scholarly journals 390. Can Testing the Environment for SARS-CoV-2 Be a Signal for Staff Infections in Nursing Homes (NHs)?

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S297-S297
Author(s):  
Gabrielle Gussin ◽  
Raveena Singh ◽  
Izabela Coimbra Ibraim ◽  
Raheeb Saavedra ◽  
Thomas Tjoa ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Limit Of Detection ◽  
Cross Sectional Study ◽  
Environmental Sampling ◽  
Cohen’S Kappa ◽  
Cross Sectional ◽  
Material Support ◽  
Cohen's Kappa ◽  
Cleaning Products ◽  
Using Data

Abstract Background Federal mandate requires NHs to perform weekly COVID-19 testing of staff. Testing is effective due to barriers to disclosing mild illness, but it is unclear how long the mandate will last. We explored if environmental samples can be used to signal staff COVID-19 cases as an alternative screening tool in NHs. Methods We conducted a cross sectional study to assess the value of environmental sampling as a trigger for COVID-19 testing of NH staff using data from currently performed weekly staff sweeps. We performed 35 sampling sweeps across 21 NHs from 6/2020-2/2021. For each sweep, we sampled up to 24 high touch objects in NH breakrooms (N=226), entryways (N=216), and nursing stations (N=194) assuming that positive samples were due to contamination from infected staff. Total staff and positive staff counts were tallied for the staff testing sweeps performed the week of and week prior to environmental sampling. Object samples were processed for SARS-CoV-2 using PCR (StepOnePlus) with a 1 copy/mL limit of detection. We evaluated concordance between object and staff positivity using Cohen’s kappa and calculated the positive and negative predictive value (PPV, NPV) of environmental sweeps for staff positivity, including the attributable capture of positive staff. We tested the association between the proportion of staff positivity and object contamination by room type in a linear regression model when clustering by NH. Results Among 35 environmental sweeps, 49% had SARS-CoV-2 positive objects and 69% had positive staff in the same or prior week. Mean positivity was 16% (range 0-83%) among objects and 4% (range 0-22%) among staff. Overall, NPV was 61% and Cohen’s kappa was 0.60. PPV of object sampling as an indicator of positive staff was 100% for every room type, with an attributable capture of positive staff of 76%, with values varying by room type (Table). Breakroom samples were the strongest indicator of any staff cases. Each percent increase in object positivity was associated with an increase in staff positivity in entryways (7.2% increased staff positivity, P=0.01) and nursing stations (5.7% increased staff positivity, P=0.05). Conclusion If mandatory weekly staff testing ends in NHs, environmental sampling may serve as an effective tool to trigger targeted COVID-19 testing sweeps of NH staff. Disclosures Gabrielle Gussin, MS, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Stryker (Sage) (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic products)Xttrium (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic products) Raveena Singh, MA, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Stryker (Sage) (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic products)Xttrium (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic products) Raheeb Saavedra, AS, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Stryker (Sage) (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic products)Xttrium (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic products) Susan S. Huang, MD, MPH, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Molnlycke (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Stryker (Sage) (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Xttrium (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)

Comparison of Agreement between Several Diagnostic Criteria of Sarcopenia in Community-Dwelling Older Adults

2021 ◽  
pp. 1-7
Author(s):  
N. Sosowska ◽  
M. Pigłowska ◽  
A. Guligowska ◽  
B. Sołtysik ◽  
T. Kostka
Keyword(s):  
Older Adults ◽  
Working Group ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Cohen’S Kappa ◽  
Cross Sectional ◽  
Diagnostic Algorithms ◽  
Cohen's Kappa ◽  
European Working ◽  
Community Dwelling Older Adults

