Hygiene Program Research Articles

Modes of Educating Teachers About Vocal Hygiene: A Comparative Study

Educating teachers about vocal hygiene can be a means of alleviation or prevention of voice problems in this population. The present study aimed to compare four modes of educating teachers in India (n=80) about vocal hygiene. Four groups of 20 teachers were exposed to educative material on the vocal hygiene program created for the present study. Each group received it either in audio mode delivered by the researcher posing as a voice therapist (VA); in audio mode delivered by a researcher posing as a teacher (TA); in written mode delivered by the researcher posing as a voice therapist (VW); or in written mode delivered by a researcher posing as a teacher (TW). The improvement in the knowledge of teachers before and after vocal hygiene education was gauged by administering a written questionnaire before and after the content that the teachers received. Results revealed that all four modes were effective in vocal hygiene education. However, no significant difference (P>0.05) in the improvement of knowledge in teachers across the four modes was seen although the relative mean difference was observed higher for TW mode than other modes. Individual item analyses revealed that some concepts were conveyed more effectively than others. This gave insights into improving the quality and efficacy of vocal hygiene programs in the future. Findings have implications in reaching out to remote areas and employing peer-to-peer teaching as an effective way of vocal hygiene education among teachers.

Matrix-matched calibrators are necessary for robust and high-quality dried blood spots lead screening assays by inductively coupled plasma-mass spectrometry

Background and aimsReliable lead screening methods are necessary to support early identification of lead exposure in children. Sample collection using dried blood spots (DBS) offers advantages compared to traditional venipuncture and capillary collection. Here, we describe and compare three lead DBS inductively coupled plasma-mass spectrometry (ICP-MS) methods for lead screening. Materials and methodsLead was extracted from Whatman 903 protein saver cards punches and analyzed by ICP-MS across three independent clinical laboratories. Each laboratory evaluated the performance of aqueous and matrix-matched DBS calibrators using external quality control samples (WI State of Laboratory of Hygiene Program). Leftover patient samples (n = 39) were used for an interlaboratory comparison of lead DBS. Lead DBS results were compared to whole blood methods. ResultsThe DBS ICP-MS methods using matrix-matched DBS calibrators had superior performance to the aqueous calibrations. There was a strong correlation between lead measured in DBS (matrix-matched) and whole blood for the three methods evaluated. ConclusionLead can be measured accurately by ICP-MS in DBS samples when matrix-matched calibrators are used. External quality control programs are valuable to assess the performance of DBS methods. DBS lead ICP-MS methods are a robust analytical option for lead screening even though the limitations of DBS are well recognized.

Interprofessional Education: Collaborative Team Work Among Undergraduate Medical Students.

Madam, The last decade has been a global shift towards collaborative learning and practice. A Joint Commission Report noticed that 80% of all medical errors were due to miscommunications during patient handoffs, with 44% occurring in inpatient settings1. Learning Together to Work Together for Health is the essential guide for the working of Interprofessional Education (IPE), the idea presented by WHO and is defined as an experience that “occurs when students from two or more professions learn about, from, and with each other to enable effective collaboration and improve outcomes”2. The core competencies for IPE include collaborative teamwork, communication skills, ethical practice, roles and responsibilities, and conflict resolution2. IPE expects to improve the knowledge, skills, and attitudes towards collaboration to enhance their future clinical practice. Pakistan is a developing country that is strengthening IPE. The Karachi Medical and Dental College launched a training program on research methodology focusing on the principles of IPE to improve primary care delivery2. The Dental Hygiene Program at Aga Khan University is also an example of IPE improving patient healthcare3. These deficiencies can be overcome by vertically and horizontally integrating IPE in the curriculum. The absence of a formal team-based care programme deprives most students from learning about professional roles. This warrants a need to focus on learning approaches that can be used in undergraduate curricula and thereby create and foster a collaborative learning environment. Case-based learning and team-based learning are valuable approaches resulting in experiential learning and reflection. Simulations allow students to practice and improve their communication and collaboration among medical students. E-learning is worthwhile for enlightening their understanding and cognizance of further profession’s duties and authorities, which is unique to the leading competencies of IPE4. The logistics of setting up IPE activities may be more challenging. The leadership confrontation such as lack of management between the faculties and lack of support by organization, curriculum challenges like IPE courses designing, teaching challenges, such as shortage of faculty members training, skills and competence in interprofessional and resistance to transformation i.e. dearth of resources are the main challenges for the institutions5. The institutions should engage in policies in the best strategies to implement interprofessional education. Hierarchical heads and policymakers need to put forth an effort to advance IPE so that different professions can benefit from each other more easily.

