Differences in insomnia-related self-reported outcomes among elderly hospitalized patients

Insomnia is among the most common sleep disorders worldwide.Insomnia in older adults is a social and public health problem.Insomnia affects the physical and mental health of elderly hospitalized patients and can aggravate or induce physical illnesses.Understanding subjective feelings and providing reasonable and standardized care for elderly hospitalized patients with insomnia are urgent issues.AIM To explore the differences in self-reported outcomes associated with insomnia among elderly hospitalized patients.METHODS One hundred patients admitted to the geriatric unit of our hospital between June 2021 and December 2021 were included in this study.Self-reported symptoms were assessed using the Athens Insomnia Scale(AIS),Generalized Anxiety Disorder Scale-7(GAD-7),Geriatric Depression Scale-15(GDS-15),Memorial University of Newfoundland Scale of Happiness(MUNSH),Barthel Index Evaluation(BI),Morse Fall Scale(MFS),Mini-Mental State Examination,and the Short Form 36 Health Survey Questionnaire(SF-36).Correlation coefficients were used to analyze the correlation between sleep quality and self-reported symptoms.Effects of insomnia was analyzed using Logistic regression analysis.RESULTS Nineteen patients with AIS≥6 were included in the insomnia group,and the incidence of insomnia was 19%(19/100).The remaining 81 patients were assigned to the non-insomnia group.There were significant differences between the two groups in the GDA-7,GDS-15,MUNSH,BI,MFS,and SF-36 items(P<0.05).Patients in the insomnia group were more likely to experience anxiety,depression,and other mental illnesses,as well as difficulties with everyday tasks and a greater risk of falling(P<0.05).Subjective well-being and quality of life were poorer in the insomnia group than in the control group.The AIS scores positively correlated with the GAD-7,GDS-15,and MFS scores in elderly hospitalized patients with insomnia(P<0.05).Logistic regression analysis showed that GDS-15≥5 was an independent risk factor for insomnia in elderly hospitalized patients(P<0.05).CONCLUSION The number of self-reported symptoms was higher among elderly hospitalized patients with insomnia.Therefore,we should focus on the main complaints of patients to meet their care needs.

Comparison of Oral Manifestations in Hospitalized COVID-19 Positive Patients and COVID-19 Negative Dental Outpatients. A Case Series Study and Literature Review

Background: The Coronavirus disease 2019 (COVID-19) is a respiratory infectious disease, also named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which can cause various systemic manifestations that pose a threat to human life. Oral lesions in patients with COVID-19 may appear during or after the illness and may or may not be a consequence of the viral infection. Objective: In this case series we compare the oral manifestations in hospitalized COVID-19 positive patients and COVID-19 negative dental outpatients. Methods: 60 hospitalized COVID-19 patients and 41 control patients, were examined for oral signs and symptoms. The controls were dental patients who visited the hospital for dental care without complaining of any problems related to the oral cavity itself. Results: We have observed a strong association between certain clinical findings and COVID-19, including alterations in taste (ageusia, dysgeusia, and hypogeusia), anosmia, hairy tongue, tongue imprints, red tongue, erythematous candidiasis, pseudomembranous candidiasis, and exfoliative cheilitis. A trend but not statistically significant association at the level of 5% was also noted for colored tongue, linea alba, and pale mucosa. On the contrary, fissured tongue and oral mucosa pigmentation were more frequent in the controls, statistically significant at the level of 5%. Conclusion: COVID-19 has been found to impact the oral cavity, resulting in various oral lesions that can be attributed to either the direct action of the virus or the patient’s immune response.

Recent Advances in Glycemic Management for Hospitalized Diabetic Patients

With the increase in the number of diabetic patients,hospitalized diabetes management has become very important.During hospitalization,diabetic patients are prone to high or low blood glucose levels,which pose significant risks and challenges for treatment and recovery.Therefore,glycemic management of diabetic patients during hospitalization is critical.This article reviews the latest research progress in glycemic management of hospitalized diabetic patients from several aspects,develops individualized treatment plans,and uses various methods to manage and control blood glucose in hospitalized diabetic patients.

