Laura C. Zambrano-Jerez;Karen D. Diaz-Santamaria;Maria A. Rodriguez-Santos;Diego F. Alarcon-Ariza;Genny L. Melendez-Florez;Monica A. Ramirez-Blanco
Archives of Plastic Surgery
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v.50
no.6
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pp.627-634
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2023
In recent decades, a number of simulation models for microsurgical training have been published. The human placenta has received extensive validation in microneurosurgery and is a useful instrument to facilitate learning in microvascular repair techniques as an alternative to using live animals. This study uses a straightforward, step-by-step procedure for instructing the creation of simulators with dynamic flow to characterize the placental vascular tree and assess its relevance for plastic surgery departments. Measurements of the placental vasculature and morphological characterization of 18 placentas were made. After the model was used in a basic microsurgery training laboratory session, a survey was given to nine plastic surgery residents, two microsurgeons, and one hand surgeon. In all divisions, venous diameters were larger than arterial diameters, with minimum diameters of 0.8 and 0.6 mm, respectively. The majority of the participants considered that the model faithfully reproduces a real microsurgical scenario; the consistency of the vessels and their dissection are similar in in vivo tissue. Furthermore, all the participants considered that this model could improve their surgical technique and would propose it for microsurgical training. As some of the model's disadvantages, an abundantly thick adventitia, a thin tunica media, and higher adherence to the underlying tissue were identified. The color-perfused placenta is an excellent tool for microsurgical training in plastic surgery. It can faithfully reproduce a microsurgical scenario, offering an abundance of vasculature with varying sizes similar to tissue in vivo, enhancing technical proficiency, and lowering patient error.
According to the results of related studies, one of the typical factors related to procedure related human errors is the complexity of procedures. This means that comparing the change of the operators' behavior with respect to the complexity of procedures may be meaningful in clarifying the reasons for the operators' non-compliance behavior. In this study, to obtain data related to the operators' non-compliance behavior, emergency training records were collected using a full scope simulator. And three types of the operators' behavior (such as strict adherence, skipping redundant actions and modifying action sequences) observed from the collected emergency training records were compared with the complexity of the procedural steps. As the results, two remarkable relationships are obtained. They are: 1) the operators seem to frequently adopt non-compliance behavior to conduct the procedural steps that have an intermediate procedural complexity, 2) the operators seems to accommodate their non-compliance behavior to the complexity of the procedural steps. Therefore, it is expected that these relationships can be used as meaningful clues not only to scrutinize the reason for non-compliance behavior but also to suggest appropriate remedies for the reduction of non-compliance behavior that can result in procedure related human error.
Resistance training (RT) is associated with reduced risk of low grade inflammation related diseases, such as cardiovascular disease and type 2 diabetes. The majority of the data studying cytokines and exercise comes from endurance exercise. In contrast, evidence establishing a relationship between RT and inflammation is more limited. This review focuses on the cytokine responses both following an acute bout, and after chronic RT. In addition, the effect of RT on low grade systemic inflammation such as individuals at risk for type 2 diabetes is reviewed. Cytokines are secreted proteins that influence the survival, proliferation, and differentiation of immune cells and other organ systems. Cytokines function as intracellular signals and almost all cells in the body either secrete them or have cytokine receptors. Thus, understanding cytokine role in a specific physiological situation such as a bout of RT can be exceedingly complex. The overall effect of long term RT appears to ameliorate inflammation, but the specific effects on the inflammatory cytokine, tumor necrosis factor alpha are not clear, requiring further research. Furthermore, it is critical to differentiate between chronically and acute Interleukin-6 levels and its sources. The intensity of the RT and the characteristics of the training protocol may exert singular cytokine responses and as a result different adaptations to exercise. More research is needed in the area of RT in healthy populations, specifically sorting out gender and age RT acute responses. More importantly, studies are needed in obese individuals who are at high risk of developing low grade systemic inflammatory related diseases. Assuring adherence to the RT program is essential to get the benefits after overcoming the first acute RT responses. Hence RT could be an effective way to prevent, and delay low grade systemic inflammatory related diseases.