Health Effects of Oral Contraceptives on Periodontal Disease and Gingivitis: A Cross-Sectional Questionnaire-Based Study Among Saudi Women in Jeddah.

Sex hormones strongly influence the health and ailment of the oral cavity. For instance, a woman's oral health is influenced by her menstrual cycle, menopause, pregnancy, and usage of oral contraceptives. The use of various therapeutic medication results in intraoral alterations. Oral contraceptive pills (OCPs) are among the drugs that produce intraoral alterations. The study's objective was to evaluate attitudes and oral health conditions of Saudi women's utilizing OCPs in Jeddah, Saudi Arabia. A cross-sectional questionnaire-based study was conducted among Saudi women in Jeddah, Saudi Arabia. The self-administered questionnaire was made and sent to women to evaluate the attitude and oral health condition of women utilizing OCPs. The women using OCPs were asked to self-administer 17 questions to evaluate attitudes and oral health conditions. The questionnaire had multiple-choice questions and was consisted of four sections. The number of participants who used contraceptives was 125 (35.9%) women; of them, only 94 (75.2%) used oral contraceptives. The duration of using oral contraceptives mainly was 1-5 years (39.4%), then > 5 years (34.0%), and <1 year (26.6%). Of the 94 women, 34 (36.2%) had gingival diseases, 23 (24.5%) treated their gums; and 13 (13.8%) cleaned their gums at a dental clinic regularly. Times of teeth brushing per day were one time in 32 women (34%), twice in 47 women (50.0%), and three times in 15 (16.0%). Of the 94 women, 4 (4.3%) were smoking, 24 (25.5%) took medication other than OCPs, and 16 (17.02%) had chronic diseases. Common oral complications noticed by participants were gum bleeding after brushing (51.6%), dental caries (25.5%), and oral ulcers (10.6%). Females on OCPs had a high rate of gingival bleeding, dental caries, and oral ulcers. OCPs users had poor periodontal and gingival health. Establishing an oral hygiene program was necessary to treat gingival and periodontal inflammation that exacerbated by OCPs.

Trends in dental hygiene academic leadership development: Influencers, barriers, and enabling mechanisms.

This quantitative exploratory study was designed to learn about trends and forces impacting leadership development (LD) opportunities for dental hygiene (DH) program directors. A 10-item electronic survey was created and disseminated using Qualtrics system to directors of all accredited DH programs in the United States (N = 325). Surveys included closed and open-ended response items to capture quantitative and qualitative data. The analysis included descriptive statistics and thematic categorization of free responses. Eight-two surveys were returned (25% response rate). Leadership development training experiences varied among participants; 79% (n = 65) reported completing some form of LD training. Institutional support was variable among the DH program directors, yet most (76%, N = 62) indicated some level of school support for LD training opportunities for DH program directors. Feedback indicated that most options included campus-sponsored courses or events (28%, N = 47), professional association courses or events (24%, N = 40), and programs within the school, department, or division (24%, N = 40). Study findings support positive perceptions of the need, demand, and value of LD. Respondents shared beliefs in the benefits of LD and the value of placing resources to support these opportunities, yet also acknowledged substantial challenges including time, funding, and workforce needs. By addressing barriers and capitalizing on driving forces, programs can create systemic approaches to fostering LD for current and future DH program directors.

Social enterprises as effective exit strategies for development NGOs: the case of Bilada in Burkina Faso

ABSTRACT This article discusses the capacity of NGOs to develop and implement relevant and effective exit strategies. In other words, how an NGO can disengage from their interventions in the recipient country in a manner consistent with the goal of ensuring local sustainable development. In this context, we are interested in the exit strategy implemented by the Antenna Foundation in Burkina Faso, a country often seen as the laboratory of NGOs in Africa. This strategy included the handover of a nation-wide water sanitation and hygiene program to a social enterprise - an organisation, purposed to benefit the community that values autonomy and economic risk-taking related to ongoing socio-economic activity. Led by a local entrepreneur, the social enterprise benefited from the favourable market conditions created by the NGOs program activities and active advocacy for government support. Equally, the social enterprise leveraged its roots in the local ecosystem and used its entrepreneurial prerogative to take appropriate risks and adapt the business’ strategy. These factors were critical to ensuring the enterprises viability post-NGOs disengagement and capacity to sustainably promote local development, by supplying water treatment and hygiene solutions in Burkina Faso.

