Noise pollution in hospital impact quality and safety of healthcare

first_imgReviewed by James Ives, M.Psych. (Editor)Nov 19 2018In an editorial published today in the BMJ, researchers from King’s College London and the University of the Arts London (UAL) argue that it is a worsening problem, with levels regularly exceeding international recommendations.”Even in intensive care units, which cater for the most vulnerable patients, noise levels over 100dB have been measured, the equivalent of loud music through headphones,” said lead author Dr Andreas Xyrichis.Noise in hospitals is known to hinder communication among staff, causing annoyance, irritation and fatigue, and detrimentally impact the quality and safety of healthcare. High noise levels and noise-induced stress impact negatively on staff performance and wellbeing, compromising caring behavior and contributing to burnout.The team highlight that it can also impact a patients’ ability to rest, heal and recover, since it has been linked to the development of ICU psychosis, hospitalization-induced stress, increased pain sensitivity, high blood pressure and poor mental health.”We know hospital noise has disruptive consequences for sleep – machine sounds in particular have a greater negative effect on arousal than human voices. Post-hospitalization recovery is also compromised. For example, coronary care patients treated during noisy periods were found to have a higher incidence of rehospitalization compared to those treated during quieter periods,” explained Andreas.Patients report that hospital noise can have a cumulative effect on their hospital experience. Patients who are in hospital for several nights are left feeling trapped and stressed, leading to requests for premature discharge from hospital and heightened risk of trauma and readmission.The team from King’s and UAL believes that the following areas urgently need to be addressed to ensure significant progress in this slow-moving field: Source:https://www.kcl.ac.uk/ Noise is often incorrectly associated with high sound pressure levels (SPLs). Dripping taps for example, may register low SPLs yet still be considered noisy. Prioritizing SPL reduction does not ensure improved noise perception. Therefore, a new approach is needed, one that views the hospital soundscape as a positive and malleable component of the environment. There are a number of potential sources of noise in hospitals. Alarms, televisions, rattling trolleys, and ringing phones, as well as staff, visitor, and patient conversations. However, not all of them are perceived as noise by patients – for example, some find the sound of the tea trolley pleasing, associating it with receiving a warm drink. Research has also shown that some ICU patients welcome ringing telephones as a sign that they are not alone. So far ways to measure patients’ perceptions of noise are limited, and more research investment is needed in this area. Patients and families need clear information about likely noise levels during admissions, so they are better prepared in advance, and can consider simple solutions such as headphones with their own choice of audio content. Education for staff is also needed, to encourage a culture that considers noise reduction an integral part of safe high quality healthcare.center_img Related StoriesResearch finds link between air pollution and coronary heart disease in ChinaLiving environment, air pollution may be linked to increased risk of hypertensionInternational tourists are more susceptible to harmful effects of air pollution”Measures to tackle this problem have included ear plugs, noise warning systems, acoustic treatment panels, educational initiatives and noise reduction protocols, which have provided some benefit,” said Andreas.”However, so far, patients have been seen as passive recipients of hospital noise rather than active participants in its creation. It is essential that future solutions should have greater patient participation as a key feature.”Guides about potential ward sounds could also enhance patients’ understanding of their surroundings and increase relaxation. Sound masking – the addition of background, broadband sound optimized for particular environments to reduce noise-induced disturbance – has also been used widely in open-plan offices for many years and has recently shown promise for improving sleep in hospitals.”last_img read more

