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Ridgway, Jessica P., Jessica Schmitt, Ellen Almirol, Monique Millington, Erika Harding und David Pitrak. „Electronic data sharing between public health department and clinical providers improves accuracy of HIV retention data“. Open Forum Infectious Diseases 4, suppl_1 (2017): S421—S422. http://dx.doi.org/10.1093/ofid/ofx163.1059.
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Abstract Background Retention in care is critical for treatment and prevention of HIV. Many HIV care clinics measure retention rate, but data are often incomplete for patients who are classified as lost to follow-up but may be actually in care elsewhere, moved, or died. The Data to Care (D2C) initiative supports data sharing between health departments and HIV providers to confirm patient care status and facilitate reengagement efforts for out of care HIV patients. Methods The University of Chicago Medicine (UCM) provided an electronic list to the Chicago Department of Public Health (CDPH) of adult HIV-positive patients whose retention status was not certain. Retention in care was defined as at least 2 visits >90 days apart within the prior 12 months. CDPH matched this list of patients with data from the Chicago electronic HIV surveillance database. Matches were based on patient name, including alternative spellings and phonetics, and birth date. CDPH also cross-checked patient names with the CDC’s national enhanced HIV-AIDS Reporting System (eHARS) database. CDPH provided UCM with patient current care status, i.e., patient was in care elsewhere (as verified by lab data), moved out of state, or deceased. Results 780 HIV-positive patients received care in the UCM adult HIV clinic from January 1, 2013 to March 31, 2017. Of these, 360 were retained in care as of March 2017. We shared data with CDPH for 492 patients. Of these, 294 (59.8%) were matched, and 168 (34.1%) had a date of last medical care provided. See Table 1 for patient dispositions, before and after data sharing. 24 (13.4%) of patients believed to be lost to follow up according to UCM records were confirmed either transferred care or deceased according to health department data. Conclusion Data sharing between the health department and HIV providers can improve data accuracy regarding retention in care among people living with HIV. Disclosures J. P. Ridgway, Gilead FOCUS: Grant Investigator, Grant recipient; D. Pitrak, Gilead Sciences FOCUS: Grant Investigator, Grant recipient
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Cimino, J. J. „Desiderata for Controlled Medical Vocabularies in the Twenty-First Century“. Methods of Information in Medicine 37, Nr. 04/05 (Oktober 1998): 394–403. http://dx.doi.org/10.1055/s-0038-1634558.
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AbstractBuilders of medical informatics applications need controlled medical vocabularies to support their applications and it is to their advantage to use available standards. In order to do so, however, these standards need to address the requirements of their intended users. Overthe past decade, medical informatics researchers have begun to articulate some of these requirements. This paper brings together some of the common themes which have been described, including: vocabulary content, concept orientation, concept permanence, nonsemantic concept identifiers, polyhierarchy, formal definitions, rejection of “not elsewhere classified” terms, multiple granularities, mUltiple consistent views, context representation, graceful evolution, and recognized redundancy. Standards developers are beginning to recognize and address these desiderata and adapt their offerings to meet them.
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Masaki, Motofumi, und Akira Koizumi. „Demographic characteristics and their genetic implications in a small island“. Journal of Biosocial Science 20, Nr. 2 (April 1988): 225–34. http://dx.doi.org/10.1017/s0021932000017454.
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SummaryThe family registration records from a village population in a small island of Japan are used to assess the effect of demographic differentiation within a population on genetic measures. When the couples studied are classified by birth cohorts and origins, wives of the couples where one spouse came from elsewhere were older at marriage and had a shorter duration of marriage or registration than wives where both spouses were natives of the village. The mean number of offspring is statistically smaller in the former except for the latest cohort, due mainly to out-migration during the reproductive ages which also resulted in low rates of marriage among the offspring within the village. This leads to a small effective population size and an increased likelihood of genetic drift in the overall population.
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Matthews, Peter C. „Pathological Habit Disorder?“ Canadian Journal of Psychiatry 33, Nr. 9 (Dezember 1988): 826–29. http://dx.doi.org/10.1177/070674378803300908.
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This paper outlines a diagnostic entity called ‘Pathological Habit Disorder’ which is suggested for inclusion in the DSM as an Axis II option. Specific areas of concern, either mental (Axis I) or physical (Axis III), would delineate the syndrome. Pathological Habit Disorder (PHD) points to treatment options where the syndrome is wholly or partly habit-driven. Whether the syndrome is habit-driven or not will remain a clinical judgement even though many conditions, previously thought immutable except by medication, are proving accessible to behavioural engineering. In the ICD system, PHD seems to fit in “Special Symptoms or Syndromes not elsewhere Classified”. It is demonstrably useful to have a diagnosis such as PHD and to incorporate it into the body of medical classification, recognizing current practices for dealing with unwelcome or damaging habits.
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Shrestha, Lochana, und Shambhu Nath Pant. „Motivational Profiles of Medical Students of Nepalese Army Institute of Health Sciences“. Journal of Nepal Health Research Council 15, Nr. 3 (01.01.2018): 252–57. http://dx.doi.org/10.3126/jnhrc.v15i3.18850.
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Background: Students enter the medical study with different types of motives. Given the importance of academic motivation for good academic achievement of the students, the present study was designed to reveal the possible relationship between academic motivation and achievement in medical students.Methods: In this cross-sectional study medical students (N=364) of Nepalese Army institute of Health Sciences were participated and classified to different subgroups using intrinsic and controlled motivation scores. Cluster membership was used as an independent variable to assess differences in study strategies and academic performance. Results: Four clusters were obtained: High Intrinsic High Controlled, Low Intrinsic High Controlled, High Intrinsic Low Controlled, and Low Intrinsic Low Controlled. High Intrinsic High Controlled and High Intrinsic Low Controlled profile students constituted 36.1%, 22.6% of the population, respectively. No significant differences were observed as regards to deep strategy and surface strategy between high interest status motivated and high interest-motivated students. However, both of the clusters had significantly deeper, surface strategy and better academic performance than status-motivated and low-motivation clusters (p < 0.001). Conclusions: The interest status motivated and interest-motivated medical students were associated with good deep and surface study strategy and good academic performance. Low-motivation and status-motivated students were associated with the least academic performance with less interest learning behaviors. This reflected that motivation is important required component for good learning outcomes for medical student.
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Visintini, Sarah, Mish Boutet, Melissa Helwig und Alison Manley. „Research Support in Health Sciences Libraries: A Scoping Review“. Journal of the Canadian Health Libraries Association / Journal de l'Association des bibliothèques de la santé du Canada 39, Nr. 2 (24.07.2018): 56–78. http://dx.doi.org/10.29173/jchla29366.
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Background:As part of a health sciences library’s internal assessment of its research support services, an environmental scan and literature review were conducted to identify research services offered elsewhere in Canada. Through this process, it became clear that a more formal review of the academic literature would help libraries make informed decisions about their services. To address this gap, we conducted a scoping review of research services provided in health sciences libraries contexts.Methods:Searches were conducted in Medline, Embase, ERIC, CINAHL, LISTA, LISS, Scopus, Web of Science, Google Scholar and Google for articles which described the development, implementation, or evaluation of one or more research support initiatives in a health sciences library context. We identified additional articles by searching reference lists of included studies and soliciting medical library listservs.Results:Our database searches retrieved 7134 records, 4026 after duplicates were removed. Title/abstract screening excluded 3751, with 333 records retained for full-text screening. Seventy-five records were included, reporting on 74 different initiatives. Included studies were published between 1990 and 2017, the majority from North American and academic library contexts. Major service areas reported were the creation of new research support positions, and support services for systematic review support, grants, data management, open access and repositories.Conclusion:This scoping review is the first review to our knowledge to map research support services in the health sciences library context. It identified main areas of research service support provided by health sciences libraries that can be used for benchmarking or information gathering purposes.
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Marutha, Ngoako Solomon, und Mpho Ngoepe. „Medical records management framework to support public healthcare services in Limpopo province of South Africa“. Records Management Journal 28, Nr. 2 (16.07.2018): 187–203. http://dx.doi.org/10.1108/rmj-10-2017-0030.
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Purpose This study aims to develop a framework for the management of medical records in support of health-care service delivery in the hospitals in the Limpopo province of South Africa. Design/methodology/approach The study was predominantly quantitative and has used the questionnaires, system analysis, document analysis and observation to collect data in 40 hospitals of Limpopo province. The sample of 49 per cent (306) records management officials were drawn out of 622 (100 per cent) total population. The response rate was 71 per cent (217) out of the entire sample. Findings The study discovered that a framework for management of medical records in the public hospitals is not in place because of several reasons and further demonstrates that public health-care institutions need an integrative framework for the proper management of medical records of all forms and in all media. Originality/value The study develops and suggests a framework to embed medical records management into the health-care service delivery workflow for effective records management and ease of access. It is hoped that such a framework will help hospitals in South Africa and elsewhere to improve their medical records management to support health-care service provision.
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Niyonsaba, Ruben, Astère Manirakiza und Laurent Irakoze. „Cancer in Patients Referred Abroad For Health Care and Related Foreign Currency Expenses“. East African Health Research Journal 5, Nr. 2 (15.11.2021): 164–69. http://dx.doi.org/10.24248/eahrj.v5i2.668.
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Background: There is limited access to health services in Burundi, as most of the services such as cancer care are unavailable. Burundian citizen who can afford the costs involved in seeking treatment elsewhere are referred abroad. The purpose of this study was to assess the proportion of patients suffering from cancer among patients referred abroad for healthcare and to evaluate the costs incurred by those patients in relation to what the country would save by establishing cancer healthcare facilities. Methodology: The study was performed retrospectively from January 2016 to December 2018. With approval of Ministry of Public Health and AIDS control, the data was collected from medical reports at the general management of health facilities and AIDS control office. All patients with medical reports containing the reason for referral were included in the study. Medical reports assessing occupational disability were excluded. Data analysis was performed using Statistical Package for the Social Sciences (SPSS). Results: Male, female and unclear was 45.3%, 39.9% and 14.8% respectively. Average age was 31,82. The main reason for referral was MRI (21.7%). Cancer patients represented 18% of all patients referred abroad for healthcare and the most common type of cancer found was breast (26.5%), genitourinary (15.7%) and digestive (14,2%). If all patients from 2016-2018 were referred to Kenya, Uganda, Rwanda, India or Europe for 30 years, the country would spend in foreign currency US$3,858,229; US$638,342.80; US$21,288,592; US$10,410,192.90; US$54,718,329.70 respectively. Also, if all patients estimated by Globocan in 2018 were to be referred to these countries, the cost of foreign currencies would be US$52,455,122.60; US$38,264,740.88; US$129,272,590.40; US$81,330,325.94; US$276,601,008.02 respectively. Conclusion: There is a good number of cancer patients among patients referred abroad for health care. The estimated costs incurred by patients referred abroad for cancer care are far greater than funds needed to setup modern cancer care centres in Burundi.
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Pogorzelczyk, Katarzyna, Joanna Synoweć, Andrzej Basiński, Daniel Ślęzak, Marlena Robakowska, Przemysław Żuratyński und Wioletta Mędrzycka-Dąbrowska. „Cost analysis of treating pain patients on the example of the Clinical accident ward Of university Clinical Centre in Gdańsk“. BÓL 20, Nr. 2 / Zjazd PTBB (17.09.2019): 1–6. http://dx.doi.org/10.5604/01.3001.0013.4614.
