ABSTRACT
Objective:To explore the clinical effectiveness of hemostatic bandage on wound safety and comfort after transradial coronary angiography and/or interventional therapy.Methods:This was a experimental study. A total of 400 consecutive patients who underwent transradial coronary angiography and/or interventional therapy in the Department of Cardiology, Peking University Third Hospital from July to October 2022 were enrolled and randomly divided into the hemostatic bandage group and the hemostatic balloon compressor group by the envelope method with 200 cases in each group. The hemostatic bandage group and the hemostatic balloon compressor group were treated with hemostatic bandage and hemostatic balloon compressor as transradial artery hemostatic device, respectively, to observe and compare postoperative hemostatic effect, hemostat use time, complication rate, postoperative pain, the degree of numbness in the finger on the operated side and wristband comfort between the two groups.Results:The hemostatic success rate was 98.5% (197/200) and 99.0% (198/200) in the hemostatic bandage and the hemostatic balloon compressor group, respectively, with no statistical difference ( χ2=0.20, P>0.05). The hemostat use time in the hemostatic bandage group and the hemostatic balloon compressor group was (6.23 ± 0.47) h and (17.01 ± 7.74) h, respectively, and the difference was statistically significant ( t=-19.66, P<0.01). The incidence of complications in the hemostatic bandage group and the hemostatic balloon compressor group was 13.5%(27/200) and 29.5%(59/200), respectively, and the difference was statistically significant ( χ2=8.01, P<0.05). Among the complications, swelling occurred in 21 individuals of the hemostatic bandage group and 54 individuals of the hemostatic balloon compressor group with statistically significant differences ( U=16 689.50, P<0.01). Besides, the hemostatic bandage group was significantly better than the hemostatic balloon compressor group with statistically significant differences in wound pain at immediate postoperative ( U=13 669.50, P<0.01), in finger numbness at immediate postoperative and 1-hour postoperative (immediate postoperative: U=17 838.00, P<0.05; 1-hour postoperative: U=13 342.50, P<0.01), in comfort at immediate postoperative, 4-hours, 8-hours and 12-hour postoperative(immediate postoperative: U=9 966.50, P<0.01; 4-hour postoperative: U=12 851, P<0.01; 8-hour postoperative: U=14 900, P<0.01; 12-hour postoperative: U=15 920, P<0.01). Conclusions:The hemostatic bandage shows better hemostatic effect, shorter compression time, lower complication rate, less wound pain, less numbness of the finger on the operation side, and higher comfort of the wrist band compared to hemostatic balloon compressor after transradial coronary angiography and/or interventional therapy, which is worthy of clinical promotion.
ABSTRACT
Acupuncture and Tuina are the main non-drug therapies for low back pain, which are recommended by the guidelines. Acupuncture and Tuina can alleviate pain, which is regarded as conditional specific outcome, and improve mental, emotional problems, as non-conditional specific outcomes. There are some problems of the outcome assessment of acupuncture and Tuina treatment for pain such as insufficient evaluation of specific effect and unclear evaluation of characteristic outcome. Therefore, the key to above problems is to construct a Specific ouTcomE Assessment Modal of acupuncture and Tuina treatment for pain (STEAM-A&T) based on the qualitive and quantitative methods. By describing the experience, narrative expression, feelings and needs of patients who receiving acupuncture and Tuina treatment, the item banks of acupuncture and Tuina treatment effect are constructed, and the characteristic outcome of acupuncture and Tuina for pain will be screened, and then the relationship model among outcomes is constructed and optimized, which reflected the characteristics of acupuncture and Tuina for pain from multiple dimensions, multiple levels and multiple views. We reveal the relationship between the outcome of acupuncture and Tuina for pain. It will provide a new theory and methods for the construction of specific outcome assessment modal of Traditional Chinese Medicine.
ABSTRACT
The clinical questions of acupuncture-moxibustion (Acup-Mox) guidelines are complicated, including not only the curative effect of Acup-Mox intervention measures, but also the operational elements of Acup-Mox. This paper aimed to put forward the idea and process of collecting clinical questions in developing international acupuncture clinical practice guidelines. The experience was collected and the idea of collecting clinical questions of Acup-Mox was formed through expert consultation and discussion in combination with expert opinions. Based on the characteristics of Acup-Mox discipline. This paper put forward the thinking of collecting elements of clinical questions following the intervention-population-outcome-control (I-P-O-C) inquiry process, according to the discipline of Acup-Mox. It was emphasized that in the process of collecting clinical questions, "treatable population" and "alleviable outcome indicators" for a specific Acup-Mox intervention with certain therapeutic effect should be focused on, so as to highlight the pertinence of clinical questions of Acup-Mox guidelines in terms of population and outcome elements.
