Valid quality metrics, and more importantly, improvement in healthcare delivery, depend on frontline provider engagement. We explore a pilot for using a familiar technology model, customized to the needs of frontline users, to foster a culture of teamwork, accountability, and improve patient care. Pre-intervention surveys measured awareness of quality indicators and their importance among frontline staff of a Mayo Clinic cardiovascular unit. Post-intervention surveys indicated substantial to significant increases in awareness of three critical metrics and two related best practices. We conclude with qualitative remarks on attitudinal changes that resulted from participation in the pilot.

Aim: To investigate prevalence of Escherichia coli in drinking water samples collected from municipal and local water supply in the period January 2013 to December 2013 in Zenica-Doboj Canton, Bosnia and Herzegovina.

Methods: A total of 1080 and 2206 water samples from municipal and local water supply were taken over one year from the Protocols of the Laboratory for Sanitary and Clinical Microbiology (Cantonal Public Health Institute of Zenica-Doboj Canton). Membrane filtration method was used for the analysis the samples of drinking water, according to International standards.

Results: Among total of 1080 water samples from municipal water supply, 59 (5.5%) were positive for Escherichia coli, while from local water supply, 560 (25.4%; out of 2206) were positive on E. coli. Fourty-five samples from municipal water supply (4.2%; out of 1080) were positive on coliforms, and 724 from local water supply (32.8%; out of 2206) were positive on other organisms.

The highest number of positive samples on E. coli from municipal and local water supply were from the municipality of Olovo, 30 (27.8%; out of 108), and the lowest was from the municipalities of Doboj-Jug and Usora, in each 12%, respectively.

Conclusion: Monitoring the microbiological quality of drinking water relies largely on examination of indicator bacteria such as coliforms, Escherichia coli, and Pseudomonas aeruginosa. Preventive activities and more frequent water sampling are necessary measures.

Background: Diabetes mellitus has been associated with an increased risk of hospital malnutrition.

Objective: The aim of this study was to estimate the prevalence of hospital malnutrition and its related costs in hospitalized diabetic patients in Spain.

Methods: We evaluated the prevalence of hospital malnutrition, length of hospital stay and related costs in the subset of patients from PREDyCES® study with diabetes mellitus. PREDyCES® study was a nationwide, cross-sectional, observational, multicentre study in routine clinical practice. Prevalence of hospital malnutrition was assessed both at patient admission and discharge using NRS-2002®

Results: 387 patients were included, of whom 53.7% were males. Mean age was 69.9 ± 12 y/o. Mean weight and mean body mass index were 69.8 ± 18.3 kg and 26.3 ± 6.9 kg/m2, respectively. 30.1% patients were malnourished (NRS®-2002 ≥ 3) at admission and 29.3% were malnourished at discharge. Prevalence of malnutrition was significantly higher in women than in men (36.9% vs. 24.2%; p < 0.01), in ≥ 70 than in < 70 y/o (41.2% vs. 15.2%; p < 0.001) and in urgent vs. programmed admissions (32.7% vs. 21.7%; p < 0.05). Weight loss during hospitalization was significant in 9.5% of patients and severe in 33.3%. Length of hospital stay and costs were significantly higher in malnourished patients than in patients who were not malnourished (12.3 ± 8.3 vs. 8.4 ± 5.5 days; p < 0.001; €8 911.3 ± 6 755 vs €5 965.1 ± 4 654; p = 0.001). 73.3% of patients who were malnourished did not receive nutritional support.

Conclusion: A third of diabetic patients admitted at Spanish hospitals are malnourished. Malnourished diabetic patients have longer hospitalizations and higher costs than those at no nutritional risk.

I summarize our work over the past decade to illustrate how improper management of heavy metal in manufacturing has caused pollution to the environment and as a result, has negatively influenced the health of local people in Changhua, a county in central Taiwan. Our study found a frightening 5.3-fold increase in the incidence of male oral cancer from 1982 to 2001 in Taiwan. Changhua, one of the 23 counties in Taiwan, ranked first in the list of oral cancer incidence. The incidence of male oral cancer in Changhua was also leading in the world (45.07/100,000/year in 2001). Heavy metal contained in waste water from electroplating factories was released into the environment and polluted farm soil. The incidence and prognosis of oral cancer in Changhua was strongly correlated with the densities of electroplating factories and the levels of heavy metal in the farm soil. In addition, the levels of heavy metal in the blood from the patients correlated strongly with the levels in the farm soil of their residence areas. Moreover, the patients had higher levels of heavy metal in their blood, compared with the blood levels in controls. Evidence shows that the detrimental effects from the environmental pollution can persist for generations.

Almost every statistical test generates a P value (or several). Yet, many physicians don’t really understand what P values are. It is mentioned that P value is probably the most ubiquitous and at the same time, misunderstood, misinterpreted, and occasionally miscalculated index