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This paper analyzes the dissociation behavior of children from pregnancy to birth and resultant sub-normality using genetic counseling in an attempt to mainstream children with birth disabilities and the challenges of the genetic counselor. Genetic counseling is a process of communication to provide information about a genetic condition, or inheritance, and support decision making and adjustment in families with the inheritance gene. It uses children that need special needs, the blind, deaf and dumb. Genetic counseling approach, re-affirmation, care and integration, and confidence-building institutionalized in school and family life remains some of the vital tools needed to support these children using genetic guidance and counseling as the best approach to adjusting the different maladaptive behavior of children. The genetic counseling approach includes information about the implications of testing positive for the genetic disorder, including the psychological impact and other consequences, whether to inform relatives of your intention to test, or not to test and the usual pattern of progression of the sub-normality identified tested for and its potential treatments. Thus, the paper seems to analyze sub-normality as classified within the adequacy of social adaptation. Analysis of dissociation behavior associated with sub mentality shows discouragement, contempt, and neglect from an early age, emotionally and maladjusted social growth. Therefore, the counselor must experience sub-normality by getting involved and clarifying their feeling toward the children with these disabilities.
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Introducción: El conocimiento y desarrollo de habilidades relacionadas con la gestión por procesos en los profesionales sanitarios son vitales para mejorar la calidad de los servicios. Objetivo: Proponer acciones para la eliminación de las mudas en la gestión de los procesos en instituciones de salud cubanas. Métodos: Investigación descriptiva, transversal entre enero-junio 2020 centrada en la búsqueda del conocimiento sobre los procesos en 35 instituciones de salud. Se indagó a partir de preguntas realizadas a los participantes sobre los procesos que realizaban en sus instituciones, sus desperdicios y propuestas de mejora. Se aplicó del enfoque Lean a los procesos estudiados. Resultados: Se identificaron las siguientes mudas: demoras en los tiempos de espera; duplicidad de documentos y exámenes complementarios, exceso de modelajes, traslados innecesarios del personal, errores en la planificación de las acciones de promoción y utilización de recursos humanos en actividades no vinculadas a su formación. Se propusieron para su mejora las siguientes acciones: programación de consultas por horarios escalonados, distribución del modelaje según tipo de institución, utilización de las tecnologías de la información y las comunicaciones, control gerencial de los procesos. Conclusiones: La aplicación del enfoque Lean en la gestión de procesos en instituciones sanitarias permite identificar mudas en su flujo y proponer acciones de mejoras fundamentalmente de tipo organizativo y de control gerencial(AU)
Introduction: The knowledge and development of skills related to process management in health professionals are vital for improving the quality of services. Objective: To propose actions for the elimination of changes in the processes management in Cuban health institutions. Methods: This is a descriptive, cross-sectional research from January to June 2020 focused on the search for knowledge about the processes in 35 health institutions. It was examined from questions asked to the participants about the processes they carried out in their institutions, their waste and proposals for improvement. The Lean approach was applied to the processes studied. Results: The following changes were identified: delays in waiting times; duplication of documents and complementary exams, excessive modeling, unnecessary transfers of personnel, errors in the planning of promotion actions and use of human resources in activities not related to their training. The following actions were proposed for improvement: scheduling of consultations by staggered hours, distribution of modeling according to the type of institution, use of information and communication technologies, managerial control of processes. Conclusions: The application of the Lean approach in the management of processes in health institutions makes it possible to identify their flow changes and propose improvement actions, fundamentally of an organizational and managerial control nature(AU)
Subject(s)
Humans , Male , Female , Process Assessment, Health Care/methods , Total Quality Management/organization & administration , Epidemiology, Descriptive , Cross-Sectional StudiesABSTRACT
Perioperative management of deaf and dumb patients can be a challenging task. For smooth postoperative recovery, proper care should begin in the preoperative period. Understanding the patients’ needs and training him to follow the instructions requires to involve a communication specialist. Judicious use of sedatives and analgesics is essential to keep the patient pain‑free and comfortable. Postoperatively, the patient should be kept awake, enough to understand the internal need of the body and to make a meaningful response to external stimuli. Adequate preoperative planning and coordinated team efforts with involvement of specialists can help in delivering better postoperative care.
