Nosocomial Tuberculosis Exposure in an Outpatient Setting Evaluation of Patients Exposed to Healthcare Providers With Tuberculosis

Objective:To evaluate the risk of tuberculosis (TB) transmission to patients potentially exposed to two healthcare providers who worked in outpatient settings for several weeks prior to being diagnosed with acid-fast bacilli smear-positive pulmonary TB.Design:Potentially exposed patients were notified by letter and television reports of the recommended evaluation for TB infection or disease and availability of free screening at the hospital. Prevalence of infection in the screened patients and the incidence rate of TB over the subsequent 2 years were compared to those of a control group of unexposed outpatients.Setting:An urban inner-city hospital.Patients:1,905 patients with potential exposure to the ill healthcare workers; 487 (25%) presented for evaluation. Controls consisted of 951 unexposed patients.Results:361 potentially exposed patients had their tuberculin test read; 97 (27%) had a purified protein derivative ≥10 mm. In the comparison group, 148 (25%) of 600 with test readings had a ≥10-mm reaction (risk ratio, 1.18; 95% confidence interval, 0.86-1.60). In multivariate analysis, male gender, non-white race, and older age were significantly associated with a positive tuberculin test; exposure was not. No TB cases were identified during screening. Two years after the exposure, 7 TB cases had been reported to the state registry among 1,905 potentially exposed patients (184 cases/100,000 person-years) versus 4 cases in the comparison group of 951 (210 cases/100,000 person-years).Conclusions:Evaluation of patients exposed to health-care workers with TB disease in ambulatory settings of an inner-city hospital revealed no evidence of transmission ofMycobacterium tuberculosisdue to the exposure.

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Causes of Staff Abuse in Health Care Facilities

AAOHN Journal ◽

10.1177/216507999804601007 ◽

1998 ◽

Vol 46 (10) ◽

pp. 484-491 ◽

Cited By ~ 7

Author(s):

Annalee Yassi ◽

Robert Tate ◽

Juliette Cooper ◽

Joan Jenkins ◽

June Trottier

Keyword(s):

Health Care ◽

Inner City ◽

Physical Abuse ◽

Health Care Workers ◽

Verbal Abuse ◽

Health Care Facilities ◽

City Hospital ◽

Care Workers ◽

Care Facilities ◽

Abuse In Health Care

Verbal and physical abuse of health care workers (HCWs) is prevalent and costly. A 3 month prospective study was conducted to characterize precipitating conditions and the perpetrators of abusive incidents reported by HCWs at a large inner city hospital. Sixty-six HCWs reporting 102 incidents were interviewed by a research nurse within 48 hours of the incident. Abusive incidents resulted from 55 different patients and 11 visitors. Verbal abuse accounted for 42 incidents (41%) and 60 (59%) involved physical abuse. Two thirds of the abuse occurred on psychiatric wards, 20% on inpatient wards, and 13% in other settings. Overall, twice as many abusive incidents were inflicted by males as females. Cognitive impairment accounted for 19% of the incidents and one abuser was intoxicated at the time. Rule enforcement precipitated abuse in 70% of incidents. Researchers concluded that reviewing rules that apply to patients, how HCWs are trained to enforce rules, how to respond when service requested cannot be provided promptly, and how HCWs can protect themselves when performing a service were important elements in the prevention of staff abuse.

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Thromboembolic complications prevention in the obstetric practice

HEALTH OF WOMAN ◽

10.15574/hw.2017.117.19 ◽

2017 ◽

pp. 19-24

Author(s):

O.V. Grishchenko ◽

◽

V.V. Bobrytska ◽

Keyword(s):

Pulmonary Embolism ◽

Comparison Group ◽

Main Group ◽

Control Group ◽

Efficacy And Safety ◽

Thromboembolic Complications ◽

Moderate Risk ◽

Obstetric Practice ◽

Thrombotic Complications ◽

And Control

The objective: To evaluate the clinical efficacy and safety of Enoxaparin-Pharmex for the prevention of thrombotic complications (pulmonary embolism) in the postoperative period in patients with moderate risk of these complications. Patients and methods. The study included 50 women after a caesarean section had an average degree of risk of pulmonary embolism. Patients were divided into the main group (n=25) and control group (n=25) in accordance with the treatment: patients of the main group received postoperative Еnoxaparin- Pharmex, group comparisons enoxaparin sodium (brand foreign manufacturer’s). Patients in both groups received the drug at a dose of 20 mg for 5 days, 1 time per day subcutaneously. Results. The research data analysis showed identity results of hemostasiogram of patients in the main group and the comparison group, no side effects after treatment in both groups. Conclusion. The clinical studies suggest the drug Enoxaparin-Pharmex is effective, safe LMWH, which can be used to prevent troboembolic complications, including post-operative treatment in obstetric practice. Spectrum of Enoxaparin-Pharmex can be extended to the prevention and treatment of thromboembolic conditions of varying severity with appropriate doses of the drug. Key words: Enoxaparin-Pharmex, prevention of pulmonary embolism.