New study provides insights on increased risk of suicide in young patients

Source:https://www.elsevier.com/ Reviewed by James Ives, M.Psych. (Editor)Dec 17 2018Identifying patterns in medical encounters prior to self-directed violence events can help shape screening and prevention strategies, according to a new study in the American Journal of Preventive Medicine A new study published in the American Journal of Preventive Medicine provides detailed insights on the increased risk of self-directed violence that patients aged 15-29 years visiting the emergency department (ED) for medical complaints subsequently experience. This underscores the importance of EDs in suicide prevention. The broad number of physical health conditions associated with an increased risk of self-directed violence may serve to support expanded or broader screening among teens and young adults.Suicide is the second leading cause of death for youth, with mental disorders and substance abuse as the two leading risk factors. Approximately 40 percent of suicide decedents aged 16 and older visit EDs in the year prior to their deaths; 60 percent of them receive medical diagnoses other than mental health or substance abuse.”Young people presenting to the ED for certain medical conditions are at an increased risk of subsequent self-directed violence,” explained lead investigator Jing Wang, MD, MPH, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA, in the study’s findings. “An awareness of these medical encounters may help guide screening efforts for suicide prevention in clinical settings.”This study addresses important gaps in prior research by identifying the medical reasons triggering youth ED visits that are associated with higher risk of subsequent suicidal behavior. Using 2011-2013 data from six states (Florida, New York, Nebraska, Vermont, Iowa, and Massachusetts) from databases sponsored by the Agency for Healthcare Research and Quality, investigators followed more than two million teens and young adults (aged 15-29) who visited EDs for medical reasons during 2012-2013. Of that group, nearly 8,500 subsequently engaged in self-directed violence within six months of the initial visit; anyone who exhibited suicidal behavior in 2011 was excluded from the study.Related StoriesBridging the Gaps to Advance Research in the Cannabis IndustryAMSBIO offers new, best-in-class CAR-T cell range for research and immunotherapySchwann cells capable of generating protective myelin over nerves finds researchTeens and young adults who presented with diagnoses of epilepsy or seizures, or visited two or more times for various types of pain, syncope (fainting), or vomiting had a 3-9 fold increased risk of suicidal behavior in the following six months. Individuals who visited three or more times for dental complaints were also found to be more likely to engage in subsequent self-directed violence. ED visitors in the group who received diagnoses of minor infections served as a reference group.The findings also showed that half of the self-directed violence events occurred within 42 days of the initial ED visit. Identification of the heightened risk for suicide following visits for these medical conditions provides ED clinicians with a critical window of opportunity for detection, assessment, and intervention. The broad number of physical health conditions associated with an increased risk of subsequent suicidal behavior may help inform and support expanded screening and suicide prevention strategies in EDs.A limitation of the study is that about 70 percent of people who engage in self-directed violence do not seek medical assistance.​ read more

