Tree: Reducing the use of restrictive practices on psychiatric wards through virtual reality immersive technology training

BACKGROUND Restrictive practices(RPs)are defined by measures linked to physical and chemical restraints to reduce the movement or control behaviours during any emergency.Seclusion is an equal part of RPs intended to isolate and reduce the sensory stimulation to safeguard the patient and those within the vicinity.Using interventions by way of virtual reality(VR)could assist with reducing the need for RPs as it could help reduce anxiety or agitation by way of placing users into realistic and immersive environments.This could also aid staff to and change current RPs.AIM To assess the feasibility and effectiveness of using a VR platform to provide reduction in RP training.METHODS A randomised controlled feasibility study,accompanied by evaluations at 1 month and 6 months,was conducted within inpatient psychiatric wards at Southern Health National Health Service Foundation Trust,United Kingdom.Virti VR scenarios were used on VR headsets to provide training on reducing RPs in 3 inpatient psychiatric wards.Outcome measures included general self-efficacy scale,generalised anxiety disorder assessment 7(GAD-7),Burnout Assessment Tool 12,the Everyday Discrimination Scale,and the Compassionate Engagement and Action Scale.RESULTS Findings revealed statistically significant differences between the VR and treatment as usual groups,in the Everyday Discrimination Scale items Q8 and Q9:P=0.023 and P=0.040 respectively,indicating higher levels of perceived discrimination in the VR group.There were no significant differences between groups in terms of general self-efficacy,generalised anxiety disorder assessment 9,and Burnout Assessment Tool 12 scores.A significant difference was observed within the VR group for compassionate engagement from others(P=0.005)over time.Most respondents recorded System Usability Scale scores above 70,with an average score of 71.79.There was a significant reduction in rates of RPs in the VR group vs treatment as usual group with a fluctuating variability observed in the VR group likely due to external factors not captured in the study.CONCLUSION Ongoing advancement of VR technology enables the possibility of creating scenarios and simulations tailored to healthcare environments that empower staff by providing more comprehensive and effective training for handling situations.

Window Views of Wards in Foreign Hospitals

Through the collection and systematic analysis of documents related to window views of hospitals,it is found that natural window views had a significant impact on patients’health benefits.The research focused on three aspects:“shortening length of stay”,“pain reduction”and“improvement of recovery rate”,mainly covering three types of patients:“heart patients”,“postoperative patients”and“patients of rehabilitation centers”.Based on the above analysis,summary and sorting,new directions and perspectives of hospital environment design and research under the concept of comprehensive health of people’s physiological,psychological and social adaptation will be obtained to provide references for the research and practice of health architecture,rehabilitation architecture,biophile design and other fields.

Research on the Application Effect of Humanized Nursing Management in Pediatric Rehabilitation Wards

Objective:To explore the application effect of humanized nursing management in pediatric rehabilitation wards.Methods:82 pediatric patients admitted to our hospital between January 2023 and January 2024 were randomly divided into a control group and an observation group.Among them,the control group was given routine care,while the observation group received humanized nursing management,and the clinical nursing effects and situations of the two groups of children were compared and analyzed.Results:After nursing,the observation group showed significantly better performance in intelligent Developmental Quotient(DQ)values(P<0.05).The clinical nursing satisfaction of the observation group was significantly better than that of the control group(χ^(2)=11.710,P<0.05).Conclusion:Humanized nursing management for patients in pediatric rehabilitation wards not only improves their recovery but also significantly enhances parental satisfaction,which is worth learning from and promoting in clinical settings.