Bleeding at the Margins: Understanding Period Poverty among SC and ST Women Using Decomposition Analysis

Scheduled Caste (SC) and Scheduled Tribe (ST) women in India have relatively lower usage of period products than women of the General category. This paper attempts to understand and uncover the social factors explaining inequalities in the period product usage among these groups. This paper uses data from the National Family Health Survey (NFHS-5), conducted in 2019–21, for this study, with a sample of 49,136 SC, 44,392 ST, and 41,045 General caste women in the age group of 15 to 24 years. Using the Fairlie decomposition method, we explain the inequalities in the period product usage between SC, ST, and general categories. Differences in wealth index (SC-Gen: 49.54%; ST-Gen: 46.6%), respondent’s education level (SC-Gen: 22.85%; ST-Gen: 17.3%), watching television (SC-Gen: 09.44%; ST-Gen: 10.1%), reading newspaper (SC-Gen: 08.71%; ST-Gen: 05.09%), and toilet facility (SC-Gen: 06.36%; ST-Gen: 03.05%) account for a large portion of the gap in the period product usage among these groups. Government, policymakers, and NGOs should focus on creating comprehensive menstrual health and hygiene (MHH) programmes, including educational programmes and mass media campaigns, while increasing focus on disadvantaged communities, viz. SCs and STs to make the necessary nudge for girls and women to adopt hygienic menstrual practices.

Colour-blind racial attitudes in entry-level dental hygiene students in Virginia.

Subscribing to colour-blind racial attitudes may contribute to inequities in the delivery of oral care and affect treatment of diverse patients. The purpose of this study was to survey all entry-level dental hygiene students in one state to determine colour-blind racial attitudes. After IRB approval, a convenience sample of 220 dental hygiene students in all entry-level programmes in Virginia were invited to participate in this cross-sectional study. The Colour-Blind Racial Attitudes Scale (CoBRAS), an effective, validated measuring instrument, was used to quantify unawareness of contemporary racist ideals. Three subscales (Racial Privilege, Institutional Discrimination and Blatant Racial Issues) were also measured by the survey. Descriptive statistics, separate one-way between-subjects ANOVA and independent samples t-tests were used to analyse the data. One-hundred and sixty (n = 160) dental hygiene students completed the survey. Independent samples t-tests revealed statistically significant differences when comparing year in programme and programme type. Participants in their second year of dental hygiene education had significantly lower overall CoBRAS scores compared to those in their first year of education (M = 50.76, M = 59.13, respectively; p = 0.004). Participants enrolled in a baccalaureate dental hygiene (B.S.) programme had significantly lower overall CoBRAS scores compared to those enrolled in an associate (A.S.) programme (M = 50.53, M = 59.54, respectively; p = 0.002). Participants possessed moderate levels of colour-blindness, suggesting a need for more awareness and training early in dental hygiene education to increase delivery of culturally competent oral healthcare.

Assessment of prerequisite programs implementation at food packaging manufacturing companies and hygiene status of food packaging in a developing country: Cross-sectional study