Duration of thrombectomies proves crucial in success of the procedure

first_img Source:http://www.musc.edu/ Reviewed by Kate Anderton, B.Sc. (Editor)Apr 15 2019The “Stroke Belt” refers to the swath of states in the Southeast where rates of stroke death are high, and according to the Department of Health and Environmental Control, South Carolina comes in at number six for the nation’s highest rates of stroke death.A stroke occurs when blood flow to a particular area of the brain is cut off, which could be due to a clot, a blood vessel leak or the bursting of a brain aneurysm. Without enough oxygen, the cells in that part of the brain begin to die and can leave behind motor and cognitive deficits.But while a stroke can be caused by vessel blockages or bleeding into the brain, the most common form is ischemic, meaning it is caused by a clot rather than a bleed, and is responsible for 87% of all strokes, according to the National Stroke Association.Timely removal of the blockage is vital when treating a stroke, and while the acceptable time to treatment has slowly lengthened with more effective thrombectomy techniques, physicians and surgeons must still act within 24 hours of the onset of stroke. Researchers at the Medical University of South Carolina (MUSC) report in a recent paper in the Journal of the American College of Cardiology that the current standard of care for stroke should also factor in procedure time when considering surgical intervention.”People will try once to remove the clot,” said Ali Alawieh, M.D, Ph.D., neurosurgery researcher at MUSC who worked on the study under the direction of MUSC’s Division of Neuroendovascular Surgery Director Alejandro Spiotta, M.D. “They’ll then try two, three and even four times or more hoping for a successful attempt. The idea of the paper is to quantify that, to look for a limit where you start doing more harm than good.”By studying the number of attempts and the amount of time spent performing procedures, this team of researchers concluded that the likelihood of completing an endovascular thrombectomy without significantly increasing the risk for the patient decreases dramatically after the first 30-60 minutes, depending on the technique used.Endovascular thrombectomies are performed using either stent retrievers or aspiration thrombectomy (ADAPT). By comparing both techniques, Alawieh and Spiotta found that the most important detail to consider was the time spent manipulating the vessel. Conducting the procedure with an SR means it takes the surgeon longer to get to the vessel than with ADAPT, but the factor that influences patient outcomes is the amount of time needed once the surgical team reaches the clot. Using SRs, the golden time for the procedure is at the hour mark, and using ADAPT, it is a half-hour.Related StoriesResearchers report how a popular antidepressant drug could rewire the brainSugary drinks linked to cancer finds studyNew protein target for deadly ovarian cancer”We had noticed this trend at MUSC, but we wanted to know if it extended nationally,” said Alawieh. “As it turns out, it does. After that 30- to 60-minute mark, depending on the procedure, surgeons should pause and reassess if the procedure is worth continuing.”Prior studies have shown that extending the duration of mechanical thrombectomies past 60 minutes, and more recently past 35 minutes, decreases the chance a patient will show few-to-no neurological disabilities after 90 days and increases the chance of a postprocedural hemorrhage. This study supports those findings at a multicenter national level and shows complication rates increase by the minute and were not dependent on the treatment center.Because they are in the Stroke Belt, physicians at MUSC perform some of the largest numbers of endovascular thrombectomies in the country, totaling over 200 procedures a year. Endovascular thrombectomy remains an important area of study with guidelines changing every year, and surgical teams at MUSC have already begun contributing to and incorporating the new guidelines into their surgeries.If a procedure is taking longer than the intended 30 to 60 minutes and a surgeon decides not to continue with the endovascular thrombectomy, the patient will be treated using medical intervention. While rates of positive outcomes are highest with successful surgical intervention, patients may still recover some of the deficits with medical management.This work involved a collaboration between MUSC and other centers across the country who are part of the Stroke Thrombectomy and Aneurysm Registry (STAR), a collaborative effort coordinated and initiated by MUSC to monitor outcomes in stroke patients nationally. To date, there are more than 12 centers across the U.S.”Stroke intervention procedures have improved dramatically in recent years, and they are so effective in helping patients, that it’s difficult for the physician to give up on a procedure when it’s not successful,” said Spiotta. “The major impact of this work is that it provides a potential stopping point for surgeons where the procedure can cause more harm than good.”last_img read more

Neuroscientists investigate how olfactory brain influences memory formation

first_imgReviewed by Kate Anderton, B.Sc. (Editor)Apr 29 2019How sensory perception in the brain affects learning and memory processes is far from fully understood. Two neuroscientists of Ruhr-Universität Bochum (RUB) have discovered a new aspect of how the processing of odors impacts memory centers. They showed that the piriform cortex – a part of the olfactory brain – has a direct influence on information storage in our most important memory structure, the hippocampus. Dr. Christina Strauch and Professor Denise Manahan-Vaughan report about their findings in the online edition of the magazine Cerebral Cortex on 9 April 2019.Related StoriesNew therapy shows promise in preventing brain damage after traumatic brain injuryMercy Medical Center adds O-arm imaging system to improve spinal surgery resultsWearing a hearing aid may mitigate dementia riskElectric impulses simulate odorsTo find out how odors affect memory formation, the researchers triggered an artificial perception of an odor in the brains of rats. To do this, they stimulated the piriform cortex with electrical impulses. “We were very surprised to see that the hippocampus directly responds to stimulation of the piriform cortex,” remarked Christina Strauch.The hippocampus uses sensory information to create complex memories. The basis of this processes is its ability to increase the efficacy of information transmission across synapses and thereby store memory contents. This process is called synaptic plasticity. Manahan-Vaughan and Strauch were the first to show that stimulation of the anterior piriform cortex triggers synaptic plasticity in the hippocampus.Special role for olfactionIn a second step, the researchers examined to what extent the piriform cortex competes with the entorhinal cortex in driving hippocampal synaptic plasticity. This structure sends information about activity in all sensory modalities to the hippocampus. Activating the afferent pathway of this structure, called the perforant path, triggered completely different reaction patterns in the hippocampus, to those generated by the piriform cortex. “The study gives us a theoretical basis for understanding how olfaction plays such a special role in memory formation and retrieval,” commented Denise Manahan-Vaughan.The two scientists have been working together since 2010 to investigate how odors cause memory formation. Source:https://news.rub.de/english/press-releases/2019-04-29-sensory-perception-how-olfactory-brain-affects-memorylast_img read more

