Development Work in Healthcare: What Supportive and Deterrent Factors Do Employees Working in a Hospital Department Experience in an Improved Work Environment?

Work-related mental health issues, accounting for high worker absenteeism in the world’s developed economies, are increasing, with the main cause being workplace conditions. The health services sector is especially experiencing great problems with this, because of challenging psychosocial working conditions. The aim of this study was to explore employees’ experiences of development work with a focus on the work environment within a hospital department with an outspoken special development assignment. The special assignment was decided by the highest management at the hospital and concerned work environment, caring processes, and ways of organizing the work. Eleven employees completed two individually semi-structured interviews, approximately 7 and 13 months after the start of the special assignment at the department. Interviews were analyzed using thematic analysis. The results reveal that both internal and external aspects influence the development work and highlight the importance of viewing the local development work in relation to how the rest of the organization functions. Important factors and conditions for a supportive and change-friendly work culture are discussed, as well as the need to plan for integration and change to create conditions for successful implementation of the results from organizational development and change initiatives.

Assessment and Management of Eyelid Injury

Background and aim: Among all sites of injury, eyelid laceration seems to be neglected in terms of sufficient epidemiological investigations. With a thorough understanding of the causes of eye lid lacerations, it is possible to develop a better preventive strategy and hence improve the public health policy in this respect. Hence the aim of the study was to understand the type of eyelid injury and study management of the injuries. Materials and methods: A total of 100 cases that were reported to the hospital department opd with the chief complain of blunt as well as penetrating eye lid injuries were included in the study. Evaluation by a physician was done for all cases to note the presence of any systemic diseases and for opinion regarding fitness for surgery. In cases where General Anaesthesia (GA) was used, Anaesthetist examined the patient and opined regarding status of the patient towards GA. Results: The results of the present study showed that 3rd and 4th decade were more prone to the eyelid injuries. Majority of the 58 cases showed involvement of left eye whereas the involvement of right eye was seen in 42 cases. In the present study, Minimonoka stent was used for 8 cases of canalicular lacerations and 8 cases of canalicular tear that were not affordable were repaired with 24G Venflon tube. Conclusion: As the injuries occur more commonly due to road traffic accidents showing 54 cases in our study, preventive measures are to be taken while riding such as controlling speed. Domestic injuries are more common in females. This study showed that Minimonoka stent is an effective and easy tool in reconstructing canalicular tear, with successful anatomical and functional integrity.

Modern trends in the prevalence of large intestinal diseases in the udmurt republic in 2019–2020.

At the present stage of the development of medicine there is a tendency to increase diseases of the gastrointestinal tract (gastrointestinal tract). The colon is the final stage of the digestion process, but it is no less important link in the gastrointestinal tract. The large intestine includes such important functions as: transport, motor, excretory. Colon pathologies in the structure of surgical morbidity are widespread; in recent years, an increase in their incidence has been noted. According to literature data, more than 11.3 % of the total adult population of the planet suffer from non-neoplastic diseases of the large intestine. This is 16–29 % of the total number of coloproctological patients. Men 30–50 years old get sick 4 times more often than women of the same age. At the present stage of the development of medicine, diseases of the colon are divided into inflammatory and non-inflammatory in nature. Inflammatory diseases include Crohn's disease and ulcerative colitis, which are recurrent diseases in which chronic inflammation of various parts of the gastrointestinal tract is observed. Non-inflammatory diseases include diseases such as hemorrhoids, anal fissures, colon diverticula, and others [1–8]. In the Udmurt Republic, the incidence of non-inflammatory diseases of the large intestine prevails over inflammatory ones. The aim of our study was to study the structure and identify the most common noninflammatory diseases of the large intestine in the Udmurt Republic for 75 2019–2020. It is difficult to understand the real prevalence of colon diseases because people are embarrassed to see a doctor due to the emergence of psychological barriers. Without adequate treatment, these diseases lead to the chronicity of processes and the occurrence of complications, most often with which patients are admitted to the hospital department. However, our research is certainly important in the field of coloproctology, statistics show the main aspects that require close attention of practitioners.

Medical Thoracoscopy Implementation after a European Respiratory Society Course Held from 2003 to 2016: A Survey

<b><i>Background:</i></b> Medical thoracoscopy (MT) is an important procedure in the management of patients with pleural diseases. <b><i>Objectives:</i></b> We designed a survey to explore whether the participants of our courses implement MT at their hospital after attending the course as no real-life data exist. <b><i>Methods:</i></b> We distributed by e-mail a questionnaire to the participants of the courses. The questionnaire included general information about the participants, the precourse experience on MT, the postcourse implementation of the technique, and the reasons for failure. <b><i>Results:</i></b> Responses were obtained from 104 of 324 (32.3%) identified emails. Responders were males (76%), seniors (59.7%), respiratory physicians (91.3%), working in a public/university hospital (78.8%), and mostly beginners (65.3%) from 41 countries. Following the course, 58.6% of responders either created or modified a MT program in their workplace. The reasons for not performing MT before the course were as follows: patients’ referral to a thoracic surgeon, not enough training, lack of funding, department understaffed, and refusal by the hospital/department. Overall, these reasons were significantly decreased (<i>p</i> = 0.002) after the course. <b><i>Conclusions:</i></b> Real-life data of our survey suggest that more than half of the responders have implemented the technique or modified their practice according to the skills they got from the course.

