The objective of this study is to clarify the relevance of qualitative research in the context of critical care and renal dialysis requires using narrative sources. Also specific objectives are to identify the phases ...The objective of this study is to clarify the relevance of qualitative research in the context of critical care and renal dialysis requires using narrative sources. Also specific objectives are to identify the phases or cultural moments that are distinguished in these processes. Research Question: How can the narrative materials contribute to the study of the processes of critical care and/or qualitative research in nephrology? Method and Sources: There have been studies focusing on the narrative of patients who have written their experiences building a literature experience ill (Siles et al., 1997, 1999, 2000). Sources have been used to extract testimony retrospective autobiographies written by people who have experienced the experiences of different diseases (Allué, 1996, 1997, Zorn, 1991, Gilbert, 1993;Comas, 2009;Gracia Armendáriz, 2010;Sampedro, 1996, Sacks, 2010). The analysis was developed by categorizing units of meaning, meaning families and networks. To identify the cultural moments we have followed the criteria established by Siles and Solano (2009): Multiculturalism, interculturalism and transculturalism. To identify rites of passage and liminality states have followed the principles outlined by Van Gennep (2013) and Turner (1990, 2008). Results: We identified cultural moments and characteristic states of liminality in critical care and kidney. Conclusions: narrative sources are effective for analyzing the meanings and experiences of patients in critical care and nephrology tool.展开更多
Bettering orphan rescue and assistance policies and improving the upbringing of orphans have been top on the agenda of China＇s civil affairs departments in 2006. A survey conducted by the Ministry of Civil Affairs in...Bettering orphan rescue and assistance policies and improving the upbringing of orphans have been top on the agenda of China＇s civil affairs departments in 2006. A survey conducted by the Ministry of Civil Affairs in 2005 shows that one-third of the country＇s 573,＇30 orphans do not receive regular, system-guaranteed help. Some orphans have been forced to drop out of school and lead a vagrant life, Some have even become petty thieves.展开更多
BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective pr...BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective preventive measures.AIM To identify significant risk factors for ICU-AW through iterative machine learning techniques and offer recommendations for its prevention and treatment.METHODS Patients were categorized into ICU-AW and non-ICU-AW groups on the 14th day post-ICU admission.Relevant data from the initial 14 d of ICU stay,such as age,comorbidities,sedative dosage,vasopressor dosage,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,were gathered.The relationships between these variables and ICU-AW were examined.Utilizing iterative machine learning techniques,a multilayer perceptron neural network model was developed,and its predictive performance for ICU-AW was assessed using the receiver operating characteristic curve.RESULTS Within the ICU-AW group,age,duration of mechanical ventilation,lorazepam dosage,adrenaline dosage,and length of ICU stay were significantly higher than in the non-ICU-AW group.Additionally,sepsis,multiple organ dysfunction syndrome,hypoalbuminemia,acute heart failure,respiratory failure,acute kidney injury,anemia,stress-related gastrointestinal bleeding,shock,hypertension,coronary artery disease,malignant tumors,and rehabilitation therapy ratios were significantly higher in the ICU-AW group,demonstrating statistical significance.The most influential factors contributing to ICU-AW were identified as the length of ICU stay(100.0%)and the duration of mechanical ventilation(54.9%).The neural network model predicted ICU-AW with an area under the curve of 0.941,sensitivity of 92.2%,and specificity of 82.7%.CONCLUSION The main factors influencing ICU-AW are the length of ICU stay and the duration of mechanical ventilation.A primary preventive strategy,when feasible,involves minimizing both ICU stay and mechanical ventilation duration.展开更多