San Francisco set to ban sales of ecigarettes

first_img This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente. Reviewed by Kate Anderton, B.Sc. (Editor)Jun 25 2019 San Francisco’s Board of Supervisors is slated to vote Tuesday to ban the sale and distribution of e-cigarettes in the city. The city is the corporate home of Juul Labs, the biggest producer of e-cigarettes in the country.The ordinances would make the sale of e-cigarettes illegal in brick-and-mortar stores and online when shipping to San Francisco addresses.San Francisco Mayor London Breed has 10 days to sign the legislation, which she has said she will do. The law will be enforced seven months from that date, in early 2020.San Francisco Supervisor Shamann Walton, who co-authored the legislation, sees it as part of a long-term battle against the effects of smoking.”We spent a few decades fighting big tobacco in the form of cigarettes,” Walton said. “Now we have to do it again in the form of e-cigarettes.”Under federal law, the minimum age to buy tobacco products is 18.  California and 15 other states, however, have raised that age to 21 or passed measures that will set it to 21 by 2021. Despite this, use of e-cigarettes, or vaping, has skyrocketed among teenagers nationally.Last year, 1 in 5 high school seniors reported vaping in the past month. That’s almost double the number from the year before. Even eighth graders are vaping in record numbers.These increases come after years of declines in teenagers smoking traditional cigarettes.Public health officials are concerned about the rising number of teenagers using e-cigarettes, as nicotine can harm a young person’s developing brain. The Centers for Disease Control and Prevention warns that young people who vape may be more likely to start smoking traditional cigarettes.Walton said he’s disgusted with the actions of Juul and similar companies, who he said are “putting profits before the health of young people, and people in general.”Despite the tobacco age limit, Walton noted that vaping devices are commonly confiscated from students in the city’s middle and high schools.The ordinance is accompanied by another that prevents the manufacture, distribution and sale of e-cigarettes on San Francisco property. The ordinance takes direct aim at Juul Labs, which leases space from the city on San Francisco’s Pier 70. The ordinance is not retroactive, so it would not remove Juul from the company’s current space, but it would prevent other e-cigarette makers from renting city property in the future. In a statement, Juul spokesman Ted Kwong wrote that, regardless, the company does not “manufacture, distribute or sell our product from this space.”Juul’s vaping device was introduced in 2015. It’s small, sleek and discreet, looking similar to a flash drive. The company now controls 70% of the vaping market.In a statement, Juul Labs said it shares the city’s goal of keeping e-cigarettes away from young people. The company said it has made it harder for underage buyers to purchase Juul off its website and has shut down Juul accounts on Facebook and Instagram.Related StoriesStudies show no evidence of fall in cigarette consumption due to WHO’s FCTCStudy finds increase in cigarette smoking among minority teens after college affirmative action bansCollege affirmative action bans may increase smoking rates among minority high school studentsBut, the company argues that “the prohibition of vapor products for all adults in San Francisco will not effectively address underage use and will leave cigarettes on shelves as the only choice for adult smokers, even though they kill 40,000 Californians every year.”Walton doesn’t buy that argument, however. He said that’s simply “trading one nicotine addiction for another.” What’s more, he’s concerned that for every adult that might benefit, dozens of young people could become addicted.San Francisco resident Jay Friedman said the complete e-cigarette ban goes too far. The software engineer smoked a pack of cigarettes a day for 20 years, and smoking e-cigarettes has reduced his regular cigarette habit to two to three a day. He said he feels better physically.Friedman supported a ban on flavored tobacco that city voters passed last year. “I feel like it was good to get rid of the fruit flavors for kids,” he said, “but this feels like maybe a step too far.”If e-cigarettes are banned, he said, he would try to quit nicotine altogether. But, “there would be a point in a moment of weakness where I’d just end up buying a pack of smokes again and then it’s just a slippery slope from there.”Small businesses in San Francisco are concerned the ban will hurt their bottom line.Miriam Zouzounis and her family own Ted’s Market, a convenience store near downtown San Francisco. She said e-cigarettes are an “anchor” product: They draw people into the store.”When people come and want to purchase something at the store and we don’t have that exact item that they want, they’re not going to buy the rest of the items that they might on that trip: a drink or a sandwich,” Zouzounis said.She said sales from e-cigarettes account for at least $200 to $300 a day in sales. As a board member of the Arab American Grocers Association, she said she believes laws like this mostly affect businesses owned by immigrants.Abbey Chaitin is a 15-year-old lifelong San Francisco resident. She isn’t drawn to using e-cigarettes, she said, because she has seen peers become addicted to them.”I’ll see them in class fidgeting,” Chaitin said. “They need it to focus, to function.”And Chaitin predicted that, regardless of a ban, young people will still get their hands on e-cigarettes: “People my age can find a way around that if they really need to,” she said.Meanwhile, Juul is collecting signatures for a November ballot initiative to override the ban.This story is part of a partnership that includes KQED, NPR and Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.last_img read more