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The cost analysis of pain treatment is not a topic often taken up by the health economists community. The subjective dimension and pain assessment by the patient is one of the main determinants of the lack of interest in this topic. Work carried out on this topic currently includes analysis accompanying the process of pharmacotherapy treatment, care provided by medical personnel as well as costs resulting from administrative services. The aim of the work is to present the cost analysis of care for a „pain” patient and to indicate the most optimal financial package of these activities. The study was performed on the basis of financial data of the Clinical Emergency Department of the University Clinical Center in Gdańsk for the last year. We analyzed the cases of patients complaining of pain who received pharmacotherapy. Results The total cost for 2017 amounted to 1.128.668 PLN. The largest amount of money was allocated to the group of patients qualified to the group R: „Symptoms, disease features and abnormal results of clinical trials not classified elsewhere” – 327.313.72 PLN. The symptom of pain is one of the most frequently indicated symptoms among patients who receive medical help at the Clinical Emergency Department of the University Clinical Center in Gdańsk, which should be associated with a greater degree of involvement in analgesic therapy in patients who require it.
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Abidah, Hilda Nur, Hashifah Azatil Ismah, Selvi Irmayanti, Globila Nurika und Edza Aria Wikurendra. „The Effectivity of Solid Medical Waste Management in Pandemic Era“. Journal of Public Health for Tropical and Coastal Region 4, Nr. 3 (30.12.2021): 98–107. http://dx.doi.org/10.14710/jphtcr.v4i3.10618.
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Introduction: The increasing of confirmed positive case of SARS-Cov-2 Virus impacts to the need for improvement of health services, especially to the health workers and medical equipment. Along with the importance of regarding need of health service, it causes the rise number of medical waste that leads to health problem crisis. Therefore, this article presents common insight of the effectivity and challenge of medical waste management in Covid-19 pandemic.Methods: The notion is gained by finding out the source database from Pubmed, ScienceDirect, Google scholar, Researchgate that classified based on the research purpose. The keywords used were: (1) Covid-19 and medical waste; (2) pandemic solid waste; (3) waste and Covid-19; (4) management and pandemics.Results: An effective method to be applied is sterilizer technology, such as VH2O2 dan Stryker STERIZONE VP4, and the development of late waste respirator with the pyrolysis process. The method and the management process is considered, either nationally or internationally, as effective, but still we found challenge to implement the method, as lack of socialisation and support from the functionary. Conclusion: the method management can be implemented in the various countries, based on the needs and capability.
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Lun, K. C. „New Challenges for Health Informatics“. Yearbook of Medical Informatics 13, Nr. 01 (August 2004): 181–84. http://dx.doi.org/10.1055/s-0038-1638190.
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Abstract:In March 2001, the International Medical Informatics Association organized a workshop entitled “Challenges in Medical Informatics” in Madrid, Spain. It invited twenty members of the medical* informatics community to discuss current issues relating to the academic standing of the field. The broad objectives of the workshop were (a) to review the relevance of medical informatics as an academic discipline in today’s setting and (b) to examine its impact by the new world economy. One of the issues discussed was to find an appropriate response to the growing emergence of bioinformatics in the age of genomic discovery and molecular medicine. With the exciting discoveries in molecular medicine coming hot on the heels of the first draft of the mapping of the human genome and the availability of high-throughput measurement of gene expressions using microarray techniques, bioinformatics has, in recent years, gained prominence in life sciences research and development. As the next phase of research will see the applications of genomic and proteomic data in the clinical management and treatment of patients, it is inevitable that bioinformatics and health informatics will converge, presenting an exciting new challenge for our field. The terms “biomedical informatics” and “clinical bioinformatics” have been used to describe this convergence.Another exciting challenge for health informatics comes from the spectre of global bioterrorism. Following the September 11, 2001 terrorist attacks in the USA and the spate of anthrax outbreaks there and elsewhere, there has been an urgent need to review current methods of disease surveillance. Current research in “preventive bioterrorism” focuses on the use of prodromal (warning) symptoms to predict serious infectious disease outbreaks. The health informatics challenge, in this case, is to develop a wide area network of health information systems to achieve real-time reporting of prodromal symptoms from sentinel stations and to deploy datamining and decision analytical techniques for the outbreak predictions.The third challenge to be covered in this presentation relates to the deployment of networked virtual reality for remote tele-rehabilitation of patients with cognitive and physical impairments. While the benefits of deploying telemedicinal principles for remote medical rehabilitation of patients are clear, the costs and use of virtual reality pose a real challenge. Some solutions are proposed in this paper.
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Aryal, Binod. „Continuing the Legacy of Editorial of the First Issue of Journal of Karnali Academy of Health Sciences“. Journal of Karnali Academy of Health Sciences 1, Nr. 2 (06.10.2018): 4. http://dx.doi.org/10.3126/jkahs.v1i2.24126.
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Professor Dr MN Marhatta wrote in detail about the 'Milestones of Medical Education in Karnali Academy of Health Sciences' in the first issue of Journal of Karnali Academy of Health Sciences (JKAHS). By the time of this second issue of JKAHS, there has been substantial progress in achieving the goals set and plans put forward by the Academy.
Two bachelor programs, i.e., Bachelor in Midwifery Sciences (BMS) and Bachelor in Public Health (BPH) studies are going to start from Mangsir 2075. Certified Anesthesia Assistant (CAA) training course is running smoothly. The Academic Council has prepared and the panel of experts has endorsed the curriculum of Masters in Obstetrics and Gynecology (MD), Masters in Orthopedics and Trauma Surgery (MS), and Masters in Anesthesiology and Critical Care (MD). Masters in General Practice and Emergency Medicine (MDGP) curriculum was prepared in the presence of experts of the various subjects, endorsed by the Academic Council of the Academy and submitted to the Nepal Medical Council (NMC) for approval and accreditation. The NMC has already agreed to take the process forward and has decided to visit KAHS for feasibility study and inspection of its preparation.
KAHS is reasonably prepared to start its first Masters academic program. The Academic Council has appointed two professors in MDGP, one each in Obstetrics and Gynecology, Orthopedics, and General surgery, which is an essential and major asset for starting residency programs in the Academy. As per the criteria set by the NMC, the Academic Council has appointed the faculties in the Departments of Psychiatry and Dermatology, and the departments in Basic Medical Sciences including Anatomy, Physiology, Pharmacology, and Microbiology have been established. The class/ lecture rooms are well set up and the faculties of various department are excited and ready to welcome the first batch of MDGP residents in Jumla.
There has been huge progress in the field of research and publication as well. The Nepal Health research Council has agreed to permit establishing Institutional Review Committee (IRC) in the Academy, which, we believe, will encourage the faculties and the students to participate in various national as well as locallevel scientific studies and research. There was overwhelming response from the Academy faculties as well as the faculties from various other academic institutes during the call for papers for publication in this journal.
The future of Karnali Academy of Health Sciences is looking bright as this Academy was established to provide education and health services to the most marginalized people of the country. This Academy is located in a unique geography which has a huge possibility of becoming a unique institute in the field of medical education. And, this journal will continue to publish cutting-edge research and studies done in this Academy and elsewhere in the country.
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Jones, Marshall B., und Donald R. Jones. „Specificity of Effect in Psychiatric Research*“. Canadian Journal of Psychiatry 37, Nr. 1 (Februar 1992): 40–45. http://dx.doi.org/10.1177/070674379203700109.
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In the last ten years the genes responsible for Huntington's disease and several other neurological disorders have been localized to specific chromosomes. Huntington's disease is now known to be caused by a gene on the short arm of chromosome 4. While these advances are welcome, they also pose a problem. All studies to date have been passive observational studies; none has been experimental. Arguably the most successful and significant attributions of cause in neurological history have been achieved by non experimental methods. This realization is somewhat disconcerting, considering that virtually all textbooks in epidemiology insist that true experiments (randomized trials) are the prime means of establishing cause. One cannot help but ask how these unauthorized successes were achieved. What are the principles of investigation that made them possible? In this paper we argue that the recent advances in neurological genetics, along with much else in human genetics, depend heavily on “specificity of effect.” Just what this principle is and how it allows successful attribution of cause is explained. Various applications elsewhere in the medical and behavioural sciences and in psychiatry are discussed.
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Elvas, Luis B., Carlos Serrão und Joao C. Ferreira. „Sharing Health Information Using a Blockchain“. Healthcare 11, Nr. 2 (05.01.2023): 170. http://dx.doi.org/10.3390/healthcare11020170.
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Data sharing in the health sector represents a big problem due to privacy and security issues. Health data have tremendous value for organisations and criminals. The European Commission has classified health data as a unique resource owing to their ability to enable both retrospective and prospective research at a low cost. Similarly, the Organisation for Economic Co-operation and Development (OECD) encourages member nations to create and implement health data governance systems that protect individual privacy while allowing data sharing. This paper proposes adopting a blockchain framework to enable the transparent sharing of medical information among health entities in a secure environment. We develop a laboratory-based prototype using a design science research methodology (DSRM). This approach has its roots in the sciences of engineering and artificial intelligence, and its primary goal is to create relevant artefacts that add value to the fields in which they are used. We adopt a patient-centric approach, according to which a patient is the owner of their data and may allow hospitals and health professionals access to their data.
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Francisco, Jose Mario. „Becoming a People of Greater Hospitality“. Social Sciences and Missions 35, Nr. 3-4 (28.11.2022): 373–97. http://dx.doi.org/10.1163/18748945-bja10054.
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Abstract Unlike some religious traditions elsewhere, Philippine Catholicism readily recognized the severity of the Covid-19 pandemic as described by medical science and public health protocols. Given this general perspective, it promoted communal worship online and inclusive feeding programs – practices integral to Catholicism and rooted in the local religious ethos. The defining characteristics of these practices during the pandemic invite critical inquiry on its theological foundations. The first provides greater accessibility to the ekklesia and interrogates therefore the traditional notion of Catholic belonging and identity. The second exemplifies a more inclusive framework for social ministry on account of the wide diversity of roles among those involved and its integration of charitable services with structural change. Thus both practices challenge Philippine Catholicism to become a people of greater hospitality.
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Venyo, Anthony Kodzo-Grey. „Signet Ring Cell Carcinoma of the Prostate Gland: A Review and Update“. Cancer Research and Cellular Therapeutics 5, Nr. 3 (26.07.2021): 01–14. http://dx.doi.org/10.31579/2640-1053/082.