Purpose: Several diagnostic algorithms exist to detect sarcopenia in older adults. We compared the prevalence of sarcopenia according to the selected diagnostic algorithms. Methods: This cross-sectional study compared the European Working Group of Sarcopenia in Older People (EWGSOP) 2010, updated EWGSOP 2019, the Foundation for National Institutes of Health (FNIH) and the International Working Group on Sarcopenia (IWGS) criteria in 778 outpatients of the Geriatric Clinic aged 60 to 89 years. Bioimpedance analysis (BIA) to estimate muscle mass, hand-held hydraulic dynamometer to measure muscle strength, the TUG test and gait speed to assess physical function were used. Results: The prevalence of sarcopenia varied from 0% to 6.43% depending on the algorithm. For the majority of associations between the different definitions of sarcopenia the agreement was null or fair (Cohen’s kappa between 0.2 and 0.4). Moderate agreement (Cohen’s kappa between 0.4 and 0.6) was found for only three relationships. Nevertheless, for these three relationships, McNemar’s test has given different results, indicating that even in the moderately agreeing algorithms, the shared diagnoses of sarcopenia concerned only part of subjects. Conclusions: According to diagnostic algorithms the prevalence of sarcopenia is low in independent community-dwelling older adults. The agreement between the different definitions is poor.

scholarly journals Drug modification by nurses in Norwegian nursing homes: A cross-sectional study

2021 ◽  
Vol 42 (2) ◽  
pp. 351-357
Author(s):  
Hege Solberg ◽  
Siri Andreassen Devik ◽  
Hege Therese Bell ◽  
Daniel Horst Zeiss ◽  
Rose Mari Olsen
Keyword(s):  
Nursing Homes ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Drug Modification

scholarly journals A New Approach to the Identification of Palliative Care Needs and Advanced Chronic Patients among Nursing Home Residents

2021 ◽  
Vol 18 (6) ◽  
pp. 3171
Author(s):  
Ana A. Esteban-Burgos ◽  
María José Lozano-Terrón ◽  
Daniel Puente-Fernandez ◽  
César Hueso-Montoro ◽  
Rafael Montoya-Juárez ◽  
...  
Keyword(s):  
Palliative Care ◽  
Nursing Homes ◽  
Statistical Significance ◽  
Nursing Home Residents ◽  
Cross Sectional Study ◽  
Care Needs ◽  
Chronic Patients ◽  
Cross Sectional ◽  
Surprise Question ◽  
Palliative Care Needs

Background: Proper planning of Palliative Care in nursing homes requires advanced knowledge of the care needs that residents show. The aim of the study was to evaluate Palliative Needs and other conditions such as fragility, complexity, and prognosis and also to suggest new indicators for the establishment of the resident’s advanced chronic condition. Methods: Cross-sectional study conducted in 149 nursing homes Complex Chronic residents evaluated by trained professionals. Palliative Care Needs, assessed by the NECPAL ICO-CCOMS© tool, and fragility, case and palliative complexity and prognosis were evaluate through a comprehensive assessment. Descriptive analyses and association measures were performed setting the statistical significance at 0.05. Results: More than 50% of the residents had positive Surprise Question and other Palliative Needs and were classified as Advanced Chronic Patients. Distress and/or Severe Adaptative Disorder was the most frequent need shown by the residents and significant differences in levels of frailty and other characteristics, were found between the Positive and the Negative Surprise Question Groups. Statistically significant correlations were also found between aspects of both groups. Conclusions: Nursing homes residents show Palliative Needs regardless of the response to the Surprise Question of the NECPAL tool. Other characteristics such as presence of an intermediate level of frailty are suggested as a new perspective to identify advanced chronic patients among nursing homes residents.

scholarly journals 33. Concerning Trends of Pediatric Leprosy in Minas Gerais, Brazil and Associations with Number of Municipality Medical Facilities

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S17-S17
Author(s):  
Taylor Landay ◽  
Julie A Clennon ◽  
José A Ferreira ◽  
Lucia A Fraga ◽  
Maria Aparecida F Grossi ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Minas Gerais ◽  
Chi Square ◽  
Cross Sectional ◽  
Period 2 ◽  
Time Period ◽  
Medical Facilities ◽  
Age Of Diagnosis ◽  
Using Data ◽  
Incident Cases