Food packaging has a critical role in all food types and along the food chain from product preservation to transportation, distribution, storage, retailing, and end-use. However, it can become a source of contamination and transfer of microorganisms to the packed food when its hygienic status is not well maintained. The aim of this study was to evaluate the Prerequisite programs (PRPs) implementation in 5 food packaging companies across Mount Lebanon through on-site inspections and to assess the compliance of contact surfaces, employee hands and packaging materials to microbiological specifications. Following on-site inspection, none of the companies achieved a full total score of 100% and scores ranged from 25 to 62%. Regarding the assessment of hygienic status of contact surfaces, non-conforming results (acceptable limit ≤0.6 log colony forming units (CFU)/cm2) were observed in 50% (5/10) of the surfaces for total viable count (TVC). For the employee hands, none of the hand swab samples (10/10) was conforming for TVC that was present in all samples above the acceptable limit. Highest and lowest reported values were 4.4 and 1.7 log CFU/hands respectively. For packaging samples collected during on-site inspections, TVC and yeasts and molds were detected in 20% (2/10) of the samples. However, the samples collected from the retail market, had higher contamination rates of 95% (19/20) and 65% (13/20) for TVC and yeasts and molds, respectively. As for Enterobacteriaceae, it was not detected in all tested contact surfaces, employees' hands, and packaging samples. PRPs assessment and related verification activities showed the need for companies to strengthen their hygienic programs and highlighted the importance of food safety management systems (FSMS) implementation not only in food companies but also in food packaging companies. Additionally, the effectiveness of PRPs implementation should be assessed on planned routine basis.

The effect of sleep hygiene and physiotherapy on bruxism, sleep, and oral habits in children with sleep bruxism during the COVID-19 pandemic.

Sleep bruxism has been associated with temporomandibular dysfunction, pain, fatigue, and poor sleep quality. The aim of this study was to determine the gender and age distribution of sleep and oral habits of children with sleep bruxism and to examine the effect of a sleep hygiene and physiotherapy program. In this cross-sectional study, 82 children aged 6-13 years with sleep bruxism were initially screened between March 2020 and June 2021, from which 37 of them voluntarily attended an 8-week sleep hygiene and physiotherapy program. Evaluations were made using a Visual Analogue Scale (VAS), the Children's Sleep Habits Questionnaire (CSHQ), and the Oral Habits Questionnaire (OHQ) at the beginning and at the end of the 8-week program. Statistically significant differences were determined between the 6-9 years and 10-13-year age groups in respect of the sleep habits subcategories of resistance to bedtime (p= 0.001), sleep anxiety (p= 0.043), parasomnia (p= 0.040), and sleep respiratory disorder (p= 0.041). Following the 8-week treatment program, a significant reduction was obtained in the VAS value (p< 0.05), CSHQ subcategories of resistance to bedtime (p= 0.001), sleep duration (p= 0.008), parasomnia (p= 0.000), and in the OHQ score (p= 0.000). There was no relationship between sleep bruxism and gender, but a relationship was found with age. The rate of bruxism was seen to decrease with an increase in age. It was determined that oral, sleep habits, and bruxism are closely related, and the rates at which bruxism is seen are affected by the oral habits. Sleep hygiene and physiotherapy have been effective in children with sleep bruxism.

Assessment of Self Reported Oral Health Attitudes and Behaviors of a Group of Dental Students using the Hiroshima University - Dental Behavioural Inventory in Turkey

Purpose: Dental students play a crucial role in promoting positive oral health attitudes and behaviors among their relatives and patients. Students' self reported oral health behaviors may tend to improve as they progress in their dental education. Therefore, this study aimed to assess the difference in self reported oral health behavior and attitudes of a group of Turkish first and final-year students using the Hiroshima University Dental Behavioural Inventory. Materials &amp;amp; Methods: In this cross-sectional study, 237 students, including first and final-year, studying at XXX University Faculty of Dentistry, were invited. Of these, 187 students (108 first, 73 final-year) agreed to participate. Eleven students (7 first-year, 4 final-year) who did not fill out the questionnaire were excluded. The Hiroshima University Dental Behavioural Inventory was used to measure the behaviors and attitudes of the students regarding oral and dental health. Additionally, three items other than HU-DBI were added to the questionnaire. The analysis was conducted using the Chi-square test, and Independent t-test. Results: The responses of 178 students (107 first-year, 69 final-year; 122 female, 54 male) were analyzed. The self reported oral health behavior scores of the final-year students (6.21 ± 1.54) were statistically higher than the scores of the first-year students (5.03 ± 1.76) (p &amp;lt; 0.001). Although the score was slightly higher in females (5.57 ± 1.96) compared to males (5.33 ± 1.27), the difference was not statistically significant (p = 0.334). Conclusions: According to the results of this study, education may have a significant positive effect on self reported oral health behavior and attitude of dental students. Based on the findings of university-based evaluations as this study, curricula that can gain positive attitudes to students and oral hygiene programs aimed at improving students' self-care should be developed from the early years. However, further studies that also evaluate the effect of possible confounding variables on oral health behavior should be done to clearly highlight the impact of education.

