St. Charles Medical Center – Bend is a hospital in Bend, Oregon, United States. It is the largest hospital in Central Oregon,[citation needed] and a level 2 trauma center. St. Charles medical center [SCMC-B] is owned and operated by St. Charles Health System, Inc. (SCHS), a private, not-for-profit Oregon corporation. SCHS also owns and operates the St. Charles Medical Center - Redmond..
BACKGROUND:Malaria results in over 600,000 deaths per year, with 95 percent of all cases occurring in sub-Saharan Africa. Insecticide treated mosquito nets have long been proven to be the most effective prevention method to protect at-risk people from malaria. Temperature increases may now be changing sleeping habits and how people use available mosquito nets. Based on observations of increasing outdoor sleeping and fragility of the mosquito nets, this study evaluated a rural west African population to determine barriers to mosquito net use, including net fragility, heat and outdoor sleeping. METHODS:This study used a social ecological framework used by the Peace Corps to determine this community's barriers to malaria prevention. We practiced community-based participatory research by developing and implementing a survey in rural southeast Senegal. Local village health workers received special training to implement this survey. Observations of the mosquito nets and sleeping spaces were performed by surveyors. 164 households in 20 villages were surveyed from October to November of 2012. RESULTS:There was a 100% response rate, with 164 of the 164 selected households surveyed, representing 21% of this local population. For the 1806 family members, respondents assessed a total need of 1565 nets, implying that each individual in this area needs 0.86 nets (95% CI: 0.77-0.95). Survey responses gave rich, informative responses about mosquito net use. For example: 'If it's in the room set up properly under the mattress then it will be fine. But if it's outside with the beds that don't have mattresses, then it will deteriorate quickly.' The main reasons for not using an available net were heat and fragility of the nets. This population had very positive attitudes regarding mosquito nets and appreciated the work of local malaria educators. CONCLUSIONS:In a rural Senegalese population with a high malaria burden, our survey indicated a need for 0.86 insecticide treated nets per person. This is 54% higher than the current WHO recommendation of 0.56 ITNs per person. Our findings suggest that there are not enough nets because routine village conditions lead to considerable net damage, and because the heat leads people to sleep outdoors, where they likely do not have mosquito nets. With global warming, we suspect this population will spend even more time sleeping outside, aggravating the current insufficiency. Further research should investigate optimal interventions to address this challenge, including nets designed for outside use and for higher durability.
Recent studies have suggested an association between sleep duration and cardiovascular diseases; however, the link to AF is inconclusive. This study aimed to explore the relationship between sleep duration and AF by conducting a systematic review and meta-analysis of primary studies to provide evidence of the link between insufficient sleep and AF. A review of the existing literature was conducted to identify the primary studies that examined the association between AF and sleep duration. The inquiry spanned databases, including PubMed, Embase, MEDLINE, and Google Scholar, from their inception through October 2023. Meta-analysis revealed a statistically significant association (p < 0.01) between shorter sleep duration and the incidence of AF (hazard ratio (HR), 1.18; 95
BACKGROUND:Hydatid disease, also known as echinococcosis, is a zoonotic parasitic infection caused by the larvae of the Echinococcus tapeworm. It is endemic in various regions worldwide, particularly in rural areas of countries in southern South America, Central Asia, China, parts of Africa, the Mediterranean, and parts of the Middle East. The disease primarily affects the liver (60-70% of cases) and the lungs (10-25% of cases), but it can involve any organ, including the brain, bones, and rarely the pelvic region, as seen in our case report. Hydatid disease typically follows an asymptomatic course in the early stages of the primary infection and may remain so potentially for years or even permanently. If symptoms occur, they depend on various factors, such as the number, size, and location among other factors. Typically, hydatid disease presents with nonspecific symptoms. Common symptoms include abdominal pain, hepatomegaly, as well as anaphylaxis in case of cyst rupture. Extrahepatic intra-abdominal isolated hydatic cyst is a rare finding (6-11%). CASE PRESENTATION:In our case, a 70 year-old Asian white male presented with right thigh pain radiating to the lower leg, which is an atypical presentation for an extrahepatic intraabdominal hydatid cyst. Primary intraabdominal hydatid cysts involving the pelvic region are relatively rare, and such cases pose diagnostic and management challenges. CONCLUSION:This case report underscores the challenges in diagnosing and managing extrahepatic intraabdominal hydatid cysts, particularly in atypical presentations. A combination of clinical evaluation, serological studies, and imaging techniques facilitates accurate diagnosis.
Aims To reach the target of 100% for VTE (venous thromboembolism) prophylaxis data submitted for all St Charles Older Adult inpatients. Methods It was found at the start of the QI project, the service was at 63% (August 2023). I reviewed this data and discussed it with the ward managers of the older adult inpatient wards and implemented two PDSA cycles. I went through the ward list of service users and noted on the database who had an outstanding VTE prophylaxis check. From this, I then created a section for the nursing handovers to include whether each service user had their VTE prophylaxis forms filled in and whether VTE prophylaxis was appropriately prescribed. The wards have a weekly MDT meeting where this could be discussed and all staff could be reminded to document the VTE data on the trust data system. I rechecked the data two months later to see if the data had improved. Following this, I created a VTE poster to be distributed via email to ward staff and hung up in the ward doctors' offices to help educate staff on the importance of VTE prophylaxis. The statistics were rechecked two months later for further improvement. Results At the start of the QI, it was found that the service was underperforming in reaching its target of 100% of the VTE prophylaxis data entry for all service users in older adult inpatient wards. After implementing the first PDSA cycle, the data increased to 84% compliance (October 2023 data). After implementing the second PDSA cycle, the data increased to 100% compliance (December 2023 data). The data showed both implementations had a significant impact on the data input and the target being reached. The new strategy has now been firmly placed into the team working pattern as a routine measurement and continues to be actively utilised. Conclusion In an older adult inpatient ward setting with service users who have co-morbidities, reduced mobility and risk of dehydration from self neglect, it is vital they are assessed appropriately for VTE risk factors and prescribed the appropriate prophylaxis. Once this was highlighted to the ward staff and an easy system of the PDSAs were implemented, the team are now able to actively input the data and provide optimal care for the service users.