Subject(s)
Moxibustion , Acupuncture Therapy , AcupunctureABSTRACT
Resumo: Indicadores de efetividade assistencial contribuem para avaliação e melhoria dos resultados assistenciais. Objetivou-se relacionar fatores dos ambientes interno e externo operacional de hospitais que influenciam e contribuem para a elegibilidade e o monitoramento de indicadores de efetividade assistencial, nas dimensões segurança do paciente e cuidado centrado no paciente. Especificamente, objetivou-se caracterizar ambientes hospitalares, identificar indicadores monitorados, suas características, estratégias, métodos e procedimentos utilizados para monitorá-los. Pesquisa descritiva-exploratória, qualitativa, utilizando-se o método de estudo de caso múltiplo, contemplando hospitais de alta complexidade do sul do Brasil, um público de ensino e dois privados acreditados em nível de excelência. Utilizou-se a Técnica de Bola de Neve, iniciada pela Direção hospitalar, obtendo-se 58 participantes atuantes nos níveis estratégico, tático e operacional. Dados foram coletados entre junho/20 a dezembro/21 mediante levantamentos estruturados em sites oficiais; análise documental; questionários online; entrevistas; visitas técnicas; anotações em diário de campo, grupos focais, e foram submetidos à análise de conteúdo categorial. Com relação à segurança do paciente, os três hospitais monitoram: Cirurgia no local errado do corpo do paciente; Cirurgia realizada no paciente errado; Material estranho deixado no corpo durante um procedimento; Incidentes graves relacionados a equipamentos; Incidentes devido a falhas na identificação do paciente; Infecção de sítio cirúrgico em cirurgias limpas; Quedas com dano em pacientes internados; Lesão por pressão; Densidade de infecção primária de corrente sanguínea em pacientes em uso de cateter venoso central, internados em UTI de Adulto; Densidade de Infecção do Trato Urinário associada ao cateter vesical de demora em pacientes internados em UTI; Reação Transfusional graus II, III e IV; Reações hemolíticas por incompatibilidade sanguínea. Indicadores Deiscência de ferida pós-operatória e Embolia pulmonar ou trombose venosa profunda pós-operatória são monitorados em 2 hospitais; Hemorragia ou hematoma pós-operatório em cirurgias de grande porte em um hospital, e Fratura de quadril por queda e Fratura de quadril pós-operatória, em pacientes internados, em nenhum. Em relação ao cuidado centrado ao paciente, são monitorados: Satisfação do paciente; Cirurgias canceladas no dia agendado e Recomendação do hospital pelo paciente; não monitoram Envolvimento do paciente com seu próprio cuidado. Entre categorias relativas à influência de fatores ambientais internos, foram convergentes as relacionadas a: planejamento estratégico institucional; apoio da Direção à gestão da qualidade; Sistemas de Informação; estratégias, métodos e procedimentos. A categoria não convergente foi a influência da natureza pública do hospital de ensino universitário. As categorias convergentes do ambiente externo operacional referiram-se à influência de políticas públicas e da Anvisa; e de fatores epidemiológicos - Pandemia do COVID-19; as não convergentes, à influência das Agências Acreditadoras; e da Ebserh na gestão da qualidade. Os resultados explicitam a influência de fatores ambientais na elegibilidade e monitoramento dos indicadores de atividade assistencial, a partir das perspectivas, experiências, estratégias, métodos e procedimentos apresentados por hospitais brasileiros que buscam a melhoria contínua de seus processos e resultados. Ressalta-se a contribuição da tese para planejamento, avaliação, monitoramento e comparação da efetividade assistencial entre serviços e hospitais.
Abstract: Care effectiveness indicators contribute to the evaluation and improvement of care results, with a view to quality, resource optimization and reduction of operating costs in hospitals. The objective was to relate factors of the internal and external operational environments of hospitals that influence and contribute to the eligibility and monitoring of indicators of care effectiveness, in the dimensions of patient safety and patient-centered care. The specific objectives were to characterize hospital environments, identify monitored indicators, their characteristics, strategies, methods and procedures used to monitor them. Descriptive-exploratory, qualitative research, using the multiple case study method, covering high-complexity hospitals in southern Brazil, a teaching public and two private ones accredited at a level of excellence. The Snowball Technique, initiated by the hospital management, was used, obtaining 58 active participants at the strategic, tactical and operational levels. Data were collected between June/2020 and December/2021 through structured surveys on official websites; document analysis; online questionnaires; face-to-face and virtual interviews; technical visits; field diary notes, focus groups, and were subjected to categorical content analysis. Regarding patient safety, the three hospitals monitor: Surgery in the wrong place on the patient's body; Surgery performed on the wrong patient; Foreign material left in the body during a procedure; Serious incidents related to equipment; Incidents