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Puspita, Sylvie, and Enny Puspita. "THE RELATIONSHIP BETWEEN NURSE’S KNOWLEDGE ABOUT NURSING CARE AND PATIENT’S SATISFACTION." Nurse and Health: Jurnal Keperawatan 9, no. 1 (June 15, 2020): 42–49. http://dx.doi.org/10.36720/nhjk.v9i1.149.
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Background: Caring of nurses is an important component in evaluating patient satisfaction. Nurses have a big influence in determining the quality of hospital services (Rumagit, Mulyadi, & Malara, 2017).Objectives: The purpose of this study was to analyze the relationship between nurse's knowledge of nursing care and patient's satisfaction.Methods: The design of this study used descriptive correlation design with cross sectional approach. The population in this study were all nurses and patients in Asoka and Flamboyan rooms of the General Hospital of Jombang Regency. The sampling technique used Purposive Sampling with following criteria: cooperative patient, patient awareness composer, able to read and write. The sample in this study were all of Nurse Associated or who did the nursing care to patients totaling 26 people consisting of 15 nurses of Flamboyan room and 11 nurses of Asoka room. For assessing the satisfaction of the sample patients, the sample of this study were 11 patients of Asoka room and 15 patients of Flamboyan room who will return home after being hospitalized. Instrument of this study used modification of Nurse’s Knowledge about Nursing Care Questionnaire developed by Surjiyem (2017) consist of 20 items with Cronbach Alpha .635 and Patient Satisfaction Questionnaire developed by General Hospital of Jombang Regency consist of 20 items with Cronbach Alpha .660. The data of this study were analyzed by Fisher’s Exact Test with significance value less than .05.Results: Based on the research results obtained Exact Sig. (2-sided) .010, which means there is a relationship between nurses' knowledge and patient satisfaction.Conclusion: Nurse’s knowledge about nursing care related to patient’s satisfaction. Based on the results of this study, the nurses are expected to have good knowledge in nursing care, so they can provide optimal services and provide satisfaction to patients and families for these services. Keywords: Nurse’s Knowledge, Nursing Care, Patients Satisfaction
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Zsheliaskova-Koynova, Zsh, and E. Mileva. "STUDENTS’ SATISFACTION WITH PEDAGOGY TEACHING." Trakia Journal of Sciences 17, Suppl.1 (2019): 832–37. http://dx.doi.org/10.15547/tjs.2019.s.01.137.
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Satisfaction with the training process is seen as one of the main criteria for accreditation of all higher education programs, according to the requirements of the National Evaluation and Accreditation Agency in Bulgaria. Students’ satisfaction is connected with the students' perception of the extent to which their needs or expectations have been met in the learning process. The aim of the research was to study students' satisfaction with the quality of pedagogy teaching at the National Sports Academy. The research involved 65 students (33 men, 32 women). The satisfaction survey was conducted using an online-based questionnaire (Google-Form). Subjects did not indicate their names, but only their group and gender. The results obtained show that, as a whole, students were satisfied to a very large extent with pedagogy teaching. Gender did not affect satisfaction. However, the attendance rate affected it. Students who attended all lectures had the highest degree of satisfaction, while students who did not attend any lectures had the lowest. Students who had finished elite secondary school (which is related to very high expectations of teaching), were the least satisfied and they were the ones who most often skipped lectures. The most important factor affecting students’ satisfaction was the behavior of lecturers and their interaction with the students.
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Saaty, Thomas L., H. J. Zoffer, and Lirong Wei. "An Indicator of One’s Life Satisfaction." European Journal of Pure and Applied Mathematics 11, no. 3 (July 31, 2018): 553–74. http://dx.doi.org/10.29020/nybg.ejpam.v11i3.3313.