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Signet-ring cell carcinoma of the prostate gland (SRCCP) an uncommon and aggressive malignant tumour of the prostate gland which is characterized by histopathology examination features of compression of the nucleus into the form of a crescent by a large cytoplasmic vacuole. SRCCPs that have so far been reported have been either (a) primary tumours, metastatic tumours with the primary tumour elsewhere with the gastro-intestinal tract being the site of the primary tumour but the primary tumour could originate elsewhere, and additionally some reported SRCCPs have been classified as carcinoma of unknown primary. SRCCP could be a pure tumour or a tumour that is contemporaneously associated with other types of tumour including various variants of adenocarcinoma. SRCCP can manifest in various ways including: Incidental finding following prostatectomy that has been undertaken for a presumed benign prostatic hyperplasia, lower urinary tract symptoms, visible and non-visible haematuria, raised levels of serum PSA but some SRCCPs have been diagnosed with normal / low levels of serum PSA, there may be a history of dyspepsia in cases of metastatic signet-ring cell carcinoma in association with contemporaneous primary signet-ring cell carcinoma of the stomach or there may be a past history of surgical treatment for signet-ring cell carcinoma of the gastrointestinal tract, or bleeding from the gastrointestinal tract in cases of upper gastrointestinal tract and rectal bleeding as well as change in bowel habit for primary tumours of the anorectal region, retention of urine, and rarely a rectal mass in the case of SRCCP with an anorectal primary tumour. In order to exclude a primary signet ring cell carcinoma elsewhere, a detailed past medical history is required as well as radiology imaging including contrast – enhanced computed tomography (CECT) scan and contrast-enhanced magnetic resonance imaging (CEMRI) scan as well as upper gastrointestinal endoscopy and colonoscopy to exclude a primary lesion within the gastrointestinal tract. Diagnosis of SRCCP requires utilization of the histopathology and immunohistochemistry examination features of prostate biopsy, prostatic chips obtained from trans-urethral resection of prostate specimen or radical prostatectomy specimen. SRCCPs upon immunohistochemistry staining studies tend to show tumour that tend to exhibit positive staining for the following tumour markers as follows: PSA – positive staining for PSA has been variable in some studies, AE1/AE3, CAM 5.2, Ki-67 with a mean of 8%, PAS-diastase, Mucicarmine (50%), Alcian blue (60%), Alpha-methyl-acyl coenzyme A racemase (P504S), and Cytokeratin 5/6. SRCCPs also tend to exhibit negative staining for: Bcl2 (rare positive), and CEA (80%). Traditionally the treatment of Primary Signet-Ring Cell Carcinoma of the Prostate Gland has tended to be similar to the treatment of the traditional adenocarcinoma of the prostate gland which does include: hormonal treatment, radiotherapy, and surgery. Nevertheless, considering that primary SRCCPs and metastatic SRCCPs that have been reported in the literature have generally tended to be associated with an aggressive biological behaviour, even though there is no consensus opinion on the treatment of the disease it would be strongly recommended that these tumours that tend to be associated with rapid progress of the disease and poor survival there is an urgent need to treat all these tumours with aggressive surgery including radical prostatectomy plus adjuvant therapies including: radical radiotherapy, combination chemotherapy, selective prostatic angiography and super-selective embolization of the artery feeding the tumour including intra-arterial infusion of chemotherapy agents directly to the tumour, radiofrequency ablation of the tumour as well as irreversible electroporation of the tumour which should form part of a global multicentre study of various treatment options. With regard to metastatic signet-ring cell carcinomas of the prostate gland with a contemporaneous primary tumour elsewhere the primary tumour should also be treated by radical and complete excision of the primary tumour plus radical surgery and aggressive adjuvant therapy. Considering that SRCCPs have tendered not to respond well to available chemotherapy agents, there is need for urologists, oncologists, and pharmacotherapy research workers to identify new chemotherapy medicaments that would more effectively and safely destroy signet-ring cell tumours in order to improve upon the prognosis.
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MOHANTY, S. K., und P. K. PATHAK. „RICH–POOR GAP IN UTILIZATION OF REPRODUCTIVE AND CHILD HEALTH SERVICES IN INDIA, 1992–2005“. Journal of Biosocial Science 41, Nr. 3 (Mai 2009): 381–98. http://dx.doi.org/10.1017/s002193200800309x.
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SummaryThis paper examines the trends in utilization of five indicators of reproductive and child health services, namely, childhood immunization, medical assistance at delivery, antenatal care, contraceptive use and unmet need for contraception, by wealth index of the household in India and two disparate states, Uttar Pradesh and Maharashtra. The data from three rounds of the National Family and Health Survey conducted during 1992–2005 are analysed. The wealth index is computed using principal component derived weights from a set of consumer durables, land size, housing quality and water and sanitation facilities of the household, and classified into quintiles for all three rounds. Bivariate analyses, rich–poor ratio and concentration index are used to understand the trends in utilization of, and inequality in, reproductive and child health services. The results indicate huge disparities in utilization of these services, largely to the disadvantage of the poor. Utilization of basic childhood immunization among the poorest and the poor stagnated in India, as well as in both states, during 1998–2005 compared with 1992–1998. The use of maternal care services such as medical assistance at delivery and antenatal care remained at a low level among the poor over this period. However, contraceptive use increased relatively faster among the poor, even with higher unmet need. Of all these services, the inequality in medical assistance at delivery is consistently large, while that of contraceptive use is small. The state-level differences in service coverage by wealth quintiles over time are large.
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Kasangaki, Arabat, Andrew Macnab und Faith Gagnon. „A Descriptive, Cross-Sectional Study of Ugandan Students in Health Care Education regarding Postgraduate Migration and Future Practice“. ISRN Education 2012 (29.02.2012): 1–5. http://dx.doi.org/10.5402/2012/357280.
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A growing challenge of globalization is the migration of many healthcare trainees to richer nations when they complete their education. This loss of intellectual capital compromises the ability of low-income countries to provide adequate health care. Despite recognition of this loss most African nations keep no track of those they train. Effective investment in health care demands retention of this resource; the ability to direct healthcare providers where needed; understanding of local factors driving migration, choices regarding postgraduate training abroad, and future practice preference. Self-administered questionnaires were distributed to a random sample of 200 Uganda College of Health Sciences students for anonymous completion; 141/200 (70.5%) were completed; 84% of respondents intended to pursue postgraduate studies abroad; 63% to migrate within five years of graduation; 57% to work in urban areas. While partly due to global trends and awareness of international opportunities, this negative trend of migration and shunning rural practice is also influenced by sociopolitical and educational elements within Uganda. One option (adopted elsewhere) is mandatory practice in government community health centers for a period following graduation. But the ethics, consequences, and implications of current international migratory trends need to be addressed locally and by the global medical education community.
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Thapa, Lekhjung J., RS Twayana, R. Shilpakar, MR Ghimire, A. Shrestha, S. Sapkota und PVS Rana. „Clinical profile and outcome of acute encephalitis syndrome (AES) patients treated in College of Medical Sciences-Teaching Hospital“. Journal of College of Medical Sciences-Nepal 9, Nr. 2 (21.01.2014): 31–37. http://dx.doi.org/10.3126/jcmsn.v9i2.9685.
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Objective: Acute encephalitis syndrome is a cause of significant morbidity and mortality in Nepal. Although Japanese encephalitis virus (JEV) was thought to be a major cause for acute encephalitis syndrome, more non-Japanese encephalitis virus cases are reported. The outcome of patients with acute encephalitis syndrome is variable. Our study was designed to study the clinical profile and outcome of patients with acute encephalitis syndrome managed in tertiary care center in central Nepal. Methods: The record of patients admitted with diagnosis of acute encephalitis syndrome,from January 2010 to December 2010 in College of Medical Sciences-Teaching Hospital (CMS-TH) was reviewed. They were classified clinically as meningitis, encephalitis and meningoencephalitis. The clinical details and reports of the patients were recorded and analyzed. Results: Total of 85 cases of meningitis and encephalitis were identified. Mean age was 19.18 years. Fifty-six (65.9%) patients were males and 29 (34.1%) were females. Sixty (70.58%) patients had meningitis, 8 (9.41%) had encephalitis, and 17 (20.0%) had meningoencephalitis. JE serology was positive in 4 patients (4.7%). Seventy-two (84.7%) patients made full recovery and were discharged from hospital. Thirteen (15.3%) patients left against medical advice (LAMA). Conclusion: Acute encephalitis syndrome is still a major public health problem in Nepal. Few of these patients have Japanese Encephalitis. There is a trend towards improved outcome because of availability of improved health services. However, financial constraint remains a challenge in management of acute encephalitis syndrome. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-2, 31-37 DOI: http://dx.doi.org/10.3126/jcmsn.v9i2.9685
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Darabinia, Morteza, Alimorad Heidari Gorji und Shirzad Gholami. „Self-care study in the Iranian medical students based on Islamic thought“. Journal of Nursing Education and Practice 7, Nr. 9 (18.04.2017): 85. http://dx.doi.org/10.5430/jnep.v7n9p85.
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Objective: This study aimed to investigate Islamic Self-care in Iranian medical students.Methods: In this descriptive study that was done in 2015, students of the Mazandaran University of Medical Sciences (faculties of health, paramedical, pharmacy, medicine and dentistry) were selected through classified random sampling. Study sample was calculated 269 from 900 students based on Krejcie and Morgan’s table. Data gathering was done using demographic and a standardized questionnaire about Islamic Self-care.Results: In this study, 269 students were entered to study. The mean (SD) score of Stipulation, Meditation, Calculation and Expostulation of students were 9.82 (2.35), 10.04 (2.85), 8.74 (2.65) and 7.64 (2.48) respectively. Results shows that correlation between all the components of the Self-care are positive and significant (p < .001).Conclusions: It is worthy that further study will be aimed to investigate ways to strengthen it, as well as explaining the benefits of Islamic Self-care among students with the theoretical and practical examples.
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Duron, Rebecca, Michael Mugavero und Andrew Westfall. „2497“. Journal of Clinical and Translational Science 1, S1 (September 2017): 81. http://dx.doi.org/10.1017/cts.2017.286.
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OBJECTIVES/SPECIFIC AIMS: Approximately 50% of people who have been diagnosed with HIV are either not linked to a care provider or not retained in medical care. This has substantial implications for both individual and public health outcomes. On an individual level, being retained in care is necessary for continuous receipt of antiretroviral therapy and sustained viral suppression. The public health implications of poor retention in HIV care are also serious, as it is estimated that people with HIV who are not retained in medical care are responsible for a majority of HIV transmissions, even more than the number of transmissions attributable to those who are HIV infected but undiagnosed. State departments of health routinely collect surveillance data including positive HIV test results, CD4 counts and viral load measures for monitoring trends in HIV infection. A shift in the use of these surveillance measures, guided by the CDC, has brought forth the opportunity to use these data for direct patient services and, more specifically, to direct re-engagement and retention in care efforts. Although the risk factors for poor retention in HIV care have been characterized using information from individual or multiple clinics, this study seeks to incorporate state surveillance data into the retention measures. METHODS/STUDY POPULATION: This retrospective cohort study was performed at the University of Alabama at Birmingham 1917 HIV/AIDS Clinic among patients with at least one attended HIV primary care visit during the calendar year of 2015. Retention during the calendar year of 2016 was then measured as whether or not a patient had 2 or more completed clinic visits which were separated by more than 90 days (in accordance with the Health Resources and Services Administration or HRSA guidelines, a National HIV Quality Indicator). For patients who did not have any primary care visit in 2016, the Alabama Department of Public Health will provide a status of care (out of care, in care elsewhere, died, moved out of state, and cannot locate) based on HIV laboratory results reported from all clinics and labs across the state and/or mortality information. A multinominal regression model of the status of care will be fitted to demographic, clinical, laboratory, and behavioral patient reported outcomes captured during an index visit in 2015. RESULTS/ANTICIPATED RESULTS: Data were recently obtained and is currently being analyzed on 3107 patients included in this study. We anticipate that there will be differences in the factors significantly associated with patients classified as out of care, poorly retained (patients who have only one completed clinic visit), and retained in care by the HRSA measure during calendar year 2016. DISCUSSION/SIGNIFICANCE OF IMPACT: By incorporating state surveillance data into our analysis, we expect to obtain a more precise picture of the risk factors for poor retention among HIV patients. For the first time, we will be able to determine if patients lost to our HIV clinic (~10% annually) are entirely lost to medical care or are seeking care elsewhere as indicated by HIV lab data reported to public health via surveillance. Identified risk factors will then be able to better inform the efforts to proactively improve the efficiency for HIV patient retention and re-engagement, and therefore lead to better individual outcomes for HIV patients and reduce the incidence of new HIV cases.
