scholarly journals On-site comparison of an enzymatic detergent and a non-enzymatic detergent-disinfectant for routine manual cleaning of flexible endoscopes

2019 ◽  
Vol 07 (04) ◽  
pp. E412-E420 ◽  
Author(s):  
Jonathan Gonzalez ◽  
Thomas Vanzieleghem ◽  
Axelle Dumazy ◽  
Christelle Meuris ◽  
Jacques Mutsers ◽  
...  
Keyword(s):  
Adenosine Triphosphate ◽  
Physiological Saline ◽  
Pathogen Transmission ◽  
Cleaning Procedure ◽  
Before And After ◽  
Two Phases ◽  
High Level ◽  
The Impact

Abstract Background and study aims Flexible endoscopes are potential vectors of pathogen transmission to patients that are subjected to cleaning and high-level disinfection after each procedure. Efficient manual cleaning is a prerequisite for effective high-level disinfection. The goal of this study was to demonstrate the impact of the cleaning chemistry in the outcome of the manual cleaning of endoscopes. Materials and methods Twelve endoscopes were included in this study: four colonoscopes, four gastroscopes, two duodenoscopes and two bronchoscopes. This study was designed with two phases; in each of them, the manual cleaning procedure remained identical, but a different detergent was used: a non-enzymatic detergent-disinfectant (NEDD) and an enzymatic detergent (ED). Biopsy and suction channels of endoscopes were sampled using 10 mL of physiological saline at two points: before and after manual cleaning, and adenosine triphosphate (ATP) was measured on each sample. In total, 208 procedures were analyzed for the NEDD phase and 253 for the ED phase. Results For each endoscope type, cleaning endoscopes with ED resulted in larger median decrease in ATP than with NEDD: respectively 99.43 % and 95.95 % for bronchoscopes (P = 0.0007), 99.28 % and 96.93 % for colonoscopes (P < 0.0001) and 98.36 % and 95.36 % for gastroscopes (P < 0.0001). In addition, acceptability rates of endoscopes based on defined post-manual cleaning ATP thresholds (200, 150, 100 or 50 relative light units) for all endoscope types were significantly higher with ED compared to NEDD. Conclusions With all other parameters of manual cleaning remaining unchanged, the enzymatic chemistry of ED provided more consistent and improved cleaning of endoscopes compared to NEDD. Therefore, choice of the detergent for endoscope cleaning has an impact on the outcome of this process.

scholarly journals A Therapeutic Educational Program in Oral Health for Persons with Schizophrenia: A Qualitative Feasibility Study

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Audrey Peteuil ◽  
Corinne Rat ◽  
Sahar Moussa-Badran ◽  
Maud Carpentier ◽  
Jean-François Pelletier ◽  
...  
Keyword(s):  
Oral Health ◽  
Educational Program ◽  
Periodontal Diseases ◽  
Level Of Evidence ◽  
Face To Face ◽  
Before And After ◽  
Health Quality ◽  
Persons With Schizophrenia ◽  
High Level ◽  
The Impact

Objective. The aim of this study was to test the feasibility of a therapeutic educational program in oral health (TEPOH) for persons with schizophrenia (PWS). Design. In a qualitative study, we explored the representation of oral health before and after a TEPOH. Clinical Setting: PWS are at greater risk of decayed and missing teeth and periodontal diseases. In a previous publication, we described the different steps in building a TEPOH by taking into account the experiences of PWS concerning oral health quality of life. This TEPOH aimed at promoting a global health approach. Participants: Voluntary PWS and their caregivers were recruited during face-to-face interviews at “Les Boisseaux” (a psychiatric outpatient centre) in Auxerre (France) and were included in the study between November and December 2016. Intervention: We explored the experiences of participants and their perceptions of oral health before and after the TEPOH with focus group meetings. Results. Four females and three males participated in the study, and the mean age was 29.4 ± 5. Before the TEPOH, the PWS produced 28 ideas about oral health perception and 37 after the TEPOH. After the TEPOH, elements relating to the determinants of oral health (smoking and poor diet) emerged. Conclusions. These results show an evolution in oral health representation, and after some adjustments to the TEPOH, the second step will be to test this program in a large sample to generate a high level of evidence of the impact of TEPOH in the long term.