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How satisfied is each of us with the fulfillment of his life? In this paper after a thor-ough search of the literature about satisfaction, 58 criteria and subcriteria related to satisfaction or fulfillment were identified and arranged in a hierarchic structure. A process of prioritization known as the Analytic Hierarchy Process is used with the structure, putting in judgments from knowledgeable people to derive priorities for the criteria and subcriteria. A template was then developed for the reader to rate his satisfaction on each of the subcriteria in the structure to obtain an overall measure of satisfaction with their life. Someone who feels they have a perfect life would get 100%. The template can be used by any individual to determine what grade they get in life satisfaction. Readers can get the model to assess the reader’s level of life-satisfaction proposed in this paper at https://1drv.ms/x/s!Ao0b6FaIKSXM_AiH8x7JG5E09QCV.
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Chen, Jenny, Natalie Justicz, and Linda Lee. "Platelet-Rich Plasma for the Treatment of Androgenic Alopecia: A Systematic Review." Facial Plastic Surgery 34, no. 06 (June 28, 2018): 631–40. http://dx.doi.org/10.1055/s-0038-1660845.
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AbstractThe use of platelet-rich plasma (PRP) has become increasingly commonplace in facial plastic surgery for the treatment of androgenic alopecia (AGA). However, this treatment remains novel with a range of application techniques and outcomes described in the literature. Herein, the authors systematically review the existing literature on the use and efficacy of PRP for AGA. Systematic review of PubMed, Embase, and Cochrane databases was performed. Case reports were excluded. Twenty-four papers met inclusion criteria for this study: 8 randomized control trials and 16 prospective cohort studies. Twenty-one studies used clinical criteria to diagnose AGA, while three used confirmatory biopsies. PRP was injected with or without the use of a numbing agent, and most studies performed multiple injections (three or more separated by several weeks). Twenty-one studies reported positive outcomes by objective criteria (88%), while three suggested that there was no clinical improvement, although in two of these studies patients still reported increased satisfaction. There were no complications reported other than transient edema/erythema and pain/headache associated with the procedure. The existing literature suggests that PRP is a low-risk intervention to treat AGA associated with good patient satisfaction and objective improvements in outcomes. Further research is needed to optimize preparation and delivery methods as well as standardize measurements of clinical outcomes.
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., Muthmainah, and Muhammad Cholil. "DETERMINANTS OF CUSTOMER`S SWITCHING INTENTION BASED ON EXPERIENCE AND SHARIA VALUE CONGRUITY." MIX: JURNAL ILMIAH MANAJEMEN 9, no. 1 (February 18, 2019): 109. http://dx.doi.org/10.22441/mix.2019.v9i1.007.
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This study aims to examine the factors that influence the customer`s switching intention, which are influenced by customer satisfaction and customer loyalty based on customer experience and congruity of sharia values. The sample size of 195 Sharia banks customers in Surakarta was taken using convenient sampling method. The research analysis used hierarchical regression with customer satisfaction as the independent variable, customer`s switching intention as the dependent variable and customer loyalty as a mediator variable. Besides that, it also uses customer experience and congrueity to sharia values as a moderator variable.Validity test, reliability test and classic assumption test have been carried out and the results meet the criteria according to the specified standards. The results of the research analysis show that customer satisfaction has a positive and significant effect on customer loyalty and has a negative effect on the customer`s switching intention and customer loyalty has a negative effect on customer`s switching intention. Customer loyalty partially mediates the effect of customer satisfaction on customer`s switching intention. However, the customer experience and congrueity sharia value does not strengthen or weaken the influence of customer satisfaction on customer loyalty and on customer`s switching intention and does not strengthen or weaken the influence of customer loyalty on customer`s switching intention. The theoretical and practical implications of the results of research that are considered relevant and need to be discussed can be used as orientation and direction for future research
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Hong, Sung-Mook, and Effy Giannakopoulos. "Effects of Age, Sex, and University Status on Life-Satisfaction." Psychological Reports 74, no. 1 (February 1994): 99–103. http://dx.doi.org/10.2466/pr0.1994.74.1.99.