Abstract Background Leprosy in children under 15 years of age, and in particular, the presence of leprosy grade 2 disability (G2D) in children, signifies ongoing transmission and the need for improved surveillance. Our objective was to describe the epidemiology of pediatric leprosy in Minas Gerais, Brazil and to explore associations with access to medical facilities. Methods A cross-sectional study was conducted using data from the Brazilian Notifiable Diseases Surveillance System (SINAN) from 2002–2017. Incident cases were included if they resided in a municipality with both adult and pediatric cases. Municipalities were divided by the number of medical facilities per municipality: < 5, 5–17, and 18 or higher. Analyses compared pediatric cases across two time periods (2002–2009 and 2010–2017) and number of medical facilities / municipality using chi-square, t-tests, and logistic regression. Results A total of 27,725 cases were reported with 1,611 under 15 years of age. Overall incidence declined from 34.8 per 100,000 to 13.6 per 100,000 during the study period with pediatric incidence declining from 2.6 per 100,000 to 0.8 per 100,000. Time period 2 (TP2) showed an increase in the proportion of pediatric G2D (2.58% vs 1.91%, p < 0.0001) when compared to time period 1 (TP1). Mean age of diagnosis in children was younger in TP2 then in TP1 (10.06 vs 10.43, p=0.02). In 2017, the pediatric incidence in municipalities with the fewest medical facilities was 0.95 per 100,000 compared to 0.23 per 100,000 in municipalities with > 5 facilities (p=0.009). There was significantly higher odds of disability at diagnosis (grades 1 and 2) in pediatric cases residing in municipalities with < 5 medical facilities (aOR 1.88; 95% CI 1.37–2.59), adjusted for age and sex. See map (Fig 1). Figure 1. Cases of Pediatric Disability By Number of Municipality Medical Facilities from 2002–2017 (White areas without reported pediatric leprosy) Conclusion The increasing proportion of G2D in children in the second half of the study period despite declining incidence suggest occult infections among children and adults alike in Minas Gerais. Furthermore, the average age of diagnosis in children should increase, not decrease, if M. leprae transmission was truly declining. Lastly, the association between fewer municipality health facilities and increased disability suggest barriers to timely diagnosis and a critical area of focus for research into access to healthcare and leprosy risk. Disclosures All Authors: No reported disclosures

scholarly journals Association between chronic low back pain and degree of stress: a nationwide cross-sectional study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sungwoo Choi ◽  
Sangun Nah ◽  
Hae-Dong Jang ◽  
Ji Eun Moon ◽  
Sangsoo Han
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Multiple Logistic Regression Analysis ◽  
Cross Sectional Study ◽  
Low Back ◽  
Sectional Study ◽  
Severe Stress ◽  
Cross Sectional ◽  
Korean People ◽  
Using Data

AbstractLow back pain (LBP) is a very common health problem worldwide, and has a major impact on quality of life. This is a cross-sectional study using data obtained from the Korea National Health and Nutrition Examination Survey (KNHANES) to investigate the health and nutritional status of Korean people, conducted in 2013, 2014, and 2015. The total of 8,473 patients included in the analysis. A 357 (19.34%) subjects in the chronic LBP group and 1,697 (25.61%) subjects in the no chronic LBP group reported no stress (P < 0.001). The numbers of subjects reporting mild, moderate, and severe stress in the two groups were 934 (50.6%) vs. 3,785 (57.11%), 432 (23.4%) vs. 910 (13.73%), and 123 (6.66%) and 235 (3.55%), respectively (all P < 0.001). Multiple logistic regression analysis with full adjustment for other variables indicated higher OR for severe stress (OR 2.82, P < 0.001) than moderate (OR 2.54, P < 0.001) and mild (OR 1.55, P < 0.001) stress. We confirmed that there was a significant association between chronic LBP and degree of stress. Therefore, the degree of stress should be assessed in clinical treatment of chronic LBP patients.

The influence of prescriber and patient gender on the prescription of benzodiazepines: results from the Florida Medicaid Dataset

CNS Spectrums ◽  
2021 ◽  
pp. 1-5
Author(s):  
Leanna M. W. Lui ◽  
Yena Lee ◽  
Orly Lipsitz ◽  
Nelson B. Rodrigues ◽  
Hartej Gill ◽  
...  
Keyword(s):  
The United States ◽  
Sociodemographic Factors ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Assistance Program ◽  
Patient Gender ◽  
Prescription Rates ◽  
Male Patients ◽  
Using Data ◽  
Main Effects