A COMPARISON OF ASSESSMENT, DIAGNOSIS AND TREATMENT OF PATIENTS WITH CEREBRAL VENOUS THROMBOSIS BEFORE AND AFTER INTRODUCTION OF A NEW POLICY AND GUIDELINE ACROSS GREATER MANCHESTER

2015 ◽  
Vol 86 (11) ◽  
pp. e4.103-e4
Author(s):  
James Keitley ◽  
Timothy Lavin ◽  
Martin Punter ◽  
Jason McMinn ◽  
Mark Kellett
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Diagnosis And Treatment ◽  
Clinical Assessments ◽  
Before And After ◽  
Valid Comparison ◽  
High Level ◽  
The Impact

BackgroundFrom June 2014, regional guidelines to transfer within 24 hours all radiologically confirmed cases of cerebral venous thrombosis (CVT) were implemented across Greater Manchester. This service review assesses the impact on assessment, diagnosis and treatment.MethodsWe prospectively recorded all CVT cases transferred into our unit between June 1st and November 30th 2014 (14 patients), and retrospectively reviewed the casenotes of patients admitted in 2012, 2013 and early 2014 (13 patients).ResultsMean number of days from diagnosis to transfer after guideline introduction was 0.4. More patients underwent fundoscopy (86% vs 77%), visual acuity (50% vs 27%), visual field (79% vs 69%) and otoscopy (29% vs 8%). Patients admitted to SRFT previously had shorter symptom to diagnosis, imaging, transfer, and treatment times.ConclusionsAfter guideline introduction we found a high level of compliance with time to transfer, with improvements in several aspects of clinical assessments. We expect that patients previously admitted to our centre were more unwell or already admitted for other reasons (e.g. neurosurgical) and therefore time from symptoms to diagnosis appears longer. We aim to extend the current evaluation to all patients in the region who weren't transferred to our centre to allow a more valid comparison.

The impact of financial safety act and corporate governance on the level of financial disclosure

2016 ◽  
Vol 58 (6) ◽  
pp. 618-633 ◽  
Author(s):  
Ali Ahmadi ◽  
Abdelfettah Bouri
Keyword(s):  
Corporate Governance ◽  
Design Methodology ◽  
Stock Exchange ◽  
Financial Disclosure ◽  
Content Type ◽  
Study Results ◽  
Before And After ◽  
The Subject ◽  
High Level ◽  
The Impact

Purpose This research paper aims to identify and measure the contribution of the financial safety act (FSA) regulation in improving the level of financial disclosure of listed Tunisian firms. To answer the problems of the subject, the authors tried to hold accountable several determinants of the level of financial disclosure relating to the particular characteristics of the firm, and the adoption of the recommendations envisaged by the FSA, as likely to have an impact on the level of financial disclosure of Tunisian firms. Design/methodology/approach With a sample composed by 20 companies during the period from 2003 to 2010 (160 observations), the contribution of the FSA regulation in improving the level of financial disclosure of listed Tunisian firms was identified and measured. After that, the levels of financial disclosure before and after the FSA were compared. Findings The study results confirm the positive and significant effect of the FSA on the level of financial disclosure. This impact seems to appear through the improvement of the disclosure level during the years which follow the adoption of the new regulation. The results of this study also show that firms with a high level of financial disclosure are those which have an independent board of directors, auditor BIG and joint audit. Originality/value This paper is devoted to evaluate the impact of the FSA n°2005-96 and corporate governance on the level of financial disclosure. The empirical study relates to a sample of 20 firms listed on the Tunis Stock Exchange observed over the period 2003-2010.

scholarly journals Evaluating the Rapid Emergence of Daptomycin Resistance in Corynebacterium: A Multi-Center Study