Education of Hospitalized Diabetic Patients: Analysis of Training Needs among Nurses in a Lebanese Hospital - A Secondary Publication

The design of diabetes inpatient educational preparation should be based on the needs of the nurses involved in terms of skills in this area. The objective of this qualitative study is to identify the preparatory needs of nurses working in the medical and surgical units of a Lebanese hospital in terms of Survival Skills Education for Hospitalized Diabetic Patients (SSEHDP). Method: The focus group method is used for data collection using a semi-structured interview guide. The needs expressed by the thirty-two participating nurses were classified into categories of the competency framework for providing self-management education to diabetic patients proposed by the American Diabetes Association. Results: By focusing on the themes of an SSEHDP, a list of preparatory needs was drawn up. The needs identified and analyzed are then translated into general and specific learning objectives for educational preparation. Conclusion: The needs analysis is only the first step in a work that will ideally continue into the implementation and eventual evaluation of an educational program developed to help nurses acquire skills in the education of diabetic patients.

Patients’ Perception and Satisfaction with Waiting Time, and Facilities Available in a State Teaching Hospital Eye Clinic, Southeast, Nigeria

Patients’ satisfaction with waiting time and the facilities in eye clinics is an important indication of the patients’ assessment of the quality of service in the eye clinic. In this study, waiting time was defined as time spent from arrival to time when the patient is seen by a doctor. Some factors that affect patients’ waiting time in health clinics include: healthcare setting, availability of adequate resources and personnel, efficient deployment of available resources and competence of healthcare workers, and punctuality of healthcare workers. The physical environment, comfort of patients, and level of infrastructure in the hospital also influence patients’ satisfaction. This observational, descriptive, cross-sectional study was conducted among patients that attended an eye care clinic, in a tertiary hospital, and 348 respondents were interviewed. Most of the respondents were aged 40 years and above (64.4%), females (63.5%), Igbos by tribe (94.8%), married (63.2%), Christians (96.6%), and had at least a secondary level of education (78.4%). Most perceived waiting time as being very long or long (60.1%), and only 48.8 were satisfied or very satisfied with the waiting time. Most also perceived the cleanliness of the eye clinic as being clean or very clean (85.0%), and 70.7% perceived the ventilation as being adequate or very adequate. The majority reported that a health talk was given (71.6%), and 62.7% were satisfied or very satisfied with the talk. More respondents (46.8%) perceived the waiting space as very inadequate or inadequate, as against 43.4% that perceived it as adequate or very adequate. More reported that prescribed drugs were completely unavailable or few available (48.0%), while 42.3% reported drugs as being reasonably or completely available. It is important that management of health facilities that offer eye care services, work towards improving patients’ perception and satisfaction with services provided in the eye clinics.

Patient satisfaction and follow-up adherence to glaucoma case management clinic in China

AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a total of 119 patients completed a Patient Satisfaction Questionnaire-18 and a sociodemographic questionnaire.Clinical data was obtained from the case management system.Follow-up adherence was defined as completing each follow-up within±30d of the scheduled time set by ophthalmologists during the study period.RESULTS:Average satisfaction scored 78.65±7,with an average of 4.39±0.58 across the seven dimensions.Age negatively correlated with satisfaction(P=0.008),whilst patients with follow-up duration of 2 or more years reported higher satisfaction(P=0.045).Multivariate logistics regression analysis revealed that longer follow-up durations were associated with lower follow-up adherence(OR=0.97,95%CI,0.95-1.00,P=0.044).Additionally,patients with suspected glaucoma(OR=2.72,95%CI,1.03-7.20,P=0.044)and those with an annual income over 100000 Chinese yuan demonstrated higher adherence(OR=5.57,95%CI,1.00-30.89,P=0.049).CONCLUSION:The case management model proves effective for glaucoma patients,with positive adherence rates.The implementation of this model can be optimized in the future based on the identified factors and extended to glaucoma patients in more hospitals.