Temporal-spatial Distribution of Various Types of Crime in the Special Wards of Tokyo

Based on the official criminal data released by the Tokyo Metropolitan Police Department in 2019,this paper discusses the temporal-spatial distribution of various types of crimes in the special wards of Tokyo.The results show that:(1)The times of high and low incidence of different types of crime differ significantly.Although vicious crime and violent crime present no obvious monthly distribution,property crime clearly differs between the first and second half of a calendar year.(2)The month before the new year sees a surge in most types of crime.(3)Vicious crime peaks in the hours between night and early morning.Violent crime and property crime correlate positively with the frequency of human interaction and peak in the morning and evening commuting hours.(4)The spatial distribution of crime resembles the concentric circles of the three rings of the special wards of Tokyo,with a central high-incidence area,a center-peripheral low-incidence area,and a marginal high-incidence area.In addition,the center sees more personal crime than the periphery,whereas property crimes show the opposite trend.(5)A spatial autocorrelation analysis shows that the special wards of Tokyo may be grouped into the“high-high”and“low-low”agglomeration modes of different types of crime,with marked differences between the various types of crime.The crime can be divided into three types:central agglomeration,double central agglomeration,and decentralized agglomeration.

Caring Behaviour of Nurses in Orthopaedic Wards of Selected Health Institutions as Perceived by Patients

Nurses are trained to provide hands-on care to patients in a variety of settings, which include physical care which can range from total care to helping a patient prevent illness. The health of a patient can significantly improve when they (patients) perceive caring nursing behaviours and are satisfied with the quality of care been received from their care giver. The aim of this study was to determine the caring behaviour of nurses as perceived by patients admitted to orthopaedic ward in some selected hospitals in Osogbo, Osun state, Nigeria. A descriptive comparative design was used. Convenient sample technique was used to select 616 respondents consisting of male and female patients admitted to orthopaedic wards of selected hospitals. The questionnaire on Caring Behaviour Assessment scale was adapted from CBI. The most highly ranked perceived nurses’ behaviour by patients rated “satisfactory” was the general perception of the patients and rendering of basic needs. The findings also revealed that patients rated nurses behaviour (care-giving) with respect to human needs assistance, the provision of safe environment, assisting in psychological care and giving physical comfort as average. Lastly, findings also revealed that patients rated perceived nurses behaviour (care-giving) as “not satisfactory” with regards to meeting their communication needs, nutritional needs and individualized care. In conclusion, care giving is an important branch of nursing and it depicts the quality of care received by a patient which in turn is capable of aiding speedy recovery.

Economic efficiency of radiology wards using data envelopment analysis: Case study of Iran

Background: In evaluating the activities and performance of radiology units, the main aim of applying feasible scientific methods is to use technological and human resources optimally. One of the suitable scientific methods in this field is determining the technical, economic, and allocative efficacy of these centers. We aimed to assess the economic efficiency of radiology units of hospitals affiliated to Shiraz University of Medical Sciences, southern Iran. Methods: In this descriptive-analytical cross-sectional study, the technical, economical, and allocative efficiency of 27 radiology units of public hospitals was assessed using data envelopment analysis. The input oriented envelopment form with the assumption of the varied outputs with respect to the scale was used. Related forms were filled using the existing information in the archives of radiology centers. Input variables in this study were the number of radiology devices, the number of expert personnel, the number of technicians, equipment maintenance and depreciation costs, and the salaries of the experts and technician. Output variables included the number of admitted patients and the number of photographic film. Then, data were analyzed using the DEAP software for calculating the various forms of efficiency. Results: The mean scores of economic, technical, and allocative efficiencies of radiology units were 0.749, 0.880, and 0.852, respectively. The final score of economical efficiency was lower than the technical and allocative efficiency scores. Only 15% of radiology units were economically efficient. Conclusion: Economical efficiency can be attained when resources are used in the best possible way and not wasted. Therefore, a combination of inputs that comprise the lowest costs should be selected.