2021 ◽  
Author(s):  
Kaitlin F. Mitchell ◽  
Erin McElvania ◽  
Meghan A. Wallace ◽  
Lauren E. Droske ◽  
Amy E. Robertson ◽  
...  
Keyword(s):  
Antimicrobial Agents ◽  
Exposure Period ◽  
Corynebacterium Striatum ◽  
Before And After ◽  
Multi Center Study ◽  
High Level ◽  
The Impact ◽  
Repeated Subculture ◽  
Center Study

Background: Members of the genus Corynebacterium are increasingly recognized as pathobionts and can be very resistant to antimicrobial agents. Previous studies have demonstrated that Corynebacterium striatum can rapidly develop high-level daptomycin resistance (HLDR) (minimum inhibitory concentration [MIC] ≥256 μg/mL). Here we conducted a multi-center study to assay for this in vitro phenotype in diverse Corynebacterium species. Methods: Corynebacterium clinical isolates (n=157) from four medical centers were evaluated. MIC values to daptomycin, vancomycin, and telavancin were determined before and after overnight exposure to daptomycin to identify isolates able to rapidly develop daptomycin non-susceptibility. To investigate assay reproducibility, 18 isolates were evaluated at three study sites. In addition, stability of daptomycin non-susceptibility was tested using repeated subculture without selective pressure. The impact of different media brands was also investigated. Results: Daptomycin non-susceptibility emerged in 12 of 23 species evaluated in this study (C. afermentans, amycolatum, aurimucosum, bovis, jeikeium, macginleyi, pseudodiphtheriticum, resistens, simulans, striatum, tuberculostearicum, and ulcerans) and was detected in 50 of 157 (31.8%) isolates tested. All isolates displayed low (susceptible) MIC values to vancomycin and telavancin before and after daptomycin exposure. Repeated subculture demonstrated 2 of 9 isolates (22.2%) exhibiting HLDR reverted to a susceptible phenotype. Of 30 isolates tested on three media brands, 13 (43.3%) had differences in daptomycin MIC values between brands. Conclusions: Multiple Corynebacterium species can rapidly develop daptomycin non-susceptibility, including HLDR, after a short daptomycin exposure period.

scholarly journals 819. How effective is alcohol flush and drying cycle of automatic endoscope reprocessor (AER): Stripped Endoscope (SE) model

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S452-S452
Author(s):  
Mohamed Yassin ◽  
Heather Dixon ◽  
Michelle Nerandzic ◽  
Curtis Donskey
Keyword(s):  
Visual Inspection ◽  
Compressed Air ◽  
Usual Practice ◽  
Essential Step ◽  
Limited Efficacy ◽  
Disinfection Process ◽  
Before And After ◽  
High Level ◽  
The Impact ◽  
Water Borne

Abstract Background Endoscopic designs are more ergonomic and technically sophisticated than ever. Endoscope transmitted infections continues despite scrutiny and optimization of disinfection processes. Effective endoscopic dryness has been largely overlooked, even though it is paramount for prevention of water-borne pathogens accumulating after high level disinfection (HDL). Additionally, complete dryness is required to achieve sterilization. The aim of this study is to evaluate the dryness of the endoscopes after routine a routine disinfection process. Methods Three endoscopes were stripped from their outer sheaths to allow for visual inspection of the inside channels. SE were processed as per usual practice. After HLD in an automatic endoscope reprocessor (AER) that included an alcohol flush and drying cycle, SE were hung and observed for any water within the channels. SE were flushed with filtered compressed air. Dryness was monitored visually and by feeling for the impact of water spray at the distal tip of SE. Dryness of the channels before and after air flush was observed for the three SE for three trials each. Results All the SE were grossly wet after HLD despite the AER’s alcohol flush and drying cycle. Hanging vertically had no effect on the narrow diameter channels. Applying compressed air to each channel was effective for drying the channels based on visual inspection and water emission from the distal tip of the SE. The filtered compressed air had a flow rate of 20 L/minute for an average of 2 minutes to assure complete dryness. The nozzle for applying the filtered compressed air was ill-fitting to the openings of the cylinders and ports on the control handle, making it difficult to get a good seal for applying the filtered compressed air. Conclusion The AER’s drying cycle was not effective for drying endoscope channels. Vertical hanging had limited efficacy on endoscopic dryness. The application of filtered compressed air to individual channels was effective for drying the channels. This SE model was useful and direct for assessing the degree of moisture inside the channels. The application of filtered compressed air should be an essential step in endoscopic reprocessing regardless of the need for sterilization. Disclosures All Authors: No reported disclosures