Expectations and Level of Satisfaction of the Patient with Parkinson’s Disease Undergoing Deep Brain Stimulation Surgery at the National Institute of Neurology and Neurosurgery

Background: Deep brain stimulation (DBS) is an established treatment for patients with advanced Parkinson’s disease (PD). Reports show continued patient satisfaction after surgery despite not maintaining clinical improvement as measured by evolution scales. Objectives: The present study sought to explore expectations and level of satisfaction in patients after DBS surgery with a semi-structured questionnaire and subsequent correlation with functional scales, Quality of Life (QoL), and motor and non-motor symptoms. Methods: We performed descriptive statistics to represent demographic data, Wilcoxon rank tests to determine significant differences, and Spearman correlation between the applied scales. Results: We evaluated 20 patients with a history of DBS surgery. 45% were female, with a mean age of 55.7 ± 14.15 years, a mean disease duration of 13.42 ± 8.3 years, and a mean time after surgery of 3.18 ± 1.86 years. Patients reported surgery meeting expectations in 85.5% and continued satisfaction in 92%. These two variables showed a significant correlation. Conclusions: This sample of patients remained satisfied after DBS surgery, although we found no differences in motor and non-motor clinimetric scales. Further studies are needed to confirm the importance of assessing quality of life in patients with DBS.

Experiences of Social Isolation in Older Hospitalized Patients with COVID-19 and Their Close Relatives: A Qualitative Study

Background: Proximity between older patients and their close relatives is essential during hospitalisation. During the first wave of the pandemic, the Danish Patient Safety Authority restricted no hospital visitors. Aim: To explore how older patients with COVID-19 and their close relatives experienced physical separation during hospitalization. Method: A qualitative study using semi-structured interviews and thematic analysis was employed. Findings: Six interviews were conducted: three patients with a mean age of 81 years and three close relatives—two daughters and one spouse. The patients felt boredom, loneliness, and a sense of imprisonment, yet they felt safe and satisfied. Isolation was known beforehand from the media. Close relatives emphasised that information, involvement, and collaboration with hospital staff were crucial. Conclusion: Although older patients with COVID-19 and their close relatives widely accept their situation during hospitalization, they experience negative consequences from social isolation.

Retroperitoneal and abdominal bleeding in anticoagulated COVID-19 hospitalized patients:Case series and brief literature review

BACKGROUND Hospitalized and severely ill coronavirus disease 2019(COVID-19)patients necessitate prophylactic or therapeutic anticoagulation to minimize the risk of thrombosis at different sites.Life-threatening bleeding complications include spontaneous iliopsoas hematoma,peritoneal bleeding,and extra-abdominal manifestations such as intracranial hemorrhage.CASE SUMMARY Bleeding in the abdominal wall results in less severe complications than seen with iliopsoas hematoma or peritoneal bleeding.In our case series of 9 patients,we present retroperitoneal and abdominal bleeding complications following anticoagulation in hospitalized COVID-19 patients with severe acute respiratory syndrome coronavirus 2 pneumonia.Contrast-enhanced computed tomography(CE-CT)is the best imaging modality for assessing hematoma secondary to anticoagulation and determines the therapeutic approach,whether interventional,surgical,or conservative management.CONCLUSION We present the role of CE-CT for rapid and precise localization of the bleeding site and prognostic counseling.Finally,we provide a brief review of the literature.

Quality of life of hospitalized patients after lung cancer operation and analysis of influencing factors