Relation between Family Functioning and Quality of Life among Family Caregivers of Patients with Terminal Cancer Hospitalized in General Wards

Caring for a patient with terminal cancer poses difficulties for family caregivers. Although families of patients with cancer have been classified by type, little is known about the relation between family functioning and quality of life (QOL) in family caregivers. This study aimed to develop a typology of family functioning in family caregivers of patients with terminal cancer and then examine the relation between the family functioning and QOL of family caregivers. From December 2013 to August 2014, fifty-one family caregivers of patients with terminal cancer were recruited at three hospitals in Tokyo, Japan. Perceptions of family functioning were assessed with the Family Relationship Index, and its three subscores were classified into three groups by cluster analysis. Caregivers’ QOL was measured with the Caregiver Quality of Life Index-Cancer. The average total FRI score among 51 caregivers was 8.5 (SD = 2.8). Family functioning was categorized into three clusters: supportive (n = 12), communicative (n = 30), or conflictive (n = 8). Their QOL was categorized into two groups: the communicative group, with relatively high confliction, showed high QOL comparable to the supportive group. Family functioning in the families of patients with terminal cancer hospitalized in general wards was not good. For improving the QOL of family caregivers, it may be important for the family members to express their feelings and distress if they have conflicts.

What Contributes to Satisfaction with Care for Family Caregivers of Terminal Cancer Patients Admitted to General Wards? A Qualitative Study

Satisfaction with care is an important indicator for family caregivers of patients with terminal cancer and is linked to the quality of life. Despite this, few studies have examined the aspects of satisfaction with care of family caregivers of inpatients with cancer in general wards. This qualitative study aimed to elucidate the elements of satisfaction with the care that inpatients with terminal cancer in general wards and their family caregivers receive from medical staff, as perceived by the family caregivers. Semi-structured interviews were conducted with 10 family caregivers of inpatients with terminal cancer. Participants were asked about the care received until then from medical staff, the features of satisfactory care, and the aspects of care they felt were unsatisfactory or could become satisfactory with improvement. The data were analyzed with the content analysis method and the six categories were extracted. For family caregivers of inpatients with terminal cancer in general wards, along with the care identified as important in palliative care, the methods of alleviating symptoms and explaining the patient’s condition were also important. The results highlight the importance of determining a patient-oriented approach and explanations together with each patient and family caregiver, based on an understanding of the long treatment process.

Criteria for Determining the Need for Admission of People with Dementia to Dementia Nursing Wards of Psychiatric Hospitals in Japan

Purpose: This study aims to establish criteria to determine the need for admission of people with dementia to dementia nursing wards of psychiatric hospitals—based on the experience of nurses working in dementia nursing wards. Methods: Semi-structured interviews were conducted with nurses who had worked in dementia nursing wards of psychiatric hospitals for more than 3 years, to collect data related to the “condition at the time of admission and the process of hospitalization of dementia patients”. Data were analyzed using the content analysis approach. Focusing on “What is the condition of patients with dementia admitted to the dementia nursing ward?”, we created codes according to similarities in the meaning, and classified these into categories where they were evaluated to fully fit in. Results and Discussion: The analysis yielded 4 categories, and 44 codes. The four categories are as follows: [Appearance of a state where self-control is difficult] which expresses a state where behavioral and psychological symptoms of dementia (BPSD) have appeared, and the remaining three categories [Insufficient support provided], [Appearance of symptoms that make living difficult], and [Appearance of physical symptoms that require treatment] express the states that may trigger the appearance of BPSD. These show that the appearance of BPSD is a criterion for determining hospitalization. By providing support to prevent the states described in the 44 codes, nurses may help people with dementia avoid being hospitalized in dementia nursing wards in psychiatric hospitals.

Development of a nurse robot serving in infectious disease isolation wards

A prototype of nurse robot system serving in infectious disease wards is developed by analyzing the systems requirement. Firstly, the type synthesis and dimension synthesis for optimizing the workspace are presented. Secondly, the tele-control system based on velocity control mode is introduced, and tele-control program is written. Finally, the imitation of position workspace and experiment of transforming objects from buffer area to isolation area are carried out.

