Purpose: This study describes a case report of wound care performed by a community health practitioner for a rural older adult with diabetic ulcers. Methods: Data were collected from a rural older adult who had a diabetic lower extremity ulcer, and wound dressing was applied over 20 weeks after the skin graft operation. Results: The patient visited a primary healthcare post for regular ulcer care, and a community health practitioner applied appropriate wound dressings and managed the patient's diabetic condition. Conclusion: In rural areas, where healthcare resources are scarce compared with urban areas, rural nurses, such as community health practitioners, are primarily required to manage rural residents' health problems. Advanced nursing practices such as complicated wound care should also be appropriately provided to patients by enhancing rural nurses' competencies in the changing health care environment.
Ilknur Dolu;Serap Acikgoz;Ali Riza Demirbas;Erdem Karabulut
Safety and Health at Work
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v.15
no.1
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pp.102-109
/
2024
Background: In today's modern world, longer working hours, shift work, and working at night have become major causes of the disruption of our natural circadian rhythms. This study aimed to investigate the effects of the type of shift work (rotating vs. fixed day), duty period (on-duty vs. off-duty), and working period within each shift (nighttime vs. daytime) on the circadian rhythm characteristics of nurses who provide direct patient care. Methods: This cross-sectional study used a purposive sampling method. Cosinor analysis was applied to analyze the actigraphy data of nurses providing direct patient care for seven consecutive days. The linear mixed effects model was then used to determine any variances between shift type, duty period, and working period within each shift for the nurses. Results: The mesor value did not differ according to nurses' shift type, duty period, and working period within each shift. The amplitude was statistically higher in on-duty nurses and in daytime working hours. The acrophase was significantly delayed in nighttime working hours. As well as nurses in rotating shift had experience. Conclusion: Our findings revealed that the peak activity of nurses occurs significantly later at night while working and nurses working during nighttime hours may have a weaker or less distinct circadian rhythm. Thus, this study suggests that limits be placed on the number of rotating nighttime shifts for nurses.
In Seok Lee;Kyounglan Kang;Yun Mi Chung;Junghwa Lee
Clinical Nutrition Research
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v.13
no.3
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pp.149-155
/
2024
Estimating the nutritional requirements for pediatric patients requires a comprehensive approach with various factors including age, gender, body mass index, and physical activity level, due to the significant growth and developmental changes observed in this population. This complexity renders the use of a simplistic generalization or a standard formula impractical. A number of methodologies have been established to calculate nutritional needs for the pediatric population. However, the application of these methodologies is challenging due to the variability in the aforementioned factors. Determining nutritional requirements for pediatric patients with underlying medical conditions is complicate, influenced by variables such as the nature of the illness, treatment modalities, and the patient's overall condition. Nutritional support in severely traumatically brain-injured pediatric patients is directly correlated with prognosis and growth outcomes. Therefore, this case study aims to validate existing methodologies for estimating nutritional requirements in pediatric patients with severe traumatic brain injury and to provide primary data for the development of effective nutritional support strategies. A case of a 5-year-old male patient admitted to the intensive care unit due to severe traumatic brain injury is examined. Future case studies and ongoing research are imperative to ensure the safe and effective nutritional support of pediatric patients with severe traumatic brain injury.
Patient satisfaction is now recognized as a outcome indicator of health care quality. The objective of this research was to evaluate a patient satisfaction survey instrument specially applicable to dental care, and to examines the reliability and the effect of response biases on reported satisfaction. The acceptability of satisfaction as a quality indicators was qualified by several measurement problems. The patient questionnaire was administered in four different study samples to examine the consistency of data. Cronbach's alpha was used as the measure of internal consistency. A aquiesent bias was found in the sample of 80(20%) respondents. Response biases affacted level of measured satisfaction. Highly acquiesent respondents were older, less well educated than nonaquiesent subject.