Metabolic dysfunction-associated steatotic liver disease(MASLD)is the most common liver disease worldwide,with an estimated prevalence of 31%in Latin America.The presence of metabolic comorbidities coexisting with liv...Metabolic dysfunction-associated steatotic liver disease(MASLD)is the most common liver disease worldwide,with an estimated prevalence of 31%in Latin America.The presence of metabolic comorbidities coexisting with liver disease varies substantially among populations.It is acknowledged that obesity is boosting the type 2 diabetes mellitus“epidemic,”and both conditions are significant contributors to the increasing number of patients with MASLD.Nonalcoholic steatohepatitis represents a condition of chronic liver inflammation and is considered the most severe form of MASLD.MASLD diagnosis is based on the presence of steatosis,noninvasive scores and altered liver tests.Noninvasive scores of liver fibrosis,such as serum biomarkers,which should be used in primary care to rule out advanced fibrosis,are simple,inexpensive,and widely available.Currently,guidelines from international hepatology societies recommend using noninvasive strategies to simplify case finding and management of high-risk patients with MASLD in clinical practice.Unfortunately,there is no definite pharmacological treatment for the condition.Creating public health policies to treat patients with risk factors for MASLD prevention is essential.展开更多
BACKGROUND Traditional paper-based preoperative patient education is a struggle for new nurses and requires extensive training.In this situation,virtual reality technology can help the new nurses.Despite its potential...BACKGROUND Traditional paper-based preoperative patient education is a struggle for new nurses and requires extensive training.In this situation,virtual reality technology can help the new nurses.Despite its potential benefits,there are studies on patient satisfaction but there is limited information on the usability of virtual reality(VR)technology for new nurses in giving preoperative education to patients.AIM To investigate the impact on satisfaction,usability,and burnout of a system using VR technology in preoperative patient education.METHODS The study involved 20 nurses from the plastic surgery ward and 80 patients admitted between April and May 2019.Each nurse taught four patients:Two using traditional verbal education and two using virtual reality.The System Usability Scale,After-Scenario Questionnaire,and Maslach Burnout Inventory(MBI)were employed to evaluate the impact of these education methods.RESULTS The VR education groups showed a statistically higher satisfaction than the traditional verbal education groups.Among the three subscales of the MBI,emotional exhaustion and personal accomplishment improved statistically significantly.VR was also better in terms of usability.CONCLUSION This study suggests VR enhances usability and reduces burnout in nurses,but further research is needed to assess its impact on depersonalization and objective measures like stress and heart rate.展开更多
BACKGROUND Gallstone disease is one of the most common digestive disorders in the United States and leads to significant morbidity,mortality,and health care utilization.AIM To expand on earlier findings and investigat...BACKGROUND Gallstone disease is one of the most common digestive disorders in the United States and leads to significant morbidity,mortality,and health care utilization.AIM To expand on earlier findings and investigate prepandemic rates and trends in the gallstone disease burden in the United States using national survey and claims databases.METHODS The National Ambulatory Medical Care Survey,National Inpatient Sample,Nationwide Emergency Department Sample,Nationwide Ambulatory Surgery Sample,Vital Statistics of the United States,Optum Clinformatics®Data Mart,and Centers for Medicare and Medicaid Services Medicare 5%Sample and Medicaid files were used to estimate claims-based prevalence,medical care including cholecystectomy,and mortality with a primary or other gallstone diagnosis.Rates were age-adjusted(for national databases)and shown per 100000 population.RESULTS Gallstone disease prevalence(claims-based,2019)was 0.70%among commercial insurance enrollees,1.03%among Medicaid beneficiaries,and 2.09%among Medicare beneficiaries and rose over the previous decade.Recently,in the United States population,gallstone disease contributed to approximately 2.2 million ambulatory care visits,1.2 million emergency department visits,625000 hospital discharges,and 2000 deaths annually.Women had higher medical care rates with a gallstone disease diagnosis,but mortality rates were higher among men.Hispanics had higher ambulatory care visit and hospital discharge rates compared with Whites,but not mortality rates.Blacks had lower ambulatory care visit and mortality rates,but similar hospital discharge rates compared