Study of the effect of humanistic nursing care model wards in Children Caring Ward School on the nurses'caring ability

Objective： To understand the effect of humanistic nursing care model wards in Children Caring Ward School （CCWS） on the nurses＇ caring ability. Methods： Questionnaire 25 nurses of humanistic nursing care model wards in CCWS using the Nkongho Caring Ability Inventory （CAI） before and after implement the humanistic nursing care model, including reform the systems of nursing care, introduce humanistic care model, implement the humanistic care, to measure the nurses＇ caring ability. Results： The nurses＇ caring ability had significantly developed on total, cognition dimension, courage dimension and patience dimension after all measures considered （p 〈 0.05）. Conclusions： The humanistic nursing care model wards in CCWS has a positive effect on the nurses＇ caring ability, not only to help build great relationships between nurses and patients but also to enhance the patients＇ satisfaction.

Development of a Scale to Evaluate the Depressive State among Elderly Patients in General Wards

This study aims to develop a scale to evaluate depressive states among elderly patients in general wards, and verify the reliability and validity of the scale. Based on the results of interviews with nurses, we developed a draft of a scale comprised of 48 questions (NDE48). The Geriatric Depression Scale short version (GDS15), and the Zung Self-rating Depression Scale (SDS) were administered to 54 elderly patients. Two groups of nurses completed the NDE48 on different days. After performing an explanatory factor analysis, the NDE48 was simplified to a 16 question item scale (NDE16), comprising three factors. The correlation coefficient between GDS15 and NDE16 was 0.41 (p = 0.00191), and between SDS and NDE16 was 0.30 (p = 0.02633). Alpha coefficient of the total score of NDE16 was 0.88. For inter-rater reliability, the correlation coefficient was 0.57 (p = 0.00005). The findings suggest that the NDE16 will be highly useful when nurses evaluate depressive states among elderly inpatients.

Potential drug–drug interactions in pediatric wards of Gondar University Hospital,Ethiopia:A cross sectional study

Objective: To determine the prevalence, level of severity of potential drug–drug interactions(PDDIs) and the associated factors for PDDIs in hospitalized pediatric patients of Gondar University Hospital.Methods: A retrospective cross-sectional study was conducted for a period of 3 months from March to May 2014 in pediatric wards of Gondar University Hospital. Systematic random sampling technique was used to select charts from all pediatric patients' charts with every 7th interval to get sample size of 384. Univariate and multivariate analysis were performed to compute crude odds ratio and adjusted odds ratio respectively. Statistical significance was set at P value < 0.05.Results: A total of 176(45.8%) patients had at least one PDDI. A total of 393 PDDIs,which were comprised of 283 types of interacting combinations, were identified. Of the total of 393 PDDIs, most were of moderate severity [201(51%)] followed by minor [152(39%)] and major severity [40(10%)]. The most common interacting pairs of major severity were gentamicin + furosemide(6), cotrimoxazole + methotrexate(4) and phenytoin + artemether(4). The occurrence of PDDIs was significantly associated with age and polypharmacy.Conclusions: The study showed that most of the interactions had moderate severity followed by minor severity. Age and polypharmacy were found to show statistically significant association with the occurrence of PDDIs. Due to sensitive nature of pediatrics population, close monitoring is recommended for the detection and management of PDDIs to prevent its negative consequences.