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Nakata, Priscila Tadei, Lenice Ines Koltermann, Kellyn Rocha de Vargas, Priscilla Wolff Moreira, Erica Rosalba Mallmann Duarte und Idiane Rosset-Cruz. „Classification of Family Risk in a Family Health Center“. Revista Latino-Americana de Enfermagem 21, Nr. 5 (September 2013): 1088–95. http://dx.doi.org/10.1590/s0104-11692013000500011.
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OBJECTIVE: to identify and classify the degree of family risk in a Family Health Center by means of a multidimensional evaluation instrument. METHOD: a cross-sectional study, with a quantitative and descriptive design, which evaluated 927 families registered in the center, which covers five micro-areas. The Coelho and Savassi Scale was applied, this consisting of 13 sentinels of evaluation of the social risk, using secondary data available in the File A of the families' medical records, in the last trimester of 2011. The data was analyzed using the SPSS (Statistical Package for the Social Sciences) for Windows software, version 18.0. RESULTS: among the families studied, 68.5% were classified as not being at risk. It was ascertained that the smallest proportion of at-risk families (8.2%) was found in micro-area 1, and that micro-area 4 had the highest proportion (55.9%). The most-prevalent risk situations were poor conditions of basic sanitation, systemic arterial hypertension, diabetes mellitus and drug addiction. CONCLUSION: this study's results make it possible to create support for the planning of home visits, to implement health surveillance actions, and for health professionals to better understand the vulnerabilities of the families attended.
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Manandhar, Seerina Adhikari, Tapas Pramanik, Krishna Chandra Devkota und Prem Prasad Panta. „Prevalence of Anemia and Morphological Variation in RBC among COPD Patients admitted at a Tertiary Health Care Center, Kathmandu, Nepal“. Nepal Medical College Journal 23, Nr. 4 (31.12.2021): 324–28. http://dx.doi.org/10.3126/nmcj.v23i4.42224.
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Many studies have depicted that anemia is one of the most common co-morbidity among Chronic Obstructive Pulmonary Disease (COPD) patients. Therefore, its correction in those patients is an important aspect of the treatment protocol. Our study was designed to explore the prevalence of anemia and morphological alteration, if any, in RBC among COPD patients. The study was conducted from November 2020 to June 2021 among the COPD patients admitted in the Medical ward of Nepal Medical College Teaching Hospital. If hemoglobin level was <13gm/dl in males and <12gm/dl in females and/or hematocrit level was <39%, the patient was considered anemic. Anemia was morphologically classified following standardized procedure with RBC indices as a reference. Among the COPD patients (n=101), 40 (39.6%) were anemic, out of which 21(52.5%) was normocytic normochromic, 10 (25%) were microcytic hypochromic, 5 (12.5%) were normocytic hypochromic, 3 (7.5%) were microcytic normochromic and (2.5%) was macrocytic hyperchromic. Anisocytosis was commonly noted (25.7%) among the COPD patients with microcytosis (20.8%) and macrocytosis (4.9%) among them. Among the patients, 23.8% showed hypochromia while only 0.9% showed hyperchromia. Polycythemia was present in 24 (23.8%) of them. Inflammatory mediators and cytokines in COPD causes a compromised response of marrow cells to erythropoietin and shortens the survival of red blood cells.
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Martina, Cecily, und Bradley Jones. „Employing Evidence: Does it Have a Job in Vocational Libraries?“ Evidence Based Library and Information Practice 1, Nr. 1 (15.03.2006): 26. http://dx.doi.org/10.18438/b83w2d.
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Objective - Evidence based librarianship (EBL) springs from medical and academic origins. As librarians are tertiary educated (only occasionally with supplementary qualifications covering research and statistics) EBL has had an academic focus. The EBL literature has significant content from school and university perspectives, but has had little, if any, vocational content. This paper suggests a possible Evidence Based Librarianship context for vocational libraries.
Methods - A multidisciplinary scan of evidence based literature was undertaken, covering medicine and allied health, librarianship, law, science and education. National and international vocational education developments were examined. The concept and use of evidence in vocational libraries was considered.
Results - Library practice can generally benefit from generic empirical science methodologies used elsewhere. Different areas, however, may have different concepts of what constitutes evidence and appropriate methodologies. Libraries also need to reflect the evidence used in their host organisations. The Australian vocational librarian has been functioning in an evidence based educational sector: national, transportable, prescriptive, competency based and outcome driven Training Packages. These require a qualitatively different concept of evidence compared to other educational sectors as they reflect pragmatic, economic, employability outcomes.
Conclusions - Vocational and other librarians have been doing research but need to be more systematic about design and analysis. Librarians need to develop ‘evidence literacy’ as one of their professional evaluation skills. Libraries will need to utilise evidence relevant to their host organisations to establish and maintain credibility, and in the vocational sector this is set in a competency based framework. Competency based measures are becoming increasingly relevant in school and university (including medical) education.
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Bastola, Prabha Dawadi, A. Rijal und D. Upreti. „Study of pregnancy dermatoses in patients attending outpatient of B P Koirala Institute of Health Sciences, Dharan, Nepal“. Nepal Journal of Dermatology, Venereology & Leprology 13, Nr. 1 (12.01.2016): 38–44. http://dx.doi.org/10.3126/njdvl.v13i1.14304.
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Background: Pregnancy causes immense hormonal, vascular and immunologic changes affecting every organ system including skin. It can have a positive as well as a negative effect on the course of pre-existing skin diseases. Specific dermatoses of pregnancy constitute a heterogenous group of inflammatory dermatoses associated exclusively with pregnancy. Objectives: To study the spectrum and frequency of pregnancy dermatoses and to compare the clinico- epidemiological profile of non-specific dermatoses among pregnant versus non-pregnant women of reproductive age.Material and Methods: This descriptive hospital based study recruited 300 patients with skin lesions; the test group comprised 150 pregnant ladies while the control group comprised 150 non-pregnant female of reproductive age. Demographic characteristics, medical history, examination findings, and relevant investigation reports were noted and diagnosis established. The patients of test group were then classified into distinct subgroups of dermatoses and were compared with non-pregnant patients of control group. Results: Specific dermatoses of pregnancy was very common (41.33%) in our study among which Prurigo of pregnancy was the commonest (24%). Inflammatory lesions were predominant in pregnant group (57.33%, p=<0.001) whereas infectious diseases were predominant in the non-pregnants (44.67%). The demographic variables had no significant role in determining the distribution of any of the skin lesions in this study. Conclusion: Inflammatory lesions mostly specific dermatoses of pregnancy are found to be the commonest skin lesions among the pregnant ladies whereas infectious diseases are found to be comparable among pregnant and non pregnant ladies in our study.NJDVL Vol. 13, No. 1, 2015 Page: 38-44
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Choi, Yong-Keum, Ji-Hye Yun, Hyang-Ah Park und Eun-Kyung Cha. „A Study on the Status of Contents Related to Oral Functional Rehabilitation Exercise Based on Application“. Korean Society of Oral Health Science 10, Nr. 4 (31.12.2022): 55–61. http://dx.doi.org/10.33615/jkohs.2022.10.4.55.
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Objectives: Based on the application status survey related to oral functional rehabilitation exercise, the need for content development in the field of dentistry is presented and basic data for development are prepared. Methods: The application was searched for keywords related to oral functional rehabilitation exercise in the Play Store and App Store, and it was classified and investigated by category, operating system, delivery method, language, cost, search term, target user, age, and exercise content. Results: As a result of searching for ‘Oral health’, ‘Tongue therapy’, ‘Oral motor’, ‘Swallowing’, ‘Dysfagi’, and ‘Oral motor exercises’ in Play Store and App Store, 10 suitable apps were found. Conclusions: The number of apps related to oral functional rehabilitation exercise is small, and there are many apps developed in other fields. Therefore, it is necessary to develop an app based on expertise in the dental medical field.
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Lamer, Antoine, Osama Abou-Arab, Alexandre Bourgeois, Adrien Parrot, Benjamin Popoff, Jean-Baptiste Beuscart, Benoît Tavernier und Mouhamed Djahoum Moussa. „Transforming Anesthesia Data Into the Observational Medical Outcomes Partnership Common Data Model: Development and Usability Study“. Journal of Medical Internet Research 23, Nr. 10 (29.10.2021): e29259. http://dx.doi.org/10.2196/29259.
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Background Electronic health records (EHRs, such as those created by an anesthesia management system) generate a large amount of data that can notably be reused for clinical audits and scientific research. The sharing of these data and tools is generally affected by the lack of system interoperability. To overcome these issues, Observational Health Data Sciences and Informatics (OHDSI) developed the Observational Medical Outcomes Partnership (OMOP) common data model (CDM) to standardize EHR data and promote large-scale observational and longitudinal research. Anesthesia data have not previously been mapped into the OMOP CDM. Objective The primary objective was to transform anesthesia data into the OMOP CDM. The secondary objective was to provide vocabularies, queries, and dashboards that might promote the exploitation and sharing of anesthesia data through the CDM. Methods Using our local anesthesia data warehouse, a group of 5 experts from 5 different medical centers identified local concepts related to anesthesia. The concepts were then matched with standard concepts in the OHDSI vocabularies. We performed structural mapping between the design of our local anesthesia data warehouse and the OMOP CDM tables and fields. To validate the implementation of anesthesia data into the OMOP CDM, we developed a set of queries and dashboards. Results We identified 522 concepts related to anesthesia care. They were classified as demographics, units, measurements, operating room steps, drugs, periods of interest, and features. After semantic mapping, 353 (67.7%) of these anesthesia concepts were mapped to OHDSI concepts. Further, 169 (32.3%) concepts related to periods and features were added to the OHDSI vocabularies. Then, 8 OMOP CDM tables were implemented with anesthesia data and 2 new tables (EPISODE and FEATURE) were added to store secondarily computed data. We integrated data from 5,72,609 operations and provided the code for a set of 8 queries and 4 dashboards related to anesthesia care. Conclusions Generic data concerning demographics, drugs, units, measurements, and operating room steps were already available in OHDSI vocabularies. However, most of the intraoperative concepts (the duration of specific steps, an episode of hypotension, etc) were not present in OHDSI vocabularies. The OMOP mapping provided here enables anesthesia data reuse.
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Christensen, Karoline Bjerg. „Diagnoses and mortality for patients with unclear problems calling for an ambulance“. Dansk Tidsskrift for Akutmedicin 5, Nr. 1 (27.03.2022): 9. http://dx.doi.org/10.7146/akut.v5i1.132151.
