BACKGROUND Aerosols containing disease-causing microorganisms are produced during oral diagnosis and treatment can cause secondary contamination.AIM To investigate the use of graphene material for air disinfection in ...BACKGROUND Aerosols containing disease-causing microorganisms are produced during oral diagnosis and treatment can cause secondary contamination.AIM To investigate the use of graphene material for air disinfection in dental clinics by leveraging its adsorption and antibacterial properties.METHODS Patients who received ultrasonic cleaning at our hospital from April 2023 to April 2024.They were randomly assigned to three groups(n=20 each):Graphene nanocomposite material suction group(Group A),ordinary filter suction group(Group B),and no air suction device group(Group C).The air quality and air colony count in the clinic rooms were assessed before,during,and after the procedure.Additionally,bacterial colony counts were obtained from the air outlets of the suction devices and the filter screens in Groups A and B.RESULTS Before ultrasonic cleaning,no significant differences in air quality PM2.5 and colony counts were observed among the three groups.However,significant differences in air quality PM2.5 and colony counts were noted among the three groups during ultrasonic cleaning and after ultrasonic treatment.Additionally,the number of colonies on the exhaust port of the suction device and the surface of the filter were significantly lower in Group A than in Group B(P=0.000 and P=0.000,respectively).CONCLUSION Graphene nanocomposites can effectively sterilize the air in dental clinics by exerting their antimicrobial effects and may be used to reduce secondary pollution.展开更多
A summary of the exploration of the teaching mode of the general practice teaching clinic, a summary of the deficiencies of the teaching clinic and a summary of the significance of the establishment of the general pra...A summary of the exploration of the teaching mode of the general practice teaching clinic, a summary of the deficiencies of the teaching clinic and a summary of the significance of the establishment of the general practice teaching clinic are presented with a view to promoting the development of general practice and cultivating more excellent successors in general practice.展开更多
Objective:This study designs and implements the health prescription of children’s health education specialized nursing clinic based on the physical and mental characteristics of children with Tourette’s syndrome.Met...Objective:This study designs and implements the health prescription of children’s health education specialized nursing clinic based on the physical and mental characteristics of children with Tourette’s syndrome.Methods:Applying the evidence-based nursing model and nursing intervention theory based on the survey research by searching China Knowledge Network,Wanfang Database and Wipro Chinese Science and Technology Journal Database,the study collected the literature on the health prescription intervention research in children’s Tourette’s disorders health education in children’s health education of specialized nursing outpatient clinic for review and combined with the specialty characteristics to formulate“Children’s Tourette’s Disorder Health Education Prescription.”Results:Tourette’s syndrome in children is a common pediatric neurological disorder,mainly manifested as involuntary,rapid and repeated muscle twitching and vocal tics,which brings serious psychological pressure and life disturbance to the affected children.Conclusion:For children with Tourette’s syndrome,healthcare professionals should give enough care and understanding to the children and their parents,provide timely and effective health education to them,help them improve their bad behavioral habits,establish correct cognitive attitudes,enhance self-confidence,improve patient compliance,reduce the frequency of recurrence,reduce the incidence of complications and promote children’s physical and mental health development.展开更多
Urgent care clinics and emergency departments around the world periodically suffer from extended wait times beyond patient expectations due to surges in patient flows.The delays arising from inadequate staffing levels...Urgent care clinics and emergency departments around the world periodically suffer from extended wait times beyond patient expectations due to surges in patient flows.The delays arising from inadequate staffing levels during these periods have been linked with adverse clinical outcomes.Previous research into forecasting patient flows has mostly used statistical techniques.These studies have also predominately focussed on short‐term forecasts,which have limited practicality for the resourcing of medical personnel.This study joins an emerging body of work which seeks to explore the potential of machine learning algorithms to generate accurate forecasts of patient presentations.Our research uses datasets covering 10 years from two large urgent care clinics to develop long‐term patient flow forecasts up to one quarter ahead using a range of state‐of‐the‐art algo-rithms.A distinctive feature of this study is the use of eXplainable Artificial Intelligence(XAI)tools like Shapely and LIME that enable an in‐depth analysis of the behaviour of the models,which would otherwise be uninterpretable.These analysis tools enabled us to explore the ability of the models to adapt to the volatility in patient demand during the COVID‐19 pandemic lockdowns and to identify the most impactful variables,resulting in valuable insights into their performance.The results showed that a novel combination of advanced univariate models like Prophet as well as gradient boosting,into an ensemble,delivered the most accurate and consistent solutions on average.This approach generated improvements in the range of 16%-30%over the existing in‐house methods for esti-mating the daily patient flows 90 days ahead.展开更多
Background: Preeclampsia (PE) is one of the forms of hypertensive diseases that occur during pregnancy. Early-onset preeclampsia (EOP), which occurred before 34 weeks, proved to be the deadliest. Indeed, it is charact...Background: Preeclampsia (PE) is one of the forms of hypertensive diseases that occur during pregnancy. Early-onset preeclampsia (EOP), which occurred before 34 weeks, proved to be the deadliest. Indeed, it is characterized by a poor maternal and fetal prognosis. EOP has a disparate incidence in the world varying between 0.9% and 31%. Several risks factors are associated with the occurrence of EOP, which is responsible of several adverse obstetrical outcomes. Complications can affect up to 85% of pregnant women with EOP, especially when EOP appears very early, before 28 or even 25 weeks’ gestation. Objectives: To determine frequency of EOP at the University Clinics of Kinshasa, to describe sociodemographic and clinical characteristics of pregnant women with EOP and to identify its risks factors and its association adverse obstetrical outcomes. Methods: The study will be a cross-sectional analytical study in University Clinics of Kinshasa from January 2016 to December 2022. The minimal size will be 119. Our study population will consist of pregnant women who consult for antenatal best care and are neonates in our Clinic. Result will be presented as percentage proportion. Comparison and proportion means between groups will be made using Student’s test and Pearson’s chi-square test, respectively. Our test will be statistically significant for a p-value ≤ than less 0.05. Data will be collected and analysed anonymously and confidentiality. Conclusion: We believe that our study should enable us to identify profile of gestational carriers at risk of EOP in our environment, as well as prognosis associated with this entity, with a view to arousing particular interest in EOP.展开更多