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Diener, et al.'s 1985 Satisfaction With Life Scale was administered to 1749 adult Australians to examine differences between men and women, university students and nonuniversity students, and among 17- to 22-, 23- to 29-, and 30- to 40-yr.-olds. No significant differences in Life-satisfaction emerged in relation to sex or university status, but age showed a significant effect as higher life-satisfaction characterized older subjects. No interactions were found for any combination of the three variables. The results are interpreted in terms of egalitarian sex-role ideologies regarding sex, status-specific criteria in the assessment and conceptualisation of life-satisfaction for university status, and maturity trends in viewing life events concerning age.
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Teoh, Teoh Yeon Kin, Suzanawati Abu Hasan, and Siti Nur Atikah Zahari. "Data Envelopment Analysis for Malaysia Courier Services Performance and Customer Satisfaction." Journal of Computing Research and Innovation 5, no. 3 (October 21, 2020): 25–33. http://dx.doi.org/10.24191/jcrinn.v5i3.135.
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One of the key issues of the current courier services in Malaysia is the efficiency of the courier itself. In today's competition, many factors have recognized that influence the efficiency of courier services. Hence, numbers of analytical models and formu las were introduced to measure the efficiency of courier service. This paper presents a practical approach for identifying the level of customers’ satisfaction towards courier service companies using Data Envelopment Analysis and four courier services whic h were Poslaju, City - Link Express , J&T Expres s, and GD Express in Hulu Terengganu were selected. Data Envelopment Analysis is chosen in this study because it can deal with complex connections between several inputs and outputs on performance evaluation iss ues. The input criteria considered in this study are assurance, empathy, reliability, responsiveness, tangibility, and price. Meanwhile, customer satisfaction is chosen as the output criteria. The results showed that Poslaju is ranked as the most efficient company, followed by City - Link Express in second and J&T Express as the third. The least efficiency score obtained makes GD Express as the last ranked courier service among these four courier services. Furthermore, the results are mainly influenced by the input criteria of assurance, empathy, and tangibility. This study helps the customer to select the most efficient courier service that can save their time, money, and energy. Finally, this study also can guide courier services to decide on which criteria are effective to be improved to enhance their business performance.
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Ammenwerth, E., R. Haux, and F. Ehlers. "Process Potential Screening." Methods of Information in Medicine 45, no. 05 (2006): 506–14. http://dx.doi.org/10.1055/s-0038-1634111.
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Summary Objectives: Hospitals are increasingly under pressure to optimize their processes. So far, an instrument to systematically identify the potentials for improvement of a given business process is missing. The aim of this project is to develop such an instrument. Methods: Initially, central aspects of the quality of a hospital process were identified on the basis of a systematic literature review. Secondary to that, criteria to measure quality aspects were defined: More than 300 criteria from medical and business informatics, economics and quality management publications were gathered and systematically aggregated. Results: As a result, the Process Potential Screening (PPS) instrument was developed. The PPS is a matrix containing two axes: Axis I comprises 30 quality aspects referring to results, execution and control of hospital processes. Axis II comprises 16 quality criteria (e.g., customer satisfaction, time). The PPS displays approximately 400 relevant combinations of those quality aspects and quality criteria that help to identify potentials for improvement of a given hospital process. It utilizes different methods for the measurement of the criteria and for application by way of individuals or groups. Conclusions: In using the PPS, relevant potentials for improvement were identified in ten typical hospital processes. The instrument’s practicability must now be examined in further studies by the final target group (e.g., quality or project managers, and the staff responsible for processes).
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Lopes, Fernanda, Nelson Carvas Júnior, Mary Uchiyama Nakamura, and Roseli Mieko Yamamoto Nomura. "Content and Face Validity of the Mackey Childbirth Satisfaction Rating Scale Questionnaire Cross-culturally Adapted to Brazilian Portuguese." Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics 41, no. 06 (June 2019): 371–78. http://dx.doi.org/10.1055/s-0039-1692125.
