Anal fistula is among the most common illnesses affecting man.Medical literature dating back to 400 BC has discussed this problem.Various causative factors have been proposed throughout the centuries,but it appears th...Anal fistula is among the most common illnesses affecting man.Medical literature dating back to 400 BC has discussed this problem.Various causative factors have been proposed throughout the centuries,but it appears that the majority of fistulas unrelated to specific causes (e.g.Tuberculosis,Crohn’s disease) result from infection (abscess) in anal glands extending from the intersphincteric plane to various anorectal spaces.The tubular structure of an anal fistula easily yields itself to division or unroofing (fistulotomy) or excision (fistulectomy) in most cases.The problem with this single,yet effective,treatment plan is that depending on the thickness of sphincter muscle the fistula transgresses,the patient will have varying degrees of fecal incontinence from minor to total.In an attempt to preserve continence,various procedures have been proposed to deal with the fistulas.These include: (1) simple drainage (Seton);(2) closure of fistula tract using fibrin sealant or anal fistula plug;(3) closure of primary opening using endorectal or dermal flaps,and more recently;and (4) ligation of intersphincteric fistula tract (LIFT).In most complex cases (i.e.Crohn’s disease),a proximal fecal diversion offers a measure of symptom-atic relief.The fact remains that an "ideal" procedure for anal fistula remains elusive.The failure of each sphincter-preserving procedure (30%-50% recurrence) often results in multiple operations.In essence,the price of preservation of continence at all cost is multiple and often different operations,prolonged disability and disappointment for the patient and the surgeon.Nevertheless,the surgeon treating anal fistulas on an occasional basis should never hesitate in referring the patient to a specialist.Conversely,an expert colorectal surgeon must be familiar with many different operations in order to selectively tailor an operation to the individual patient.展开更多
Objective:This study examined the relationship between structural empowerment and nurses’experience and attitudes toward computer use.Methods:This study was conducted using a cross-sectional quantitative design.A tot...Objective:This study examined the relationship between structural empowerment and nurses’experience and attitudes toward computer use.Methods:This study was conducted using a cross-sectional quantitative design.A total of 184 registered nurses from four hospitals in Jordan participated in the current study.Data were collected using a demographics questionnaire,the Conditions for Work Effectiveness Questionnaire-II(CWEQ-II),and the Pretest for Attitudes toward Computers in Healthcare(PATCH).Results:The median of experience in years among nurses was 5.0,ranging from one to 26 years.The mean score for the attitudes toward computer use was 61.90±11.38.Almost half of the participants,45.11%,were in the category of“feel comfortable using user-friendly computers.”The participants’mean average of the total structural empowerment was 12.40±2.43,and the values for its four subscales were:opportunity 3.57±0.87,resources 2.83±0.85,information 3.06±0.79,and support 2.95±0.86.The frequencies analysis revealed that most participants had a moderate level of empowerment(n¼127,69.02%).The bivariate correlation between nurses’experience and attitudes toward computer use was significant(r¼0.17,P<0.05).The relationship between the total structural empowerment score and attitudes toward computer use was positive but weak(r¼0.20,P<0.01).Conclusion:The results indicated that more experienced nurses are more reluctant toward computer use.However,creating an empowering work environment can facilitate nurses’attitudes toward computer use.展开更多
This study＇s purpose is to evaluate and analyse the indoor daylight quality in Pediatrics Ward in JUH （Jordan University Hospital）. It conducts an investigative analysis associated with an evaluative approach for t...This study＇s purpose is to evaluate and analyse the indoor daylight quality in Pediatrics Ward in JUH （Jordan University Hospital）. It conducts an investigative analysis associated with an evaluative approach for the daylight situation in patient rooms in the children section. A multi-method approach used including on-site measurements, and building model to develop a framework for lighting design in Paediatrics Ward, in order to determine whether the current quality meets the recommended values for patient rooms by CIBSE or not. The study considered the following variables： the differences in daylight environments （illuminance, luminance level, daylight factor）, and the physical environment properties of patient rooms in the hospital. The study found that the indoor daylight performance in terms of illuminance, luminance level, and daylight factor in east patient rooms are higher than the recommended values by CIBSE in the area nearest to glass window at the morning and less than the recommended values in the depth of the room at afternoon. Therefore, solar reflective technologies and shading system must be provided for enhanced day lighting control, avoid excessive glare and to guarantee a good level of visual comfort for patients and staff while reducing artificial lighting demand.展开更多
Anal stenosis is a rare but serious complication of anorectal surgery, most commonly seen after hemorrhoidectomy. Anal stenosis represents a technical challenge in terms of surgical management. A Medline search of stu...Anal stenosis is a rare but serious complication of anorectal surgery, most commonly seen after hemorrhoidectomy. Anal stenosis represents a technical challenge in terms of surgical management. A Medline search of studies relevant to the management of anal stenosis was undertaken. The etiology, pathophysiology and classification of anal stenosis were reviewed. An overview of surgical and non-surgical therapeutic options was developed. Ninety percent of anal stenosis is caused by overzealous hemorrhoidectomy. Treatment, both medical and surgical, should be modulated based on stenosis severity. Mild stenosis can be managed conservatively with stool softeners or fiber supplements. Sphincterotomy may be quite adequate for a patient with a mild degree of narrowing. For more severe stenosis, a formal anoplasty should be performed to treat the loss of anal canal tissue. Anal stenosis may be anatomic or functional. Anal stricture is most often a preventable complication. Many techniques have been used for the treatment of anal stenosis with variable healing rates. It is extremely difficult to interpret the results of the various anoplastic procedures described in the literature as prospective trials have not been performed. However, almost any approach will at least improve patient symptoms.展开更多