Clean hospitals day 2023 marks the global launch of a self-assessment tool

Healthcare environmental hygiene is increasingly recognized as critical in infection prevention and control. The objective of the Clean Hospitals Day, celebrated each year on October 20, is to raise awareness and foster engagement among healthcare facilities around the world. The newly published tool, the Healthcare Environmental Hygiene Self-Assessment Framework (HEHSAF), has been internationally validated to help healthcare facilities to identify areas for improvement in their environmental hygiene programs, as well as benchmark this improvement over time. Healthcare facilities can download the full promotional toolkit and posters for Clean Hospitals Day 2023 from: www.CleanHospitals.com.

Stress and Sleep Difficulties in a Sample of Medical Students, Ain-Shams University

Introduction: Background Becoming a medical doctor is a highly complex process. High incidence of stress disorders among medical students was reported. Psychological stress is a triggering factor for insomnia and has a bidirectional association with poor sleep quality. the relationship between stress and sleep difficulties among medical students should be assessed and evaluated as it may affect Academic achievement, and cause difficulty in concentration, tiredness, headache, bad appetite, disturbed bowel habits and tiredness and weakness during daytime, To raise the awareness about the importance of good sleep quality for health and academic achievement Objective To measure stress among medical students, determine pattern of sleep difficulties and to find relationship between stress and sleep quality among medical students. Subjects and Methods: A cross sectional study, Questionnaire based, convenience sample. The sample consisted of 300 undergraduate medical students at Faculty of Medicine, Ain-Shams University, Egypt from January 2019 to March 2020. All students fulfilling the inclusion criteria were offered to participate in the study by using GHQ, PSQI, MSSQ &amp; SCID I Results 300 medical students were recruited in this study; their mean age were 21.4 ± 2.3 year ranging from 17-30 years. 40 % (n = 120) of them were males &amp; 60% (n = 180) were females. 98% (n = 294) of the study sample were single and 4.7% of students (n = 14) were smoker. 50.7% (n = 152) had one or more hobbies. Females reported higher Mean ± SD than males in all MSSQ domains except Drive &amp; desire related stressors. There was statistically significant difference regarding female gender was reported. Conclusion There is high prevalence of stress and poor sleep quality in medical school students. Strong association between sleep quality and stress was found. Medical students need to be educated about sleep hygiene and stress management programs to emphasize on study skills, time management, healthy lifestyles, and effective coping strategies. Conflicts of Interest None of the authors have any conflicts of interest to disclose. Abbreviations PSQI: Pittsburgh Sleep Quality Index; GHQ: General health Questionnaire; MSSQ: medical students stress scale

Evaluation of the effectiveness of sleep hygiene education and FITBIT devices on quality of sleep and psychological worry: a pilot quasi-experimental study among first-year college students.

College students report disturbed sleep patterns that can negatively impact their wellbeing and academic performance. This study examined the effect of a 4-week sleep hygiene program that included sleep education and actigraph sleep trackers (FITBITs) on improving sleep quality and reducing psychological worry without control group. A pilot quasi-experimental design, participants were randomly selected medical and health sciences from a university students in the United-Arab-Emirates. Students were asked to wear FITBITs and log their daily sleep data and completed the Pittsburgh Sleep Quality Index (PSQI) and Penn State Worry Questionnaire (PSWQ). Extensive sleep hygiene education was delivered via lectures, a WhatsApp group, and the Blackboard platform. In total, 50 students completed pre-and post-assessments and returned FITBIT data. There was a significant difference in the prevalence of good sleep postintervention compared with pre-intervention (46% vs. 28%; p = 0.0126). The mean PSQI score was significantly lower post-intervention compared with pre-intervention (6.17 ± 3.16 vs. 7.12.87; p = 0.04, Cohen's d 0.33). After the intervention, subjective sleep quality, sleep latency, and daytime dysfunction were significantly improved compared with pre-intervention (p < 0.05). In addition, FITBIT data showed total sleep time and the number of restless episodes per night were significantly improved postintervention compared with pre-intervention (p = 0.013). The mean PSWQ score significantly decreased from pre-intervention to p = 0.049, Cohen' d = 0.25. The correlation between PSQI and PSWQ scores was significant post-intervention (β = 0.40, p = 0.02). Our results may inform university educational policy and curricular reform to incorporate sleep hygiene awareness programs to empower students and improve their sleep habits.