due to failure to identify the patient; Surgical site infection in clean surgeries; Falls with damage in hospitalized patients; Pressure injury; Density of primary bloodstream infection in patients using central venous catheters, hospitalized in an Adult ICU; Density of Urinary Tract Infection associated with indwelling urinary catheter in ICU patients; Grade II, III and IV Transfusion Reaction; Hemolytic reactions due to blood incompatibility. Indicators Postoperative wound dehiscence and postoperative pulmonary embolism or deep vein thrombosis are monitored in 2 hospitals; Postoperative haemorrhage or hematoma in major surgery in a hospital, and Falling hip fracture and Postoperative hip fracture, in inpatients, in none. In relation to patient-centered care, the following are monitored: Patient satisfaction; Surgeries canceled on the scheduled day and Hospital recommendation by the patient; do not monitor Patient involvement in their own care. Among the categories related to the influence of internal environmental factors, those related to: institutional strategic planning; management support for quality management; Information systems; strategies, methods and procedures. The non-convergent category was the influence of the public nature of the university teaching hospital. The converging categories of the external operational environment referred to the influence of public policies and Anvisa; and epidemiological factors - COVID-19 Pandemic; non-convergent ones, to the influence of Accrediting Agencies; and Ebserh in quality management. The results show the influence of environmental factors on the eligibility and monitoring of health care indicators, from the perspectives, experiences, strategies, methods and procedures presented by Brazilian hospitals that seek the continuous improvement of their processes and results. The contribution of the thesis to planning, evaluation, monitoring and comparison of care effectiveness between services and hospitals is highlighted.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Ancillary Services, Hospital , Hospital Care , Patient Safety , Patient Care , Health Facility EnvironmentABSTRACT
ABSTRACT Objectives: to measure the frequency and compliance of breast cancer screening, according to the risk for this disease. Methods: a cross-sectional study with 950 female users of 38 public Primary Health Care services in São Paulo, between October and December 2013. According to UHS criteria, participants were grouped into high risk and standard risk, and frequency, association (p≤0.05), and screening compliance were measured. Results: 6.7% had high risk and 93.3% standard risk, respectively; in these groups, the frequency and compliance of clinical breast examination were 40.3% and 37.1%, and 43.5% and 43.0% (frequency p=0.631, compliance p=0.290). Mammograms were 67.7% and 35.5% for participants at high risk, and 57.4% and 25.4% for those at standard risk (frequency p=0.090, compliance p=0.000). Conclusions: in the groups, attendance and conformity of the clinical breast exam were similar; for mammography, it was higher in those at high risk, with assertiveness lower than the 70% set in UHS.
RESUMEN Objetivos: mensurar frecuencia y conformidad de rastreo del cáncer mamario, segundo riesgo para esa enfermedad. Métodos: estudio transversal con 950 usuarias de 38 servicios de Atención Primaria púbicos en São Paulo, entre octubre y diciembre de 2013. Segundo criterios del SUS, agruparon las participantes en riesgo elevado y riesgo-estándar, y mensurado frecuencia, relación (p≤0,05) y conformidad del rastreo. Resultados: 6,7% tenían riesgo elevado y 93,3% riesgo-estándar, respectivamente; en eses grupos, la frecuencia y conformidad del examen clínico mamario fueron de 40,3% y 37,1% y de 43,5% y 43,0% (frecuencia, p=0,631; conformidad, p=0,290). Realización de mamografía alcanzó porcentuales de 67,7% y 35,5% para participantes con riesgo elevado, y de 57,4% y 25,4% en con riesgo-estándar (frecuencia, p=0,090; conformidad, p=0,000). Conclusiones: En los grupos, la frecuencia y conformidad del examen clínico mamario fueron semejantes, para mamografía fue mayor en las con riesgo elevado, habiendo asertividad inferior a 70% pactados en el SUS.
RESUMO Objetivos: mensurar a frequência e conformidade de rastreio do câncer mamário segundo risco para esta doença. Métodos: estudo transversal em São Paulo, com 950 usuárias de 38 da atenção primária no SUS entre outubro a dezembro de 2013. Segundo critérios do SUS, as participantes foram agrupadas como risco elevado ou padrão e mensurou-se frequência, associação (p≤0,05) e conformidade do rastreio. Resultados: 6,7% tinha risco elevado e 93,3% risco padrão, respectivamente, nestes grupos a frequência e conformidade do exame clínico mamário foram de 40,3% e 37,1% e de 43,5% e 43,0% (frequência p=0,631, conformidade p=0,290). Realização de mamografia alcançou percentuais de 67,7 e 35,5 para as com risco elevado, e de 57,4 e 25,4 nas com risco padrão (frequência p=0,090, conformidade p=0,000). Conclusões: nos grupos, a frequência e conformidade do exame clínico mamário foram semelhantes, para mamografia foi maior nas com risco elevado, tendo assertividade inferior aos 70% pactuados no SUS.
