures for nurses working abroad

Safety measures for nurses working abroad

Characterization of Extrafocal Dose Influence on the Out-of-Field Dose Distribution by Monte Carlo Simulations and Dose Measurements.

Out-of-field scattered and transmitted extrafocal radiation may induce secondary cancer in long-term survivors of external radiotherapy. Pediatric patients have higher life expectancy and tend to receive higher secondary radiation damage due to geometric and biological factors. The goal of this study is to characterize the location and the magnitude of extrafocal dose regions in the case of three-dimensional conformal radiotherapy and volumetric arc therapy, to apply this information to clinical treatment cases, and to provide mitigation strategies. Extrafocal dose has been investigated in a Varian TrueBeam linac equipped with a high-definition 120 multileaf collimator using different physical and virtual phantoms, dose calculation (including Monte Carlo techniques), and dose measurement methods. All Monte Carlo calculations showed excellent agreement with measurements. Treatment planning system calculations failed to provide reliable results out of the treatment field. Both Monte Carlo calculations and dose measurements showed regions with higher dose (extrafocal dose areas) when compared to the background. These areas start to be noticeable beyond 11 cm from the isocenter in the direction perpendicular to the multileaf collimator leaves' travel direction. Out-of-field extrafocal doses up to 160% of the mean dose transmitted through the closed multileaf collimator were registered. Two overlapping components were observed in the extrafocal distribution: the first is an almost elliptical blurred dose distribution, and the second is a well-defined rectangular dose distribution. Extra precautions should be taken into consideration when treating pediatric patients with a high-definition 120 multileaf collimator to avoid directing the extrafocal radiation into a radiosensitive organ during external beam therapy.