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Danish patients calling the Emergency Medical Services (EMS) with unclear problems are assigned a Danish Index for Emergency Care (DI) criteria called ‘unclear problem’. Previous Danish studies found ‘unclear problem’ in 17% and 19% of all emergency calls. In the Emergency Departments, unclear problems identified as non-specific symptoms are well documented. We investigated EMS patients given an ‘unclear problem’ DI-criteria prehospitally, their hospital discharge diagnoses and 1-day and 30-day mortality rates.
Population-based observational cohort study investigating 7,935 EMS patients who received the DI-criteria ‘unclear problem’ upon an emergency call and who were brought to hospital in the North Denmark Region during January 1st, 2016 – December 31st, 2018. Outcome variables were; number of emergency ambulances dispatched, ‘unclear problem’ DI-criteria, and vital status (dead or alive) 30 days after hospital contact. We evaluated the association between ICD-10 diagnosis chapters and mortality adjusted for age, gender, and comorbidity. ICD-10 chapters 18: “Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified” and 21: “Factors influencing health status and contact with health services” were defined as ‘non-specific diagnoses’.All ICD-10 chapters were represented in the discharge diagnoses. The majority (40.4%) were non-specific diagnoses. Common discharge diagnoses were circulatory (9.6%), injuries and poisoning (9.4%), and respiratory diseases (6.9%). Overall mortality rates were for 1-day and 30-day 2.3% (n=181) and 7.1% (n=566), respectively. Day 1 mortality rates were highest for circulatory diseases (8.6%), infections (5.4%), and respiratory diseases (4.0%). Mortality on day 30 was 2.6% and 4.1% for non-specific diagnoses, whereas circulatory, respiratory diagnoses and infections exhibted highest mortality rates. Risk of mortality was associated with age and comorbidities and when adjusted for these confounders, mortality rates decreased for all diagnoses.
EMS patients assigned ‘unclear problem’ and brought to the hospital received diagnoses from all ICD-10 chapters, the majority with non-specific diagnoses, followed by injuries and poisoning, circulatory and respiratory diseases. The latter two groups exhibited the highest crude mortality rates, decreasing substantially when adjusted for age and comorbidity. Mortality rates among patients with unclear problems were associated with age and comorbidities rather than the unclear emergency medical call and following discharge diagnoses.
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Cohn, Amy, Ami Sedani, Taylor Niznik, Adam Alexander, Bryce Lowery, Julia McQuoid und Janis Campbell. „Population and Neighborhood Correlates of Cannabis Dispensary Locations in Oklahoma“. Cannabis 6, Nr. 1 (07.02.2023): 99–113. http://dx.doi.org/10.26828/cannabis/2023.01.008.
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Background: Cannabis dispensaries have proliferated exponentially in Oklahoma since the state legalized medical cannabis in 2018. Oklahoma is unique from many other legalized states given its high number of lower income, rural, and uninsured residents, who may seek medical cannabis as an alternative to traditional medical treatment. Methods: This study examined demographic and neighborhood characteristics associated with dispensary density (n = 1,046 census tracts) in Oklahoma. Results: Compared to census tracts with no dispensaries, those with at least one dispensary had a higher proportion of uninsured individuals living below the poverty level and a greater number of hospitals and pharmacies. Almost half (42.35%) of census tracts with at least one dispensary were classified as a rural locale. In fully adjusted models, percent uninsured, percent of household rentals, and the number of schools and pharmacies were positively associated with greater number of cannabis dispensaries, while the number of hospitals was negatively associated. In the best fitting interaction models, dispensaries were predominant in areas with a higher percentage of uninsured residents and no pharmacies, suggesting that cannabis retailers may capitalize on the health needs of communities with limited healthcare outlets or access to medical treatment. Conclusions: Policies and regulatory actions that seek to decrease disparities in dispensary locations should be considered. Future studies should examine whether people living in communities with a scarcity of health resources are more likely to associate cannabis with medical uses than those living in communities with more resources.
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Gelmini, And Yara Particelli, Márcio Luís Duarte, André Moreira de Assis, Josias Bueno Guimarães Junior und Francisco César Carnevale. „Virtual reality in interventional radiology education: a systematic review“. Radiologia Brasileira 54, Nr. 4 (August 2021): 254–60. http://dx.doi.org/10.1590/0100-3984.2020.0162.
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Abstract The aim of this study was to compare virtual reality simulation with other methods of teaching interventional radiology. We searched multiple databases-Cochrane Library; Medline (PubMed); Embase; Trip Medical; Education Resources Information Center; Cumulative Index to Nursing and Allied Health Literature; Scientific Electronic Library Online; and Latin-American and Caribbean Health Sciences Literature-for studies comparing virtual reality simulation and other methods of teaching interventional radiology. This systematic review was performed in accordance with the criteria established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Best Evidence Medical Education (BEME) Collaboration. Eligible studies were evaluated by using the quality indicators provided in the BEME Guide No. 11 and the Kirkpatrick model of training evaluation. After the eligibility and quality criteria had been applied, five randomized clinical trials were included in the review. The Kirkpatrick level of impact varied among the studies evaluated, three studies being classified as level 2B and two being classified as level 4B. Among the studies evaluated, there was a consensus that virtual reality aggregates concepts and is beneficial for the teaching of interventional radiology. Although the use of virtual reality has been shown to be effective for skill acquisition and learning in interventional radiology, there is still a lack of studies evaluating and standardizing the employment of this technology in relation to the numerous procedures that exist within the field of expertise.
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Rui, Tan Wen, Ahmad Rashidi Mohamed Tahir und Nur Aizati Athirah Daud. „Medical Problems Among Rohingya Refugees and Medications Prescribed During IMARET Clinic Visits in Kelantan“. International Journal of Human and Health Sciences (IJHHS) 5 (05.03.2021): 26. http://dx.doi.org/10.31344/ijhhs.v5i0.317.
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Introduction: For years, thousands of the Rohingya have fled Myanmar to reside in different states in Malaysia. Without any legal status, they have limited access to government medical and healthcare facilities. This is because Malaysia is not a State party to the 1951 Refugee Convention and its 1967 Protocol. IMAM Response and Relief Team (IMARET), a medical NGO, has organized charity clinics for this minority group to provide basic medical aids. Objectives: To identify common medical problems and medications prescribed during IMARET charity clinics in Kelantan. Methods: This was a cross-sectional study among Rohingya refugees attending IMARET charity clinics in Kelantan from June 2017 until May 2018. Data was collected from a medical clerking sheet. Medical problems were classified using ICD-10 classification, while medications prescribed were classified according to the first level of ATC code. Data were analysed using SPSS Version 24.0. Results: From 315 patients attended the clinic, most of the patients are of male gender (n=232, 73.1%). Mean age of the patients was 21.9 + 13.6 years (range: 1 – 75). Patients attended either one of the clinic locations; Tanah Merah (n=153, 48.5%), PengkalanChepa (n=78, 24.8%), and Kok Lanas (n=84, 26.6%). Most common medical problems observed were related to musculoskeletal system (n=104, 19.9%), mostly involving myalgia (n=96, 30.5%). Other common problems involved respiratory system (n=94, 18.0%), digestive system (n=68, 13.0%), and skin problems (n=57, 10.9%). Medications used for gastrointestinal disorders were mostly being prescribed in the clinics (n=179, 56.8%), followed by medications used for nervous system (n=114, 36.2%) and respiratory system (n=97, 30.8%). Most frequently prescribed medications include paracetamol, diclofenac, chlorpheniramine and multivitamins. Conclusion: Common medical problems observed among Rohingya refugees include myalgia, respiratory diseases and gastrointestinal problems. Therefore, medications used to treat these problems were shown to be frequently prescribed during clinics.International Journal of Human and Health Sciences Supplementary Issue: 2021 Page: S26
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Engel, Charles C., Kenneth C. Hyams und Ken Scott. „Managing future Gulf War Syndromes: international lessons and new models of care“. Philosophical Transactions of the Royal Society B: Biological Sciences 361, Nr. 1468 (24.03.2006): 707–20. http://dx.doi.org/10.1098/rstb.2006.1829.
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After the 1991 Gulf War, veterans of the conflict from the United States, United Kingdom, Canada, Australia and other nations described chronic idiopathic symptoms that became popularly known as ‘Gulf War Syndrome’. Nearly 15 years later, some 250 million dollars in United States medical research has failed to confirm a novel war-related syndrome and controversy over the existence and causes of idiopathic physical symptoms has persisted. Wartime exposures implicated as possible causes of subsequent symptoms include oil well fire smoke, infectious diseases, vaccines, chemical and biological warfare agents, depleted uranium munitions and post-traumatic stress disorder. Recent historical analyses have identified controversial idiopathic symptom syndromes associated with nearly every modern war, suggesting that war typically sets into motion interrelated physical, emotional and fiscal consequences for veterans and for society. We anticipate future controversial war syndromes and maintain that a population-based approach to care can mitigate their impact. This paper delineates essential features of the model, describes its public health and scientific underpinnings and details how several countries are trying to implement it. With troops returning from combat in Afghanistan, Iraq and elsewhere, the model is already getting put to the test.
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Yadava, Pushpa A., Nausheen N. Gogia, Shital T. Mehta, Shashwat K. Jani und Silkey Mittal. „Analysis of labour by modified WHO partograph in primigravida and multigravida term patients: an observational study“. International Journal of Reproduction, Contraception, Obstetrics and Gynecology 11, Nr. 6 (26.05.2022): 1762. http://dx.doi.org/10.18203/2320-1770.ijrcog20221454.
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Background: The World Health Organization (WHO) recommends the use of a partograph to follow labor and delivery, with the aim of improving health care and reducing maternal and foetal mortality. The partograph is a graphic representation of events of labour and is an effective visual resource for early detection of abnormal progress of labour and prevention of prolonged labour. The aim of this study is to use partograph to monitor labor, analyse cervical effacement and dilatation, uterine contraction, foetal presentation while avoiding uterine hypo-stimulation, hyperstimulation and reducing the risk of sepsis, obstructed labor or postpartum haemorrhage (PPH).Methods: This was a single year hospital-based observational study conducted in 2021 of the deliveries in Sardar Vallabhbhai Patel Institute of Medical Sciences and Research (SVPIMSR) and Sheth V.S General Hospital, Ahmedabad. Analysis of labor of 60 randomly selected patients was done using WHO modified partograph. The patients were classified as primigravida and multigravida. The partograph recording started at 4cm dilatation, continuous maternal and foetal monitoring was ensured throughout the labor and partogram was plotted against time in hours. Any deviations from the normal course were recorded.Results: In this observational study, 60 patients were analysed. They were classified into primigravida and multigravida and based on the recordings from partograph further classified into mode of delivery. 3 out of 26 primigravida and 1 out of 34 multigravida patients underwent caesarean deliveries. 25 patients crossed the alert line and 4 patients crossed the action line. 5 deliveries out of 60 had APGAR score of <7 at 5 minutes.Conclusions: The WHO modified partograph is highly effective in reducing both maternal and neonatal morbidity. It is an excellent visual resource to analyse cervical effacement and dilatation, uterine contraction and foetal presentation in relation to time. It is effective in early detection of abnormal progress of labor, prevention of prolonged labor, obstructed labor, PPH and improvement in neonatal outcome.