Purpose: Radiographs is an integral part of patient management in dentistry, despite their detrimental effects. As the literature pertaining to radiation protection among Indian dental practitioners is sparse, exploring such protection is needed. Materials and Methods: All private dental practitioners in Mangalore, India were included in the study. A structured, pre-tested, self-administered questionnaire was employed to assess the knowledge, attitudes, practices, previous training, perceptions towards the need to spread awareness, and willingness to gain and implement knowledge about radiation hazards and protection. Information regarding each respondent's age, gender, education, and type and duration of practice was collected. Results: Overall, 87 out of 120 practitioners participated in the study. The mean knowledge, attitude, and practice scores were $9.54{\pm}2.54$, $59.39{\pm}7.01$, and $5.80{\pm}3.19$, respectively. Overall, 25.3% of the respondents had undergone training in radiation protection, 98.9% perceived a need to spread awareness, and 94.3% were willing to improve their knowledge. Previous training showed a significant correlation with age, sex, and duration of practice; attitude was significantly correlated with education and type of practice; and knowledge scores showed a significant correlation with type of practice. Conclusion: Although the knowledge and practices of respondents were poor, they had a positive attitude and were willing to improve their knowledge. Age, sex, and duration of practice were associated with previous training; education and type of practice with attitude scores; and type of practice with knowledge scores. The findings of this study suggest a policy is needed to ensure the adherence of dental practitioners to radiation protection guidelines.
Objectives: This study aims to explain the process of photovoice, to review relevant research cases, and to discuss the issues in photovoice applications for community health promotion. Methods: Literature review is performed on photovoice manuals, systematic review literature on international photovoice research, and Korean photovoice studies. The review was based on 8 research papers and 6 practice manuals. Results: Photovoice so far has specified its orientation to participatory research. Its implementation includes photovoice training, photo taking and sharing, interviews and discussions, photo exhibit, and social action planning for policy change. SHOWeD questions and the like guide photovoice discussions while they face some challenges in application. Social action planning for policy change part of the photovoice needs attention in implementation and evaluation. Conclusions: Adherence to the participatory principles and action research orientation in photovoice requires persistent efforts. Process and impact evaluation with development of photovoice research infrastructure will enhance photovoice application.
This study aims to determine the effect of a trained dedicated dietitian on clinical outcomes among Lebanese hemodialysis (HD) patients: and thus demonstrate a viable developing country model. This paper describes the study protocol and baseline data. The study was a multicenter randomized controlled trial with parallel-group design involving 12 HD units: assigned to cluster A (n = 6) or B (n = 6). A total of 570 patients met the inclusion criteria. Patients in cluster A were randomly assigned as per dialysis shift to the following: Dedicated Dietitian (DD) (n = 133) and Existing Practice (EP) (n = 138) protocols. Cluster B patients (n = 299) received Trained Hospital Dietitian (THD) protocol. Dietitians of the DD and THD groups were trained by the research team on Kidney Disease Outcomes Quality Initiative nutrition guidelines. DD protocol included: individualized nutrition education for 2 hours/month/HD patient for 6 months focusing on renal osteodystrophy and using the Trans-theoretical theory for behavioral change. EP protocol included nutrition education given to patients by hospital dietitians who were blinded to the study. The THD protocol included nutrition education to patients given by hospital dietitian as per the training received but within hospital responsibilities, with no set educational protocol or tools. Baseline data revealed that 40% of patients were hyperphosphatemics (> 5.5 mg/dl) with low dietary adherence and knowledge of dietary P restriction in addition to inadequate daily protein intake ($58.86%{\pm}33.87%$ of needs) yet adequate dietary P intake ($795.52{\pm}366.94$ mg/day). Quality of life (QOL) ranged from 48-75% of full health. Baseline differences between the 3 groups revealed significant differences in serum P, malnutrition status, adherence to diet and P chelators and in 2 factors of the QOL: physical and social functioning. The data show room for improvement in the nutritional status of the patients. The NEMO trial may be able to demonstrate a better nutritional management of HD patients.