ABSTRACT
Abstract Objective To determine time period for hospital discharge and pain and function improvement in patients submitted to percutaneous endoscopic lumbar discectomy (PELD). Methods Retrospective evaluation of length of stay and visual analog scale (VAS), Oswestry disability index (ODI), and Roland-Morris questionnaire results in 32 patients undergoing PELD at the preoperative period and at 2 days and 1, 2, 4, 6 and 12 postoperative weeks. Results All patients were discharged in less than 6 hours. There was a statistically significant improvement between the results obtained before the procedure and 2 days postsurgery: the mean VAS for axial pain went from 6.63 to 3.31, the VAS for irradiated pain went from 6.66 to 2.75, the Oswestry score went from 44.59 to 33.17%, and the Roland-Morris score went from 14.03 to 10.34. This difference progressively improved up to 12 weeks in all questionnaires. Regarding the Oswestry score, minimum disability values (19.39%) were observed at 6 weeks. Conclusion All 32 patients were discharged within 6 hours. Pain and function improved significantly after 48 hours, with further significant and progressive improvement until the 3rd month.
Resumo Objetivo Determinar o tempo de alta hospitalar e o período de melhora funcional e da dor dos pacientes submetidos a discectomia endoscópica percutânea lombar (DEPL). Métodos Avaliação retrospectiva do tempo de internação e dos questionários escala visual análoga (EVA), índice de incapacidade Oswestry (IIO), e Roland-Morris de 32 pacientes submetidos a DEPL nos períodos pré-operatório e com 2 dias, e 1, 2, 4, 6, e 12 semanas pós-operatórias. Resultados Todos os pacientes receberam alta em menos de 6 horas houve melhora estatística entre o período pré-operatório e 2 dias pós-operatório , sendo o valor médio do questionário EVA axial de 6,63 para 3,31, do EVA irradiado de 6,66 para 2,75, do IIO de 44,59% para 33,17% e do Roland-Morris de 14,03 para 10,34. Tal diferença apresentou melhora progressiva até 12 semanas em todos os questionários. O IIO atingiu valores de incapacidade mínima (19,39%) com 6 semanas de avaliação. Conclusão Todos os 32 pacientes receberam alta hospitalar em até 6 horas. Houve melhora significativa dos sintomas funcionais e de dor já com 48 horas, apresentando ainda melhora adicional significativa e progressiva até o 3º mês.
Subject(s)
Humans , Pain , Spine , Diskectomy , Preoperative Period , Length of StayABSTRACT
Drug withdrawal has always been a tough challenge in drug quality management for the pharmacist. In order to optimize the drug withdrawal process, the hospital has introduced an inpatient pharmacy IT system. This system can efficiently minimize the drug withdrawal rate of major departments and withdrawal counts due to substandard quality problems, thus sizably avoiding human resource wastes in the conventional withdrawal process, reducing drug quality problem, enhancing management efficiency and efficiency of nursing staff and pharmacists, and ensuring clinical drug use safety.
ABSTRACT
Resumo A complexidade e a diversidade do que se propõe sob a lógica da Medicina Tradicional Complementar e Integrativa (MTCI) constituem um desafio para os interessados em evidências de sua efetividade. Seu crescimento, oferta e uso justificam a necessidade de construir referenciais metodológicos mais complexos e mais adequados para explicitar a singularidade do cuidado e a diversidade de suas técnicas. Este artigo, partindo de uma revisão narrativa da literatura, visa contribuir para a construção de um modelo de avaliação que, centrado na compreensão da singularidade e nas diversas dimensões do cuidado, busca refletir sobre os desafios de se buscar evidências do êxito terapêutico. O modelo proposto tem como base as abordagens qualitativas em saúde em que experiências dos agentes envolvidos (profissionais e usuários) no processo terapêutico ganham centralidade. Avaliar a efetividade do cuidado significa reconhecer a cadeia de processos interligados e suas diversas dimensões: acolhimento, diálogo, diagnóstico, ação e resultados alcançados.
Abstract The complexity and diversity of what is proposed in Traditional and Complementary Medicine constitute a challenge for those seeking evidence of its effectiveness. Its growth, offer and, use justify the need to build more complex and more appropriate methodological frameworks to explicit the uniqueness of this approach to healthcare and the diversity of its techniques. Based on a narrative review of the recent literature, this article aims to contribute to the construction of an evaluation model, focused on understanding the uniqueness and diverse dimensions of this specific care, seeking to reflect on the challenges and evidences of successful therapy. The proposed model is based on qualitative healthcare approaches, in which the experiences of the involved agents (professionals and users) in the therapeutic process become central. Assessing their effectiveness means recognizing the interconnected processes and their multiple dimensions: host practices, dialogue, diagnosis, action, and outcomes achieved.
