scholarly journals Variability of respiratory rate measurements in neonates- every minute counts

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Catherine Muthoni Njeru ◽  
J. Mark Ansermino ◽  
William M. Macharia ◽  
Dustin T. Dunsmuir
Keyword(s):  
Respiratory Rate ◽  
World Health Organisation ◽  
Detection Algorithm ◽  
World Health ◽  
Limits Of Agreement ◽  
Short Period ◽  
Respiratory Pathology ◽  
The Mean ◽  
The One ◽  
The Impact

Abstract Background Respiratory rate is difficult to measure, especially in neonates who have an irregular breathing pattern. The World Health Organisation recommends a one-minute count, but there is limited data to support this length of observation. We sought to evaluate agreement between the respiratory rate (RR) derived from capnography in neonates, over 15 s, 30 s, 120 s and 300 s, against the recommended 60 s. Methods Neonates at two hospitals in Nairobi were recruited and had capnograph waveforms recorded using the Masimo Rad 97. A single high quality 5 min epoch was randomly chosen from each subject. For each selected epoch, the mean RR was calculated using a breath-detection algorithm applied to the waveform. The RR in the first 60 s was compared to the mean RR measured over the first 15 s, 30 s, 120 s, full 300 s, and last 60 s. We calculated bias and limits of agreement for each comparison and used Bland-Altman plots for visual comparisons. Results A total of 306 capnographs were analysed from individual subjects. The subjects had a median gestation age of 39 weeks with slightly more females (52.3%) than males (47.7%). The majority of the population were term neonates (70.1%) with 39 (12.8%) having a primary respiratory pathology. There was poor agreement between all the comparisons based on the limits of agreement [confidence interval], ranging between 11.9 [− 6.79 to 6.23] breaths per minute in the one versus 2 min comparison, and 34.7 [− 17.59 to 20.53] breaths per minute in the first versus last minute comparison. Worsening agreement was observed in plots with higher RRs. Conclusions Neonates have high variability of RR, even over a short period of time. A slight degradation in the agreement is noted over periods shorter than 1 min. However, this is smaller than observations done 3 min apart in the same subject. Longer periods of observation also reduce agreement. For device developers, precise synchronization is needed when comparing devices to reduce the impact of RR variation. For clinicians, where possible, continuous or repeated monitoring of neonates would be preferable to one time RR measurements.

scholarly journals Variability of Respiratory Rate Measurements in Neonates- Every Minute Counts

2021 ◽  
Author(s):  
Catherine M. Njeru ◽  
Dustin T. Dunsmuir ◽  
William M. Macharia ◽  
J. Mark Ansermino
Keyword(s):  
Respiratory Rate ◽  
World Health Organisation ◽  
Detection Algorithm ◽  
World Health ◽  
Limits Of Agreement ◽  
Short Period ◽  
Respiratory Pathology ◽  
The Mean ◽  
The One ◽  
The Impact

Abstract Background: Respiratory rate is difficult to measure, especially in neonates who have an irregular breathing pattern. The World Health Organisation recommends a one-minute count, but there is limited data to support this length of observation. We sought to evaluate agreement between the respiratory rate (RR) derived from capnography in neonates, over 15 seconds, 30 seconds, 120 seconds and 300 seconds, against the recommended 60 seconds.Methods: Neonates at two hospitals in Nairobi were recruited and had capnograph waveforms recorded using the Masimo Rad 97. A single high quality 5 minute epoch was randomly chosen from each subject. For each selected epoch, the mean RR was calculated using a breath-detection algorithm applied to the waveform. The RR in the first 60 seconds was compared to the mean RR measured over the first 15 seconds, 30 seconds, 120 seconds, full 300 seconds, and last 60 seconds. We calculated bias and limits of agreement for each comparison and used Bland-Altman plots for visual comparisons.Results: A total of 306 capnographs were analysed from individual subjects. The subjects had a median gestation age of 39 weeks with slightly more females (52.3%) than males (47.7%). The majority of the population were term neonates (70.1%) with 39 (12.8%) having a primary respiratory pathology. There was poor agreement between all the comparisons based on the limits of agreement [confidence interval], ranging between 11.9 [-6.79 to 6.23] breaths per minute in the one versus two minutes comparison, and 34.7 [-17.59 to 20.53] breaths per minute in the first versus last minute comparison. Worsening agreement was observed in plots with higher RRs.Conclusions: Neonates have high variability of RR, even over a short period of time. A slight degradation in the agreement is noted over periods shorter than one minute. However, this is smaller than observations done three minutes apart in the same subject. Longer periods of observation also reduce agreement. For device developers, precise synchronization is needed when comparing devices to reduce the impact of RR variation. For clinicians, where possible, continuous or repeated monitoring of neonates would be preferable to one time RR measurements.