Purpose: The objective of the study is to identify plastic surgeons' views on the effects of online communication between doctors and patients.Methods: Cross-sectional online survey of members of the Korean Society of Plastic and Reconstructive Surgeons was made to identify their evaluation on the accuracy and the relevance of the internet health information and their perceptions of the effects of discussing the information with the patients on time-efficiency, requests for specific interventions, health outcomes, and the doctor-patient relationship. A questionnaire with 25 items was sent to the surgeons' e-mails, and 111 replied. SPSS Win version 12.0 was used to analyze the statistical differences and meanings among data.Results: The percentage of the plastic surgeons who were experiencing the online communication was 65.8%, and the most frequent medium used was homepage of the clinic/hospital. Even though the percentage of the plastic surgeons who were using the online communication for their everyday practice was high, the percentage of patients who visited the clinic/hospital after using the website of the clinic/hospital was relatively low. The effects of online communication on doctor-patient relationship were neutral in 40(36.0%) and positive in 39(35.1%). The effects on the efficiency of the practice was positive in 45(40.5%), and the effects on the quality of care and the patients' outcome were positive in 46(41.4%) respectively.Conclusion: The ratio of surgeons who are experiencing the online communication is relatively high, whereas the ratio of patients who are using online communication is low. Most of plastic surgeons are positive on the effects of the online communication on doctor-patient relationship, quality of care, and patients' outcome.
Background: Delay in diagnosis of breast cancer is associated with a poorer survival and a pivotal contribution to this delayed diagnosis comes from patient delay in presenting at a clinic. Reasons involved must be evaluated in order to decrease this reducible delay. Objectives: i) To evaluate the reasons for patient delay in diagnosis of breast cancer; ii) to investigate any association with other variables. Materials and Methods: A 6 month cross sectional study (from July 2012 to Dec 2012), was carried out in Surgical and Oncology Units of Civil Hospital, Karachi. A total of 100 females diagnosed with breast cancer of any histological type were interviewed after informed consent and relevant data were collected. Due ethical clearance was obtained. Results: Mean age was $47.5{\pm}12.1$ years with a range from 25-77 years. Mean duration of delay was $5.13{\pm}4.8$ months, from shortest 1 month to longest 36 months. Duration of delay was observed to be no delay (<1 month) in 28%, short delay (1-3 months) in 30% and long delay (>3 months) in 42% of patients. Considering the symptoms as "harmless" (39%) was the most frequent reason of delay followed by "temporary" (20%) and the "use of traditional methods" (12%). Most common reason for later approaches was an increase in the size of the lump (41%). Statistically significant association (p-value <0.05) of longer patient delay was obtained with being single, being illiterate, painless breast lump as the first symptom, negative family history of breast cancer and vague attribution of the symptoms. Conclusions: Significant delay in approach to health care facility was observed in our study due to variable reasons given by women. Sufficient awareness regarding breast cancer, its symptoms and favorable effects of a timely diagnosis on prognosis must be imparted to our general population.
PACS Import external image of the thread of the tasks and duties of hospital revenue and business efficiency falls over time. 500 beds or more medical imaging import work outside of the hospital, most hospitals use a PC, KIOSK, and was used in 15 hospitals where, CD Autoloader where use was the only one. Working hours compared to CD and DVD media to test the results of the Import target PC, KIOSK, CD Autoloader Import spent less time in the order, and also the greater capacity of CD Autoloader four times the PC, KIOSK 2 times Import could be implemented quickly. In addition, the waiting time of the patients was measured using the PC's time to Import, 2011 14.5 minutes and the average patient waiting time, KIOSK and later use CD Autoloader 2012 average patient wait time of 8.25 minutes, 43% of the existing average waiting time was 5.25 minutes to reduce. However, KIOSK case of a patient in a way that directly Import latency time was soon. Import of three ways: in terms of efficiency and excellent CD Autoloader way, the patient waiting time in terms of ease of use and KIOSK was excellent. In addition, with the introduction of CD Autoloader with KIOSK Joint of the items waiting time of patients and patient satisfaction rating is considered to be a major contribution.