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Sebastian, Shaliet Rose, und Bichu P. Babu. „Impact of metaverse in health care: a study from the care giver’s perspective“. International Journal Of Community Medicine And Public Health 9, Nr. 12 (28.11.2022): 4613. http://dx.doi.org/10.18203/2394-6040.ijcmph20223221.
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Background: Metaverse means a world in which virtual and reality interact and coevolve, and social, economic, and cultural activities are carried out in it to create value. The application of metaverse in the field of healthcare can help improving access to healthcare services by overcoming the physical barriers between hospitals and patients, thereby enhancing overall patient satisfaction, particularly in small towns and cities. Objective was to assess the perceptions of doctor interns on the impact of metaverse in the health care field.Methods: This cross-sectional study was conducted among medical graduates doing internship in Pathanamthitta district, central Kerala. A semi structured pilot-tested structured questionnaire was shared among the study participants via a chain-referral procedure. The quantitative data collected was analysed using the software statistical package for social sciences. The responses on participants’ perceptions collected were analysed using the inductive approach of thematic analysis and classified into themes and subthemes.Results: Out of the study participants, 37.6% (150) considered metaverse to be the future of internet. Augmented reality and its applications in real life were the factors that excited a vast majority of the study population. Study participants expressed concerned about data privacy, cyber risks and vulnerabilities.Conclusions: The introduction of metaverse is also not without early challenges.
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Yu, Yue, Kathryn Ruddy, Aaron Mansfield, Nansu Zong, Andrew Wen, Shintaro Tsuji, Ming Huang, Hongfang Liu, Nilay Shah und Guoqian Jiang. „Detecting and Filtering Immune-Related Adverse Events Signal Based on Text Mining and Observational Health Data Sciences and Informatics Common Data Model: Framework Development Study“. JMIR Medical Informatics 8, Nr. 6 (12.06.2020): e17353. http://dx.doi.org/10.2196/17353.
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Background Immune checkpoint inhibitors are associated with unique immune-related adverse events (irAEs). As most of the immune checkpoint inhibitors are new to the market, it is important to conduct studies using real-world data sources to investigate their safety profiles. Objective The aim of the study was to develop a framework for signal detection and filtration of novel irAEs for 6 Food and Drug Administration–approved immune checkpoint inhibitors. Methods In our framework, we first used the Food and Drug Administration’s Adverse Event Reporting System (FAERS) standardized in an Observational Health Data Sciences and Informatics (OHDSI) common data model (CDM) to collect immune checkpoint inhibitor-related event data and conducted irAE signal detection. OHDSI CDM is a standard-driven data model that focuses on transforming different databases into a common format and standardizing medical terms to a common representation. We then filtered those already known irAEs from drug labels and literature by using a customized text-mining pipeline based on clinical text analysis and knowledge extraction system with Medical Dictionary for Regulatory Activities (MedDRA) as a dictionary. Finally, we classified the irAE detection results into three different categories to discover potentially new irAE signals. Results By our text-mining pipeline, 490 irAE terms were identified from drug labels, and 918 terms were identified from the literature. In addition, of the 94 positive signals detected using CDM-based FAERS, 53 signals (56%) were labeled signals, 10 (11%) were unlabeled published signals, and 31 (33%) were potentially new signals. Conclusions We demonstrated that our approach is effective for irAE signal detection and filtration. Moreover, our CDM-based framework could facilitate adverse drug events detection and filtration toward the goal of next-generation pharmacovigilance that seamlessly integrates electronic health record data for improved signal detection.
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Bossé, Dominick, Katrin Milger und Rory E. Morty. „Clinician-Scientist Trainee: A German Perspective“. Clinical & Investigative Medicine 34, Nr. 6 (01.12.2011): 324. http://dx.doi.org/10.25011/cim.v34i6.15891.
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Clinician-scientists are particularly well positioned to bring basic science findings to the patient’s bedside; the ultimate objective of basic research in the health sciences. Concerns have recently been raised about the decreasing workforce of clinician-scientists in both the United States of America and in Canada; however, little is known about clinician-scientists elsewhere around the globe. The purpose of this article is two-fold: 1) to feature clinician-scientist training in Germany; and 2) to provide a comparison with the Canadian system. In a question/answer interview, Rory E. Morty, director of a leading clinician-scientist training program in Germany, and Katrin Milger, a physician and graduate from that program, draw a picture of clinician-scientist training and career opportunities in Germany, outlining the place of clinician-scientists in the German medical system, the advantages and drawbacks of this training, and government initiatives to promote training and career development of clinician-scientists. The interview is followed by a discussion comparing the German and Canadian clinician-scientist development programs, focusing on barriers to trainee recruitment and career progress, and efforts to eliminate the barriers encountered along this very demanding but also very rewarding career path.
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Pukale, Ravindra S., Nadia Nishat und Shravanthi Venkatesh. „Study of the diagnosis and management of ectopic pregnancy in a rural medical college and hospital“. International Journal of Reproduction, Contraception, Obstetrics and Gynecology 10, Nr. 11 (27.10.2021): 4287. http://dx.doi.org/10.18203/2320-1770.ijrcog20214348.
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Background: Ectopic pregnancy is the implantation of the blastocyst elsewhere except the endometrial lining of the uterus. Ectopic pregnancy is a potentially life-threatening adverse pregnancy outcome and it requires prompt evaluation and treatment. It remains to be one of the leading causes of maternal death in the first trimester. But with better health facilities, early diagnosis and prompt treatment morbidity and mortality can be reduced.Methods: This retrospective study was conducted over a period of 2 and a half-years from July 2018 to December 2020, in the department of obstetrics and gynaecology at Adichunchanagiri Hospital and Research Centre, B. G. Nagara, Karnataka. A total of 22 cases were admitted at our hospital during this time frame. Four modes of treatment were given according to the patient's condition, ultrasound findings and beta-human chorionic gonadotropin (hCG) levels; these were laparoscopy, laparotomy, methotrexate injection and conservative management. The outcome measures included success of each treatment modality, need for second mode of treatment in each group and duration of hospital stay. Data was collected in a preconceived format from the patient database retrospectively and analyzed.Results: Total numbers of vaginal deliveries were 4626 during the study period. Of which 0.49% were diagnosed as ectopic pregnancy. The mean age in this study was 26.5 years. Previous history of tubectomy (22.7%), lower segment caesarean section (13.6%), and previous abortion/medical termination of pregnancy (18.1%), pelvic inflammatory disease (9.09%), previous oral contraceptive pills (OCP) use (9.09%), and ovulation induction (4.5%) were major contributing factors responsible for incidence of ectopic pregnancy. The pain was the most consistent presenting symptom in 90.9% of women. A classical triad of ectopic pregnancy (pain, amenorrhea and bleeding per vaginum) seen in 77.2% women. The incidence of tubal ectopic was maximum, i.e. 19 (86.4%) cases out of 22 cases. Among tubal ectopic pregnancies, the most common site was ampulla (68.18%). 14 (63.61%) cases were of ruptured ectopic pregnancies. Complete salpingectomy (50%) was done in maximum women. Salpingo oophorectomy was done in 9.09%. Methotrexate was given to 22.7% of the women. No significant morbidity and mortality was found in our study among 22 patients.Conclusions: Proper evaluation of pregnancy with associated risk factors and early diagnosis will help to preserve the tube and in turn her fertility and thus helps in decreasing morbidity and mortality.
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Triep, Karen, Nenad Torbica, Luigi Raio, Daniel Surbek und Olga Endrich. „The Robson classification for caesarean section—A proposed method based on routinely collected health data“. PLOS ONE 15, Nr. 11 (30.11.2020): e0242736. http://dx.doi.org/10.1371/journal.pone.0242736.
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Background With an increasing rate of caesarean sections as well as rising numbers of multiple pregnancies, valid classifications for benchmarking are needed. The Robson classification provides a method to group cases with caesarean section in order to assess differences in outcome across regions and sites. In this study we set up a novel method of classification by using routinely collected health data. We hypothesize i that routinely collected health data can be used to apply complex medical classifications and ii that the Robson classification is capable of classifying mothers and their corresponding newborn into meaningful groups with regard to outcome. Methods and findings The study was conducted at the coding department and the department of obstetrics and gynecology Inselspital, University Hospital of Bern, Switzerland. The study population contained inpatient cases from 2014 until 2017. Administrative and health data were extracted from the Data Warehouse. Cases were classified by a Structured Query Language code according to the Robson criteria using data from the administrative system, the electronic health record and from the laboratory system. An automated query to classify the cases according to Robson could be implemented and successfully validated. A linkage of the mother’s class to the corresponding newborn could be established. The distribution of clinical indicators was described. It could be shown that the Robson classes are associated to outcome parameters and case related costs. Conclusions With this study it could be demonstrated, that a complex query on routinely collected health data would serve for medical classification and monitoring of quality and outcome. Risk-stratification might be conducted using this data set and should be the next step in order to evaluate the Robson criteria and outcome. This study will enhance the discussion to adopt an automated classification on routinely collected health data for quality assurance purposes.
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Field, Simon, und Andrea Lantz. „Emergency department use by CTAS Levels IV and V patients“. CJEM 8, Nr. 05 (September 2006): 317–22. http://dx.doi.org/10.1017/s1481803500013968.
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ABSTRACT Introduction: Many emergency department (ED) visits are non-urgent. Postulated reasons for these visits include lack of access to family physicians, convenience and 24/7 access, perceived need for investigations or treatment not available elsewhere, and as a mechanism for expedited referral to other specialists. We conducted a patient survey to determine why non-urgent patients use our tertiary care ED. Our primary objective was to determine how often the lack of a family physician was associated with non-urgent ED use. Methods: The survey was administered to Canadian Emergency Department Triage and Acuity Scale (CTAS) Level IV and V patients who attended the ED of the Queen Elizabeth II Health Sciences Centre in Halifax, NS, from March 7 to March 13, 2005. Results: Of the 352 eligible patients, 235 completed the survey (response rate, 67%). Fifty-six percent (132/235) had an acute medical problem of less than 48 hours, including 48% (114/235) with a recent injury. Thirty-four percent (82/235) had been referred to the ED, 49% (114/235) believed they required a specific service that was unavailable elsewhere (e.g., radiology, suturing, casting) and 43% (100/235) presented because of self-perceived urgency of their condition. Eighty-four percent (198/235) had a family physician; 23% (55/235) used the ED because of limited access to theirfamily physician and 3% (6/235) used the ED because they did not have a family physician. Conclusions: In this setting, most non-urgent ED visits involved patients who required a specific service offered by the ED, patients who believed their condition was urgent, or patients who were referred from the community to the ED. From a patient perspective, relatively few visits would be considered inappropriate. Lack of a family physician was not associated with non-urgent ED use; however, inability to obtain timely access to the FP was a factor in one-quarter of cases.
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Caan, Woody. „The experimental research on well-being since 2004“. Journal of Public Mental Health 14, Nr. 4 (21.12.2015): 211–13. http://dx.doi.org/10.1108/jpmh-09-2015-0043.