with whites.During the study period,ambulatory care and emergency department visit rates with a gallstone disease diagnosis rose,while hospital discharge and mortality rates declined.Among commercial insurance enrollees,rates were higher compared with national data for ambulatory care visits and hospitalizations,but lower for emergency department visits.Cholecystectomies performed in the United States included 605000 ambulatory laparoscopic,280000 inpatient laparoscopic,and 49000 inpatient open procedures annually.Among commercial insurance enrollees,rates were higher compared with national data for laparoscopic procedures.CONCLUSION The gallstone disease burden in the United States is substantial and increasing,particularly among women,Hispanics,and older adults with laparoscopic cholecystectomy as the mainstay treatment.Current practice patterns should be monitored for better health care access.展开更多
BACKGROUND Lung cancer is a common disease with high mortality,and psychological support is very important in the diagnosis and treatment of postoperative patients with cancer pain.AIM To explore the application effec...BACKGROUND Lung cancer is a common disease with high mortality,and psychological support is very important in the diagnosis and treatment of postoperative patients with cancer pain.AIM To explore the application effect of the narrative nursing method in postoperative lung cancer patients in the intensive care unit.METHODS A total of 120 patients diagnosed with lung cancer and experiencing cancer-related pain were randomly allocated into two groups:an observation group and a control group,each consisting of 60 cases.The control group was given routine analgesic and psychological care,while the research group applied the five-step narrative nursing method based on routine care,comparing the visual analogue scale scores,sleep status,anxiety and depression status,and quality of life of the two groups of patients before and after the intervention.RESULTS The pain scores,anxiety scores,and depression scores of the study group were lower than those of the control group after the intervention using the narrative nursing method,and the difference was statistically significant(P<0.05).CONCLUSION Using narrative nursing methods to intervene in patients with lung cancer combined with cancerous pain can help patients to correctly recognize their disease,adjust their mentality,establish confidence,alleviate patients'subjective pain feelings,and improve their adverse emotions.展开更多
Point-of-care testing(POCT)is the practice of diagnosing and monitoring diseases where the patient is located,as opposed to traditional treatment conducted solely in a medical laboratory or other clinical setting.POCT...Point-of-care testing(POCT)is the practice of diagnosing and monitoring diseases where the patient is located,as opposed to traditional treatment conducted solely in a medical laboratory or other clinical setting.POCT has been less common in the recent past due to a lack of portable medical devices capable of facilitating effective medical testing.However,recent growth has occurred in this field due to advances in diagnostic technologies,device miniaturization,and progress in wearable electronics.Among these developments,electrochemical sensors have attracted interest in the POCT field due to their high sensitivity,compact size,and affordability.They are used in various applications,from disease diagnosis to health status monitoring.In this paper we explore recent advancements in electrochemical sensors,the methods of fabricating them,and the various types of sensing mechanisms that can be used.Furthermore,we delve into methods for immobilizing specific biorecognition elements,including enzymes,antibodies,and aptamers,onto electrode surfaces and how these sensors are used in real-world POCT settings.展开更多
Knee osteoarthritis is a degenerative disorder of the knee,which leads to joint pain,stiffness,and inactivity and significantly affects the quality of life.With an increased prevalence of obesity and greater life expe...Knee osteoarthritis is a degenerative disorder of the knee,which leads to joint pain,stiffness,and inactivity and significantly affects the quality of life.With an increased prevalence of obesity and greater life expectancies,total knee arthroplasty(TKA)is now one of the major arthroplasty surgeries performed for knee osteoarthritis.When enhanced recovery after surgery(ERAS)was introduced in TKA,clinical outcomes were enhanced and the economic burden on the healthcare system was reduced.ERAS is an evidence-based scientific protocol aimed at ameliorating the surgical stress response.ERAS aims to enhance the recovery phase,which encompasses multidisciplinary strategies at every step of perioperative care,including the rehabilitation phase.Implementation of ERAS in TKA aids in reducing the length of hospital stay,improving pain management,reducing perioperative complications,and enhancing patient satisfaction.Multidisciplinary collaboration,integrating the expertise of anesthesiologists,orthopedic surgeons,nursing personnel,and other healthcare professionals,is the cornerstone of ERAS in patients undergoing TKA.展开更多