Objective:To explore the current status and influencing factors of quality of life in patients with lung cancer after surgery in a tertiary hospital in Hainan province.Methods:To investigate the influencing factors of quality of life of lung cancer patients after surgery in a tertiary hospital in Hainan province by cross‑sectional survey method.Results:The scores of insomnia,appetite loss,constipation and pain in 186 lung cancer patients after surgery in a tertiary hospital in Hainan Province were significantly higher than the reference value.Multiple linear regression analysis showed that older patients(>60 years)had lower scores in physical function domain(β=-0.193),and female patients had more appetite loss symptoms(β=0.245).Compared with other minority ethnic groups,Han ethnic group had lower scores in role function domain(β=0.179),more severe fatigue symptoms(β=-0.162),and higher general health level(β=0.166).Patients with employee medical insurance had lower scores of emotional function(β=0.194),cognitive function(β=0.281),the lowest score in social function(β=0.188),and severe pain in other parts(β=-0.227).Smokers had less cough symptoms(β=0.175)and more arm and shoulder pain symptoms(β=-0.21)than non‑smokers.Patients with secondhand smoke exposure had lower cognitive function scores(β=-0.158)and more obvious symptoms of oral ulcer(β=0.185).Patients who drank alcohol frequently(drinking frequency>1 time/day)had more severe cough symptoms(β=0.27).Patients with small number of children(0‑1)had milder cough symptoms(β=0.178).Patients who did not understand the disease had obvious symptoms of arm and shoulder pain(β=0.151).Patients with early pathological stage(stageⅠ‑Ⅱ)had more severe shortness of breath(β=-0.159)and pain(β=-0.181).The symptoms of appetite loss were more obvious in patients living in cities(β=0.192).The symptoms of peripheral neuropathy were more obvious(β=0.174).Patients who often consumed pickulated food had severe pain symptoms(β=-0.219),and pain in other parts was obvious(β=-0.149).Male patients had obvious alopecia symptoms(β=-0.306).Conclusion:Age,ethnicity,residence,type of medical insurance,number of children,pathological stage of lung cancer,smoking,second‑hand smoke exposure,alcohol consumption,and frequent consumption of pickled food were related to the quality of life of lung cancer patients in hospital after surgery.Medical staff and family members should pay attention to the emotional communication of patients during the treatment of lung cancer patients in hospital after surgery.Patients should avoid exposure to smoking,alcohol and second‑hand smoke,and reduce consumption of pickled food.

Vitamin D deficiency among outpatients and hospitalized patients with diabetic foot ulcers:A systematic review and meta-analysis

BACKGROUND The definition of diabetic foot syndrome(DFS)varies depending on the location and resources.Few classifications are available according to the indication.DF ulcers and vitamin D deficiency are common diseases among patients with diabetes.Previous literature has shown an association between DF ulcer(DFU)and vitamin D deficiency.However,the available meta-0analysis was limited by substantial bias.AIM To investigate the association between DFUs and vitamin D levels.METHODS We searched PubMed,MEDLINE,and Cochrane Library,EBSCO,and Google Scholar for studies comparing vitamin D levels and DF.The keywords DFU,DFS,diabetic septic foot,vitamin D level,25-hydroxy vitamin D,vitamin D status,and vitamin D deficiency were used.The search engine was set for articles published during the period from inception to October 2022.A predetermined table was used to collect the study information.RESULTS Vitamin D level was lower among patients with DFU compared to their counterparts[odds ratio(OR):-5.77;95%confidence interval(CI):-7.87 to-3.66;χ2 was 84.62,mean difference,9;I2 for heterogeneity,89%;P<0.001 and P for overall effect<0.001].The results remained robust for hospitalized patients(OR:-6.3295%CI:-11.66 to-0.97;χ2 was 19.39;mean difference,2;I2 for heterogeneity,90%;P=0.02).CONCLUSION Vitamin D was lower among outpatients and hospitalized patients with DFUs.Further larger randomized controlled trials are needed.

The level of patients’ satisfaction and perception on quality of nursing services in the Renal unit, Kenyatta National Hospital Nairobi, Kenya

Introduction: Renal failure is on the increase and patients have to identify with renal services and centres where services for renal replacement therapies are rendered. This calls for health care workers to offer services that are perceived as quality and satisfying in order to meet the biophysical and psychological needs of the patients. Study design: This was a descriptive cross-sectional study undertaken at the Renal unit of Kenyatta National Hospital (KNH). Purpose: The study aimed at determining the level of satisfaction and perception of the quality of nursing services in the Renal unit. Methodology: The study population included all patients who were seeking dialysis services during one month period of data collection. The sample size was 151 following data collection. Data collection tools consisted of semi-structured questionnaires which were administered with the aid of research assistants as well as checklists which were self administered. Data analysis and results: Analysis of data was performed using the statistical package of social sciences (SPSS) version 16. Results of data analysis were presented in form of descriptive statistics which included mean, standard deviation and percentages. Regression analysis, t-test and ANOVA were conducted to determine demographic predictors of patient satisfaction with the nursing services. The results of the study revealed that patients in the Renal unit were generally satisfied with the nursing services. The aggregate mean score for all patients on Likert scale was 71.2 out of 105, with a standard deviation of 16.8. Level of satisfaction was 67.8%. The findings also showed that there was no association between demographic characteristics with the levels of satisfaction with the nursing services. Recommendation: The hospital should keep the patients’ level of satisfaction high and maintain it through the provision of more dialysis machines and hiring more nurses.