scholarly journals Planning and Evaluating Educational Work in Slovene Preschools

2012 ◽  
Vol 2 (2) ◽  
pp. 125-144
Author(s):  
Marcela Batistič Zorec ◽  
Andreja Hočevar
Keyword(s):  
Preschool Teachers ◽  
Education Programme ◽  
Educational Work ◽  
National Education ◽  
The Past ◽  
Conceptual Changes ◽  
Professional Workers ◽  
Before And After ◽  
Two Phases ◽  
High Level

The present article examines the changes in Slovene preschools subsequent to Slovenia’s independence in 1991. In the socialist period, the national education programme for preschools was highly structured, goaland content-oriented and subject to schoolization. The Curriculum for Preschools (1999) brought conceptual changes towards education “based on the child” and the process approach, as well as giving more autonomy to preschool teachers and their assistants. In the empirical study, we examine changes in planning and evaluating educational work compared to the past. The results show that the majority of professionalworkers have reduced the high level of structure and rigidity in planning, and that there is better cooperation between preschool teachers and teachers’ assistants. Unlike in the past, most professional workers regularly evaluate their educational work. As the data was gathered in two phases, before and after the training of professional workers in the Reggio Emilia concept, we also search for the (probably indirect) influences of this training. We conclude that after the training the participation of children in planning and evaluating educational work is higher.

scholarly journals “My Last Husband and Marriage:” The Impact of Inheritance Disputes on Chinese Immigrants’ Widowhood in the United States

2021 ◽  
Author(s):  
Hua Shi
Keyword(s):  
United States ◽  
Social Relations ◽  
Emotional Processing ◽  
Chinese Women ◽  
The United States ◽  
Immigrant Background ◽  
Chinese Origin ◽  
Before And After ◽  
High Level ◽  
The Impact

AbstractThis study explores the unique experiences of the emotional processing of the widowhood of individuals of the Chinese seniors, and immigrant background in the United States. By interviewing eight Chinese immigrant widows living in Phoenix, the United States, this study focuses on the comparison of social relations and lifestyles before and after their spousal loss, as well as the unique forces of their Chinese backgrounds and the transnational remarriages in their bereavement process, and then widow status. The narrative accounts of the participants therein illustrate that transnational marriage and blended families generate a series of practical challenges, including unexpected severed friendships and inheritance disputes between stepmother and stepchildren. The consequences are reflected in the increase of self-loathing and low self-esteem, the refusal to remarry, the rising anger at the betrayal of friends, as well as the rapid formation of a high level of independence and self-determination in such circumstances. These findings increase knowledge of widowhood of Chinese women with immigrant background, therein enrich ethno-cultural diversity in the widowhood studies.This study concludes with the implications of providing bilingual legal aid and counseling to Chinese-origin, US-based, and widows.

scholarly journals Analysis of the Increase of Transformer Power Losses due to the Operation of Unbalanced Nonlinier Loads

2018 ◽  
Vol 2 (2) ◽  
pp. 38
Author(s):  
I Wayan Rinas ◽  
I Made Suartika ◽  
Anak Agung Maharta Pemayun
Keyword(s):  
Electrical Power ◽  
Harmonic Distortion ◽  
Power Losses ◽  
Loss Analysis ◽  
Before And After ◽  
Transformer Power ◽  
Quality Of Electric Power ◽  
High Level ◽  
The Impact