Outcome of In-Hospital Cardiac Arrest in Adult General Wards

Objective: Few studies have focused on factors influencing outcomes of patients with in-hospital cardiac arrest (IHCA) in general wards. The goal of this study was to report the outcomes of adult patients with IHCA in the general wards and identified the prognostic factors. Methods: Adult patients with IHCA having received cardiopulmonary resuscitation in general wards from January 2008 to December 2011 were retrospectively reviewed from our registry system. The primary outcome was survival to hospital discharge, while the secondary outcome was sustained return of spontaneous circulation (ROSC). Results: A total of 544 general ward patients were analyzed for event variables and resuscitation results. The rate of establishing a ROSC was 40.1% and the rate of survival to discharge was 5.1%. Ventricular tachycardia/ventricular fibrillation (VT/VF) was the initial rhythm in 3.9% of patients. Pre-arrest factors including a high Charlson comorbidity index (CCI) ≥ 9 (OR 0.251, 95% CI 0.098 - 0.646), cardiac comorbidity (OR 0.612, 95% CI 0.401 - 0.933), and arrest time on the midnight shift (OR 0.403, 95% CI 0.252 - 0.642) were independently associated with a low possibility of ROSC. The initial VT/VF presenting rhythms (OR 0.135, 95% CI 0.030 - 0.601) were independently associated with a high survival rate, whereas patients with deteriorated disease course were independently associated with a decreased hospital survival (OR 3.902, 95% CI 1.619 - 9.403). Conclusions: We demonstrated that pre-arrest factors can predict patient outcome after IHCA in general wards, including the association of a CCI ≥ 9 and cardiac comorbidity with poor ROSC, and deteriorated disease course as an independent predictor of a low survival rate.

Development of a Scale to Evaluate Depressive States among Elderly Patients in General Wards —Verification of the Contents to Improve the Accuracy of the Scale

Purpose: This study aims to verify the validity of the contents of the Nurse Administered Depression Scale for Elderly Inpatients16 (NDE16) using the Delphi approach in order to further improve the accuracy of the NDE16, a scale for rating potential depressive states in elderly inpatients through the observations reported by nurses. Methods: Participants were nurses working in general wards for longer than 3 years and who expressed consent to the study participation. Data were collected using the Delphi method (3 times). Responses are scored from 1 to 5 (3 - 5 points as positive) using the Likert method. The standard criteria for inclusion in the further evaluation are “mean ≥ 3.0”, “standard deviation < 1.0”, “median ≥ 3.0”, and “IQR ≤ 1.0”. Items that meet all the criteria at the third survey are employed as question items in the final questionnaire. Results: The respondents were 139 females, 10 males, and 1 unknown, aged 25 to 65. The collection rates of the three surveys were 75% to 82%. Based on the results of the first survey, wordings of 9 questions were modified. Since Question 13 “Queries are not really responded to.” did not meet the criteria (IQR = 2) at the third survey, we excluded this question and named the revised scale NDE15. Discussion: The reason why Question 13 did not meet the criteria could be due to the difficulty in distinguishing “Expressing thought suppression” from the state of cognitive decline in dementia. Further studies are needed to determine cutoff points.

Nursing Care Management Strategies in Isolation Wards during the COVID-19 Outbreak

Coronavirus disease 2019 (COVID-19) is highly infectious and has spread worldwide. Medical staff may be exposed to the infection under circumstances of medical supply shortages and improper protection. How to better protect medical staff has become the focus of all walks of life. Therefore, during the COVID-19 outbreak, timely adjustments and optimization of nursing management strategies in isolation wards are important for improving care quality and reducing the infection of medical staff. Based on a literature review and clinical nursing management practices, this article summarizes the nursing management strategies in isolation wards during the COVID-19 outbreak, aiming to provide references for clinical nursing managers.

颜值控——2020 WARDS十佳内饰

2020年6月25日,美国《Wards Auto》杂志公布了2020年十佳内饰榜单(2020 Wards 10 Best Interiors)。十佳内饰奖已进入第10个年头,8名评委用了两个多月时间对入选的32款车型从设计美学、用料、人体工程学、安全性、舒适性、价值、工艺以及信息娱乐系统用户体验性和创新性等方面进行了综合考量,最终10款车脱颖而出,入选2020年十佳内饰榜单。这些获奖车型的内饰个个都是精品,具有一流的颜值。下面就让我们一起来看看,究竟有哪些车型入选该名单。