Subject(s)
Humans , Complementary Therapies , Delivery of Health Care/organization & administration , Integrative Medicine/organization & administration , Medicine, Traditional/methods , Models, TheoreticalABSTRACT
Objective To assess the implementation and impact of programs carried out by the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases.Methods Both sociological and epidemiological methods were used to collect qualitative and quantitative data in November and December,2016 in order to conduct on process and outcome evaluation of the above mentioned objective.In the meantime,case study was also conducted.Results All the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases were found well implemented across the country,with health education and health promotion,surveillance and safeguard measures in particular.A government-led and inter-sector coordination and communication mechanism had been well established,with more than 16 non-health departments actively involved.28.7％ of the residents living in the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases were aware of the key messages related to chronic diseases.Among the residents,72.1％ of them consumed vegetables and 53.6％ consumed fruits daily,with another 86.9％ walked at least 10 minutes per day.Over 70％ of the patients with hypertension or diabetes reported that they were taken care of by the Community Health Centers,and above 50％ of them were under standardized management.Residents,living in the National Demonstration Areas under higher ranking of implementation scores,were more likely to be aware of relevant knowledge on chronic disease control and prevention (OR=6.591,95％CI:5.188-8.373),salt reduction (OR=1.352,95％CI:1.151-1.589),oil reduction (OR=1.477,95％CI:1.249-1.746) and recommendation on physical activities (OR =1.975,95％ CI:1.623-2.403).Conclusion The implementation of programs carried out by the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases had served a local platform for the control and prevention of non-communicable diseases,and thus become an important'carrier'for chronic disease prevention and control programs in China.
ABSTRACT
Objective To assess the implementation and impact of programs carried out by the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases.Methods Both sociological and epidemiological methods were used to collect qualitative and quantitative data in November and December,2016 in order to conduct on process and outcome evaluation of the above mentioned objective.In the meantime,case study was also conducted.Results All the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases were found well implemented across the country,with health education and health promotion,surveillance and safeguard measures in particular.A government-led and inter-sector coordination and communication mechanism had been well established,with more than 16 non-health departments actively involved.28.7％ of the residents living in the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases were aware of the key messages related to chronic diseases.Among the residents,72.1％ of them consumed vegetables and 53.6％ consumed fruits daily,with another 86.9％ walked at least 10 minutes per day.Over 70％ of the patients with hypertension or diabetes reported that they were taken care of by the Community Health Centers,and above 50％ of them were under standardized management.Residents,living in the National Demonstration Areas under higher ranking of implementation scores,were more likely to be aware of relevant knowledge on chronic disease control and prevention (OR=6.591,95％CI:5.188-8.373),salt reduction (OR=1.352,95％CI:1.151-1.589),oil reduction (OR=1.477,95％CI:1.249-1.746) and recommendation on physical activities (OR =1.975,95％ CI:1.623-2.403).Conclusion The implementation of programs carried out by the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases had served a local platform for the control and prevention of non-communicable diseases,and thus become an important'carrier'for chronic disease prevention and control programs in China.
ABSTRACT
Objective To evaluate the outcomes of the payment reform at public hospitals in Sanming city.Methods Interrupted time series analysis was used to compare changes of the average days of stay,per capita hospitalization expense,outpatient expense per visit,proportion of medical expense and that of drugs during hospitalization at 21 public hospitals at or above county level before and after the DRGs reform.Results Comparisons before and after the reform found the average days of stay at the original momentum,poor control in curbing the proportion of medical expense and that of drugs during hospitalization,adropping followed by rising trend in the outpatient expense per visit,and minimal drop of the abovementioned proportions.Conclusions The rapid growth of outpatient and hospitalization costs at tertiary hospitals may be incurred by unreasonable cost transfer,structural trend of hospitalization expense makeup,and rationality pending scrutiny.
ABSTRACT
Background: The Rhinoplasty Outcome Evaluation (ROE) is an instrument to assess the cosmetic and functional aspects of the nose from the patient's perspective. Its construct validity in Chilean subjects has been published previously. Aim: To compare the ROE scores in different groups of participants. Material and Methods: The questionnaire was applied to patients waiting for a rhinoplasty, patients hospitalized for other causes and medical students. Results: The overall reliability of the scale was 84.8 percent. Significant differences between groups in the total scores of four out of six items were observed. Conclusions: The Spanish version of the ROE is adequate to evaluate the satisfaction with nasal appearance and function among Chilean individuals.
Objetivo: El Rhinoplasty Outcome Evaluation (ROE) es un instrumento específico para la evaluación cosmética y funcional de la nariz desde la perspectiva del paciente, desarrollado originalmente en inglés. El objetivo del presente estudio es comparar las distribuciones en distintas poblaciones. Material y Método: El instrumento validado en español chileno ROE fue sometido a prueba para evaluar su validez de criterio comparando los resultados de la escala en pacientes programados que deseaban someterse a rinoplastía versus 2 grupos control: 1) Pacientes hospitalizados por otras causas y 2) Estudiantes de medicina. La validez de constructo ya ha sido publicada por los creadores de la escala. Para la comparación de variables se utilizaron las pruebas t de Student, ANOVA, Wilcoxon, Kruskall Wallis, prueba exacta de Fisher o χ² según correspondiera. Para todas las pruebas se utilizó un nivel alfa de 5 por ciento. Resultados: Se aplicó la encuesta a 45 pacientes. La edad promedio de la muestra fue de 35,4 años. La confiabilidad de la escala fue de 84,78 por ciento. Se observaron diferencias estadísticamente significativas en el puntaje total (p = 0,0047) en 4 de los 6 ítems. Conclusión: Los resultados preliminares de nuestro estudio sugieren que la versión en Español del Rhinoplasty Outcomes Evaluation es útil para evaluar la satisfacción con la apariencia nasal en chilenos.