Objective To investigate the feature and frequency of medical emergencies in dental clinics in China and the Methods A survey study was conducted among 2408 dentists who attended continuing educational courses held by...Objective To investigate the feature and frequency of medical emergencies in dental clinics in China and the Methods A survey study was conducted among 2408 dentists who attended continuing educational courses held by Society of Sedation and Analgesia of Chinese Stomatological Association in 18 cities from December 2015 to December 2018.Demographic information of the dentists and the characteristics of medical emergencies they encountered were collected and analyzed.The associated demographic features for dentist experiencing medical emergencies were analyzed by logistic regression model.Results A total of 2013 dentists provided valid responses and reported 2923 events of medical emergencies in dental clinics.Among them,85.0%reported that they had encountered medical emergencies,and 35.5%had encountered at least twice.Syncope(35.9%)and hypoglycemia(30.3%)were the most common reported medical emergencies.Medical emergencies were most likely to occur during local anesthesia(49.9%),out-patient oral surgery(25.9%),and root canal treatment(11.3%).There were 6 patients(0.2%)died in emergencies.84.0%dentists reported that they had never received training courses about medical emergency management in dentistry other than Basic Life Support.Longer practicing time(10-15 years)(OR=0.59,95%CI:0.41-0.85,P=0.004),working in private dental facilities(OR=1.69,95%CI:1.20-2.38,P=0.003)were associated with an increased risk of experiencing medical emergencies.Conclusion More efforts are needed in prevention,early identification,and timely management of medical emergencies in dental clinics in order to prevent fatal outcomes.The results of this survey are useful information for re-designing emergency training courses for Chinese dentists.展开更多
This proposal focuses on the prevalence of teenage pregnancy issue in NJ and illustrates the benefits of school-based health clinics and educational programs which should be implemented for teenage pregnancy and child...This proposal focuses on the prevalence of teenage pregnancy issue in NJ and illustrates the benefits of school-based health clinics and educational programs which should be implemented for teenage pregnancy and childbearing.Without the early intervention of educational programs and preventive medical services which should be implemented in school areas,teen pregnancy and childbearing can have physical and emotional health influences on teen mothers,their babies and other family members,and the worst consequence should be abortion.What’s more,teenage pregnancy and childbearing have substantial economic consequence for state.The annual estimated cost associated with teen childbearing (teens 19 and younger) in NJ to taxpayers is at least $167 million in 2004 (24% federal costs and 76% state and local costs).Studies demonstrated that a much larger amount of money is spent on the consequences of teenage pregnancy than on prevention.NJ has an opportunity to invest in prevention and reduce not only the monetary but also the societal costs to our youth burdened by the often overwhelming responsibilities of teenage pregnancy and parenting.According to the 15 years follow-up research and data analyzing,two models of success which specifically implemented in South Carolina high schools and Chicago public schools have been proved to effectively reduce incidence of repeat pregnancy and emergency room visits,reduce incidence of teen mothers smoking during pregnancy,improve emotional outcomes among teen mothers,decrease incidence of teen mothers drug impairment,arrest,conviction,or jail time and reduce use of food stamps and other public assistances,which can consequently increase the state public health costs.In order to support teen mothers’ academic,physical,emotional and social needs in a stable and consistent school environment,the plan which titled "Physical and Mental Health Promotion for NJ Teen Mothers" is effective and practical enough to arouse the attention of some relevant departments.It’s worth patron to fund the plan because supporting teenage pregnancy at early stage can subsequently benefit the national and state economy and teen mothers.展开更多
Background: Recent research has focused on the effectiveness of different treatment regimens in pain clinics,where a call for more multifaceted treatment has been highlighted.Less attention has been paid to improvemen...Background: Recent research has focused on the effectiveness of different treatment regimens in pain clinics,where a call for more multifaceted treatment has been highlighted.Less attention has been paid to improvements within pain clinics,and how registered nurses-who usually play a key role-perceive and experience the accessibility,treatment options and follow-up offers at public pain clinics.Objective: The overall aim was to explore and describe how nurses experience health care provided to patients with chronic non-cancer pain at pain clinics.Methods: We used 10 individual interviews with nurses working at 10 different public pain clinics in Norway.The interviews were analyzed using qualitative content analysis.Results: One theme was developed from the content analysis: "Nurses' striving to provide whole-person care in pain clinics." The nurses experienced allocation of limited resources as challenging,especially when the dilemma between accepting new patients from the waiting list and offering follow-up to existing patients became apparent.Multifaceted treatment was perceived as vital,although resources,priorities,and theoretical understanding of pain within the team were challenging.Conclusions: The needs for multifaceted and integrated treatments in chronic pain management were obvious,although this approach appeared to be too demanding of resources and time.Stronger cooperation between pain clinics in specialist care and health care providers in primary care to ensure better patient flow and treatment is required.Emphasis is placed on coherent theoretical approaches to pain management within the team in the pain clinics to ensure whole person care.展开更多
AIM: To determine whether ophthalmic photographers(OPs) can conduct virtual clinics(VCs) in medical retina appropriately and whether this increases clinic capacity.METHODS: Three OPs underwent a training programme to ...AIM: To determine whether ophthalmic photographers(OPs) can conduct virtual clinics(VCs) in medical retina appropriately and whether this increases clinic capacity.METHODS: Three OPs underwent a training programme to learn how to assess and manage macular edema secondary to diabetes or retinal vein occlusion. The 300 consecutive patients over a 7-month observation period in 2018 were assessed in VCs by both OPs and medical retina consultants. The degree of agreement in treatment decisions between doctors and photographers, as well as adverse events, was recorded. The change in number of patients seen in VCs over two years was also measured.RESULTS: There was 100% agreement in management decisions between doctors and photographers during the 300-patient observation period. No adverse events were recorded. In 2017, 572 patients were seen in VCs by doctors. After OP clinics were introduced in 2018, this number increased by 24% to 709 patients seen by both photographers and doctors. There was a significant increase in mean number of patients seen per month between 2017(47.7±11.7) and 2018(59.1±14.4;P=0.045, 95%CI-22.5 to-0.296).CONCLUSION: OPs can manage certain medical retina patients in VCs appropriately and can increase clinic capacity significantly for particular conditions.展开更多
The Bellevue and the Hagley Park mental health outpatient clinics in Jamaica serve the majority of psychiatric patients in the country, but there is a dearth of research on medication compliance, which is a very impor...The Bellevue and the Hagley Park mental health outpatient clinics in Jamaica serve the majority of psychiatric patients in the country, but there is a dearth of research on medication compliance, which is a very important mental health issue. Medication compliance affects intervention outcomes. Therefore, this study seeks to examine medication compliance among psychiatric patients in Jamaica. A 33-item questionnaire which included items on demographics, health conditions, medication compliance and insightfulness was administered to a sample of 370 participants with a response rate of 93%. The majority of the participants have schizophrenia, followed by depression, bipolar disorder and drug-induced psychosis. The majority of the participants (65.3%) did not comply with their prescribed medication regimen. Medication compliance was significantly related to: gender (P < 0.05) where males were more likely to take the prescribed medication, family support (P < 0.05) where the participants who received family support (the majority being males) were more likely to take the prescribed medication, and insightfulness (P < 0.05) where the majority of participants with insightfulness were females. Locus on control was not statistically tested but a majority of the non- compliant participants reported that factors external to themselves had greater control over their disorder. Conclusion: There are three significant factors that explain the medication compliance of psychiatric patients in Jamaica. An important non-tested factor is locus of control so there needs to be more research to understand the range of factors that can inform and improve patient education about medication compliance.展开更多