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Objective The aim of this study was to determine the content and face validity of the Mackey Childbirth Satisfaction Rating Scale (MCSRS) questionnaire cross-culturally adapted to Brazilian Portuguese. Methods The MCSRS is a questionnaire with 34 items related to childbirth satisfaction. The forward- and back-translated versions were compared with the original material, and 10 experts analyzed each item according to the following criteria: clarity, semantic equivalence, appropriateness, and cultural relevance. The final version was presented to 10 mothers for face validation to ensure the questionnaire would suit the target population. Results The total of 34 items assessed by experts for clarity, semantic equivalence, appropriateness, and relevance showed positive agreement of 0.85, 0.92, 0.97 and 0.97; negative agreement of 0.13, 0.09, 0.04 and 0.04; and total agreement of 0.75; 0.85, 0.94 and 0.94, respectively. Multilevel linear modeling was applied with crossed random effects and with nested random effects for each judge. The intercept of each criterion was as follows: clarity, 0.87; semantic equivalence, 0.92; appropriateness, 0.96; and cultural relevance, 0.96. The overall mean of agreement was 92.8%. The face validity measurement yielded 80% of agreement on the items, all of them clearly understood. Conclusion The final version of the Brazilian Portuguese MCSRS questionnaire had face and content validity confirmed. This instrument of evaluation of maternal satisfaction during childbirth was validated to be applied in the Brazilian female population.
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Potemina, T. E., S. V. Kuznetsova, A. V. Pereshein, O. J. Samoilova, and O. I. Yanushanets. "Quality of life in healthcare services: criteria, goals, prospects." Russian Osteopathic Journal, no. 3-4 (January 17, 2019): 98–106. http://dx.doi.org/10.32885/2220-0975-2018-3-4-98-106.
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The quality of life (QoL) of a patient does not refl ect the absence of disease, but the satisfaction of his/her needs and adaptation in the physical, psychological and social spheres. At the beginning of the 21st century the «Quality of Life» (QoL) concept in medicine transformed into the subject of scientifi c research and became more precise — «health related quality of life» (HRQL). In medical practice QoL is used for various purposes: to evaluate the effi ciency of modern methods in clinical science and various rehabilitation technologies, to assess the patient′s conditions severity, to determine the disease prognosis, treatment and prevention programs results. At present QoL criteria are recognized as essentials for integrated analysis of new methods of diagnostics, treatment and prevention. Currently, there is an intensive development of QoL methods for the most common chronic diseases all over the world. The widespread use of QoL assessment provides health authorities with a tool for additional analysis of medical service activity, as well as for making decisions on funding priority areas.
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Ramírez-Díaz, José Laurian, and Fiorella Hidalgo-Solano. "Satisfacción de estudiantes de secundaria nocturna y su incidencia en el abandono escolar." Revista Electrónica Educare 22, no. 1 (December 11, 2017): 1. http://dx.doi.org/10.15359/ree.22-1.14.
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This paper presents an analysis on the satisfaction of night school students about their educational process, from the valuation they have of their own motivation, physical infrastructure facilities, and interpersonal relationships between students and teachers, specifically in the technical and professional education fields. All this aimed to analyze components that increase the feeling of well-being, and enhance the promotion and academic success based on criteria to prevent the school dropout. To do so, we conducted a factor analysis with information obtained from a questionnaire based on a Likert scale. The questionnaire was applied to a sample of 120 participants; with it, we identified some important indicators to be considered in actions to prevent dropout in adult students. The collected information was presented in statistical tables, which display indicators of satisfaction about infrastructure, teacher´s treatment, and student´s motivation.
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Terry, Hannah, Erica Frazier, Tamara Adler, and Derek Yates. "Evaluation of provider satisfaction with mental health clinical pharmacy specialists in outpatient mental health clinics." Mental Health Clinician 10, no. 3 (May 1, 2020): 76–79. http://dx.doi.org/10.9740/mhc.2020.05.076.