Subject(s)
Humans , Adult , Middle Aged , Quality of Life , Rhinoplasty/psychology , Surveys and Questionnaires , Patient Satisfaction , Prospective Studies , Reproducibility of Results , Treatment OutcomeABSTRACT
Objective Through investigation of children fluorosis illness,family households improved stoves and related life styles,to provide a scientific basis for sustainable control of endemic fluorosis.Methods In 2013,in Huishui County and Baiyun District,3 towns were selected in each county(district),and 3 villages were selected in each town.All 8-12 years old children in the school of these villages were checked dental fluorosis,which was diagnosed according to Dental Fluorosis Diagnosis (WS/T 208-2011); at the same time,10 families were selected to survey the situation of improved stoves and related life styles.Results Dental fluorosis detection rate of 8-12 years old children in Huishui and Baiyun were 2.75％ (23/836) and 2.26％ (11/487),which were all lower than 30％.Qualified rate of improved stoves and qualified stoves correct utilization rate were all 100.0％ (90/90).For human consumption,the correct rate of corn drying was 100.0％ (90/90) ; the correct rates of chili drying were 98.9％ (89/90) and 100.0％ (90/90).Conclusions The prevention effect is obvious,which has reached the control standards.We should continue to improve the long-term mechanism of comprehensive control measures,and to achieve substantial elimination of coal-burning endemic fluorosis.
ABSTRACT
Objective To know the changing characteristics of residents' iodine nutritional status after eating salt with different iodine concentrations in Hubei Province,according to the assessment standard of iodine nutrition recommended by WHO/UNICEF/ICCIDD provide a scientific standard for appropriate iodine concentration in edible salt.Methods According to inhabitants' salt and urine surveillance of Hubei in 2010,Xinzhou District,Tianmen City and Changyang County were selected for trial.Salt with two kinds of iodine content was used in 3 trial areas in 4 months for the study of community intervention.Before the intervention,3 months and 4 months after the intervention,urine samples of observed participants(40 from 8-10 old children,40 from pregnant women or lactating women and 40 from adults aged older than 18) were collected and tested.The urinary medians of different groups of people and at different times were calculated and compared.Results Three months and 4 months after the intervention,in those towns using iodized salt of (15 ± 3) mg/kg,the urinary medians of children,declined from 294.2 μg/L to 185.6,195.7 μg/L,respectively.The urinary medians of pregnant women or lactating women dropped from 269.0 μg/L to 141.7,176.1 μg/L.For adults aged 18 and older,the urinary medians changed from 304.9 μg/L to 199.7,202.2 μg/L.In those trial towns of using (25 ± 3)mg/kg iodized salt,the urinary medians of children,pregnant women or lactating women and adults older than 18 all went down from 301.1 μg/L to 229.7,253.8 μg/L,from 261.4.0 μg/L to 196.6 and 206.5 μg/L and from 379.7 μg/L to 244.3,237.4 μg/L,respectively.Conclusions According to the assessment standard of iodine nutrition recommended by WHO/UNICEF/ICCIDD and the decreasing of urinary iodine median and per capita daily salt intake,salt with 25 mg/kg iodine is suitable as the average level of salt iodine concentration after the adjustment in Hubei Province.
ABSTRACT
Objective To explore the changes of children's dental fluorosis before and after implementation of comprehensive prevention and control intervention in coal-burning-borne endemic fluorosis areas of Guizhou Province,and to provide a scientific basis for making corresponding prevention and control measures.Methods In 2010,according to a simple random cluster sampling method,1/5 of the villages out of 1/5 of the towns of Zunyi,Kaiyang and Longli Counties,were selected as investigation sites for inspection of dental fluorosis in 8-12 years old children and a longitudinal comparison was done with historical related dental fluorosis (year 1986 and 2000).Dental fluorosis of children was diagnosed by Dean method.Results In Zunyi,Kaiyang and Longli Counties,the detection rates of 8-12 years old children's dental fluorosis were 23.76％(202/850),15.77％ (79/501) and 11.17％(42/376),respectively.The detection rates of dental fluorosis in the 8,9,10,11 and 12 years old age group of children were 11.52％(19/165),17.19％(44/256),20.20％ (81/401),18.61％ (75/403) and 20.72％ (104/502),respectively,and there was no significant difference between groups (x2 =2.90,P ＞ 0.05).The survey results of this investigation in the three counties in 2000 were 34.20％(7 805/22 821),39.77％(1 782/ 4 481),60.88％(2 806/4 609),and the differences were statistically significant between the results of 2010 and 2000(x2 =37.81,110.91,350.76,all P ＜ 0.01).And compared with the results of 1986[34.29％ (9 463/27 596),36.30％ (2 708/7 460),35.72％ (1 896/5 308)],the difference of Zunyi County was not statistically significant (x2 =0.045,P ＞ 0.05),but for Kaiyang and Longli the differences were statistically significant(x2 =14.35,626.39,all P ＜ 0.01).Conclusions The effect of comprehensive prevention and control intervention is very obvious.In the 3 counties,the incidence rates of 8-12 years old children's dental fluorosis are already dropped to below 30％ of the control standard.Subsequent management should be carried out and the state of disease should be evaluated for organization-assessment acceptance in accordance with relevant hygiene standards in a planned way.