This article aims to study methodologically hospital buildings and, in particular, the design of day clinics in the recovery area. The definition of design guidelines to improve and qualify the day clinic, enhancing t...This article aims to study methodologically hospital buildings and, in particular, the design of day clinics in the recovery area. The definition of design guidelines to improve and qualify the day clinic, enhancing their performance, takes into account the fact that the established requirements of medical protocols must be accompanied by those new requirements related to the massive evolution in health organizations. Changes in medicine, culture and society have necessarily led to a new formulation of the hospital model and the introduction of the theme of the humanization of the curing process has conditioned the morphological-space configuration and the presence of new relationships and spatial functions in the hospitals. The research of this article attempts, therefore, to explore the use of technology to improve the quality of day clinics’ design, formulating strategies that contribute on one side to facilitating the efficiency of service, and on the other side to making the user feel at ease in a welcoming and comfortable environment.展开更多
This paper employs archival documents to research how the Gold Coast colonial government worked with European women medical doctors at preventive health to sustain infant and child welfare clinics.After the First Worl...This paper employs archival documents to research how the Gold Coast colonial government worked with European women medical doctors at preventive health to sustain infant and child welfare clinics.After the First World War,the objective of the colonial government and medical officers was to prevent child mortality and child morbidity.European women medical doctors working with the government and in private practice at infant and child welfare clinics cared for African pregnant women,mothers,and children not older than three years old.European women medical doctors at infant and child welfare clinics educated the community.In 1932,the Great Depression peaked and Percy Selwyn-Clarke in the health service needed to increase funds and staff.Selwyn-Clarke established the Gold Coast Local Branch of the British Red Cross Society to work at the infant and child welfare clinics.展开更多
Context: Breast cancer represents a significant public health problem concern the world, given its frequency (20% to 25% of female cancers) and diagnosis clinical stage with a particular frequency of locally advanced ...Context: Breast cancer represents a significant public health problem concern the world, given its frequency (20% to 25% of female cancers) and diagnosis clinical stage with a particular frequency of locally advanced cancers and inflammatory forms. Objectives: To describe the socio-demographic, clinical and histological characteristics of breast cancer at the University Clinics of Kinshasa. Methods: A descriptive and retrospective study was completed at University Clinics of Kinshasa from 1 January 2003 to 30 July 2018, including 300 cases of breast cancer diagnosed and treated. Results: The mean age of women at diagnosis was 47.5 ± 10.8 years. Most of the patients were married, multipara with an average parity of 3.7 ± 2.5 and non-menopausal. Breast mass was the main reason for medical visit (47.5%) and the majority of patients consulted 12 months after the onset of the disease (36.3%) at stage 3 (56%) and node extension was observed in 61.3%. The average size of the breast mass was 8.02 ± 3.7 cm. The infiltrating ductal carcinoma was the most common histological type in 82.5% of cases;the majority of tumors were histo-pronostic II in 47.5% of cases. 83% of the tumors were hormonal-dependent. Only 35.9% of the tumors over-expressed the HER 2/Neu receptor. Conclusion: Most patients consulted more than 12 months after the onset of the disease and the diagnosis was made at advanced stages. The tumor was large at diagnosis. The left breast was the most affected. The majority of tumors are of high histopronostic grade and are hormonal-dependent.展开更多
Context. The prevalence of macrosomia varies through the world according to racial and ethnic factors, life style and importance of non communicable diseases (maternal obesity, diabetes-gestational and type 2), post-t...Context. The prevalence of macrosomia varies through the world according to racial and ethnic factors, life style and importance of non communicable diseases (maternal obesity, diabetes-gestational and type 2), post-term gestation and multiparity. At the University Clinics of Kinshasa (UCK), 30 years ago, the frequency of macrosomia was 2.4%. Objectives. To update data on the frequency of macrosomia at UCK, regarding variations in maternal anthropometrics (obesity) and socio-demographic factors. Methods. A cross-sectional study was conducted at UCK from 1 January 2007 to 31 December 2016. Mothers who delivered babies weighing at least 4000 g were included in this study. Results. The frequency of macrosomia was 3.7%. Trend shows a variation of this frequency over time with lowest frequency (2.1%) in 2012 and highest (5.3%) in 2009. The mother average age and parity were 32.3 ± 5.4 years and 3 ± 2, respectively. Pregnancies were complicated by polyhydramnios (48%) and gestational diabetes (19.7%). Caesarean section was performed in 60.5% cases, mainly for macrosomia (47.8%) and 81.6% of newborns had constitutional macrosomia. Adverse obstetrical outcomes of macrosomia were dominated by caesarean section (28.9%), lacerations of birth canal (23%) and neonatal distress (9.2%). Conclusion. Macrosomia remains a constant finding at UCK, and is associated with maternal, fetal and neonatal adverse outcomes. Trend shows a variation of the frequency over time between 2.1% and 5.3%.展开更多
Objective: Government targets to reduce waiting times are putting enormous pressures on outpatient services. The implementation of an electronic care records service (CRS) at our hospital in 2008 has led to widespread...Objective: Government targets to reduce waiting times are putting enormous pressures on outpatient services. The implementation of an electronic care records service (CRS) at our hospital in 2008 has led to widespread press coverage of ensuing chaos in clinical administration. We wanted to know how this new electronic system impacted on our working patterns in outpatient clinics and – more specifically – on the time actually spent with the patients. Material & methods: This study was performed 4 and 12 months after implementation of CRS to assess its impact on the time distribution in clinic. Senior doctors were monitored with a stop clock during consultations. Timings for pre- and post-consultation administration, and the actual consultation with the patient were recorded. A total of 170 consultations were evaluated in this way. Results: The key findings were that the total time needed to spend on a urological outpatient of 16 minutes remains unchanged from the pre-CRS era, but a majority (57%) of this time is spent in administration on the computer without the patient involved. Conclusion: No more than 15 patients should be seen in a 4 hour outpatient clinic per doctor. This recommendation drawn up by BAUS before CRS remains still valid. Patient administration related to the consultation that has previously been done by administrative aides is now to be done by the doctors on the computer in the same consultation session. Intended to streamline patient pathways, this does reduce the quality interaction-time between doctor and patients significantly.展开更多