Satisfaction of Patients Examined with Mobile X-Ray vs. X-Ray at the Hospital—A Randomized Controlled Trial

Background: In the Municipality of Aarhus, Denmark, mobile X-ray is offered to selected patients when a transfer to the Department of Radiology may be an obstacle. To our knowledge, no studies have examined patient’s satisfaction with mobile X-ray in a randomized controlled trial, but international qualitative and quantitative studies report a high level of patient satisfaction with mobile X-ray. Purpose: The purpose of the study was to investigate whether patients in aged care facilities who were offered mobile X-ray were more satisfied with the X-ray examination compared to patients examined with X-ray at the Department of Radiology, Aarhus University Hospital. Design: A part of a randomized controlled trial. Methods: Satisfaction was measured using a self-developed questionnaire, containing 13 questions measuring satisfaction from different perspectives. Participants: Due to patient’s fragility, healthcare staff members answered questions concerning satisfaction on behalf of the patients, who had been examined with mobile X-ray (n = 66) or X-ray at the hospital (n = 63). The patients were living in nursing homes and homes for the elderly in Aarhus Municipality. Data: Data were collected and stored using the computer program REDCap. Data were statistically analyzed using Fisher’s exact test. Results: Patients examined with mobile X-ray had a significantly higher satisfaction rate than those examined with X-ray at the hospital. Conclusion: Satisfaction of patients examined with X-ray was reported by healthcare staff to be in favor of mobile X-ray.

Quality of Health Care in Resource Limited Settings-Patients’ Satisfaction Survey at a Mission Hospital in South East, Nigeria

Introduction: Quality healthcare is a major contributor to health disparities and inequalities in resource limited settings. Patient satisfaction remains an important and valuable method of assessing the quality of care. Aim: This study assessed patients’ satisfaction with quality of inpatient clinical care in a mission hospital in a semi urban setting. Methods: The study was a cross-sectional study carried out on 140 inpatients at a mission hospital in Afikpo, South East Nigeria. Data was collected using pretested structured questionnaires designed on a five-point likert scale with 1 indicating the lowest and 5 indicating the highest scale. Knowledge of factors contributing to quality of care and satisfaction in the following domains: patient-staff relationship, patient-staff (doctors/nurses) communication, facility convenience, technical aspect of care (availability of equipment, drugs and adequacy of staff) and overall general satisfaction were measured. Operationally, patients who rated 3 points and above were considered satisfied while ratings less than 3 points were considered dissatisfied. Results: Knowledge of factors contributing to quality of care was 4.65 ± 0.48. General satisfaction rated 4.22 ± 0.52. Specifically, the different domains had the following scores: inter personal relationship 4.28 ± 0.81, technical aspect of care (availability of drugs, equipment and medical personnel) 4.29 ± 0.57 and facility convenience 4.21 ± 0.51. Conclusions: Knowledge of factors contributing to quality of care and overall patients’ satisfaction with inpatient care were good and comparable with patients’ satisfaction with tertiary health institutions in Nigeria. Mission hospitals may serve as excellent alternatives to government hospitals in resource limited settings to promote health equity across populations.