Knowledge, attitudes, practices and acceptability of a school preventive chemotherapy programme for schistosomiasis and soil-transmitted helminths control in Angola.

Schistosomiasis and soil-transmitted helminth (STH) control programs require target population engagement, assessed through knowledge, attitudes and practices (KAP) surveys. We report the results of a KAP survey of Angolan schoolchildren supported by a school preventive chemotherapy (PC) programme, without or with a school water, sanitation and hygiene (WASH) programme (PC+/WASH- and PC+/WASH+, respectively); and schoolchildren without a school PC or WASH program (PC-/WASH-). Schoolchildren from PC+/WASH- (N = 218), PC+/WASH+ (N = 250) and PC-/WASH- (N = 254) schools were interviewed. Descriptive statistics were used to report demographics and survey responses. Chi-square or Fisher's exact test was used to compare PC+/WASH- schoolchildren with (i) PC+/WASH+ and (ii) PC-/WASH- schoolchildren. A lower proportion of PC+/WASH- schoolchildren used latrines and a higher proportion practised open defecation at school compared with PC+/WASH+ schoolchildren. A lower proportion of PC+/WASH- schoolchildren always washed their hands after toileting and before meals at school compared with PC+/WASH+ schoolchildren. However, the PC+/WASH- schoolchildren reported better toileting and handwashing practices at school compared to PC-/WASH- schoolchildren. Over 90% of PC+ schoolchildren agreed with schistosomiasis and STH control and accepted schoolteacher PC delivery. Expanding the integration of both school PC and WASH programs will improve health behaviours relevant to reduce the risk of schistosomiasis and STHs in schoolchildren. This article is part of the theme issue 'Challenges and opportunities in the fight against neglected tropical diseases: a decade from the London Declaration on NTDs'.

Training dental hygiene students to care for patients with disabilities.

The purpose of this study was to evaluate the impact of a novel training programme on dental hygiene students' knowledge, attitudes, and beliefs about caring for individuals with disabilities. A mixed methods approach was used. Students from five dental hygiene programmes based at community colleges completed a two-hour didactic training session to supplement their existing special care dentistry coursework. Students completed an original 14-item pretest and posttest before and after the training that assessed attitudes and beliefs, and two validated posttests that assessed knowledge. Afterwards, students completed a clinical rotation in an advanced care dental clinic at a local academic institution, gaining hands-on experience with equipment and patient treatment. Descriptive statistics were used to report training scores, types of services rendered, and modifications to treatment. Student comments about their experiences were assessed using thematic analysis. Two hundred and ninety-four students completed didactic training, and 261 completed clinical rotations. Posttest scores indicated positive improvements in knowledge, attitudes, and beliefs. All students provided direct patient care. Sixty-nine percent treated patients with intellectual and developmental disabilities; 75% placed silver diamine fluoride or fluoride varnish. Altered patient positioning was used by 70.5%. Most students (95.4%) reported that their experience positively changed their attitudes towards caring for patients with disabilities in the future. Eight themes emerged, notably increased comfort and confidence, a willingness and desire to treat patients, the acquisition of new skills, and clinician behaviours of empathy and compassion towards others. Training can help prepare dental hygiene students with the confidence and skills to address the oral health needs of individuals with disabilities.

Shared decision-making in scaling and root planing.

Estimate proportion of various approaches used by dental hygienists for engaging patients in decisions commonly arising during scaling and root planing. Distribution of approaches was compared across various task components in this procedure, practice experience of dental hygienists and patient compliance. Survey of graduates from and students in a baccalaureate dental hygiene program. Paternalism (tell then do) and informed consent (give choices and reasons and ask for permission) were more common than shared decision-making (discuss alternatives, solicit patient input and arrive at a mutual decision) and disengagement (patient refusing offered service or avoiding further involvement) by a ratio of 4 to 1 for the first 2 compared with the latter 2. This relationship was held across selecting treatment, procedural adjuncts, homecare instructions and financial arrangements. Dental hygienists exhibited a range of personal preferences for engagement approaches. No-show rate, patient disengagement outside the office, was high (20%). Dental hygienists reported using 'more controlled' approaches to engaging patients in decisions regarding treatment. Patients may prefer to engage in more shared decisions and choose this approach by staying away from the office. This may underestimate patients' decisions to stay away from treatment, for example by not showing for completion of the treatment or disregarding homecare routines.