UK lawmaker Facebook misled Parliament over data leak risk

Citation: UK lawmaker: Facebook misled Parliament over data leak risk (2018, March 18) retrieved 18 July 2019 from https://phys.org/news/2018-03-uk-lawmaker-facebook-misled-parliament.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only. Explore further © 2018 The Associated Press. All rights reserved. Facebook accused of inaction over Russian ads in Brexit vote A British lawmaker accused Facebook on Sunday of misleading officials by downplaying the risk of users’ data being shared without their consent, after a former employee of data firm Cambridge Analytica says his company harvested information from 50 million Facebook users. Conservative legislator Damian Collins, who heads the British Parliament’s media committee, said he would ask Facebook chief Mark Zuckerberg or another Facebook executive to appear before his panel, which is investigating disinformation and “fake news.”Collins said Facebook has “consistently understated” the risk of data leaks and gave misleading answers to the committee.”Someone has to take responsibility for this,” he said. “It’s time for Mark Zuckerberg to stop hiding behind his Facebook page.”Collins also accused the head of the U.K.-based data firm Cambridge Analytica, Alexander Nix, of lying. Nix told the committee last month that his firm had not received data from a researcher accused of obtaining millions of Facebook users’ personal information.Facebook suspended Cambridge Analytica, which is best known for working on President Donald Trump’s 2016 campaign, on Friday over allegations it retained improperly obtained user data after claiming it had deleted the information.Former Cambridge Analytica employee Chris Wylie said that the company obtained information from 50 million Facebook users, using it to build psychological profiles so voters could be targeted with ads and stories.Wylie told Britain’s Channel 4 news that the company was able to amass a huge database very quickly from an app developed by an academic that vacuumed up data from Facebook users who agreed to fill out a survey, as well as their friends and contacts—a process of which most were unaware.”Imagine I go and ask you: I say, ‘Hey, if I give you a dollar, two dollars, could you fill up this survey for me, just do it on this app’, and you say, ‘Fine,'” He said. “I don’t just capture what your responses are, I capture all of the information about you from Facebook. But also this app then crawls through your social network and captures all of that data also.”Wylie said that allowed the company to get roughly “50 million plus” Facebook records in several months and he criticized Facebook for facilitating the process.”Why Facebook didn’t make more inquiries when they started seeing that, you know, tens of millions of records were being pulled this way, I don’t know,” he said.Lawmaker Collins said he would summon Nix to reappear before the Parliament committee.”It seems clear that he has deliberately misled the committee and Parliament by giving false statements,” Collins said. read more

Endtoend blood testing device shows capacity to draw sample and provide diagnostic