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Purpose – The purpose of this paper is to investigate the claim by the Chief Medical Officer for England that “There is virtually no robust, peer-reviewed evidence to support a ‘well-being’ approach to mental health”. Design/methodology/approach – Secondary research using research literature from two widely available databases, Scopus and Applied Social Sciences Index and Abstracts. Randomised controlled trials were sought that focused on “well-being” (including well-being or wellness), from 2004 to the present. Findings – With both clinical samples and non-clinical populations, a variety of experimental trials were found. Studies were identified with both positive benefits and no benefits from intervention. The most numerous type of paper reported positive benefits for clinical patients. Research limitations/implications – Only a single reader classified the studies in this investigation, so the inter-rater reliability may be limited. Only two databases were searched. However, future work (such as that in progress by the What Works Centre for Wellbeing) may find an abundance of evidence on mental well-being. Practical implications – In many settings, well-being can improve after intervention. Social implications – What is measured as “well-being” may need to take into account the perspective of the specific population being studied. Originality/value – This small-scale study was undertaken to inform policy in the new Public Mental Health Network.
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Ganshorn, Heather. „Library and Informatics Training May Improve Question Formulation among Public Health Practitioners“. Evidence Based Library and Information Practice 4, Nr. 4 (14.12.2009): 71. http://dx.doi.org/10.18438/b8261t.
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A review of:
Eldredge, Jonathan D., et al. “The Effect of Training on Question Formulation among Public Health Practitioners: Results from a Randomized Controlled Trial.” Journal of the Medical Library Association 96.4 (2008): 299-309. 28 Aug 2009 .
Objectives – To determine whether providing library and informatics training to public health professionals would increase the number and sophistication of work-related questions asked by these workers.
Design – Randomised controlled trial.
Setting – New Mexico Department of Health.
Subjects – Public health professionals from a variety of professions, including administrators, nursing professionals, nutritionists, epidemiologists, physicians, social workers, and others.
Methods – All subjects received a three-hour training session on finding evidence-based public health information, with a focus on using PubMed. Two sessions were offered, two weeks apart. Participants were randomised to either an intervention group, which received instruction on the first date, or a control group, which received instruction on the second date.
The intervening two weeks constitute the study period, in which both groups were surveyed by e-mail about their work-related question generation. Three times per week, subjects received e-mail reminders asking them to submit survey responses regarding all questions that had arisen in their practice, along with information about their attempts to answer them. Questions were tallied, and totals were compared between the two groups.
Questions were also analysed for level of sophistication, and classified by the investigators as “background” questions, which are asked when one has little knowledge of the field, and can usually be answered using textbooks or other reference sources; and “foreground” questions, which are often asked when an individual is familiar with the subject, and looking for more sophisticated information that is usually found in journals and similar sources. This scheme for classifying questions was developed by Richardson and Mulrow (2001).
Main Results
The investigators found differences in both the number and sophistication of the questions asked between the control and intervention groups. The control group averaged only 0.69 questions per participant during the two-week observation period, while the intervention group averaged 1.24 questions. Investigators also found that a higher percentage of the questions asked by the intervention group were foreground questions (50.0%, versus 42.9%) for the control group. However, when two-tailed t-test analysis was performed on both the frequency of questions and the level of sophistication, the findings were no statistically significant within a 95% confidence interval.
Conclusion
This study suggests that library and informatics training for public health professionals may increase the number of questions that they ask on work-related topics, and also the sophistication of these questions. However, more studies need to be done to confirm these findings.
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Dias, Janaína Silva, Tatiana de Oliveira Vieira und Graciete Oliveira Vieira. „Factors associated to nipple trauma in lactation period: a systematic review“. Revista Brasileira de Saúde Materno Infantil 17, Nr. 1 (März 2017): 27–42. http://dx.doi.org/10.1590/1806-93042017000100003.
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Abstract Objectives: To identify the characteristics associated to nipple trauma in nursing mothers and propose a theoretical model explaining in hierarchical levels its determining factors. Methods: a systematic review of the literature based on the search of epidemiological studies of factors associated to nipple trauma in the databases of Medical Literature Analysis and Retrieval System Online/Pubmed, Literatura Latino-Americana and Caribe em Ciências da Saúde (Latin American Literature and Caribbean Health Sciences) and ScienceDirect. The conduct on searching articles occurred until June 2016. Results: 17 articles were selected which investigated 27 variables and found a significant association between 16 of these variables and nipple trauma. The factors associated to nipple trauma reported in two or more studies were: mother of race/color white or yellow, primiparity, inadequate position between mother and child during breastfeeding and handling the infant incorrectly to the mother's breast. Guidance received on handling and positioning the infant during prenatal care was a protective factor against nipple trauma. Conclusions: in the theoretical model explaining the factors associated to nipple trauma in hierarchical levels, the variables classified at the proximal level were the most investigated and were identified as risk factors in selected studies, indicating that in the postpartum care period is an important protective factor against nipple trauma.
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Golding, Jean, Rosie Clark, Steven Gregory, Genette Ellis, Matthew Suderman, Yasmin Iles-Caven und Marcus E. Pembrey. „Unexpected Associations between the Number of FRAXE Repeats in Boys and Evidence of Diabetes in Their Mothers and Maternal Grandmothers“. OBM Genetics 05, Nr. 04 (17.05.2021): 1. http://dx.doi.org/10.21926/obm.genet.2104141.
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The FRAXE section of the FMR2 gene, located on the X chromosome, contains varying numbers of trinucleotide repeats; boys with over 200 repeats tend to have mild cognitive impairments, though this is rare. Little is known, however, concerning the phenotypes of individuals with smaller numbers of repeats. Here we answer the research question as to whether the health of ancestors of boys from whom the relevant X chromosome was inherited differed in any way according to the number of FRAXE repeats. Numbers of FRAXE repeats in 5057 boys from the Avon Longitudinal Study of Parents and Children (ALSPAC) were assessed. The distribution was bimodal, with the second smaller distribution starting at 22 repeats. We tested whether possession of 22+ repeats was associated with differences in the health of mothers (who share the X chromosome) and maternal grandmothers (half of whom share it). Female ancestors of boys with >21 repeats compared with <22 showed that maternal grandmothers (MGM) and mothers (M) had an increased risk of diabetes: MGM Type I odds ratio (OR) 2.40 [95%CI: 1.07,5.38]; MGM Type II OR 1.61 [0.96,2.70]; M OR 1.95 [0.96,3.94] using self-reported questionnaire measures. These results were confirmed from maternal medical records which revealed an increased level of diabetes [OR 2.40 (1.16,4.96)] and an increased risk of repeated glycosuria during pregnancy [OR 1.60 (1.08,2.36)]. We tested numbers of FRAXA repeats and showed no such associations, indicating that the findings were not associated with triploid repeats in general. If these findings are replicated elsewhere, there are at least three possible interpretations: (i) maternal diabetes/prediabetes results in an increased number of FRAXE repeats; (ii) women with high numbers of FRAXE repeats are at increased risk of diabetes; or (iii) some common factor, e.g. genomic instability, results in both diabetes and increased repeats.
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Capsey, Matt, Cormac Ryan, Jenny Alexanders und Denis Martin. „Ambulance service use by patients with lower back pain: an observational study“. British Paramedic Journal 6, Nr. 4 (01.03.2022): 11–17. http://dx.doi.org/10.29045/14784726.2022.03.6.4.11.
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Background: Lower back pain (LBP) is the leading cause of disability globally and can be distressing for patients. It is commonly reported that serious pathologies underlying LBP are rare and most patients would be more appropriately managed in primary care. However, recent literature suggests patients accessing emergency care may differ from those accessing primary care. Currently, little is known about the use of ambulance services by people with LBP. The aim of this study was to investigate the extent and nature of ambulance services utilisation by patients presenting with LBP.Methods: This observational study is a retrospective analysis of ambulance service calls in the North East of England presenting with LBP from 1 August 2016 to 31 July 2017 (Health Research Authority registration 17/WS/0216).Results: Of 484,495 answered calls, 3315 (0.7%) calls were categorised as initially presenting with LBP. Women represented 59% of callers. Most calls were from those aged 41‐50 and 71‐80 years old. Almost half of patients (48%) initially presenting with LBP were later categorised with a problem elsewhere. Of the patients, 49% received analgesia, including Entonox (24%) and morphine (13%). Most patients (69%) were transported to an emergency department while 28% remained at home.Conclusion: LBP is a relatively common reason to call the ambulance service. Contrary to data from primary care, non-spinal causes, which include medical emergencies, make up a significant proportion of this. Current guidance on back pain focuses on primary care and specialist settings. Future updates may need to consider emergency care as a distinct setting with a potentially different patient population.
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Shehzad, Sofia. „HOSPITAL WASTE MANAGEMENT -A GROWING HEALTH CONCERN“. Journal of Gandhara Medical and Dental Science 4, Nr. 2 (20.09.2018): 1. http://dx.doi.org/10.37762/jgmds.4-2.227.