Implementation of a quality improvement project using the patient as the observer to improve hand hygiene compliance in ambulatory care practices

Monitoring hand hygiene compliance in the ambulatory setting remains a challenge because a healthcare trained observer loses line of sight once the examination room door closes. This quality improvement project focused on the implementation of a hand hygiene compliance improvement programme that is amenable to the routines and work flows of the ambulatory setting. After a review of the literature, nursing leadership and infection prevention implemented the 'patient as the observer' hand hygiene programme across 32 ambulatory practices. Patients completed 281,000 observations with an overall compliance rate of ≥90%. The average overall compliance rate by role was 91% for providers, 89% for nurses, and 91% for medical assistants/technicians/others. A 92% compliance average was noted 'before caring for you' and 89% 'after caring for you' for providers, 90% and 87% for nurses, and 92% and 89% for medical assistants/technicians/others. This study demonstrated that the implementation of a hand hygiene compliance improvement programme using the patient as the observer can be adopted successfully in the ambulatory setting. Hand hygiene compliance can be monitored effectively in the ambulatory setting with the involvement of the patient as the observer.

Effectiveness of the prevention programme on posture and the incidence of back pain in primary school children: a pilot study

Background: The incidence of back pain in childhood is rising and significantly impacts its incidence in adulthood. Important risk factors include poor posture, which is common due to a largely sedentary lifestyle. Our study aimed to determine the effect of a primary prevention programme on posture and pain incidence in primary school children.&#x0D; Methods: The research was conducted in eight 4th grades of four primary schools. Half of the grades were part of the posture hygiene programme throughout the school year, while the other half served as a control group. Before and after the programme, pupils were measured, their posture assessed, and a survey about back pain was conducted.&#x0D; Results: 179 pupils were included in the study. A history of back pain was found in 36.5% of the children, and only 9% had ideal posture. The implementation of the programme resulted in a 20% absolute reduction in the risk of pain and a 52% reduction in those who reported pain before the programme. At the end of the study, there was a statistically significant difference (p&lt;0.001) between the two groups in all the measured parameters, except in the cranioclavicular angle.&#x0D; Conclusion: The study showed marked improvement in posture and reduced back pain in the students who were included in the programme. A preventive programme to improve postural hygiene could contribute significantly to addressing the problem among young people, thus reducing the incidence of back pain in the adult population.

An approach to quantify ortho-phthalaldehyde contamination on work surfaces.

Ortho-phthalaldehyde (OPA) is used as a high-level disinfectant for reusable medical devices in healthcare settings. The ACGIH recently adopted a Threshold Limit Value-Surface Limit (TLV-SL; 25 µg/100 cm2) for OPA surface contamination to prevent induction of dermal and respiratory sensitization following dermal exposure. However, there is no current validated method to measure OPA surface contamination. This study aimed to develop a standardized approach for sample collection and quantitative determination of OPA from work surfaces for use in risk assessment practices. The reported method utilises readily available commercial wipes to collect surface samples coupled with direct detection of OPA via liquid chromatography time of flight mass spectrometry (LC-ToF-MS). This approach avoided complex derivatization steps commonly required for the analysis of aldehydes. Method evaluation was conducted in accordance with the Occupational Safety and Health Administration (OSHA) surface sampling guidelines. Overall recoveries of 25 µg/100 cm2 of OPA from stainless steel and glass surfaces were 70% and 72%, respectively. The reported LOD for this method was 1.1 µg/sample and the LOQ was 3.7 µg/sample. OPA remained stable on the sampling medium for up to 10 days, when stored at 4 °C. The method was demonstrated in a workplace surface assessment at a local hospital sterilising unit, successfully detecting OPA on work surfaces. This method is intended to supplement airborne exposure assessment and provide a quantitative assessment tool for potential dermal exposure. When used in conjunction with a thorough occupational hygiene program that includes hazard communication, engineering controls, and personal protective equipment, skin exposure and consequent sensitization risks in the workplace can be minimized.