ABSTRACT
Objective To understand the fairness of health resources of endemic diseases institutions in Henan Province,to provide evidence for endemic allocation of health resources for the government.Methods Health-related data resources in endemic disease prevention and control institutions were collected in Henan Province,including personnel,business space area,the value of equipment,and health funding,etc.The percentages of population distribution and geographical distribution of health resources were calculated; Lorenz curves of demographic fairness and geographic fairness were drawn.According to Lorenz curve (Gini coefficients of the population and the geographical distribution were calculated based on Lorenz curve),Gini coefficients were used to evaluate the fairness of the endemic disease prevention institutions for health resource allocation.Results As can be seen from Lorenz curve,the population fairness of endemic disease prevention and health personnel was the best,but the number of senior officers was less and the total value of equipment owned was low.The geographical fairness of all the indicators of health resources was poorer,and geographic fairness among senior officers was the worst.The Gini coefficient of health technical personnel,senior personnel,undergraduate or above personnel,value of equipments,area of business room and health funding allocation determined by the population distribution was less than 0.4.The health resources were relatively fair and reasonable according to the distribution of population.The Gini coefficients of all the indicators determined by the distribution of geography were higher than those determined by the distribution of population.Furthermore,the geographic Gini coefficient of senior personnel was above 0.4 which was in the vigilance state.Conclusions The equality of health resources determined by population distribution in the institutions for endemic diseases control in Henan is superior to those determined by geographic distribution.The allocations of health resources of endemic diseases control in different areas are unbalanced.
ABSTRACT
Background: The Rhinoplasty Outcome Evaluation is a questionnaire that assesses, form the point of view of the patient, the functional and cosmetic outcome of rhinoplasty. It has six items for esthetic and functional domains, using Likert type questions with five alternatives. The scale ranges from 6 that is the worst outcome to 30, the best. Aim: To translate and validate the Rhinoplasty Outcome Evaluation, to be used in Chile. Material and Methods: The linguistic validation guidelines of the MAPI/TRUST Research Institute were used. The instrument was translated from English to Spanish, counter translated and applied to a pilot sample of five patients. The internal stability was assessed using Cronbach alpha. Results: The five female patients in whom the questionnaire was applied were aged 22 +/- 4 years, had 15 +/- 2 years of studies and their body mass index was 23 +/- 4 kg/m². Cronbach alpha was 84 percent. The scale changed from 10 points in the preoperative period to 17 points in the postoperative period. Conclusions: The Rhinoplasty Outcome Evaluation is a valid and reliable questionnaire to evaluate the results of rhinoplasty.
Introducción: El Rhinoplasty Outcome Evaluation es un instrumento específico para la evaluación cosmética y funcional de la nariz desde la perspectiva del paciente; publicado originalmente en inglés, cuenta con 6 ítems pertenecientes a dominios estéticos y funcionales administrados en preguntas tipo Likert de 5 puntos. El puntaje de la escala puede tomar un valor que va de 6 a 30 puntos, donde el puntaje de 6 es la peor satisfacción con la nariz y 30 la mejor imaginable. El objetivo del presente estudio es traducir y validar este instrumento al español para su uso en Chile. Materiales y Métodos: Se utilizaron las guías de validación lingüística del MAPI/TRUST Research Institute. El proceso de validación requirió la traducción inglés-español, contra traducción español-inglés, conciliación inglés-inglés y aplicación de la escala en 5 pacientes. La estabilidad interna se evaluó con el alfa de Cronbach, se utilizó estadística descriptiva y analítica para analizar los resultados. Resultados: Las 5 pacientes evaluadas tuvieron una edad promedio de 22 +/- 4 años, IMC 23 +/- 4 kg/m² y 15 +/- 2 años de estudio, todas de sexo femenino. La estabilidad interna de la escala fue de 84 por ciento (alfa de Cronbach). Se logró evidenciar que los resultados obtenidos entre el preoperatorio y el postoperatorio de las pacientes, variaron de 10 a 17 puntos, con una mediana de 14 puntos. Conclusiones: El instrumento Rhinoplasty Outcomes Evaluation es un instrumento válido, confiable y reproducible para la evaluación de los resultados de la rinoplastía, desde la perspectiva de los pacientes chilenos hispanoparlantes.