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ALCOHOL-RELATED ADMISSIONS TO AN INNER CITY HOSPITAL INTENSIVE CARE UNIT

Alcohol and Alcoholism ◽

10.1093/oxfordjournals.alcalc.a008168 ◽

1996 ◽

Vol 31 (4) ◽

pp. 393-396 ◽

Cited By ~ 39

Author(s):

P. MARIK ◽

B. MOHEDIN

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Inner City ◽

City Hospital ◽

Hospital Intensive Care Unit

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Comparing burnout and work-life balance among specialists in internal medicine: the role of inpatient vs. outpatient workplace

Journal of Occupational Medicine and Toxicology ◽

10.1186/s12995-021-00294-3 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Felix S. Hussenoeder ◽

Erik Bodendieck ◽

Franziska Jung ◽

Ines Conrad ◽

Steffi G. Riedel-Heller

Keyword(s):

Outpatient Setting ◽

Work Life ◽

Work Life Balance ◽

Full Time ◽

Life Balance ◽

Specific Factors ◽

Physician Mental Health ◽

Outpatient Settings ◽

Subsequent Patient

Abstract Background Compared to the general population, physicians are more likely to experience increased burnout and lowered work-life balance. In our article, we want to analyze whether the workplace of a physician is associated with these outcomes. Methods In September 2019, physicians from various specialties answered a comprehensive questionnaire. We analyzed a subsample of 183 internists that were working full time, 51.4% were female. Results Multivariate analysis showed that internists working in an outpatient setting exhibit significantly higher WLB and more favorable scores on all three burnout dimensions. In the regression analysis, hospital-based physicians exhibited higher exhaustion, cynicism and total burnout score as well as lower WLB. Conclusions Physician working at hospitals exhibit less favorable outcomes compared to their colleagues in outpatient settings. This could be a consequence of workplace-specific factors that could be targeted by interventions to improve physician mental health and subsequent patient care.

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Mental health and sleep habits/problems in children aged 3–4 years: a population study

BioPsychoSocial Medicine ◽

10.1186/s13030-021-00213-2 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Fumie Horiuchi ◽

Kentaro Kawabe ◽

Yasunori Oka ◽

Kiwamu Nakachi ◽

Rie Hosokawa ◽

...

Keyword(s):

Mental Health ◽

Health Status ◽

Healthcare Providers ◽

Poor Mental Health ◽

Mental Health Status ◽

Control Group ◽

Sleep Habits ◽

Psychological Burden ◽

Wake Time ◽

Health Group

Abstract Background Sleep is essential for mental health at all ages, but few studies have investigated the importance of sleep for mental health in early childhood. Therefore, this study examined the association between mental health and sleep habits/problems in children aged 3–4 years. Methods Children aged 3 to 4 years who were living in the community (n = 415; 211/204 boys/girls) were recruited for this study. Their mental health was assessed using the Strengths and Difficulties Questionnaire (SDQ), and their sleep habits/problems were evaluated using the Child and Adolescent Sleep Checklist. Results Based on the total difficulties score of the SDQ, the children were divided into two groups: a poor mental health group (n = 76) and a control group (n = 339). In terms of sleep habits, which included total sleep time, bedtime, wake time, and nap conditions, there were no differences between the two groups. Regarding sleep-related problems, however, anxiety before going to sleep (p = 0.026), circadian rhythm abnormalities (p = 0.014), and sleepiness during classes outside of naptimes (p = 0.031) were significantly higher in the poor mental health group than in the control group. Multiple regression analysis showed that poor mental health status was significantly associated with sleepiness and snoring (p = 0.017 and p = 0.018, respectively). Conclusions The mental health status of 3–4-year-old children was associated with sleep-related problems, namely sleepiness and snoring. Healthcare providers should pay attention to children’s irregular sleep-wake patterns; moreover, interventions for appropriate sleep hygiene will reduce the psychological burden on both children and their families.

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Assessment of Early Peanut Introduction Guidelines Among Pediatricians In An Inner-city Hospital

Journal of Allergy and Clinical Immunology ◽

10.1016/j.jaci.2020.12.372 ◽

2021 ◽

Vol 147 (2) ◽

pp. AB99

Author(s):

Sumeet Sandhu ◽

Monique Hanono ◽

Carly Rabin ◽

Rob Harriz ◽

Sairaman Nagarajan ◽

...

Keyword(s):

Inner City ◽

City Hospital

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Utilizing perspectives from HIV-infected women, male partners and healthcare providers to design family planning SMS in Kenya: a qualitative study

BMC Health Services Research ◽

10.1186/s12913-019-4708-7 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Karren Lewis ◽

Elizabeth K. Harrington ◽

Daniel Matemo ◽

Alison L. Drake ◽

Keshet Ronen ◽

...

Keyword(s):

Family Planning ◽

Controlled Trial ◽

Healthcare Providers ◽

Short Message ◽

Male Partners ◽

Group Discussions ◽

Sensitive Topics ◽

Care Workers ◽

Message Service ◽

Education Support

Abstract Background Short message service (SMS) presents an opportunity to expand the reach of care and improve reproductive health outcomes. SMS could increase family planning (FP) use through education, support and demand generation. The purpose of this analysis is to determine the perspectives of potential FP users to inform design of SMS. Methods We conducted focus group discussions (FGD) with HIV-infected women and in-depth interviews (IDI) with male partners and health care workers (HCW) at urban and rural clinics in Kenya to design SMS content for a randomized controlled trial. Results Women and men indicated SMS could be used as a tool to discuss FP with their partners, and help decrease misconceptions about FP. Women stated SMS could make them more comfortable discussing sensitive topics with HCWs compared to in-person discussions. However, some women expressed concerns about FP SMS particularly if they used FP covertly or feared partner disapproval of FP use. These findings were common among women who had not disclosed their status. Providers viewed SMS as an important tool for tracking patients and clinical triage in conjunction with routine clinical visits. Conclusion Our findings suggest that SMS has the potential to facilitate FP education, counselling, and interaction with HCWs around FP.

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