Clinical efficacy of intradermal type Ⅰ collagen injections in treating skin photoaging in patients from high-altitude areas

BACKGROUND Photoaging,a result of chronic sun exposure,leads to skin damage and pigmentation changes.Traditional treatments may have limitations in high-altitude areas like Yunnan Province.Intradermal Col Ⅰ injections stimulate collagen production,potentially improving skin quality.This study aims to assess the efficacy and safety of this treatment for photoaging.AIM To evaluate the efficacy and safety of intradermal typeΙcollagen(ColΙ)injection for treating photoaging.METHODS This prospective,self-controlled study investigated the impact of intradermal injections of ColΙon skin photodamage in 20 patients from the Yunnan Province.Total six treatment sessions were conducted every 4 wk±3 d.Before and after each treatment,facial skin characteristics were quantified using a VISIA skin detector.Skin thickness data were assessed using the ultrasound probes of the Dermalab skin detector.The Face-Q scale was used for subjective evaluation of the treatment effect by the patients.RESULTS The skin thickness of the right cheek consistently increased after each treatment session compared with baseline.The skin thickness of the left cheek significantly increased after the third through sixth treatment sessions compared with baseline.The skin thickness of the right zygomatic region increased after the second to sixth treatment sessions,whereas that of the left zygomatic region showed a significant increase after the fourth through sixth treatment sessions.The skin thickness of both temporal regions significantly increased after the fifth and sixth treatment sessions compared with baseline(P<0.05).These findings were also supported by skin ultrasound images.The feature count for the red areas and wrinkle feature count decreased following the treatment(P<0.05).VISIA assessments also revealed a decrease in the red areas after treatment.The Face-QSatisfaction with Facial Appearance Overall and Face-Q-Satisfaction with Skin scores significantly increased after each treatment session.The overall appearance of the patients improved after treatment.CONCLUSION Intradermal ColΙinjection improves photoaging,with higher patient satisfaction and fewer adverse reactions,and could be an effective treatment method for populations residing in high-altitude areas.

Patient Satisfaction with Primary Health Care Services in Riyadh City, Saudi Arabia

Patient satisfaction is a crucial measure of healthcare quality and plays a vital role in ensuring effective healthcare systems. This study aims to assess the level of patient satisfaction with primary healthcare services in Riyadh, Saudi Arabia, identify social factors affecting satisfaction, and determine the reasons behind dissatisfaction and how to improve satisfaction. The study employed a cross-sectional observational design and included a random sample of 400 patients from primary healthcare centers in Riyadh. Data were collected using an electronic questionnaire and analyzed using SPSS software. The study found that patients were generally satisfied with the primary healthcare services provided in Riyadh, with high levels of satisfaction reported for booking appointments, triage services, and emergency care. However, some aspects of the healthcare experience, such as long waiting times and the physical design of healthcare centers, need improvement. These findings can be used to inform the development of policies and interventions aimed at enhancing healthcare quality in Saudi Arabia.

Surveillance of multidrug resistant uropathogenic bacteria in hospitalized patients in Indian

Objective:To record surveillance,antibiotic resistance of uropathogens of hospitalized patients over a period of 18 months.Methods:Urine samples from wards and cabins were used for isolating urinary tract infection(UTI)-causing bacteria that were cultured on suitable selective media and identified by biochemical tests;and their antibiograms were ascertained by Kirby-Bauer's disc diffusion method,in each 6-month interval of the study period,using 18 antibiotics of five different classes.Results:From wards and cabins,1 245 samples were collected,from which 996 strains of bacteria belonging to 11 species were isolated,during April 2011 to September2012.Two Gram-positive,Staphylococcus aureus(S.aureus)and Enterococcus faecalis(E.faecalis),and nine Gram-negative bacteria,Acinetobacter baumannii,Citrobactcr sp.,Escherichia coli,Enterobacter aerogenes,Klebsiella pneumoniae.Klebsiella oxytoca,Proteus mirabilis,Proteus vulgaris and Pseudomonas aeruginosa were isolated.Both S.aureus and E.faecalis were vancomycin resistant,and resistant-strains of all pathogens increased in each 6-month period of study.Particularly,all Gram-negatives were resistant to nitrofurantoin and co-trimoxazole,the most preferred antibiotics of empiric therapy for UTI.Conclusions:Antibiograms of 11 UTI-causing bacteria recorded in this study indicated moderately higher numbers of strains resistant to each antibiotic studied,generating the fear of precipitating fervent episodes in public health particularly with bacteria,Acinetobacter baumannii,Escherichia coli,Klebsiella pneumoniae and S.aureus.Moreover,vancomycin resistance in strains of S.aureus and E.faecalis is a matter of concern.