Introduction:Congestive heart failure(CHF)accounts for over$32 billion in health care costs per year and is at the epicenter of health care reform.CHF remains a major cause of hospitalizations.It is known and has been...Introduction:Congestive heart failure(CHF)accounts for over$32 billion in health care costs per year and is at the epicenter of health care reform.CHF remains a major cause of hospitalizations.It is known and has been reported that missed diagnosis of and missed opportunities to treat heart failure are associated with higher mortality and morbidity.CHF disease management programs have emerged as a potential solution to the CHF epidemic.The paradox remains that CHF disease management programs still cluster in tertiary hospital systems.The impact of heart failure specialists and specialty teams in community health systems is less well understood.Currently there are not enough CHF-trained teams in the community setting to address this unmet health need.Methods:We explored the impact of CHF clinics in a community-based hospital system on readmission rates,mortality,and symptomatic relief.A total of 384 patients were enrolled in the clinic between 2012 and 2015.Data collected included age,sex,type of heart failure,New York Heart Association class,ejection fraction,serum creatinine and brain natriuretic peptide values,and readmission and mortality rates within 30 days,3 months,6 months,and 1 year.We also compared readmission rates between patients who were followed up in the CHF clinic versus those who were not seen in the CHF clinic.Results:A statistically signifi cant difference was demonstrated in readmission rates between patients who were followed up in the CHF clinic versus those who did not visit the CHF clinic for up to 1 year of follow-up.Conclusion:CHF community hospital clinics that use a rapid and frequent follow-up format with CHF-trained teams effectively reduce rehospitalization rates up to 1 year.展开更多
The rapid spread of COVID-19 pandemic has forced several countries in the world to store vaccines in cold storage towards ensuring their protection from being damaged and to maintain their stability.However,most remot...The rapid spread of COVID-19 pandemic has forced several countries in the world to store vaccines in cold storage towards ensuring their protection from being damaged and to maintain their stability.However,most remote clinics,especially those in the equator and islands,are faced with the challenges of hot climates and the inability to afford electricity resources needed to power the cold storage facility.Meanwhile,the hot equatorial region has abundant solar energy to power the vaccine cold storage but previous studies showed that several field workers do not have the ability to maintain the vaccine storage temperature as indicated by the manufacturer’s recommendations.Therefore,this literature review study examines the prospects and challenges of implementing solar-powered cold storage to provide cooling space for remote clinics.This is expected to contribute significantly to cold chain vaccine management technology.The findings showed that four technology integration schemes including Cold Storage Ice Maker,Cold Storage Ice Maker-PCM,Refrigerator-Ice Maker and,Absorbing Cooling-PV-Ice Maker have the potential to be applied in clinics situated in certain tropical regions.展开更多
In Thailand, the site-specific nutrient management technology, known as “Tailor-made Fertilizer Technology (TFT)”, for rice, maize and sugarcane in the Northeastern region was developed between 1997-2007, using the ...In Thailand, the site-specific nutrient management technology, known as “Tailor-made Fertilizer Technology (TFT)”, for rice, maize and sugarcane in the Northeastern region was developed between 1997-2007, using the concepts of precision agriculture together with an approach of building capacity of small farmers. TFT, also called Smart-farming, comprises four components, namely 1) soil series identification, 2) N-P-K testing by soil test kit, 3) fertilizer recommendations using decision-aids and a simplified version of a complex model and 4) farmer empowerment. The benefit of TFT at the rice field of the Huay Kamin chairman farmer group was one example, the technology has been disseminated to the 80 members with a total planting area of about 320 ha. The results revealed chemical fertilizer reduction of 69%, and rice yield increased some 10% - 20% with the improved fertilizer application method. The farmers were encouraged to establish “Soil Clinics” in their communities. In a Soil Clinic, designated and trained farmer leaders analyze soil samples for member farmers and provide TFT recommendations while providing access to fertilizer materials available for sale at competitive prices. At present, there are about 70 soil clinics in 20 provinces with the support of many government and private sectors.展开更多
Measuring and improving home care clinic resource volume and geographic allocation are an important public health issue regarding prolonging home care system usage among disabled elderly people. This study examined cl...Measuring and improving home care clinic resource volume and geographic allocation are an important public health issue regarding prolonging home care system usage among disabled elderly people. This study examined clinic volume and accessibility’s association with hospitalization duration among disabled elderly people in 13 municipalities in Japan;additionally, this study compared clinic volume and accessibility’s ability to explain hospitalization duration in this population. Home care clinics’ service volume and geographic accessibility were calculated for 17 municipalities using public data and geographic information systems. We analyzed medical claim data from October 2012;the sample included 22,662 persons who were aged ≥75 years, certified as disabled in daily living, and lived in 13 municipalities regarding which data could be obtained for all examined municipality characteristics. Multilevel logistic models with random intercepts were constructed for municipalities and individual- and municipality-level independent variables in order to examine home care clinic volume and accessibility’s correlation with hospitalization duration. Clinic volume ranged from 0 to 9.53 per 10,000 elderly people;clinic accessibility ranged from 0% to 83%. Clinic volume and accessibility were both significantly negatively correlated with hospitalization duration of ≥10 days (odds ratios, 0.944 and 0.713;confidence intervals, 0.914 - 0.974 and 0.553 - 0.921, respectively). Clinics were not homogeneously geographically distributed;clinic accessibility explained hospitalization duration better than clinic volume. Clinic accessibility may more accurately indicate care clinic allocation appropriateness than clinic volume.展开更多
Parasitic liver diseases can be caused by trematodes,cestodes,nematodes,and protozoa.This pathology is significant because millions of people in different parts of the world have liver parasites,which can manifest the...Parasitic liver diseases can be caused by trematodes,cestodes,nematodes,and protozoa.This pathology is significant because millions of people in different parts of the world have liver parasites,which can manifest themselves in the development of inflammation,liver cysts,cholecystitis,cholelithiasis,pancreatitis and liver cirrhosis that are often threatening their lives.The International Agency for Research on Cancer considers three species of trematodes,Schistosoma haematobium,Opisthorchis viverrini and Clonorchis sinensis,to be carcinogens.Complex modern examination methods,in some cases including extensive screening of large populations,are required for diagnosing liver parasites.Treatment of parasitic liver diseases is differentiated and can involve a combination of surgical and therapeutic measures.There is no doubt that the clinical and epidemiological scale allows one to regard parasitic liver diseases as a global healthcare problem.展开更多
基金The Natural Science Research Project of Minhang District,No.2021MHZ070.