When people in the West think about the field of medicine and medical practices,they are often perceived as grim and expensive necessities.Healthcare in the United States,for example,can be frightening for some,as the...When people in the West think about the field of medicine and medical practices,they are often perceived as grim and expensive necessities.Healthcare in the United States,for example,can be frightening for some,as the price tags for pharmaceutical drugs and visits to the doctor are high.Additionally,after obtaining an appointment with a doctor,it can take weeks to be seen.U.S.doctors are harried and overworked,so many are forced to treat展开更多
文摘Anal fistula is among the most common illnesses affecting man.Medical literature dating back to 400 BC has discussed this problem.Various causative factors have been proposed throughout the centuries,but it appears that the majority of fistulas unrelated to specific causes (e.g.Tuberculosis,Crohn’s disease) result from infection (abscess) in anal glands extending from the intersphincteric plane to various anorectal spaces.The tubular structure of an anal fistula easily yields itself to division or unroofing (fistulotomy) or excision (fistulectomy) in most cases.The problem with this single,yet effective,treatment plan is that depending on the thickness of sphincter muscle the fistula transgresses,the patient will have varying degrees of fecal incontinence from minor to total.In an attempt to preserve continence,various procedures have been proposed to deal with the fistulas.These include: (1) simple drainage (Seton);(2) closure of fistula tract using fibrin sealant or anal fistula plug;(3) closure of primary opening using endorectal or dermal flaps,and more recently;and (4) ligation of intersphincteric fistula tract (LIFT).In most complex cases (i.e.Crohn’s disease),a proximal fecal diversion offers a measure of symptom-atic relief.The fact remains that an "ideal" procedure for anal fistula remains elusive.The failure of each sphincter-preserving procedure (30%-50% recurrence) often results in multiple operations.In essence,the price of preservation of continence at all cost is multiple and often different operations,prolonged disability and disappointment for the patient and the surgeon.Nevertheless,the surgeon treating anal fistulas on an occasional basis should never hesitate in referring the patient to a specialist.Conversely,an expert colorectal surgeon must be familiar with many different operations in order to selectively tailor an operation to the individual patient.
文摘Objective:This study examined the relationship between structural empowerment and nurses’experience and attitudes toward computer use.Methods:This study was conducted using a cross-sectional quantitative design.A total of 184 registered nurses from four hospitals in Jordan participated in the current study.Data were collected using a demographics questionnaire,the Conditions for Work Effectiveness Questionnaire-II(CWEQ-II),and the Pretest for Attitudes toward Computers in Healthcare(PATCH).Results:The median of experience in years among nurses was 5.0,ranging from one to 26 years.The mean score for the attitudes toward computer use was 61.90±11.38.Almost half of the participants,45.11%,were in the category of“feel comfortable using user-friendly computers.”The participants’mean average of the total structural empowerment was 12.40±2.43,and the values for its four subscales were:opportunity 3.57±0.87,resources 2.83±0.85,information 3.06±0.79,and support 2.95±0.86.The frequencies analysis revealed that most participants had a moderate level of empowerment(n¼127,69.02%).The bivariate correlation between nurses’experience and attitudes toward computer use was significant(r¼0.17,P<0.05).The relationship between the total structural empowerment score and attitudes toward computer use was positive but weak(r¼0.20,P<0.01).Conclusion:The results indicated that more experienced nurses are more reluctant toward computer use.However,creating an empowering work environment can facilitate nurses’attitudes toward computer use.
文摘This study＇s purpose is to evaluate and analyse the indoor daylight quality in Pediatrics Ward in JUH （Jordan University Hospital）. It conducts an investigative analysis associated with an evaluative approach for the daylight situation in patient rooms in the children section. A multi-method approach used including on-site measurements, and building model to develop a framework for lighting design in Paediatrics Ward, in order to determine whether the current quality meets the recommended values for patient rooms by CIBSE or not. The study considered the following variables： the differences in daylight environments （illuminance, luminance level, daylight factor）, and the physical environment properties of patient rooms in the hospital. The study found that the indoor daylight performance in terms of illuminance, luminance level, and daylight factor in east patient rooms are higher than the recommended values by CIBSE in the area nearest to glass window at the morning and less than the recommended values in the depth of the room at afternoon. Therefore, solar reflective technologies and shading system must be provided for enhanced day lighting control, avoid excessive glare and to guarantee a good level of visual comfort for patients and staff while reducing artificial lighting demand.
文摘Anal stenosis is a rare but serious complication of anorectal surgery, most commonly seen after hemorrhoidectomy. Anal stenosis represents a technical challenge in terms of surgical management. A Medline search of studies relevant to the management of anal stenosis was undertaken. The etiology, pathophysiology and classification of anal stenosis were reviewed. An overview of surgical and non-surgical therapeutic options was developed. Ninety percent of anal stenosis is caused by overzealous hemorrhoidectomy. Treatment, both medical and surgical, should be modulated based on stenosis severity. Mild stenosis can be managed conservatively with stool softeners or fiber supplements. Sphincterotomy may be quite adequate for a patient with a mild degree of narrowing. For more severe stenosis, a formal anoplasty should be performed to treat the loss of anal canal tissue. Anal stenosis may be anatomic or functional. Anal stricture is most often a preventable complication. Many techniques have been used for the treatment of anal stenosis with variable healing rates. It is extremely difficult to interpret the results of the various anoplastic procedures described in the literature as prospective trials have not been performed. However, almost any approach will at least improve patient symptoms.
文摘When people in the West think about the field of medicine and medical practices,they are often perceived as grim and expensive necessities.Healthcare in the United States,for example,can be frightening for some,as the price tags for pharmaceutical drugs and visits to the doctor are high.Additionally,after obtaining an appointment with a doctor,it can take weeks to be seen.U.S.doctors are harried and overworked,so many are forced to treat
