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Better System Performance
Published in Paul Batalden, Tina Foster, Sustainably Improving Health Care, 2022
Mark E. Splaine, Jeremiah R. Brown, Craig N. Melin, Rosalind A. Lasky, Tina Foster, Paul Batalden
The focus of this case is on the efforts made by the Environmental Services microsystem to improve the cleanliness of patient rooms. In doing this work, this microsystem team discovered new and better ways of creating an optimally clean environment. They researched and obtained, based on their past work, a new device that uses ultraviolet light to sterilize all surfaces in a room. The new system has been implemented and the hospital C. difficile infection rate has dropped by 82%. This story highlights the critical role the macrosystem must play in establishing the context for and support of better system performance.
The science of ageing
Published in Michael Parker, Charlie James, Fundamentals for Cosmetic Practice, 2022
Skin damage due to ultraviolet light (otherwise known as photoaging) is the primary influencer in skin ageing. Its effects are generated from both natural exposure to the sun and, in a more dangerous recent trend: sunbeds. There are three main types of ultraviolet light: UVA, UVB and UVC. UVC light has the shortest wavelength and is dissipated within the ozone layer, therefore rendering it unlikely to cause any consequent skin damage. UVB light has an intermediate wavelength which can only penetrate to the level of the dermis, and it is believed to be responsible for the erythematous changes seen in sunburn. UVA light has the longest wavelength and, until recently, was not believed to be harmful to the skin as it requires 1,000 times the level of radiation of UVB light to cause sunburn. Recent evidence suggests, however, that UVA light is able to penetrate the skin to the dermal layer and may actually be responsible for the majority of chronic skin changes associated with photoaging.
Geography
Published in Andrew M. Luks, Philip N. Ainslie, Justin S. Lawley, Robert C. Roach, Tatum S. Simonson, Ward, Milledge and West's High Altitude Medicine and Physiology, 2021
Andrew M. Luks, Philip N. Ainslie, Justin S. Lawley, Robert C. Roach, Tatum S. Simonson
With ascent to high altitude, exposure to solar radiation increases significantly (Chapter 2), with the amount absorbed by the body varying as a function of posture and clothing; dark clothing absorbs more radiation than light-colored clothing. Ultraviolet light exposure also increases considerably with ascent, but its effect can be minimized by covering the exposed area of the body and/or liberally applying sunscreen. For both types of radiation, the degree of exposure increases significantly with travel over snow-covered terrain, as snow reflects up to 90% of ultraviolet radiation, compared with 9% to 17% reflected from ground covered by grass (Buettner 1969). The altitude of the sun also plays an important role with greater exposures seen in the equatorial regions during the summer months (Chrenko and Pugh 1961). The complications associated with increased ultraviolet light exposure are discussed further in Chapter 27.
The BioWipe: a non-invasive method to detect intestinal carriage of multi-drug resistant GRAM-negative bacteria
Published in Journal of Chemotherapy, 2022
Emanuele Sozzi, Luther Bartelt, Jamie Xiao, Trey Kanumuambidi, Arash Naziripour, Laura Ruegsegger, Dylan Brown, Felicia Williams, Yuang Zhu, Xiao Bin Zhu, Tarun Prakash, Berkley Wood, Jatin Chandra Srivastava, Megan A. Stallard, Steven H. Marshall, Susan D. Rudin, Mark D. Sobsey, Robert A. Bonomo, David van Duin
Colonization precedes infection and facilitates spread of several clinically important multi-drug resistant organisms (MDRO). Reliable detection of carriage is important to improve our understanding of risk factors and spread of MDRO. Bacterial culture of stool samples obtained from peri-rectal swabs or whole stool is often used for this purpose [1]. The previously described BioWipe method is a non-invasive stool collection method that resembles the use of toilet paper, and can be self-administered [2]. The BioWipe consists of a 100 × 160 mm square of soft, absorbent synthetic fiber material attached to a plastic backing layer (Fisher Scientific, USA). It is used prior to using toilet paper after a bowel movement. The wipe with collected stool sample is placed onto the surface of an absorbent pad (3 M™ Petroleum Sorbent Pads, Fisher Scientific, USA) containing modified Cary Blair transport media. The two parts are then folded together and placed inside a plastic bag. Prior to use, both components are treated with ultraviolet light irradiation in a biological safety cabinet for 30 minutes. After sample collection, the BioWipe is eluted with 20 mL mix of Phosphate Buffer Saline solution (PBS, pH = 7.2) and 0.1% Tween 80 (vol/vol) directly in its original bag in a biosafety cabinet, until the stool sample is completely eluted. The resulting suspended stool sample is used for further processing.
Efficacy of Aloe-Vera Use for Prevention of Chemotherapy-Induced Oral Mucositis in Children with Acute Lymphoblastic Leukemia: A Randomized Controlled Clinical Trial
Published in Comprehensive Child and Adolescent Nursing, 2021
Muaaz Alkhouli, Mohannad Laflouf, Mazen Alhaddad
Fresh leaves of Aloe barbadensis plant were cut longitudinally. Then, the colorless gel present inside was extracted and changed to liquid from by placing it in a blending machine with a rotational sped of 10,000 rpm in order to remove the fibers. The resulting solution was stored at 4°C. The concentration of aloe-vera in the solution is 100% (Iquo Aso Takon ea, 2015). By adding water, the aloe-vera concentration in the solution was set at 70%. In addition, preservatives such as potassium sorbate and sodium meta-bisulfite were added to the solution (Lopez-Jornet, Camacho-Alonso, & Molino-Pagan, 2013). Potassium sorbate and sodium meta-bisulfite were used at concentrations of 0.1% and 0.01%, respectively (Barzegar, Azizi, Barzegar, & Hamidi-Esfahani, 2014; Sreeramoju & Digenis, 2018). Sterilization was performed by exposing the gel to ultraviolet light.
Impact of fibrin glue versus suture closure on double-headed pterygia in Asian eyes – a 7-year study in a tertiary institution
Published in Annals of Medicine, 2021
Wei Wei Dayna Yong, Liang Shen, Ray Manotosh, Wee Tien Anna Marie Tan, Hui Chen Charmaine Chai
Pterygia are fibrovascular overgrowth of the Tenon's capsule and bulbar conjunctiva onto the cornea, which may cause ocular surface irritation, tear film-related problems, astigmatism or reduced cosmesis [1,2]. Ultraviolet light has been found to play a key role in its pathogenesis [3]. Double-headed pterygia present as nasal and temporal pterygia in the same eye. These are rare and have a reported incidence of less than 2.5% [4]. The overall worldwide incidence of pterygium is 10.2%, based on a meta-analytic study by Liu et al. [5]. These pterygia tend to cause higher astigmatism and more visual symptoms. They are harder to treat surgically since a larger graft has to be harvested to cover the large exposed scleral after excision. With a large graft, there is potentially a higher risk of inflammation, recurrence and limbal stem cell deficiency.