Obstacles to Claiming Permanence and Injury-Relatedness for “Posttraumatic” Headache

2009 ◽  
Vol 14 (3) ◽  
pp. 3-6
Author(s):  
Robert J. Barth
Keyword(s):  
Complete Recovery ◽  
World Health ◽  
Related Factors ◽  
Posttraumatic Headache ◽  
Sixth Edition ◽  
Causative Relationship ◽  
Short Period ◽  
The One ◽  
Health Organization ◽  
Subjective Reports

Abstract “Posttraumatic” headaches claims are controversial because they are subjective reports often provided in the complex of litigation, and the underlying pathogenesis is not defined. This article reviews principles and scientific considerations in the AMAGuides to the Evaluation of Permanent Impairment (AMA Guides) that should be noted by evaluators who examine such cases. Some examples in the AMA Guides, Sixth Edition, may seem to imply that mild head trauma can cause permanent impairment due to headache. The author examines scientific findings that present obstacles to claiming that concussion or mild traumatic brain injury is a cause of permanent headache. The World Health Organization, for example, found a favorable prognosis for posttraumatic headache, and complete recovery over a short period of time was the norm. Other studies have highlighted the lack of a dose-response correlation between trauma and prolonged headache complaints, both in terms of the frequency and the severity of trauma. On the one hand, scientific studies have failed to support the hypothesis of a causative relationship between trauma and permanent or prolonged headaches; on the other hand, non–trauma-related factors are strongly associated with complaints of prolonged headache.

Osseointegrated Implants: A Comprehensive Review

2021 ◽  
Vol 2 (1) ◽  
pp. 24-30
Author(s):  
Matheus Marquez Cruvinel Santos ◽  
◽  
Flávio Barros da Silva ◽  
Idiberto José Zotarelli-Filho ◽  
Elias Naim Kassis ◽  
...  
Keyword(s):  
Dental Implants ◽  
Pharmacological Action ◽  
World Health Organisation ◽  
World Health ◽  
Density Level ◽  
Mineral Density ◽  
Osseointegrated Implants ◽  
Bone Mineral Density Level ◽  
The Mean ◽  
Normal Women

The most common bone disorder found by implant dentists is osteoporosis, which is a systemic skeletal disorder associated with aging, which is characterized by loss of bone mass, making bones fragile and more susceptible to fractures. The World Health Organisation has defined osteoporosis as a bone mineral density level greater than 2.5 standard deviations below the mean of young normal women. After 60 years of age, a third of the population have this disorder, it occurs twice as often in women than in men. It is estimated that 1.3 million fractures and 133,000 all hip fractures occur every year as a result of osteoporosis. This study aimed to discuss aspects of the pharmacological action of Bisphosphonates (BP) and their influence on the bone tissue when associated with treatment with dental implants. There are several types of treatments that prevent or prevent the progression of osteoporosis. So, BP, such as alendronate, are inhibitors of bone resorption. Act as controlling the development of osteoporosis by increasing the process of bone density and decrease its reabsorption, often acting as supporting the process of osseointegration of dental implants.

scholarly journals Children, Media and Food. A New Paradigm in Food Advertising, Social Marketing and Happiness Management

2021 ◽  
Vol 18 (7) ◽  
pp. 3588
Author(s):  
Rodrigo Elías Zambrano ◽  
Gloria Jiménez-Marín ◽  
Araceli Galiano-Coronil ◽  
Rafael Ravina-Ripoll
Keyword(s):  
Eating Habits ◽  
Self Regulation ◽  
World Health Organisation ◽  
World Health ◽  
New Paradigm ◽  
Number Of Children ◽  
Food And Beverage ◽  
Qualitative Technique ◽  
Food And Drink ◽  
The One

The growing number of children who are obese or overweight in certain countries or geographical areas is a fact, as evidenced by the continuous studies and reports on the subject, endorsed or carried out by the World Health Organisation and independent research. In this context, food and beverage advertising can contribute to this. The main objective of this research is to evaluate compliance with the Food and Drink Advertising Code for Children (PAOS Code) in Spain and its relationship with nutritional habits on television, specifically on channels aimed at children. The methodology is therefore mixed: on the one hand, a qualitative technique based on discourse analysis and, on the other, a quantitative technique based on the content analysis of the advertising broadcast for seven consecutive days on three specialised channels and two generalist channels on Spanish television. The results reveal a systematic noncompliance with this code, which translates into inadequate eating habits among children. The immediate conclusion is that 9 out of 10 parts of food and drink advertising do not comply with any of the rules of the PAOS Code and that self-regulation by the advertising companies is negligible and insufficient.

scholarly journals The Impact of Ultraviolet Radiation on the Aetiology and Development of Uveal Melanoma