Abstract Background Benzodiazepine (BZD) prescription rates have increased over the past decade in the United States. Available literature indicates that sociodemographic factors may influence diagnostic patterns and/or prescription behaviour. Herein, the aim of this study is to determine whether the gender of the prescriber and/or patient influences BZD prescription. Methods Cross-sectional study using data from the Florida Medicaid Managed Medical Assistance Program from January 1, 2018 to December 31, 2018. Eligible recipients ages 18 to 64, inclusive, enrolled in the Florida Medicaid plan for at least 1 day, and were dually eligible. Recipients either had a serious mental illness (SMI), or non-SMI and anxiety. Results Total 125 463 cases were identified (i.e., received BZD or non-BZD prescription). Main effect of patient and prescriber gender was significant F(1, 125 459) = 0.105, P = 0 .745, partial η2 < 0.001. Relative risk (RR) of male prescribers prescribing a BZD compared to female prescribers was 1.540, 95% confidence intervals (CI) [1.513, 1.567], whereas the RR of male patients being prescribed a BZD compared to female patients was 1.16, 95% CI [1.14, 1.18]. Main effects of patient and prescriber gender were statistically significant F(1, 125 459) = 188.232, P < 0.001, partial η2 = 0.001 and F(1, 125 459) = 349.704, P < 0.001, partial η2 = 0.013, respectively. Conclusions Male prescribers are more likely to prescribe BZDs, and male patients are more likely to receive BZDs. Further studies are required to characterize factors that influence this gender-by-gender interaction.

The acquisition of requests by second language learners of Spanish

2005 ◽  
Vol 2 (1) ◽  
pp. 1-27 ◽  
Author(s):  
Derrin Pinto
Keyword(s):  
Language Learning ◽  
Language Learners ◽  
Second Language Learners ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Advanced Learners ◽  
English Speaking ◽  
Request Strategies ◽  
Using Data ◽  
L1 And L2

This cross-sectional study in interlanguage pragmatics analyzes the requests employed by English-speaking learners of L2 Spanish, using data collected from university students at four different levels of language learning. The most common request strategies are first identified in a cross-linguistic analysis of Spanish and English and are then compared to the interlanguage data. The requests of lower-level students are found to be more idiosyncratic and pragmatically ambiguous than those of advanced learners, although not necessarily more direct. Advanced learners show signs of improvement, but still rely largely on L1 request behavior. Learners at all levels display more difficulties in areas in which there is cross-linguistic variation between the L1 and L2.

scholarly journals An assessment of the quality indicators of operative and non-operative times in a public university hospital

2015 ◽  
Vol 13 (4) ◽  
pp. 594-599 ◽  
Author(s):  
Altair da Silva Costa Jr ◽  
Luiz Eduardo Villaça Leão ◽  
Maykon Anderson Pires de Novais ◽  
Paola Zucchi
Keyword(s):  
Standard Deviation ◽  
Operating Room ◽  
Operative Time ◽  
Patient Flow ◽  
Cross Sectional Study ◽  
Public University ◽  
Major Effect ◽  
University Hospital ◽  
Cross Sectional ◽  
Using Data

ABSTRACT Objective To assess the operative time indicators in a public university hospital. Methods A descriptive cross-sectional study was conducted using data from operating room database. The sample was obtained from January 2011 to January 2012. The operations performed in sequence in the same operating room, between 7:00 am and 5:00 pm, elective or emergency, were included. The procedures with incomplete data in the system were excluded, as well as the operations performed after 5:00 pm or on weekends or holidays. Results We measured the operative and non-operative time of 8,420 operations. The operative time (mean and standard deviation) of anesthesias and operations were 177.6±110 and 129.8±97.1 minutes, respectively. The total time of the patient in operative room (mean and standard deviation) was 196.8±113.2. The non-operative time, e.g., between the arrival of the patient and the onset of anesthesia was 14.3±17.3 minutes. The time to set the next patient in operating room was 119.8±79.6 minutes. Our total non-operative time was 155 minutes. Conclusion Delays frequently occurred in our operating room and had a major effect on patient flow and resource utilization. The non-operative time was longer than the operative time. It is possible to increase the operating room capacity by management and training of the professionals involved. The indicators provided a tool to improve operating room efficiency.

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