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Background: Hearing loss continues to be one of the most common birth defects in the world. But recent technological advances allow for identification of hearing loss soon after birth and management with various hearing aids. Present study gives baseline information on use and impact of hearing aids in deaf and dumb children. Methods: It was an institution based cross-sectional study covering 687 children from 3 deaf and dumb institutes in Ahmedabad. Pre-design proforma was used to collect information on their grades of hearing loss, use of hearing aid, cochlear implant, etc. Data was analysed in Epi-info 7. Results: Out of Total 687 deaf and dumb children there were 415 (60.41%) boys and 272 (39.59%) girls. All children had gone through audiometry. 513 (74.67%) children were visiting ENT specialist at regular interval. Most of the children 610 (95.61%) uses hearing aid machines and few of them 49 (7.44%) gone for cochlear implants. 549 (97.86%) children improved their skill after use of hearing aid. Conclusion: Use of hearing aid improves attention and confidence among deaf children. Regular follow up is also necessary in these children. Collective efforts from government, ENT specialists and community are much needed for rehabilitation of deaf and dumb children.
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A distribuição dos cristais, laticíferos e grãos de amido foi estudada nos órgãos vegetativos de Dieffenbachia picta Schott (Araceae), conhecida por comigo-ninguém-pode, por tais estruturas serem citadas como responsáveis pela irritação mecânica e química provocada pela planta. A anatomia da folha, do caule aéreo, do rizoma e da raiz foi descrita por meio de seções histológicas coradas com azul de toluidina. A natureza química dos cristais e a presença de lipídios, alcalóides, grãos de amido e proteínas foram verificadas por reagentes diversos. Drusas e ráfides de oxalato de cálcio, associadas a lipídios, alcalóides e proteínas, ocorreram no interior de células presentes no parênquima de todos os órgãos, no colênquima caulinar e nos meristemas da raiz. O tempo de dissolução dos cristais das folhas jovem e adulta foi semelhante, o do caule foi maior que o da folha e o do rizoma maior que o da raiz. Grãos de amido, associados a proteínas, ocorreram no clorênquima do caule aéreo (forma de bastonetes) e rizoma (formas esférica e bastonete). Laticíferos ocorreram entremeando o colênquima e o parênquima; o látex continha ráfides, alcalóides e lipídios. Maior número de idioblastos cristalíferos e laticíferos foi observado no caule aéreo, sendo este, portanto, o órgão que mais representa perigo.
We studied the distribution of crystals, laticifers and starch grains of the vegetative organs from dumb cane, Dieffenbachia picta Schott (Araceae), known in Brazil as "comigo-ninguém-pode" for such structures are meant to be responsible for mechanical and chemical irritation events carried out by the plant. We described the anatomy of leaves, aerial stems, rhizomes and roots with histological sections dyed in toluidine blue. We checked the chemical nature of crystals and the presence of lipids, alkaloids, starch grains and proteins with various reagents. Druses and calcium oxalate raphides - associated with lipids, alkaloids and proteins - were found in idioblasts spread in the parenchyma of all organs, in the collenchyma of the shoot and in the root meristems. Regarding the dissolution time, it was analogous for crystals in both young and old leaves; it was higher in stems than in leaves and higher in rhizomes than in roots. Starch grains associated with proteins were found in the chlorenchyma of the aerial stem (rod-shaped) and in rhizomes (spherical and rod-shaped). Laticifers were found interspersing parenchyma and collenchyma; raphides, alkaloids and lipids were found in latex. We found a higher number of crystals and laticifers in the aerial stem, and therefore such structure is the most dangerous organ if eaten or swallowed.
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Ganglionneuroma is slow-growing benign neoplasm that orignates from the sympathetic nervous system. A case of dumb-bell shaped Ganglionneuroma at first and second cervical areas is presented on this paper with chief complaint of neck pain and quadriparesis. The tumor was totally removed under operating microscope and the diagnosis was pathohistologically confirmed. The postoperative result was good and relative literatures were reviewed.
Subject(s)
Diagnosis , Ganglioneuroma , Neck Pain , Quadriplegia , Sympathetic Nervous SystemABSTRACT
A rare case of surgically extirpated intra- and extracranial metastasis of hepatocellular carcinoma is reported. This dumb-bell shaped tumor simulated malignant meningioma on computerized tomography brain scan and cerebral angiography. Removal of the mass was successfully achieved by external carotid ligation and CUSA dissection. We suggest that, when investigating patient with suspected cranial secondaries particulary if there is a bony involvement, serum alpha-fetoprotein and hepatic ultrasound should be carried out as screening procedures.