Van Nguyen, Huy;Tran, Hieu Trung;Khuong, Long Quynh;Van Nguyen, Thanh;Ho, Na Thi Nhi;Dao, An Thi Minh;Van Hoang, Minh
Journal of Preventive Medicine and Public Health
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v.53
no.4
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pp.236-244
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2020
Objectives: Although the World Health Organization (WHO) initiative "My 5 Moments for Hand Hygiene" has been lauded as effective in preventing hospital-associated infections, little is known about healthcare workers (HCWs)' hand hygiene behavior. In this study, we sought to assess knowledge and attitudes towards the concepts in this initiative, as well as associated factors, among Vietnamese HCWs at a general hospital. Methods: A structured questionnaire was administered to HCWs at a central Vietnamese general hospital in 2015. Multiple logistic regression analysis was used to identify factors associated with HCWs' knowledge and attitudes towards hand hygiene. Results: Of 120 respondents, 65.8% and 67.5% demonstrated appropriate knowledge and a positive attitude, respectively, regarding all 5 hand hygiene moments. Logistic regression indicated better knowledge of hand hygiene in workers who were over 30 years old, who were direct HCWs (rather than managers), who had frequent access to clinical information, and who received their clinical information from training. Those who worked in infectious and tropical disease wards, who had frequent access to clinical information, and who received information from training were more likely to have a positive attitude towards hand hygiene than their counterparts. Conclusions: Although many Vietnamese HCWs displayed moderate knowledge and positive attitudes towards the WHO hand hygiene guidelines, a key gap remained. Regular education and training programs are needed to increase knowledge and to improve attitudes and practices towards hand hygiene. Furthermore, a combination of multimodal strategies and locally-adapted interventions is needed for sustainable hand hygiene adherence.
Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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2018.05a
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pp.323-326
/
2018
The purpose of this study is to suggest web accessibility improvement direction through web accessibility evaluation of 16 local government education and training institutions. For this purpose, we evaluated the websites of 14 education and training institutions excluding some websites. The evaluation was conducted through automatic evaluation by Open-WAX and manual evaluation by three experts. As a result of the analysis, although the web accessibility compliance rate improved, problems such as alternate text, skip link, and markup error prevention were found. This study suggests the future direction of research and adherence to web accessibility of local governments.
Purpose : This study aimed to identify the status of intrahospital transport (IHT) of critically ill patients and provide baseline data to form recommendations for safer transport. Methods : Data were collected from 141 intensive care unit (ICU) nurses who attended national conferences between February and August, 2018. The collected data were analyzed using descriptive statistics and ANOVA, and post-hoc analysis was conducted with the Scheffé and Games-Howell tests. Results : Of the nurses surveyed, 61.7% answered that their workplace had a transport guideline. In terms of the experience of ICU nurses, 31.2% of respondents answered that they had received training on IHT. This result indicated that the degree of implementation of the guidelines for IHT was generally high, but some, including guidelines on personnel, equipment, and monitoring, were not. Guidelines of IHT were well observed when the institutes had specific guidelines for IHT of critically ill patients with specified transport grades, a scoring system to assess stability of a patient, a checklist and a protocol for action in case of problems, and when healthcare providers were provided with training. Conclusion : These results suggest that organized infrastructure, such as a transport guideline with transport grades, a checklist to improve the implementation of guidelines, and a protocol for coping with a problem, should be provided for safe transport. Additionally, effective education and evaluation to improve the competency of staff participating in the transport of patients will help reduce the occurrence of adverse events in intensive care transport in hospitals and promote patient safety.
Purpose: Severe acute malnutrition (SAM) is an important public health problem which contributes to significant number of under five deaths. Protocol based management significantly decreases risk of deaths in children with medical complications. Methods: Outcome of children aged 2 months-5 years admitted and fulfilling definition of SAM having diarrhea (group A) was compared to children with SAM having medical complications other than diarrhea (group B). Both groups were managed according to standard recommended protocols and monitored and followed up for 12 weeks after discharge. Results: The average weight gain, defaulter rate, primary failure, secondary relapse rate and readmission rate were similar in both groups. Length of stay in group A was three days longer (p-value=0.039). Discharge rate was comparable with overall 68% of children successfully discharged and 50% of children reaching weight/height > -2 standard deviation at follow-up of 12 weeks. Conclusion: The current management protocol is equally effective for managing children with SAM having diarrhea. Good adherence to management protocol of dehydration and timely modification of therapeutic feeds in children with persistent diarrhea results in satisfactory weight gain.
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