Subject(s)
Humans , Female , Adolescent , Adult , Patient Satisfaction , Rhinoplasty/psychology , Surveys and Questionnaires , Chile , Psychometrics , Reproducibility of Results , Translating , Treatment OutcomeABSTRACT
Objective To evaluate the effects of a health education and behavior intervention project,and to provide.a scientific basis for brucellosis control.Methods By stratified cluster sampling method,target population from 6 township in Meilisi District were randomly selected to carry out baseline survey.Of these 6 townships 4 were selected as intervention townships,and two as control townships.A health education and behavior intervention program was carried out in intervention townships,and after intervention target population from 6 township were participated in the questionnaire survey.Results Awareness rate of common sense knowledge of farmers in intervention townships was 84.33％ (5237/6210) after intervention which was significantly higher than 53.56％ (2003/3740),before the intervention (x2 =112.49,P ＜ 0.01),and also higher than 54.15 ％ (1787/3300) of the control after the intervention (x2 =101.53,P ＜ 0.01).Average awareness rate(82.13％,2550/3105) of common sense on prevention after intervention was significantly higher than 58.77％(1099/1870) before the intervention (x2 =57.19,P ＜ 0.01).After intervention,average awareness rate of common sense on prevention was significantly higher than that of the average of control townships (70.36％,1161/1650,x2 =25.49,P ＜ 0.01).The awareness rate of treatment before intervention was 36.80％ (116/299),which increased to 76.36％ (436/571)after intervention (x2 =119.38,P ＜ 0.01).After the intervention the awareness rate of intervention townships was significantly higher than that of the controls (33.72％,88/261,x2 =139.69,P ＜ 0.01).In survey of these high-risk behavior in intervention townships,in addition to cattle and sheep which were regularly immunized in the intervention townships(35.91％,121/337),and the control townships(32.01％,97/303,x2 =1.08,P ＞ 0.05) and their difference was not significant,other processing such asapoblema,killing cattle,sheep,cattle to deliver,cutting the wool,regular disinfection,and accuracy of high-risk behavior protection were significantly higher than those of controls[89.83％(106/l18),91.07％(51/56),84.75％(150/177),66.67％(32/48),73.78％(242/328),51.22％(42/82),75.56％(34/45),33.69％(63/187),27.78％(15/54),21.63％(61/282),x2 value were 38.00,5.82,103.84,15.84 and 173.67,all P ＜ 0.05].Conclusion After implementation of health education and behavioral intervention,farmers brucellosis prevention knowledge and awareness of risk behaviors have significantly improved,which have achieved the desired effect.
ABSTRACT
Objective To investigate the value of local progression-free survival (LPFS) for evaluating the local long-term outcome of peripheral lung cancer treated by cyberknife.Methods Retrospective analysis was performed on the clinical records of 81 cyberknife-treated lung cancer patients (90 foci),including 43 primary lung cancer patients (43 foci) and 38 metastatic lung cancer patients (47 foci).Of all the patients,58(63 foci) were treated at a dose of 60 Gy/3 fractions (20 Gy/fraction),and 23 (27 foci) at a dose of 54 Gy/3 fractions (18 Gy/fraction).The short-term treatment outcome and LPFS were used as the indices for observation;a logistic regression was used for analyzing the predictive value of LPFS for local long-term treatment outcome.Results After the evaluation of short-term treatment outcome,63％ of all the foci needed further evaluation.As the follow-up lasted,the number of foci which needed further evaluation decreased,most rapidly during 0.5-2 years after treatment.Re-evaluation results had predictive value for the treatment outcome in the subsequent follow-up,but the predictive value declined as the follow-up lasted.Conclusions LPFS is a recommendable index for evaluating the local outcome of primary or metastatic lung cancer treated by cyberknife,and it also has predicative value for local long-term treatment outcome.
ABSTRACT
Visa-se fazer uma reflexão a respeito da avaliação de resultados do trabalho psicanalítico a partir de algumas críticas que surgiram em revistas da Psiquiatria americana sobre os resultados da psicanálise e sua eficácia, sobretudo, a de PARLOFF (1982), intitulada "Psychoterapy research evidence and reimbursement decisions: Bambi meets Godzilla". Decorrente dessas críticas, a avaliação de resultados do trabalho clínico em psicanálise constituiu-se em um desafio para o psicanalista. Frente a esse desafio fazse uma reflexão a respeito do território epistemológico da avaliação em psicanálise.
The article discusses the evaluation of the results of the psychoanalytic therapy, considering some criticisms that were issued in american Psychiatry reviews regarding the Psychoanalysis outcome and its efficiency, especially Parloff's (1982) text entitled "Psychoterapy research evidence and reimbursement decisions: Bambi meets Godzilla". Because of these recurrent criticisms, theevaluationofpsychoanalyticresultsisa challengefor psychoanalysts.Taking into account this challenge, a reflection is built upon the epistemological territory of Psychoanalysis evaluation.