文摘The objective of this study is to clarify the relevance of qualitative research in the context of critical care and renal dialysis requires using narrative sources. Also specific objectives are to identify the phases or cultural moments that are distinguished in these processes. Research Question: How can the narrative materials contribute to the study of the processes of critical care and/or qualitative research in nephrology? Method and Sources: There have been studies focusing on the narrative of patients who have written their experiences building a literature experience ill (Siles et al., 1997, 1999, 2000). Sources have been used to extract testimony retrospective autobiographies written by people who have experienced the experiences of different diseases (Allué, 1996, 1997, Zorn, 1991, Gilbert, 1993;Comas, 2009;Gracia Armendáriz, 2010;Sampedro, 1996, Sacks, 2010). The analysis was developed by categorizing units of meaning, meaning families and networks. To identify the cultural moments we have followed the criteria established by Siles and Solano (2009): Multiculturalism, interculturalism and transculturalism. To identify rites of passage and liminality states have followed the principles outlined by Van Gennep (2013) and Turner (1990, 2008). Results: We identified cultural moments and characteristic states of liminality in critical care and kidney. Conclusions: narrative sources are effective for analyzing the meanings and experiences of patients in critical care and nephrology tool.
文摘Bettering orphan rescue and assistance policies and improving the upbringing of orphans have been top on the agenda of China＇s civil affairs departments in 2006. A survey conducted by the Ministry of Civil Affairs in 2005 shows that one-third of the country＇s 573,＇30 orphans do not receive regular, system-guaranteed help. Some orphans have been forced to drop out of school and lead a vagrant life, Some have even become petty thieves.
基金Supported by Science and Technology Support Program of Qiandongnan Prefecture,No.Qiandongnan Sci-Tech Support[2021]12Guizhou Province High-Level Innovative Talent Training Program,No.Qiannan Thousand Talents[2022]201701.
文摘BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective preventive measures.AIM To identify significant risk factors for ICU-AW through iterative machine learning techniques and offer recommendations for its prevention and treatment.METHODS Patients were categorized into ICU-AW and non-ICU-AW groups on the 14th day post-ICU admission.Relevant data from the initial 14 d of ICU stay,such as age,comorbidities,sedative dosage,vasopressor dosage,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,were gathered.The relationships between these variables and ICU-AW were examined.Utilizing iterative machine learning techniques,a multilayer perceptron neural network model was developed,and its predictive performance for ICU-AW was assessed using the receiver operating characteristic curve.RESULTS Within the ICU-AW group,age,duration of mechanical ventilation,lorazepam dosage,adrenaline dosage,and length of ICU stay were significantly higher than in the non-ICU-AW group.Additionally,sepsis,multiple organ dysfunction syndrome,hypoalbuminemia,acute heart failure,respiratory failure,acute kidney injury,anemia,stress-related gastrointestinal bleeding,shock,hypertension,coronary artery disease,malignant tumors,and rehabilitation therapy ratios were significantly higher in the ICU-AW group,demonstrating statistical significance.The most influential factors contributing to ICU-AW were identified as the length of ICU stay(100.0%)and the duration of mechanical ventilation(54.9%).The neural network model predicted ICU-AW with an area under the curve of 0.941,sensitivity of 92.2%,and specificity of 82.7%.CONCLUSION The main factors influencing ICU-AW are the length of ICU stay and the duration of mechanical ventilation.A primary preventive strategy,when feasible,involves minimizing both ICU stay and mechanical ventilation duration.