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Abstract Introduction Mental health services are an area of high need in many health care systems in the United States. With a limited number of psychiatric providers and a projected increase in the deficit of psychiatrists, a call for increased mental health services is apparent. The inclusion of mental health clinical pharmacy specialists (MH-CPS) as part of interdisciplinary care teams has enabled the William S. Middleton Memorial Veterans Hospital & Clinics as well as numerous other Veterans Affairs sites to improve access to mental health providers when pharmacists serve as an integral part of the mental health team. Our objectives were to (1) evaluate impressions of nonpharmacist mental health providers of MH-CPS and (2) assess for areas of improvement in MH-CPS services. Methods A survey was formulated, using 5-point Likert scale criteria, to evaluate impressions of MH-CPS from other mental health providers. Questions were designed to address impressions of clinical skills, knowledge, team contribution, and comfort with MH-CPS providers. These were distributed and completed in December 2018 by members of mental health treatment teams at the William S. Middleton Memorial Veterans Hospital & Clinics. Results Overall, mental health team members rated satisfaction with MH-CPS highly across all evaluated criteria. Discussion Per review of these results, MH-CPS are a valued and respected part of the mental health team.
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Hongwu, Zhuo, and Jian Li. "One-Stage Arthroscopic Reduction Combined with Multiligament Reconstruction or Repair for Irreducible Posterolateral Knee Dislocation: A Retrospective Case Series with Minimum 2-Year Follow-Up." Journal of Knee Surgery 31, no. 10 (March 7, 2018): 1015–21. http://dx.doi.org/10.1055/s-0038-1632394.
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AbstractThe purpose of this study was to evaluate the clinical outcomes after arthroscopic management of irreducible posterolateral knee dislocation. Twenty-one patients with irreducible posterolateral knee dislocation were treated in our institution from January 2009 to May 2014. Inclusion criteria were as follows: (1) patients who underwent one-stage arthroscopic reduction combined with multiligament reconstruction or repair and (2) patients with a minimum 2-year follow-up. Knee stability was assessed using physical examination and side-to-side differences (SSD) determined with a KT-1000 arthrometer and Telos stress device. Other assessments included the International Knee Documentation Committee (IKDC) subjective score, Lysholm score, Tegner score, and patient satisfaction rate. Thirteen of the 21 patients (8 males and 5 females) met our inclusion criteria and were included in this analysis. The mean age was 37.8 years (range, 27–56 years). The mean time from injury to surgery was 1.84 days (range, 1–3 days). The mean follow-up period was 32.6 months (range, 24–46 months). At the final follow-up, with the exception of one patient who had an abnormal valgus stress test, all patients achieved normal or nearly normal Lachman test, pivot shift test, posterior drawer test, and varus and valgus stress tests. The mean SSD of total anterior–posterior translation and isolated anterior translation determined with a KT-1000 arthrometer were 2.15 ± 1.57 mm (range, 0–6 mm) and 1.61 ± 0.86 mm (range, 1–4 mm), respectively. The mean SSD of anterior translation, posterior translation, and medial and lateral joint gapping determined with a Telos stress device were 2.23 ± 0.92 mm (range, 1–4 mm), 3.23 ± 1.16 mm (range, 2–5 mm), 1.77 ± 1.87 mm (range, 0–7 mm), and 0.46 ± 0.52 mm (range, 0–2 mm), respectively. The IKDC subjective score, Lysholm score, and Tegner score improved significantly postoperatively (p = 0.001) with a satisfaction rate of 84.6%. One-stage arthroscopic reduction combined with multiligament reconstruction or repair was an effective, reliable treatment for irreducible posterolateral knee dislocation. This is a case series with level of evidence as IV.