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1700
Author(s):  
Melissa Chalada ◽  
Charmaine A. Ramlogan-Steel ◽  
Bijay P. Dhungel ◽  
Christopher J. Layton ◽  
Jason C. Steel
Keyword(s):  
Risk Factors ◽  
Ultraviolet Radiation ◽  
Uveal Melanoma ◽  
World Health Organisation ◽  
World Health ◽  
Genetic Mutations ◽  
High Incidence ◽  
The World ◽  
The Impact

Uveal melanoma (UM) is currently classified by the World Health Organisation as a melanoma caused by risk factors other than cumulative solar damage. However, factors relating to ultraviolet radiation (UVR) susceptibility such as light-coloured skin and eyes, propensity to burn, and proximity to the equator, frequently correlate with higher risk of UM. These risk factors echo those of the far more common cutaneous melanoma (CM), which is widely accepted to be caused by excessive UVR exposure, suggesting a role of UVR in the development and progression of a proportion of UM. Indeed, this could mean that countries, such as Australia, with high UVR exposure and the highest incidences of CM would represent a similarly high incidence of UM if UVR exposure is truly involved. Most cases of UM lack the typical genetic mutations that are related to UVR damage, although recent evidence in a small minority of cases has shown otherwise. This review therefore reassesses statistical, environmental, anatomical, and physiological evidence for and against the role of UVR in the aetiology of UM.

scholarly journals Riding the waves: the ongoing impact of COVID-19 on a national surgical training cohort

2021 ◽  
Author(s):  
Orla Hennessy ◽  
Amy Lee Fowler ◽  
Conor Hennessy ◽  
David Brinkman ◽  
Aisling Hogan ◽  
...  
Keyword(s):  
Surgical Training ◽  
World Health Organisation ◽  
World Health ◽  
Training Methods ◽  
Viral Spread ◽  
Surgical Services ◽  
Global Pandemic ◽  
Surgical Trainees ◽  
Secondary Survey ◽  
The Impact

Abstract Background The World Health Organisation declared a global pandemic on the 11 March 2020 resulting in implementation of methods to contain viral spread, including curtailment of all elective and non-emergent interventions. Many institutions have experienced changes in rostering practices and redeployment of trainees to non-surgical services. Examinations, study days, courses, and conferences have been cancelled. These changes have the potential to significantly impact the education and training of surgical trainees. Aim To investigate the impact of the COVID-19 pandemic on training, educational, and operative experiences of Irish surgical trainees. Methods Surgical trainees were surveyed anonymously regarding changes in working and educational practices since the declaration of the COVID-19 pandemic on 11 March 2020. The survey was circulated in May 2020 to both core and higher RCSI surgical trainees, when restrictions were at level five. Questions included previous and current access to operative sessions as well as operative cases, previous and current educational activities, access to senior-led training, and access to simulation-/practical-based training methods. A repeat survey was carried out in October 2020 when restrictions were at level two. Results Overall, primary and secondary survey response rates were 29% (n = 98/340) and 19.1% (n = 65/340), respectively. At the time of circulation of the second survey, the number of operative sessions attended and cases performed had significantly improved to numbers experienced pre-pandemic (p < 0.0001). Exposure to formal teaching and education sessions returned to pre-COVID levels (p < 0.0001). Initially, 23% of trainees had an examination cancelled; 53% of these trainees have subsequently sat these examinations. Of note 27.7% had courses cancelled, and 97% of these had not been rescheduled. Conclusion Surgical training and education have been significantly impacted in light of COVID-19. This is likely to continue to fluctuate in line with subsequent waves. Significant efforts have to be made to enable trainees to meet educational and operative targets.

“Air pollution arrested not imprisoned”: The impact of laws invoked on Covid-19 city lockdowns

2021 ◽  
Vol 2 (4) ◽  
Author(s):  
Emmanuel Mensah Aboagye ◽  
◽  
Nana Osei Owusu ◽  
Keyword(s):  
Air Pollution ◽  
Environmental Problem ◽  
World Health Organisation ◽  
Developed Countries ◽  
World Health ◽  
Economic Activities ◽  
Global Pandemic ◽  
Depth Study ◽  
The Government ◽  
The Impact

Air pollution continues to be an environmental problem that poses a lot of health risks to the young and aged. Developed countries have invested heavily to curb this environmental problem, causing severe threats to human lives, yet the results do not look convincing. In developing countries, the situation is difficult than they can imagine, resulting in governments borrowing to fight what looks like a lost battle [1-3]. The in-depth study of this environmental menace - air pollution, suggests that the government enacts stringent measures to help fight this battle. This is because air pollution has natural (volcanic eruption) and anthropogenic (human activities) causes. In December 2019, the deadly Coronavirus (Covid-19) outbreak was soon declared as a global pandemic by the World Health Organisation (WHO) [4]. Majority of countries have had their share of the impact of this outbreak. Many countries resorted to city lockdown to strictly control the movement of people and economic activities as recommended by WHO.