文摘Metabolic dysfunction-associated steatotic liver disease(MASLD)is the most common liver disease worldwide,with an estimated prevalence of 31%in Latin America.The presence of metabolic comorbidities coexisting with liver disease varies substantially among populations.It is acknowledged that obesity is boosting the type 2 diabetes mellitus“epidemic,”and both conditions are significant contributors to the increasing number of patients with MASLD.Nonalcoholic steatohepatitis represents a condition of chronic liver inflammation and is considered the most severe form of MASLD.MASLD diagnosis is based on the presence of steatosis,noninvasive scores and altered liver tests.Noninvasive scores of liver fibrosis,such as serum biomarkers,which should be used in primary care to rule out advanced fibrosis,are simple,inexpensive,and widely available.Currently,guidelines from international hepatology societies recommend using noninvasive strategies to simplify case finding and management of high-risk patients with MASLD in clinical practice.Unfortunately,there is no definite pharmacological treatment for the condition.Creating public health policies to treat patients with risk factors for MASLD prevention is essential.
基金Research Fund of Chungnam National University,Chungnam National University,the Ministry of Trade,Industry,and Energy,Korea,under the“Regional industry-based organization support program”,No.P0001940the Korea Institute for Advancement of Technology,and a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute,funded by the Ministry of Health&Welfare,Republic of Korea,No.HI20C2088.
文摘BACKGROUND Traditional paper-based preoperative patient education is a struggle for new nurses and requires extensive training.In this situation,virtual reality technology can help the new nurses.Despite its potential benefits,there are studies on patient satisfaction but there is limited information on the usability of virtual reality(VR)technology for new nurses in giving preoperative education to patients.AIM To investigate the impact on satisfaction,usability,and burnout of a system using VR technology in preoperative patient education.METHODS The study involved 20 nurses from the plastic surgery ward and 80 patients admitted between April and May 2019.Each nurse taught four patients:Two using traditional verbal education and two using virtual reality.The System Usability Scale,After-Scenario Questionnaire,and Maslach Burnout Inventory(MBI)were employed to evaluate the impact of these education methods.RESULTS The VR education groups showed a statistically higher satisfaction than the traditional verbal education groups.Among the three subscales of the MBI,emotional exhaustion and personal accomplishment improved statistically significantly.VR was also better in terms of usability.CONCLUSION This study suggests VR enhances usability and reduces burnout in nurses,but further research is needed to assess its impact on depersonalization and objective measures like stress and heart rate.
基金supported by a contract from the National Institute of Diabetes and Digestive and Kidney Diseases,No.75N94022F00050.
文摘BACKGROUND Gallstone disease is one of the most common digestive disorders in the United States and leads to significant morbidity,mortality,and health care utilization.AIM To expand on earlier findings and investigate prepandemic rates and trends in the gallstone disease burden in the United States using national survey and claims databases.METHODS The National Ambulatory Medical Care Survey,National Inpatient Sample,Nationwide Emergency Department Sample,Nationwide Ambulatory Surgery Sample,Vital Statistics of the United States,Optum Clinformatics®Data Mart,and Centers for Medicare and Medicaid Services Medicare 5%Sample and Medicaid files were used to estimate claims-based prevalence,medical care including cholecystectomy,and mortality with a primary or other gallstone diagnosis.Rates were age-adjusted(for national databases)and shown per 100000 population.RESULTS Gallstone disease prevalence(claims-based,2019)was 0.70%among commercial insurance enrollees,1.03%among Medicaid beneficiaries,and 2.09%among Medicare beneficiaries and rose over the previous decade.Recently,in the United States population,gallstone disease contributed to approximately 2.2 million ambulatory care visits,1.2 million emergency department visits,625000 hospital discharges,and 2000 deaths annually.Women had higher medical care rates with a gallstone disease diagnosis,but mortality rates were higher among men.Hispanics had higher ambulatory care visit and hospital discharge rates compared with Whites,but not mortality rates.Blacks had lower ambulatory care visit and mortality rates,but similar hospital discharge rates compared with whites.During the study period,ambulatory care and emergency department visit rates with a gallstone disease diagnosis rose,while hospital discharge and mortality rates declined.Among commercial insurance enrollees,rates were higher compared with national data for ambulatory care visits and hospitalizations,but lower for emergency department visits.Cholecystectomies performed in the United States included 605000 ambulatory laparoscopic,280000 inpatient laparoscopic,and 49000 inpatient open procedures annually.Among commercial insurance enrollees,rates were higher compared with national data for laparoscopic procedures.CONCLUSION The gallstone disease burden in the United States is substantial and increasing,particularly among women,Hispanics,and older adults with laparoscopic cholecystectomy as the mainstay treatment.Current practice patterns should be monitored for better health care access.