first_img Separation line Researchers from the Biomedical Engineering Department at Rutgers University have developed an end-to-end blood testing device that integrates robotic phlebotomy with downstream sample processing. This platform device performs blood draws and provides diagnostic results in a fully automated fashion at the point-of-care. By reducing turnaround times, the device has the potential to expedite hospital work-flow, allowing practitioners to devote more time to treating patients. The research has been published in a paper in the June 2018 issue of Technology. Explore further Diagnostic blood testing is the most commonly performed clinical procedure in the world and influences the majority of medical decisions made in hospital and laboratory settings. However, manual blood draw success rates are dependent on clinician skill and patient physiology, and results are generated almost exclusively in centralized labs from large-volume samples using labor-intensive analytical techniques.To address these issues, the team of researchers at Rutgers University created a device that includes an image-guided venipuncture robot, to address the challenges of routine venous access, with a centrifuge-based blood analyzer to obtain quantitative measurements of hematology. In the paper, results are presented on a white blood cell assay, using a blood mimicking fluid spiked with fluorescent microbeads. Studies were conducted on the integrated device—from blood draw to analysis—using blood vessel phantoms, demonstrating both high accuracy and repeatability of the cannulation and resulting white blood cell assay.”This device represents the holy grail in blood testing technology,” stated Martin Yarmush, M.D., Ph.D., the paper’s senior author. “Integrating miniaturized robotic and microfluidic systems, this technology combines the breadth and accuracy of traditional laboratory testing with the speed and convenience of point-of-care testing.””When designing the system, our focus was on creating a modular and expandable device”, stated Max Balter, Ph.D., first author of the paper. “With our relatively simple chip design and analysis techniques, the device can be extended to incorporate a broader panel of assays in the future”. Citation: End-to-end blood testing device shows capacity to draw sample and provide diagnostic results (2018, June 6) retrieved 18 July 2019 from https://phys.org/news/2018-06-end-to-end-blood-device-capacity-sample.htmlcenter_img More information: M.L. Balter et al, Automated end-to-end blood testing at the point-of-care: Integration of robotic phlebotomy with downstream sample processing, TECHNOLOGY (2018). DOI: 10.1142/S2339547818500048 Provided by World Scientific Publishing This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.last_img read more

Karnataka MLA Ramalinga Reddy will withdraw resignation vote for Congress

first_imgKarnataka Congress MLA Ramalinga Reddy says he will withdraw resignation, vote in favour of govtCongress MLA Ramalinga Reddy on Wednesday said he has decided to withdraw his resignation from the assembly. This comes a day before the floor test in Karnataka assembly.advertisement Press Trust of India BengaluruJuly 17, 2019UPDATED: July 17, 2019 23:50 IST Karnataka Congress MLA Ramalinga Reddy.In some relief to the embattled coalition government in Karnataka, Congress MLA Ramalinga Reddy on Wednesday said he has decided to withdraw his resignation from the assembly and will vote in favour of the trust vote to be sought by Chief Minister H D Kumaraswamy.”I will take part in the assembly session tomorrow and vote in favour of the party. I will continue to remain in the party and serve as MLA,” he told PTI here.Reddy, a former minister, is among the 13 Congress and three JDS MLAs who have tendered their resignations while two independent legislators have withdrawn their support to the 14-month old Kumaraswamy government, leaving it tottering on the brink of collapse.The survival of the Congress-JD(S) government hangs precariously on the eve of the trust vote with the Supreme Court Wednesday holding that the 15 rebel Congress-JD(S) MLAs, who had moved it, cannot be compelled to participate in the proceedings of the ongoing assembly session.While most of the rebel MLAs have been staying in Mumbai, Reddy chose to be in the city amid reports that Congress was trying to pacify him.The party had also left him out while moving the Assembly Speaker for disqualification of the rebel MLAs, saying he was an “exception.”Reddy too had maintained he would remain in Congress and he has resigned only from the assembly.Hours ahead of the floor test on Thursday, Reddy said he would withdraw his resignation letter submitted to the Speaker on July 6.The other rebel MLAs camping in Mumbai said there was no question of stepping back on their resignations or attending the session.If the resignations of the 15 MLAs are accepted or if they stay away from the assembly, the ruling coalitions tally will plummet to 102, reducing the government to a minority.Also Read | President Ram Nath Kovind hails SC’s effort to provide judgments in 9 vernacular languagesAlso Watch | Karnataka crisis: Can Kumaraswamy govt survive?For the latest World Cup news, live scores and fixtures for World Cup 2019, log on to indiatoday.in/sports. Like us on Facebook or follow us on Twitter for World Cup news, scores and updates.Get real-time alerts and all the news on your phone with the all-new India Today app. Download from Post your comment Do You Like This Story? Awesome! Now share the story Too bad. Tell us what you didn’t like in the comments Posted bySanchari Chatterjee Nextlast_img read more