不同载荷条件下三种内固定方式治疗PauwelsⅢ型股骨颈骨折的有限元分析

背景:治疗PauwelsⅢ型股骨颈骨折的最佳内固定方式仍未达成共识,既往相关有限元分析大多采用单一简化载荷条件,对于常用内固定装置的生物力学特性还需进一步探究。目的:通过有限元方法分析空心加压螺钉、动力髋螺钉和股骨颈系统治疗PauwelsⅢ型股骨颈骨折在单腿站立载荷及侧方跌倒载荷条件下的生物力学特性。方法:通过CT扫描获取健康成人股骨DICOM数据,导入Mimics 15.0软件,得到骨组织的粗糙模型,再通过Geomagics软件对Mimics导出的数据进行优化处理,然后根据空心加压螺钉、动力髋螺钉和股骨颈系统的临床应用参数采用Pro/E软件建立3种内固定模型并与股骨模型组装,最后导入Ansys软件进行加载、计算,分析3种内固定模型在单腿站立载荷及侧方跌倒载荷的不同工况下股骨和内固定的应力分布和位移情况,以及股骨距和Ward三角区的应力特点。结果与结论:(1)单腿站立载荷及侧方跌倒载荷下,3种内固定模型的股骨近端应力均主要分布在股骨颈骨折端内上方,3种内固定模型的股骨近端、骨折端、Ward三角以及股骨距的应力峰值均为股骨颈系统内固定模型最小,空心加压螺钉内固定模型最大;(2)单腿站立载荷及侧方跌倒载荷下,3种内固定模型的股骨近端位移峰值均位于股骨头顶端,且位移峰值均为股骨颈系统内固定模型最小,空心加压螺钉内固定模型最大;(3)3种内固定模型在单腿站立及侧方跌倒载荷条件下内固定的位移峰值均位于内固定装置上方顶端,且位移峰值均为股骨颈系统内固定模型最小,空心加压螺钉内固定模型最大;(4)3种内固定模型在单腿站立及侧方跌倒载荷条件下内固定的应力均主要集中在内固定装置的骨折端附近区域,且内固定应力峰值均为股骨颈系统内固定模型最小,空心加压螺钉内固定模型最大;(5)结果表明,股骨颈系统的机械稳定性最佳,但是可能存在对于骨折端和股骨距应力遮挡的风险;股骨颈系统的内固定装置应力更为分散,内固定断裂风险更低。

基于Ward等值的三绕组变压器并列运行方式实用辨识方法

变压器运行方式直接影响到电网的实时监视和控制。为准确反映电网运行信息,提出一种三绕组变压器并列运行方式的实用辨识方法。基于三绕组变压器并列运行的拓扑结构及其等值电路,结合简单环形网络的潮流分布公式与Ward等值方法,推导出两台和3台变压器高/中两侧并列运行时的有功功率分配关系。在合理近似的条件下提出变压器并列运行的有功功率分配比例判据,实现变压器并列运行方式的高效辨识。基于典型算例潮流的模拟数据和实际变电站的实测数据,仿真验证所提方法的有效性。

An artificial intelligence diabetes management architecture based on 5G

Along with the development of 5G network and Internet of Things technologies,there has been an explosion in personalized healthcare systems.When the 5G and Artificial Intelligence(Al)is introduced into diabetes management architecture,it can increase the efficiency of existing systems and complications of diabetes can be handled more effectively by taking advantage of 5G.In this article,we propose a 5G-based Artificial Intelligence Diabetes Management architecture(AIDM),which can help physicians and patients to manage both acute complications and chronic complications.The AIDM contains five layers:the sensing layer,the transmission layer,the storage layer,the computing layer,and the application layer.We build a test bed for the transmission and application layers.Specifically,we apply a delay-aware RA optimization based on a double-queue model to improve access efficiency in smart hospital wards in the transmission layer.In application layer,we build a prediction model using a deep forest algorithm.Results on real-world data show that our AIDM can enhance the efficiency of diabetes management and improve the screening rate of diabetes as well.