文摘BACKGROUND Lung cancer is a common disease with high mortality,and psychological support is very important in the diagnosis and treatment of postoperative patients with cancer pain.AIM To explore the application effect of the narrative nursing method in postoperative lung cancer patients in the intensive care unit.METHODS A total of 120 patients diagnosed with lung cancer and experiencing cancer-related pain were randomly allocated into two groups:an observation group and a control group,each consisting of 60 cases.The control group was given routine analgesic and psychological care,while the research group applied the five-step narrative nursing method based on routine care,comparing the visual analogue scale scores,sleep status,anxiety and depression status,and quality of life of the two groups of patients before and after the intervention.RESULTS The pain scores,anxiety scores,and depression scores of the study group were lower than those of the control group after the intervention using the narrative nursing method,and the difference was statistically significant(P<0.05).CONCLUSION Using narrative nursing methods to intervene in patients with lung cancer combined with cancerous pain can help patients to correctly recognize their disease,adjust their mentality,establish confidence,alleviate patients'subjective pain feelings,and improve their adverse emotions.
基金supported by the National Research Foundation of Korea(No.2021R1A2B5B03001691).
文摘Point-of-care testing(POCT)is the practice of diagnosing and monitoring diseases where the patient is located,as opposed to traditional treatment conducted solely in a medical laboratory or other clinical setting.POCT has been less common in the recent past due to a lack of portable medical devices capable of facilitating effective medical testing.However,recent growth has occurred in this field due to advances in diagnostic technologies,device miniaturization,and progress in wearable electronics.Among these developments,electrochemical sensors have attracted interest in the POCT field due to their high sensitivity,compact size,and affordability.They are used in various applications,from disease diagnosis to health status monitoring.In this paper we explore recent advancements in electrochemical sensors,the methods of fabricating them,and the various types of sensing mechanisms that can be used.Furthermore,we delve into methods for immobilizing specific biorecognition elements,including enzymes,antibodies,and aptamers,onto electrode surfaces and how these sensors are used in real-world POCT settings.
文摘Knee osteoarthritis is a degenerative disorder of the knee,which leads to joint pain,stiffness,and inactivity and significantly affects the quality of life.With an increased prevalence of obesity and greater life expectancies,total knee arthroplasty(TKA)is now one of the major arthroplasty surgeries performed for knee osteoarthritis.When enhanced recovery after surgery(ERAS)was introduced in TKA,clinical outcomes were enhanced and the economic burden on the healthcare system was reduced.ERAS is an evidence-based scientific protocol aimed at ameliorating the surgical stress response.ERAS aims to enhance the recovery phase,which encompasses multidisciplinary strategies at every step of perioperative care,including the rehabilitation phase.Implementation of ERAS in TKA aids in reducing the length of hospital stay,improving pain management,reducing perioperative complications,and enhancing patient satisfaction.Multidisciplinary collaboration,integrating the expertise of anesthesiologists,orthopedic surgeons,nursing personnel,and other healthcare professionals,is the cornerstone of ERAS in patients undergoing TKA.