Differences in risk for SARS-CoV-2 infection among healthcare workers

Healthcare workers (HCWs) are a risk group for SARS-CoV-2 infection, but which healthcare work that conveys risk and to what extent such risk can be prevented is not clear. Starting on April 24th, 2020, all employees at work (n=15,300) at the Karolinska University Hospital, Stockholm, Sweden were invited and 92% consented to participate in a SARS-CoV-2 cohort study. Complete SARS-CoV-2 serology was available for n=12,928 employees and seroprevalences were analyzed by age, sex, profession, patient contact, and hospital department. Relative risks were estimated to examine the association between type of hospital department as a proxy for different working environment exposure and risk for seropositivity, adjusting for age, sex, sampling week, and profession. Wards that were primarily responsible for COVID-19 patients were at increased risk (adjusted OR 1.95 (95% CI 1.65-2.32) with the notable exception of the infectious diseases and intensive care units (adjusted OR 0.86 (95% CI 0.66-1.13)), that were not at increased risk despite being highly exposed. Several units with similar types of work varied greatly in seroprevalences. Among the professions examined, nurse assistants had the highest risk (adjusted OR 1.62 (95% CI 1.38-1.90)). Although healthcare workers, in particular nurse assistants, who attend to COVID-19 patients are a risk group for SARS-CoV-2 infection, several units caring for COVID-19 patients had no excess risk. Large variations in seroprevalences among similar units suggest that healthcare work-related risk of SARS-CoV-2 infection may be preventable.

A Research About the Current Situation of Insulin Injection Provided by Clinical Nurses Under Kap Model on Linzhi, Tibet

Objective: to investigate the current situation of insulin injection provided by clinical nurses under KAP(Knowledge-Attitude-Practice) model on Linzhi, Tibet, and to discuss and analyse the influence factors. Methods: using a self-design questionnaire a questionnaire about the current situation of insulin injection provided by clinical nurses under KAP model on Linzhi, Tibet to investigate 268 clinical nurses in Linzhi, Tibet, who were chosen through random sampling method, in order to analyse the ‘KAP’ scoring and the influencing factors. Results: The scoring of ‘Knowledge’ is (65.642±10.313), the scoring of ‘Attitude’ is (55.478±8.099), the scoring of ‘Practice’ is (42.493±6.647), the total scoring is (163.612±19.292). The related influence factors, including hospital, department, academic credentials, professional qualifications and whether receiving diabetes specialized training, have statistical significance (P value?0.5). Conclusion: The KAP of insulin injection provided by clinical nurses in Linzhi, Tibet is on middle level. For nursing managers, it is strongly advised that a normative.

Chemical risk in hospital settings: Overview on monitoring strategies and international regulatory aspects

Chemical risk in hospital settings is a growing concern that health professionals and supervisory authorities must deal with daily. Exposure to chemical risk is quite different depending on the hospital department involved and might origin from multiple sources, such as the use of sterilizing agents, disinfectants, detergents, solvents, heavy metals, dangerous drugs, and anesthetic gases. Improving prevention procedures and constantly monitoring the presence and level of potentially toxic substances, both in workers (biological monitoring) and in working environments (environmental monitoring), might significantly reduce the risk of exposure and contaminations. The purpose of this article is to present an overview on this subject, which includes the current international regulations, the chemical pollutants to which medical and paramedical personnel are mainly exposed, and the strategies developed to improve safety conditions for all healthcare workers.

“Motherese” Prosody in Fetal-Directed Speech: An Exploratory Study Using Automatic Social Signal Processing

Introduction: Motherese, or emotional infant directed speech (IDS), is the specific form of speech used by parents to address their infants. The prosody of IDS has affective properties, expresses caregiver involvement, is a marker of caregiver-infant interaction quality. IDS prosodic characteristics can be detected with automatic analysis. We aimed to explore whether pregnant women “speak” to their unborn baby, whether they use motherese while speaking and whether anxio-depressive or obstetrical status impacts speaking to the fetus.Participants and Methods: We conducted an observational study of pregnant women with gestational ages from 26 to 38 weeks. Women were recruited in a university hospital department of obstetrics. Thirty-five women agreed to participate in the study, and 26 audio records were exploitable. We collected obstetrical and sociodemographic data, pregnancy outcomes, anxiety and depressive status using the Covy and Raskin Scales, and life events using the Sensations During Pregnancy and Life Event Questionnaire. Each participant was left alone with an audio recorder with a recommendation to feel free to speak to her fetus as she would have done at home. The recording was stopped after 3 min. Audio recordings were analyzed by two methods: psycholinguist experts' annotation and computational objective automatic analyses.Results: Most mothers (89%) reported speaking to their fetuses. We found a correlation between maternal first perceptions of fetal movements and the start of mother's speaking to fetus. Motherese prosody was detected with both annotation and automatic analysis with a significant correlation between the two methods. In this exploratory study, motherese use was not associated with maternal anxiodepressive or obstetrical status. However, the more future mothers were depressed, the less they spoke with their fetuses during the recording.Conclusion: Fetal directed speech (FDS) can be detected during pregnancy, and it contains a period of prosody that shares the same characteristics of motherese that can be described as prenatal motherese or emotional fetal-directed speech (e-FDS). This means that pregnant women start using motherese much earlier than expected. FDS seems to be correlated with maternal first perceptions of fetal movements and depression scores. However, more research is needed to confirm these exploratory results.