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Dudkina, Aija, Elza Krasta, and Juris Porozovs. "RELATIONSHIP’S SATISFACTION CONNECTION WITH THE MOTIVATION OF FORGIVENESS." SOCIETY. INTEGRATION. EDUCATION. Proceedings of the International Scientific Conference 7 (May 20, 2020): 23. http://dx.doi.org/10.17770/sie2020vol7.5109.
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The purpose of the study was to investigate whether there is a relationship betweenthe motivation of forgiveness and satisfaction with the partnership in spouses. The study was attended by 300 married respondents: 180 women and 120 men (M = 39.29, SD = 10.7). Groups were matched according to the following criteria: age (19-60 years); married. To measure motivation of forgiveness, an interpersonal motivation survey related to abuse was used: the version of 18 statements (Transgression-Related Interpersonal Motivations Inventory; TRIM-18; McCullough et al. 1998; McCullough; Root & Cohen; 2006; adaptation in Latvian by S. Brudere -Ruska and V. Perepjolkina, 2012) and couples’ satisfaction index (CSI) Funk, JL & Rogge, RD (2007) was used to measure couples’ satisfaction. The study raised the question of whether there is a relationship between the motivation for forgiveness and the satisfaction of the spouses with the relationship? There were statistically significant positive correlations between forgiveness and satisfaction, which indicates that increasing rates of forgiveness increase satisfaction rates, and a negative close correlation was obtained by avoiding and retaliation for forgiveness, indicating that, as these scales increase, they will decrease satisfaction. Most respondents of the study against their partner, who is the abuser, are showing signs of grace that can be seen in the results of this research. The results of the study are in line with previous similar studies and confirm that forgiveness contributes to the well-being of the relationship.
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Peng, Jiaxi, Yongmei Xiao, Yijun Li, Wei Liang, Hao Sun, Wen Bao, Qilin Huang, Yan Zhang, and Shengjun Wu. "Testing the reliability and validity of the Experiences in Close Relationships Scale–Short Form with Chinese college students." Social Behavior and Personality: an international journal 49, no. 7 (July 7, 2021): 1–10. http://dx.doi.org/10.2224/sbp.10400.
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Currently, there is no instrument to quickly measure adult attachment in the Chinese cultural context. In this study the Experiences in Close Relationships Scale–Short Form (ECR-S) was translated and tested in terms of reliability and validity with Chinese college students. All items of the Chinese-version ECR-S showed high discriminability and the scale had a two-dimensional structure in both exploratory and confirmatory factor analyses. The internal consistency coefficients of the two subscales of the ECR-S showed excellent reliability, and scores were modestly to highly correlated with the criteria of state adult attachment, self-esteem, anxiety, pressure, depression, and satisfaction with intimate (romantic) relationships. It can be concluded that the Chinese version of the ECR-S has high reliability and validity; thus, it meets the requirements for psychometric tools and can be used to assess Chinese adults' attachment.
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Joy, Riya, and Shynee Paul. "A QUALITATIVE STUDY ON THE LIVED EXPERIENCES OF EXPECTANT FATHERS IN MANGALORE." Journal of Health and Allied Sciences NU 02, no. 03 (September 2012): 85–89. http://dx.doi.org/10.1055/s-0040-1709356.
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AbstractThe study was conducted to explore the unique experiences of expectant fathers. The research approach used in this study was Phenomenology. Six expectant fathers who met the inclusion criteria were selected using purposive sampling technique from the OPD unit of the Fr. Muller Medical College Hospital, Mangalore and a private antenatal clinic, Saurabh clinic in Mangalore.In depth interviews were conducted in a selected room in the antenatal clinic with all privacy Colaizzi's data analysisframework was used to analyze the transcripts in this study From the analysis of the data, five themes emerged from the experiences of expectant fathers and they were as follows:Theme 1: Happiness and satisfaction - the response to pregnancy, Theme 2: Relationship with wife- Physically and emotionally, Theme 3: A change in social life, Theme 4: Coping with Pregnancy, Theme 5: Expectations about the baby
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Aroonsrimorakot, Sayam, Meena Laiphrakpam, and Warit Paisantanakij. "Impacts of Green Office Projects in Thailand: An Evaluation Consistent with Sustainable Development Goals (SDGs)." Journal of Sustainable Development 13, no. 4 (July 29, 2020): 164. http://dx.doi.org/10.5539/jsd.v13n4p164.