文摘BACKGROUND Aerosols containing disease-causing microorganisms are produced during oral diagnosis and treatment can cause secondary contamination.AIM To investigate the use of graphene material for air disinfection in dental clinics by leveraging its adsorption and antibacterial properties.METHODS Patients who received ultrasonic cleaning at our hospital from April 2023 to April 2024.They were randomly assigned to three groups(n=20 each):Graphene nanocomposite material suction group(Group A),ordinary filter suction group(Group B),and no air suction device group(Group C).The air quality and air colony count in the clinic rooms were assessed before,during,and after the procedure.Additionally,bacterial colony counts were obtained from the air outlets of the suction devices and the filter screens in Groups A and B.RESULTS Before ultrasonic cleaning,no significant differences in air quality PM2.5 and colony counts were observed among the three groups.However,significant differences in air quality PM2.5 and colony counts were noted among the three groups during ultrasonic cleaning and after ultrasonic treatment.Additionally,the number of colonies on the exhaust port of the suction device and the surface of the filter were significantly lower in Group A than in Group B(P=0.000 and P=0.000,respectively).CONCLUSION Graphene nanocomposites can effectively sterilize the air in dental clinics by exerting their antimicrobial effects and may be used to reduce secondary pollution.
文摘A summary of the exploration of the teaching mode of the general practice teaching clinic, a summary of the deficiencies of the teaching clinic and a summary of the significance of the establishment of the general practice teaching clinic are presented with a view to promoting the development of general practice and cultivating more excellent successors in general practice.
文摘Objective:This study designs and implements the health prescription of children’s health education specialized nursing clinic based on the physical and mental characteristics of children with Tourette’s syndrome.Methods:Applying the evidence-based nursing model and nursing intervention theory based on the survey research by searching China Knowledge Network,Wanfang Database and Wipro Chinese Science and Technology Journal Database,the study collected the literature on the health prescription intervention research in children’s Tourette’s disorders health education in children’s health education of specialized nursing outpatient clinic for review and combined with the specialty characteristics to formulate“Children’s Tourette’s Disorder Health Education Prescription.”Results:Tourette’s syndrome in children is a common pediatric neurological disorder,mainly manifested as involuntary,rapid and repeated muscle twitching and vocal tics,which brings serious psychological pressure and life disturbance to the affected children.Conclusion:For children with Tourette’s syndrome,healthcare professionals should give enough care and understanding to the children and their parents,provide timely and effective health education to them,help them improve their bad behavioral habits,establish correct cognitive attitudes,enhance self-confidence,improve patient compliance,reduce the frequency of recurrence,reduce the incidence of complications and promote children’s physical and mental health development.
文摘Urgent care clinics and emergency departments around the world periodically suffer from extended wait times beyond patient expectations due to surges in patient flows.The delays arising from inadequate staffing levels during these periods have been linked with adverse clinical outcomes.Previous research into forecasting patient flows has mostly used statistical techniques.These studies have also predominately focussed on short‐term forecasts,which have limited practicality for the resourcing of medical personnel.This study joins an emerging body of work which seeks to explore the potential of machine learning algorithms to generate accurate forecasts of patient presentations.Our research uses datasets covering 10 years from two large urgent care clinics to develop long‐term patient flow forecasts up to one quarter ahead using a range of state‐of‐the‐art algo-rithms.A distinctive feature of this study is the use of eXplainable Artificial Intelligence(XAI)tools like Shapely and LIME that enable an in‐depth analysis of the behaviour of the models,which would otherwise be uninterpretable.These analysis tools enabled us to explore the ability of the models to adapt to the volatility in patient demand during the COVID‐19 pandemic lockdowns and to identify the most impactful variables,resulting in valuable insights into their performance.The results showed that a novel combination of advanced univariate models like Prophet as well as gradient boosting,into an ensemble,delivered the most accurate and consistent solutions on average.This approach generated improvements in the range of 16%-30%over the existing in‐house methods for esti-mating the daily patient flows 90 days ahead.
文摘Background: Preeclampsia (PE) is one of the forms of hypertensive diseases that occur during pregnancy. Early-onset preeclampsia (EOP), which occurred before 34 weeks, proved to be the deadliest. Indeed, it is characterized by a poor maternal and fetal prognosis. EOP has a disparate incidence in the world varying between 0.9% and 31%. Several risks factors are associated with the occurrence of EOP, which is responsible of several adverse obstetrical outcomes. Complications can affect up to 85% of pregnant women with EOP, especially when EOP appears very early, before 28 or even 25 weeks’ gestation. Objectives: To determine frequency of EOP at the University Clinics of Kinshasa, to describe sociodemographic and clinical characteristics of pregnant women with EOP and to identify its risks factors and its association adverse obstetrical outcomes. Methods: The study will be a cross-sectional analytical study in University Clinics of Kinshasa from January 2016 to December 2022. The minimal size will be 119. Our study population will consist of pregnant women who consult for antenatal best care and are neonates in our Clinic. Result will be presented as percentage proportion. Comparison and proportion means between groups will be made using Student’s test and Pearson’s chi-square test, respectively. Our test will be statistically significant for a p-value ≤ than less 0.05. Data will be collected and analysed anonymously and confidentiality. Conclusion: We believe that our study should enable us to identify profile of gestational carriers at risk of EOP in our environment, as well as prognosis associated with this entity, with a view to arousing particular interest in EOP.