Non-linear loads are the source of harmonic current for electric utilities. The high level of harmonics greatly affects the increase of losses of electrical power (losses). The quality of electric power is determined by the parameters of power losses that occur in the transformer due to harmonic distortion. In this research will be analyzed THD from result of measurement and simulation in accordance with IEEE 519-2014 standard, power loss analysis on transformer before and after. Harmonics, the impact is increased due to unbalanced linear currents.

scholarly journals Therapeutic efficacy and pharmacological safety of parenteral supplementation of different concentrations of copper in cows

2012 ◽  
Vol 55 (1) ◽  
pp. 25-35
Author(s):  
J. R. García-Díaz ◽  
H. Munyori-Nderitu ◽  
M. Cuesta-Mazorra ◽  
R. Quiñones-Ramos ◽  
J. M. Figueredo-Ross ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
Blood Serum ◽  
Control Group ◽  
Second Phase ◽  
Hepatic Enzymes ◽  
Physiological Level ◽  
Before And After ◽  
Two Phases ◽  
The One ◽  
The Impact

Abstract. The objective of the present study was to determine the parenteral dosage of the trace mineral copper (Cu) which re-establishes serum and hepatic levels in hypocupperhemic animals without causing intoxication in the liver or residuals in milk. The experiment was carried out in two phases; in the first phase, 20 hypocupperhemic animals were used. Those were divided into 4 groups of 5 cows each: 3 groups which received 25, 50 and 100 mg of Cu respectively and 1 control group without supplementation, but with induced copraemia 5 days before and after the treatment. The milk of the cows treated with 100 mg Cu was examined for residuals of this element for one month. In the second phase, 25 animals were selected and divided into 5 groups of 5 cows each: 1 control group and 4 groups which received 25, 50, 100 and 200 mg of Cu respectively. The impact of this Cu dosages on liver reserves of this element, on hepatic enzymes (alanine-amine-transaminase, aspartate-amine-transferase, alkaline phosphatase and glutamate dehydrogenase) and on bilirubin was analyzed. The groups treated with 50 and 100 mg Cu showed increased levels in blood serum and hepatic tissues (P<0.05) in comparison to the control group and the one treated with 25 mg, obtaining the physiological level considered normal in cows during 60 days without an effect to the level of Cu in milk or to the liver’s enzymatic activity. We conclude that treatment with this dosage results in a restoration of the Cu concentration in blood serum and hepatic tissues without toxic effects or residuals.

scholarly journals The Use of Virtual Reality in Overcoming the State of Anxiety

2021 ◽  
Author(s):  
V.G. Anikina ◽  
P.A. Pobokin ◽  
J.Y. Ivchenkova
Keyword(s):  
Virtual Reality ◽  
The State ◽  
Older Students ◽  
General Anxiety ◽  
School Anxiety ◽  
Formative Stage ◽  
Before And After ◽  
High Level ◽  
Study Participants ◽  
The Impact

Modern research in the field of virtualistics concerns the problem of studying the impact of virtual reality on the state of a person’s personality. This perspective of research concerns the issue of corrective and therapeutic use of the potential of virtual reality in solving problems of practical psychology. The experimental study presented in the work is devoted to the study of the influence of virtual reality on the state of anxiety in senior schoolchildren (senior adolescence and early adolescence). In the framework of the diagnostic stage (before and after the experimental exposure), the following were used: Phillips’ School Anxiety Test and Color Sociometry. At the experimental — formative stage — schoolchildren who were diagnosed with high (17.5%) and increased levels of anxiety (30.1%) were included in a virtual reality program to overcome nytophobia. The results of the study confirmed the hypothesis of a decrease in the indicators of the state of anxiety in the study participants; the changes on the scale “General anxiety” of changes in the high level of anxiety φ* = 3.3 (p≤ 0.001) were significant. Micro-changes in color attribution values occurred for all color groups, but significant changes in preferences for self-attribution of crimson color φ* = 2.84 (p ≤ 0.05), and brown color also gave significant results φ* = 3.6 ** (p ≤ 0.001), which may indirectly confirm changes in the state of anxiety in older students

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