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In this era of startling developments in the medical field there remains a serious worry about the hazardous potential of various by products which if not properly addressed can lead to consequences of immense public concern. Hospitals and other health care facilities generate waste products which are evidently hazardous to all those exposed to its potentially harmful effects. Need for effective legislation ensuring its safe disposal is supposed to be an integral part of any country's health related policy. This issue is of special importance in developing countries like Pakistan which in spite of framing various regulations for safeguarding public health, seem to overlook its actual implementation. The result unfortunately is the price wehave to pay not only in terms of rampant spread of crippling infections but a significant spending of health budget on combating epidemics which could easily have been avoided through effective waste disposal measures in the first place. Waste classified under the heading 'bio-hazardous' includes any infectious or potentially infectious material which can be injurious or harmful to humans and other living organisms. Amongst the many potential sources are the hospitals or other health delivery centres which are ironically supposed to be the centres of infection control and treatment. Whilst working in these setups, health care workers such as doctors, nurses, paramedical staff and sanitation workers are actually the ones most exposed and vulnerable to these challenges. Biomedical waste may broadly be classified into Infectious and toxic waste. Infectious waste includes sharps, blood, body fluids and tissues etcwhile substances such as radioactive material and by-products of certain drugs qualify as toxic waste. Furthermore health institutions also have to cater for general municipal waste such as carton boxes, paper and plastics. The World Health Organisation has its own general classification of hospital waste divided into almost eight categories of which almost 15% (10% infectious and 5% toxic) is estimated to be of a hazardous nature while the remaining 85% is general non hazardous content.1A recent study from Faisalabad, Pakistan has estimated hospital waste generation around 1 to 1.5 kg / bed /day for public sector hospitals in the region,2while figures quoted from neighbouring India are approximately 0.5 to 2 KG / hospital bed /day.3 Elsewhere in the world variable daily hospital waste production has been observed ranging from as low as 0.14 to 0.49 kg /day in Korea4 and 0.26 to 0.89 kg/day in Greece5to as high as 2.1 to 3.83 kg/day in Turkey6 and 0.84 to 5.8 kg/day in Tanzania.7Ill effects of improper management of hospital waste can manifest as nosocomial infections or occupational hazards such as needle stick injuries. Pathogens or spores can be borne either through the oro-faecal or respiratory routes in addition to direct inoculation through contact with infected needles or sharps. Environmental pollution can result from improper burning of toxic material leading to emission of dioxins, particulate matter or furans into the air. The habitat can also be affected by illegal dumping and landfills or washing up of medical waste released into the sea or river. Potential organisms implicated in diseases secondary to mismanagement of hospital waste disposal include salmonella, cholera, shigella, helminths, strep pneumonia, measles, tuberculosis, herpesvirus, anthrax, meningitis, HIV, hepatitis and candida etc. These infections can cause a considerable strain on the overall health and finances of the community or individuals affected. The basic principal of Public health management i.e 'prevention is better than cure' cannot be more stressed in this scenario as compared to any other health challenge. Health facilities must have a clear policy on hazardous waste management. To ensure a safe environment hospitals need to adopt and implement international and local systems of waste disposal. Hospital waste management plan entails policy and procedures addressing waste generation, accumulation, handling, transportation, storage, treatment and disposal. Waste needs to be collected in marked containers usually colour coded and leak proof. Segregation at source is of vital importance. The standard practice in many countries is the Basic Three Bin System ie to segregate the waste into RED bags/ boxes for sharps, YELLOW bags for biological waste and BLUE or BLACK ones for general/ municipal waste. All hospital staff needs to be trained in the concept of putting the right waste in relevant containers/ bags. They need to know that more than anything else this practice is vital for their own safety. The message can be reinforced through appropriate labelling on the bins and having posters with simple delineations to avoid mixing of different waste types. Sharps essentially should be kept in rigid, leak and puncture-resistant containers which are tightly lidded and labelled. Regular training sessions for nurses and cleaning staff can be organised as they are the personnel who are more likely to deal with waste disposition at the level of their respective departments. Next of course is transportation of waste products to the storage or disposal. Sanitary staff and janitors must be aware of the basic concepts of waste handling and should wear protective clothing, masks and gloves etc, besides ensuring regular practice of disinfection and sterilization techniques.8Special trolleys or vehicles exclusively designed and reserved for biomedical waste and operated by trained individuals should be used for transportation to the dumping or treatment site. Biomedical waste treatment whether on site or off site is a specialised entity involving use of chemicals and equipment intended for curtailing the hazardous potential of the material at hand. Thermal treatment via incinerators, not only results in combustion of organic substances but the final product in the form of non-toxicash is only 10 to 15% of the original solid mass of waste material fed to the machine. Dedicated autoclaves and microwaves can also be used for the purpose of disinfection. Chemicals such as bleach, sodium hydroxides, chlorine dioxide and sodiumhypochlorite are also effective disinfectants having specialised indications. Countries around the world have their own regulations for waste management. United Kingdom practices strict observance of Environmental protection act 1990, Waste managementlicensing regulations 1994 and Hazardous waste regulations 2005 making it one of thesafest countries in terms of hazardous waste disposal. Similar regulations specific for each state have been adopted in United States following passage of the Medical Waste tracking act 1988. In Pakistan, every hospital must comply with the Waste Management Rules 2005 (Environment Protection Act 1997), though actual compliance is far from satisfactory. It is high time that the government and responsible community organisations shape up to seriously tackle the issue of bio hazardous waste management through enforcement of effective policies and standard operating procedures for safeguarding the health and lives of the public in general and health workers in particular.
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Ivanova, Larisa Yu. „Health consequences and control of the use of information and communication technologies by children and adolescents: literature review“. Sociology of Medicine 21, Nr. 1 (17.01.2023): 97–107. http://dx.doi.org/10.17816/socm109663.
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The review reflects publications in the field of medicine, psychology and sociology, covering: the negative impact of the uncontrolled use of information and communication technologies on the health of the child and adolescent population in the broad sense of the term health, covering not only physical, but also psychological, and social well-being. The results of medical observations and psychological research indicate that digital technologies have become a significant factor affecting the health of children and adolescents, the development of their cognitive functions, emotional and social development. Mass surveys have revealed an increase in the duration of daily use of digital devices and the Internet by the younger generation, a significant part of the surveyed adolescents are now classified as abusers of computer games and the Internet, there is also a category of users with signs of forming or developing dependence on computer games and the Internet. Considering that communication in social networks takes a significant share of the younger generations time, influencing the user, the review reflects studies of the peculiarities of communication between adolescents and young people in social networks. Taking into account that the use of electronic learning tools creates a burden on students, studies are highlighted that raise the issue of comparing the effectiveness of using digital learning tools relative to traditional forms of learning. It is well known that parental control of the use of communication technologies by children is a condition for preserving their health. Surveys show insufficient competence of parents in this matter. There is a need for sociological research of parents ideas about the specifics of the risks of using digital technologies for the health of children and adolescents of different ages, educating the population about these risks, especially the risks to the health of children of early and preschool age.
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Hovsepyan, A., R. Hovhannesyan und K. Mkhitaryan. „ESTABLISHMENT OF CAUSE-AND-ACTION RELATION BETWEEN DEFECTS OF MEDICAL TREATMENT AND FATALITY“. Archives of Criminology and Forensic Sciences 1 (16.04.2020): 54–60. http://dx.doi.org/10.32353/acfs.1.2020.03.
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The issues of identifying cause-and-effect relation (CAER) between professional violations of medical workers and the following harm to health or fatality of a patient are quite complex, insufficiently studied and covered in available domestic scientific and medical publications. This article deals with the issues of identifying and determining CAER between defects in medical treatment (MT) and fatality. The object of the study were the 177 opinions of forensic panel examination (FPE) on the archival material of the forensic medical examination department of the «National Bureau of Expertises» of the National Academy of Sciences of the Republic of Armenia for the period from 2013 to 2018.
In order to analyze the structure of defects of MT, we classified them as follows: diagnostics defects; defects of treatment; defects in organization of medical treatment; defects in medical record-keeping.
According to the opinions of the 177 FPE, in 132 (74.6%) cases, various defects while MT were detected, and in 45 (25.4%), they were not registered. According to the 132 opinions of the FPE, 250 defects while MT were recorded. Diagnostics defects (34.8%) and treatment defects (31.2%) were most common, and defects in the organization of MT (12.0%) were less common.
In the presence of defects while MT in 30.3% of cases, CAER was revealed between the frequency of defects while MT and the probability of fatality. The probability of fatality was most affected by defects in diagnosis and treatment. Thus, the relative risk was 2.41 at 95% CI (confidence interval) from 1.31% to 4.44% and 15.65 at 95% CI from 5.01% to 48.87%, accordingly.
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Bhattarai, Mahesh, Rakesh Kumar Shah, Nayan Kamal Sainju, Buna Bhandari, Sumir Keshari und Damber Bahadur Karki. „Etiological spectrum of Heart Failure in a tertiary health care facility of Central Nepal“. Nepalese Heart Journal 16, Nr. 2 (14.11.2019): 23–28. http://dx.doi.org/10.3126/njh.v16i2.26313.
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Background and Aims: High-income countries have reported common causes of heart failure as ischaemic heart diseases, hypertension, valvular heart diseases, and cardiomyopathies. There are limited data available about epidemiology of heart failure in low-income countries like Nepal. The main objective of this study is to explore etiological spectrum of heart failure in Nepal.
Methods: This cross-sectional study was conducted at the cardiology department of Kathmandu Medical College from April 15, 2019, to July 15, 2019. Data were collected from patients diagnosed as heart failure following the European Society of Cardiology criteria and having left ventricular ejection fraction less than 50% and classified into Heart failure with midrange or reduced ejection fraction. Diastolic heart failure, Cor-pulmonale, and stroke were excluded. The data were entered and analyzed in Statistical Package for Social Sciences 20.0 using descriptive and inferential statistics.
Results: Among 132 heart failure patients (mean age: 63.9±13.9 years), around two-thirds (65.2%) had heart failure with reduced ejection fraction (ejection fraction of less than 40%) and one third (34.8%) had heart failure with mid-range ejection fraction (40 to 49%). Dilated cardiomyopathy was the leading cause of heart failure among nearly half (47.7%) of study participants, followed by valvular heart disease (19.7%), hypertensive heart disease (14.4%) and ischaemic heart disease (13.6%). Almost half of the study participants with dilated cardiomyopathy had severe left ventricular systolic dysfunction. (p<0.05).
Conclusion: Dilated cardiomyopathy was the most prevalent cause of heart failure, followed by valvular heart disease in our study.
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Anderson, Robert, und Kyle Flack. „Food-Related Stimuli Impair Inhibitory Control in Adults Classified As Overweight to Obese“. Current Developments in Nutrition 6, Supplement_1 (Juni 2022): 1046. http://dx.doi.org/10.1093/cdn/nzac070.005.
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Abstract Objectives The present study investigated the influence of food-related cues on motor impulsivity in sedentary adults classified as overweight to obese (BMI 25–45) using a food-specific Go/NoGo Task. Response inhibition was measured by proportion of inhibitory failures to no-go targets (% inhibitory failures). Response activation was evaluated as time to respond to go targets (reaction time). We hypothesized the percentage of inhibitory failures to no-go targets would be greater when followed by food images than neutral images. Methods Thirty (30) participants (14 female) aged 32.9 years with a BMI of 32.7 (mean + SD) completed a food specific Go/NoGo task. Participants were required to respond to energy dense food images or neutral (non-food) images. After the cue image was presented, it turned either solid green (go) or blue (no-go). Participants were instructed to respond by pressing a button when the green target appeared and to withhold their response when the blue target appeared. Failing to withhold responding when the blue target appeared after a food-related image is indicative of poor motor impulsivity for food cues. Reaction time to go cues was also recorded. Results The proportion of inhibitory failures to no-go targets following food cues (10.8%) was significantly greater than the proportion of inhibitory failures to no-go targets following neutral cues (1.9%), P < 0.001). In measuring response activation, no differences were observed in reaction time towards go cues between food and neutral cues: Food 250.58 ± 82.62, Neutral 260.54 ± 112.97. Conclusions Adults classified as overweight to obese were less able to inhibit responding to a No-Go cue followed by a food-related image compared to neutral images. Reaction time was not different when responding to food or neutral cues, indicating the effect observed was not caused by a decrease in reaction time (i.e., accuracy was not traded for speed). Our findings suggest that food-related cues promote disinhibition and could be a prime driver of over consumption and obesity. Funding Sources The present study was supported by the National Institutes of Health P30GM127211 of the National Institute of General Medical Sciences.
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Miranda Bócoli, Guilherme, Adilson Isaias de Oliveira Junior, Flávio Vilela, Letícia Reis Cavilha, Mariana Nunes Lima Dias, Lucas Henrique de Carvalho Machado und José Dias da Silva Neto. „Development of a web application to control decubitus change in hospitalized patients“. International Journal of Health Management Review 8, Nr. 1 (05.07.2022): e0312. http://dx.doi.org/10.37497/ijhmreview.v8i1.312.
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Objectives: to present a virtual prototype of a web application (WA), to assist the medical care team in controlling the change in position of patients with reduced mobility. Method: the technique of design and virtual prototyping was used to design this WA that will be presented, through the steps from the classic life cycle of software development. Therefore, the research will be classified as “nature” applied, of the normative type, as the interest is in the development of technologies, strategies and actions to mitigate the effects of pressure injuries in hospitalized patients. Results: it can be mentioned that the presented WA is a prototype that fills a gap in the care of patients with reduced mobility, as it helps in monitoring the change in decubitus and represents, therefore, an innovative and easy-to-use technology, as indicated in the end user test report. Conclusion: a decrease in pressure injuries and a significant improvement in patient comfort and safety is expected once this prototype is implemented in a real health care context.