基金Fund supported by the Youth Educational Scholar Program of Peking Union Medical College(2016ZLGC0712).
文摘Objective To investigate the feature and frequency of medical emergencies in dental clinics in China and the Methods A survey study was conducted among 2408 dentists who attended continuing educational courses held by Society of Sedation and Analgesia of Chinese Stomatological Association in 18 cities from December 2015 to December 2018.Demographic information of the dentists and the characteristics of medical emergencies they encountered were collected and analyzed.The associated demographic features for dentist experiencing medical emergencies were analyzed by logistic regression model.Results A total of 2013 dentists provided valid responses and reported 2923 events of medical emergencies in dental clinics.Among them,85.0%reported that they had encountered medical emergencies,and 35.5%had encountered at least twice.Syncope(35.9%)and hypoglycemia(30.3%)were the most common reported medical emergencies.Medical emergencies were most likely to occur during local anesthesia(49.9%),out-patient oral surgery(25.9%),and root canal treatment(11.3%).There were 6 patients(0.2%)died in emergencies.84.0%dentists reported that they had never received training courses about medical emergency management in dentistry other than Basic Life Support.Longer practicing time(10-15 years)(OR=0.59,95%CI:0.41-0.85,P=0.004),working in private dental facilities(OR=1.69,95%CI:1.20-2.38,P=0.003)were associated with an increased risk of experiencing medical emergencies.Conclusion More efforts are needed in prevention,early identification,and timely management of medical emergencies in dental clinics in order to prevent fatal outcomes.The results of this survey are useful information for re-designing emergency training courses for Chinese dentists.
文摘This proposal focuses on the prevalence of teenage pregnancy issue in NJ and illustrates the benefits of school-based health clinics and educational programs which should be implemented for teenage pregnancy and childbearing.Without the early intervention of educational programs and preventive medical services which should be implemented in school areas,teen pregnancy and childbearing can have physical and emotional health influences on teen mothers,their babies and other family members,and the worst consequence should be abortion.What’s more,teenage pregnancy and childbearing have substantial economic consequence for state.The annual estimated cost associated with teen childbearing (teens 19 and younger) in NJ to taxpayers is at least $167 million in 2004 (24% federal costs and 76% state and local costs).Studies demonstrated that a much larger amount of money is spent on the consequences of teenage pregnancy than on prevention.NJ has an opportunity to invest in prevention and reduce not only the monetary but also the societal costs to our youth burdened by the often overwhelming responsibilities of teenage pregnancy and parenting.According to the 15 years follow-up research and data analyzing,two models of success which specifically implemented in South Carolina high schools and Chicago public schools have been proved to effectively reduce incidence of repeat pregnancy and emergency room visits,reduce incidence of teen mothers smoking during pregnancy,improve emotional outcomes among teen mothers,decrease incidence of teen mothers drug impairment,arrest,conviction,or jail time and reduce use of food stamps and other public assistances,which can consequently increase the state public health costs.In order to support teen mothers’ academic,physical,emotional and social needs in a stable and consistent school environment,the plan which titled "Physical and Mental Health Promotion for NJ Teen Mothers" is effective and practical enough to arouse the attention of some relevant departments.It’s worth patron to fund the plan because supporting teenage pregnancy at early stage can subsequently benefit the national and state economy and teen mothers.
基金This research did not receive any specific grant from funding agencies in the public,commercial,or not-for-profit sectors
文摘Background: Recent research has focused on the effectiveness of different treatment regimens in pain clinics,where a call for more multifaceted treatment has been highlighted.Less attention has been paid to improvements within pain clinics,and how registered nurses-who usually play a key role-perceive and experience the accessibility,treatment options and follow-up offers at public pain clinics.Objective: The overall aim was to explore and describe how nurses experience health care provided to patients with chronic non-cancer pain at pain clinics.Methods: We used 10 individual interviews with nurses working at 10 different public pain clinics in Norway.The interviews were analyzed using qualitative content analysis.Results: One theme was developed from the content analysis: "Nurses' striving to provide whole-person care in pain clinics." The nurses experienced allocation of limited resources as challenging,especially when the dilemma between accepting new patients from the waiting list and offering follow-up to existing patients became apparent.Multifaceted treatment was perceived as vital,although resources,priorities,and theoretical understanding of pain within the team were challenging.Conclusions: The needs for multifaceted and integrated treatments in chronic pain management were obvious,although this approach appeared to be too demanding of resources and time.Stronger cooperation between pain clinics in specialist care and health care providers in primary care to ensure better patient flow and treatment is required.Emphasis is placed on coherent theoretical approaches to pain management within the team in the pain clinics to ensure whole person care.
文摘AIM: To determine whether ophthalmic photographers(OPs) can conduct virtual clinics(VCs) in medical retina appropriately and whether this increases clinic capacity.METHODS: Three OPs underwent a training programme to learn how to assess and manage macular edema secondary to diabetes or retinal vein occlusion. The 300 consecutive patients over a 7-month observation period in 2018 were assessed in VCs by both OPs and medical retina consultants. The degree of agreement in treatment decisions between doctors and photographers, as well as adverse events, was recorded. The change in number of patients seen in VCs over two years was also measured.RESULTS: There was 100% agreement in management decisions between doctors and photographers during the 300-patient observation period. No adverse events were recorded. In 2017, 572 patients were seen in VCs by doctors. After OP clinics were introduced in 2018, this number increased by 24% to 709 patients seen by both photographers and doctors. There was a significant increase in mean number of patients seen per month between 2017(47.7±11.7) and 2018(59.1±14.4;P=0.045, 95%CI-22.5 to-0.296).CONCLUSION: OPs can manage certain medical retina patients in VCs appropriately and can increase clinic capacity significantly for particular conditions.