Comparison of perceived pain and patients’ satisfaction with traditional local anesthesia and single tooth anesthesia: A randomized clinical trial

BACKGROUND Contemporary innovations in the area of local anesthesia have attempted to provide an absolutely pain free experience for patients.Since the introduction of Computer-Controlled Local Anesthetic Delivery Systems to dentistry,many studies have compared its efficacy and safety to conventional anesthesia.However,very few studies have compared single tooth anesthesia(STA)and traditional local anesthesia.AIM To compare pain rating,changes in blood pressure,and heart rate during the local anesthetic injection.The secondary objectives were to measure the patients’level of satisfaction and the differences in anesthetic efficiency between the STA system and traditional local infiltration.METHODS A randomized controlled trial was conducted and a total of 80 patients with dental restorative needs were enrolled for the study.The patients were evaluated for their general physical status and oral clinical findings before enrollment.Information regarding perceived pain,changes in heart rate and blood pressure,and patients’satisfaction was collected using an electronic data form and was analyzed using paired and unpaired t-tests.RESULTS No significant difference was noted in perceived pain(P=0.59)and systolic blood pressure(P=0.09)during anesthetic injection using both traditional and STA techniques.STA patients had a significantly higher heart rate during anesthesia,although a statistically significant difference was noted among the traditional anesthesia and the STA groups even before anesthesia.During the restorative procedure,less pain was perceived by STA patients on the Wong-Baker FACES pain scale,which was statistically significant(P<0.001).Analyses of post-procedure patient responses showed that STA patients had a significantly better treatment experience and preferred to have the same method of injection in the future(P=0.04).CONCLUSION STA system can provide less painful and more comfortable restorative treatment procedures in comparison to the traditional infiltration technique.

Competency-based management effects on satisfaction of nurses and patients

Purpose:To evaluate the effect of competency-based management in improving nurse and patient satisfaction.Methods:According to the competency-based management objectives and principles,821 nurses were classified into different levels based on clear nurse qualifications and post responsibilities.According to the different levels of nursing staff and training plans with different emphases,the goal was for the nursing staff to gradually achieve the corresponding level.Targeted training programs for different levels of nurses were formulated to enable nurses to gradually increase their competency levels.Results:After implementation of competency-based management,nurse job satisfaction and patient satisfaction increased significantly(P<0.01).Additionally,the reported nurse job burnout decreased(P<0.01).Conclusion:Competency-based management can promote nurses’enthusiasm,reduce job burnout,improve job satisfaction,as well as improve patient satisfaction.

Hospitalized ulcerative colitis patients have an elevated risk of thromboembolic events

AIM: To compare thromboembolism rates between hospitalized patients with a diagnosis of ulcerative colitis and other hospitalized patients at high risk for thromboembolism. To compare thromboembolism rates between patients with ulcerative colitis undergoing a colorectal operation and other patients undergoing colorectal operations. METHODS: Data from the National Hospital Discharge Survey was used to compare thromboembolism rates between (1) hospitalized patients with a discharge diagnosis of ulcerative colitis and those with diverticulitis or acute respiratory failure, and (2) hospitalized patients with a discharge diagnosis of ulcerative colitis who underwent colectomy and those with diverticulitis or colorectal cancer who underwent colorectal operations. RESULTS: Patients diagnosed with ulcerative colitis had similar or higher rates of combined venous thromboembolism (2.03%) than their counterparts with diverticulitis (0.76%) or respiratory failure (1.99%), despite the overall greater prevalence of thromboembolic risk factors in the latter groups. Discharged patients with colitis that were treated surgically did not have signifi cantly different rates of venous or arterial thromboembolism than those with surgery for diverticulitis or colorectal cancer.CONCLUSION: Patients with ulcerative colitis who do not undergo an operation during their hospitalization have similar or higher rates of thromboembolism than other medical patients who are considered to be high risk for thromboembolism.