Seo, Yu-Jin;Kim, Su-Jung;Munkhshur, Janchivdorj;Chung, Kyu-Rhim;Ngan, Peter;Kim, Seong-Hun
The korean journal of orthodontics
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v.44
no.4
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pp.203-216
/
2014
The purpose of the current report is to present 6-year long-term stability and 10-year follow-up data for an adult patient who was treated with a tongue elevator for relapsed anterior open-bite. The 19-year-old male patient presented with the chief complaint of difficulty in chewing his food. Collectively, clinical and radiographic examinations revealed an anterior open-bite, low tongue posture, and tongue-tie. The patient opted for orthodontic treatment alone, without any surgical procedure. A lingual frenectomy was recommended to avoid the risk of relapse, but the patient declined because he was not experiencing tongue discomfort. Initial treatment of the anterior open-bite with molar intrusion and tongue exercises was successful, but relapse occurred during the retention period. A tongue elevator was used for retreatment, because the approach was minimally invasive and suited the patient's requirements regarding discomfort, cost, and time. The appliance changed the tongue posture and generated an altered tongue force, which ultimately resulted in intrusive dentoalveolar effects, and a subsequent counterclockwise rotation of the mandible. The results showed long-term stability and were maintained for six years through continual use of the tongue elevator. The results of this case indicated that a tongue elevator could be used not only as an alternative treatment for open-bite, but also as an active retainer.
Kim, Ha-Young;Lee, Jeong-Yol;Shin, Sang-Wan;Bryant, S. Ross
The Journal of Advanced Prosthodontics
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v.4
no.4
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pp.197-203
/
2012
PURPOSE. The aim of this systematic review was to address treatment outcome according to attachment systems for mandibular implant overdentures in terms of implant survival rate, prosthetic maintenance and complications, and patient satisfaction. MATERIALS AND METHODS. A systematic literature search was conducted using PubMed and hand searching of relevant journals considering inclusion and exclusion criteria. Clinical trial studies on mandibular implant overdentures until August, 2010 were selected if more than one type of overdenture attachment was reported. Twenty four studies from 1098 studies were finally included and the data on implant survival rate, prosthetic maintenance and complications, patient satisfaction were analyzed relative to attachment systems. RESULTS. Four studies presented implant survival rates (95.8 - 97.5% for bar, 96.2 - 100% for ball, 91.7% for magnet) according to attachment system. Ten other studies presented an implant survival rate ranging from 93.3% to 100% without respect to the attachment groups. Common prosthetic maintenance and complications were replacement of an assay for magnet attachments, and activation of a matrix or clip for ball or bar attachments. Prosthetic maintenance and complications most commonly occurred in the magnet groups. Conflicting findings were found on the rate of prosthetic maintenance and complications comparing ball and bar attachments. Most studies showed no significant differences in patient satisfaction depending upon attachment systems. CONCLUSION. The implant survival rate of mandibular overdentures seemed to be high regardless attachment systems. The prosthetic maintenance and complications may be influenced by attachment systems. However patient satisfaction may be independent of the attachment system.
Kim, Sung Yeop;Park, Jaehyeon;Park, Jae Won;Yea, Ji Woon;Oh, Se An
Progress in Medical Physics
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v.32
no.4
/
pp.107-115
/
2021
Purpose: The purpose of this study was to compare the clinical quality assurance results of portal dosimetry using an electronic portal imaging device, a method that is extensively used for patient-specific quality assurance, and the newly released Mobius3D for intensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT). Methods: This retrospective study includes data from 122 patients who underwent IMRT and VMAT on the Novalis Tx and VitalBeam linear accelerators between April and June 2020. We used a paired t-test to compare portal dosimetry using an electronic portal imaging device and the average gamma passing rates of MobiusFX using log files regenerated after patient treatment. Results: The average gamma passing rates of portal dosimetry (3%/3 mm) and MobiusFX (5%/3 mm) were 99.43%±1.02% and 99.32%±1.87% in VitalBeam and 97.53%±3.34% and 96.45%±13.94% in Novalis Tx, respectively. Comparison of the gamma passing rate results of portal dosimetry (3%/3 mm) and MobiusFX (5%/3 mm as per the manufacturer's manual) does not show any statistically significant difference. Conclusions: Log file-based patient-specific quality assurance, including independent dose calculation, can be appropriately used in clinical practice as a second-check dosimetry, and it is considered comparable with primary quality assurance such as portal dosimetry.
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