文摘The Bellevue and the Hagley Park mental health outpatient clinics in Jamaica serve the majority of psychiatric patients in the country, but there is a dearth of research on medication compliance, which is a very important mental health issue. Medication compliance affects intervention outcomes. Therefore, this study seeks to examine medication compliance among psychiatric patients in Jamaica. A 33-item questionnaire which included items on demographics, health conditions, medication compliance and insightfulness was administered to a sample of 370 participants with a response rate of 93%. The majority of the participants have schizophrenia, followed by depression, bipolar disorder and drug-induced psychosis. The majority of the participants (65.3%) did not comply with their prescribed medication regimen. Medication compliance was significantly related to: gender (P < 0.05) where males were more likely to take the prescribed medication, family support (P < 0.05) where the participants who received family support (the majority being males) were more likely to take the prescribed medication, and insightfulness (P < 0.05) where the majority of participants with insightfulness were females. Locus on control was not statistically tested but a majority of the non- compliant participants reported that factors external to themselves had greater control over their disorder. Conclusion: There are three significant factors that explain the medication compliance of psychiatric patients in Jamaica. An important non-tested factor is locus of control so there needs to be more research to understand the range of factors that can inform and improve patient education about medication compliance.
文摘This article aims to study methodologically hospital buildings and, in particular, the design of day clinics in the recovery area. The definition of design guidelines to improve and qualify the day clinic, enhancing their performance, takes into account the fact that the established requirements of medical protocols must be accompanied by those new requirements related to the massive evolution in health organizations. Changes in medicine, culture and society have necessarily led to a new formulation of the hospital model and the introduction of the theme of the humanization of the curing process has conditioned the morphological-space configuration and the presence of new relationships and spatial functions in the hospitals. The research of this article attempts, therefore, to explore the use of technology to improve the quality of day clinics’ design, formulating strategies that contribute on one side to facilitating the efficiency of service, and on the other side to making the user feel at ease in a welcoming and comfortable environment.
文摘This paper employs archival documents to research how the Gold Coast colonial government worked with European women medical doctors at preventive health to sustain infant and child welfare clinics.After the First World War,the objective of the colonial government and medical officers was to prevent child mortality and child morbidity.European women medical doctors working with the government and in private practice at infant and child welfare clinics cared for African pregnant women,mothers,and children not older than three years old.European women medical doctors at infant and child welfare clinics educated the community.In 1932,the Great Depression peaked and Percy Selwyn-Clarke in the health service needed to increase funds and staff.Selwyn-Clarke established the Gold Coast Local Branch of the British Red Cross Society to work at the infant and child welfare clinics.
文摘Context: Breast cancer represents a significant public health problem concern the world, given its frequency (20% to 25% of female cancers) and diagnosis clinical stage with a particular frequency of locally advanced cancers and inflammatory forms. Objectives: To describe the socio-demographic, clinical and histological characteristics of breast cancer at the University Clinics of Kinshasa. Methods: A descriptive and retrospective study was completed at University Clinics of Kinshasa from 1 January 2003 to 30 July 2018, including 300 cases of breast cancer diagnosed and treated. Results: The mean age of women at diagnosis was 47.5 ± 10.8 years. Most of the patients were married, multipara with an average parity of 3.7 ± 2.5 and non-menopausal. Breast mass was the main reason for medical visit (47.5%) and the majority of patients consulted 12 months after the onset of the disease (36.3%) at stage 3 (56%) and node extension was observed in 61.3%. The average size of the breast mass was 8.02 ± 3.7 cm. The infiltrating ductal carcinoma was the most common histological type in 82.5% of cases;the majority of tumors were histo-pronostic II in 47.5% of cases. 83% of the tumors were hormonal-dependent. Only 35.9% of the tumors over-expressed the HER 2/Neu receptor. Conclusion: Most patients consulted more than 12 months after the onset of the disease and the diagnosis was made at advanced stages. The tumor was large at diagnosis. The left breast was the most affected. The majority of tumors are of high histopronostic grade and are hormonal-dependent.
文摘Context. The prevalence of macrosomia varies through the world according to racial and ethnic factors, life style and importance of non communicable diseases (maternal obesity, diabetes-gestational and type 2), post-term gestation and multiparity. At the University Clinics of Kinshasa (UCK), 30 years ago, the frequency of macrosomia was 2.4%. Objectives. To update data on the frequency of macrosomia at UCK, regarding variations in maternal anthropometrics (obesity) and socio-demographic factors. Methods. A cross-sectional study was conducted at UCK from 1 January 2007 to 31 December 2016. Mothers who delivered babies weighing at least 4000 g were included in this study. Results. The frequency of macrosomia was 3.7%. Trend shows a variation of this frequency over time with lowest frequency (2.1%) in 2012 and highest (5.3%) in 2009. The mother average age and parity were 32.3 ± 5.4 years and 3 ± 2, respectively. Pregnancies were complicated by polyhydramnios (48%) and gestational diabetes (19.7%). Caesarean section was performed in 60.5% cases, mainly for macrosomia (47.8%) and 81.6% of newborns had constitutional macrosomia. Adverse obstetrical outcomes of macrosomia were dominated by caesarean section (28.9%), lacerations of birth canal (23%) and neonatal distress (9.2%). Conclusion. Macrosomia remains a constant finding at UCK, and is associated with maternal, fetal and neonatal adverse outcomes. Trend shows a variation of the frequency over time between 2.1% and 5.3%.
文摘Objective: Government targets to reduce waiting times are putting enormous pressures on outpatient services. The implementation of an electronic care records service (CRS) at our hospital in 2008 has led to widespread press coverage of ensuing chaos in clinical administration. We wanted to know how this new electronic system impacted on our working patterns in outpatient clinics and – more specifically – on the time actually spent with the patients. Material & methods: This study was performed 4 and 12 months after implementation of CRS to assess its impact on the time distribution in clinic. Senior doctors were monitored with a stop clock during consultations. Timings for pre- and post-consultation administration, and the actual consultation with the patient were recorded. A total of 170 consultations were evaluated in this way. Results: The key findings were that the total time needed to spend on a urological outpatient of 16 minutes remains unchanged from the pre-CRS era, but a majority (57%) of this time is spent in administration on the computer without the patient involved. Conclusion: No more than 15 patients should be seen in a 4 hour outpatient clinic per doctor. This recommendation drawn up by BAUS before CRS remains still valid. Patient administration related to the consultation that has previously been done by administrative aides is now to be done by the doctors on the computer in the same consultation session. Intended to streamline patient pathways, this does reduce the quality interaction-time between doctor and patients significantly.