scholarly journals Live wildlife trade in markets - a scoping review to inform risk assessment of emerging infectious diseases

2021 ◽  
Author(s):  
Victoria J Brookes ◽  
Okta Wismandanu ◽  
Etih Sudarnika ◽  
Justin A Roby ◽  
Lynne Hayes ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Infectious Diseases ◽  
Scoping Review ◽  
Epistemic Uncertainty ◽  
Mammalian Species ◽  
Emerging Infectious Diseases ◽  
World Health Organisation ◽  
World Health ◽  
Wildlife Trade ◽  
The Impact

Wet markets are important for food security in many regions worldwide but have come under scrutiny due to their potential role in the emergence of infectious diseases. The sale of live wildlife has been highlighted as a particular risk, and the World Health Organisation has called for the banning of live, wild-caught mammalian species in markets unless risk assessment and effective regulations are in place. Following PRISMA guidelines, we conducted a global scoping review of peer-reviewed information about the sale of live, terrestrial wildlife in markets that are likely to sell fresh food, and collated data about the characteristics of such markets, activities involving live wildlife, the species sold, their purpose, and animal, human, and environmental health risks that were identified. Of the 59 peer-reviewed records within scope, only 25% (n = 14) focussed on disease risks; the rest focused on the impact of wildlife sale on conservation. Although there were some global patterns (for example, the types of markets and purpose of sale of wildlife), there was wide diversity and huge epistemic uncertainty in all aspects associated with live, terrestrial wildlife sale in markets such that the feasibility of accurate assessment of the risk of emerging infectious disease associated with live wildlife trade in markets is limited. Given the value of both wet markets and wildlife trade and the need to support food affordability and accessibility, conservation, public health, and the social and economic aspects of livelihoods of often vulnerable people, there are major information gaps that need to be addressed to develop evidence-based policy in this environment. This review identifies these gaps and provides a foundation from which information for risk assessments can be collected.

scholarly journals The Impact of Covid-19 Public Health Policies on Persons with Disability and their Caregivers in Malta

2021 ◽  
Vol 4 (2) ◽  
pp. 25-37
Author(s):  
Andrew Camilleri ◽  
Samantha Pace Gasan ◽  
Andrew Azzopardi
Keyword(s):  
Public Health ◽  
World Health Organisation ◽  
World Health ◽  
Persons With Disabilities ◽  
Health Authorities ◽  
Essential Services ◽  
Public Health Authorities ◽  
Novel Coronavirus ◽  
Restrictive Measures ◽  
The Impact

On March 11, 2020, the World Health Organisation (WHO) declared a global health pandemic, due to the spread of a novel coronavirus, later named “Covid-19”. The spread of Covid-19 led to social isolation, distancing and a number of restrictive measures in Malta.  The aim of this paper is to analyse the impact of Covid-19 and the subsequent restrictive measures on persons with disability and their caregivers and families in Malta. Using thematic analysis, the study found that a variety of impacts ranging from a sense of isolation, lack of essential services being provided, additional difficulties encountered at the place of work and education and measures that were not sufficiently tailored for persons with disability issued by public health authorities. Underlying the additional difficulties brought about by Covid-19, structural difficulties to access essential services as well as ignorance from policy makers and politicians and the added “vulnerable-ization” of persons with disabilities were found to be highly impacting factors that pervade the experience of persons with disabilities and their caregivers.

29 September, International Day of Otolaryngologist

2020 ◽  
pp. 75-79
Author(s):  
Oksana Rybachok
Keyword(s):  
Injury Risk ◽  
18Th Century ◽  
Genetic Diseases ◽  
Medical Science ◽  
World Health Organisation ◽  
World Health ◽  
Medical Practitioners ◽  
The World ◽  
Injury Risk Factor ◽  
The Impact

According to the World Health Organisation, deafness is one of the most widely spread sensory disorders in the world affecting about 360 million people worldwide. The causes of deafness can be very diverse, from genetic diseases, the impact of injury-risk factor and infectious agents to the administration of ototoxic drugs. Moreover, otolaryngologists believe that about half of deafness and hearing loss cases could have been prevented. Though otolaryngology was separated as an independent medical science in the mid-18th century, the decision to celebrate the Otolaryngologist Day on September 29 as a professional holiday for medical practitioners in this speciality was made not so long ago. This date at the end of September was chosen on purpose: the influx of patients to medical practitioners in this speciality is observed closer to the mid-autumn, after the first cold snap.

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