文摘Introduction:Congestive heart failure(CHF)accounts for over$32 billion in health care costs per year and is at the epicenter of health care reform.CHF remains a major cause of hospitalizations.It is known and has been reported that missed diagnosis of and missed opportunities to treat heart failure are associated with higher mortality and morbidity.CHF disease management programs have emerged as a potential solution to the CHF epidemic.The paradox remains that CHF disease management programs still cluster in tertiary hospital systems.The impact of heart failure specialists and specialty teams in community health systems is less well understood.Currently there are not enough CHF-trained teams in the community setting to address this unmet health need.Methods:We explored the impact of CHF clinics in a community-based hospital system on readmission rates,mortality,and symptomatic relief.A total of 384 patients were enrolled in the clinic between 2012 and 2015.Data collected included age,sex,type of heart failure,New York Heart Association class,ejection fraction,serum creatinine and brain natriuretic peptide values,and readmission and mortality rates within 30 days,3 months,6 months,and 1 year.We also compared readmission rates between patients who were followed up in the CHF clinic versus those who were not seen in the CHF clinic.Results:A statistically signifi cant difference was demonstrated in readmission rates between patients who were followed up in the CHF clinic versus those who did not visit the CHF clinic for up to 1 year of follow-up.Conclusion:CHF community hospital clinics that use a rapid and frequent follow-up format with CHF-trained teams effectively reduce rehospitalization rates up to 1 year.
基金supported by the Program Penelitian Kolaborasi Indonesia(PPKI),LPPM Universitas Pendidikan Indonesia,Ministry of Education and Culture of Indonesia.
文摘The rapid spread of COVID-19 pandemic has forced several countries in the world to store vaccines in cold storage towards ensuring their protection from being damaged and to maintain their stability.However,most remote clinics,especially those in the equator and islands,are faced with the challenges of hot climates and the inability to afford electricity resources needed to power the cold storage facility.Meanwhile,the hot equatorial region has abundant solar energy to power the vaccine cold storage but previous studies showed that several field workers do not have the ability to maintain the vaccine storage temperature as indicated by the manufacturer’s recommendations.Therefore,this literature review study examines the prospects and challenges of implementing solar-powered cold storage to provide cooling space for remote clinics.This is expected to contribute significantly to cold chain vaccine management technology.The findings showed that four technology integration schemes including Cold Storage Ice Maker,Cold Storage Ice Maker-PCM,Refrigerator-Ice Maker and,Absorbing Cooling-PV-Ice Maker have the potential to be applied in clinics situated in certain tropical regions.
文摘In Thailand, the site-specific nutrient management technology, known as “Tailor-made Fertilizer Technology (TFT)”, for rice, maize and sugarcane in the Northeastern region was developed between 1997-2007, using the concepts of precision agriculture together with an approach of building capacity of small farmers. TFT, also called Smart-farming, comprises four components, namely 1) soil series identification, 2) N-P-K testing by soil test kit, 3) fertilizer recommendations using decision-aids and a simplified version of a complex model and 4) farmer empowerment. The benefit of TFT at the rice field of the Huay Kamin chairman farmer group was one example, the technology has been disseminated to the 80 members with a total planting area of about 320 ha. The results revealed chemical fertilizer reduction of 69%, and rice yield increased some 10% - 20% with the improved fertilizer application method. The farmers were encouraged to establish “Soil Clinics” in their communities. In a Soil Clinic, designated and trained farmer leaders analyze soil samples for member farmers and provide TFT recommendations while providing access to fertilizer materials available for sale at competitive prices. At present, there are about 70 soil clinics in 20 provinces with the support of many government and private sectors.
文摘Measuring and improving home care clinic resource volume and geographic allocation are an important public health issue regarding prolonging home care system usage among disabled elderly people. This study examined clinic volume and accessibility’s association with hospitalization duration among disabled elderly people in 13 municipalities in Japan;additionally, this study compared clinic volume and accessibility’s ability to explain hospitalization duration in this population. Home care clinics’ service volume and geographic accessibility were calculated for 17 municipalities using public data and geographic information systems. We analyzed medical claim data from October 2012;the sample included 22,662 persons who were aged ≥75 years, certified as disabled in daily living, and lived in 13 municipalities regarding which data could be obtained for all examined municipality characteristics. Multilevel logistic models with random intercepts were constructed for municipalities and individual- and municipality-level independent variables in order to examine home care clinic volume and accessibility’s correlation with hospitalization duration. Clinic volume ranged from 0 to 9.53 per 10,000 elderly people;clinic accessibility ranged from 0% to 83%. Clinic volume and accessibility were both significantly negatively correlated with hospitalization duration of ≥10 days (odds ratios, 0.944 and 0.713;confidence intervals, 0.914 - 0.974 and 0.553 - 0.921, respectively). Clinics were not homogeneously geographically distributed;clinic accessibility explained hospitalization duration better than clinic volume. Clinic accessibility may more accurately indicate care clinic allocation appropriateness than clinic volume.
基金Supported by the Ministry of Education and Science of the Russian Federation,No.FWES-2024-0035.
文摘Parasitic liver diseases can be caused by trematodes,cestodes,nematodes,and protozoa.This pathology is significant because millions of people in different parts of the world have liver parasites,which can manifest themselves in the development of inflammation,liver cysts,cholecystitis,cholelithiasis,pancreatitis and liver cirrhosis that are often threatening their lives.The International Agency for Research on Cancer considers three species of trematodes,Schistosoma haematobium,Opisthorchis viverrini and Clonorchis sinensis,to be carcinogens.Complex modern examination methods,in some cases including extensive screening of large populations,are required for diagnosing liver parasites.Treatment of parasitic liver diseases is differentiated and can involve a combination of surgical and therapeutic measures.There is no doubt that the clinical and epidemiological scale allows one to regard parasitic liver diseases as a global healthcare problem.