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This study aims to evaluate the environmental, economic, and social impacts of a green office project in Thailand, that is consistent with sustainable development goals (SDGs), to analyze and present the result of the study of the environmental, economic, and social impact of green office, and to evaluate satisfaction in the green office project operation. Evaluated the operating steps of green office projects, using new green office evaluation criteria, under Department of Environmental Quality Promotion (DEQP), by collecting preliminary data through questionnaires from 73 agencies, by monitoring and analyzing the project operation of participating organizations to certify as green office standard during 2015 to 2017. Besides, qualitative data were collected through the in-depth interview from 25 representative agencies, selected on the criteria of readiness to provide information and to evaluate their satisfaction in the green office project’s operation. The value of the green office project was 299 million Baht for all participant organizations equal to 1.4 million Baht/office/year. And this could be divided into economic compensation, (262.5 million Baht), social compensation (28.5 million Baht), and environmental compensation (7.55 million Baht). Evaluation of satisfaction found that most agencies (79.45%) have high satisfaction to certification on the evaluation result of national auditors, benefit on staffs’ knowledge, understanding, and observation of the importance of green office operation (86.63%), and the advantage of green office operation in their office (90.41%). The study further suggests that green office projects should be supported as a national policy to all agencies for continuous enhancement or development of the standard, to be an international level according to sustainable development goals (SDGs).
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Tekic, Jasmina, Vidosav Majstorovic, and Dejan Markovic. "Applying the model of excellence in dental healthcare." Srpski arhiv za celokupno lekarstvo 143, no. 1-2 (2015): 56–62. http://dx.doi.org/10.2298/sarh1502056t.
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Introduction. Models of excellence are considered a practical tool in the field of management that should help a variety of organizations, including dental, to carry out the measurement of the quality of provided services, and so define their position in relation to excellence. The quality of healthcare implies the degree within which the system of healthcare and health services increases the likelihood of positive treatment outcome. Objective. The aim of the present study was to define a model of excellence in the field of dental healthcare (DHC) in the Republic of Serbia and suggest the model of DHC whose services will have the characteristics of outstanding service in the dental practice. Methods. In this study a specially designed questionnaire was used for the assessment of the maturity level of applied management regarding quality in healthcare organizations of the Republic of Serbia. The questionnaire consists of 13 units and a total of 240 questions. Results. The results of the study were discussed involving four areas: (1) defining the main criteria and sub-criteria, (2) the elements of excellence of DHC in the Republic of Serbia, (3) the quality of DHC in the Republic of Serbia, and (4) defining the framework of the model of excellence for the DHC in the Republic of Serbia. The main criteria which defined the framework and implementation model of excellence in the field of DHC in Serbia were: leadership, management, human resources, policy and strategy, other resources, processes, patients? satisfaction, employee?s satisfaction, impact on society and business results. The model had two main parts: the possibilities for the first five criteria and options for the other four criteria. Conclusion. Excellence in DHC business as well as the excellence of provided dental services are increasingly becoming the norm and good practice, and progressively less the exception.
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Scholz, Torben, Verena Mainz, Christian Blume, Walid Albanna, Hans Clusmann, Andreas Müller, and Matthias Geiger. "Anterior Cervical Decompression and Fusion or Posterior Foraminotomy for Cervical Radiculopathy: Results of a Single-Center Series." Journal of Neurological Surgery Part A: Central European Neurosurgery 79, no. 03 (November 13, 2017): 211–17. http://dx.doi.org/10.1055/s-0037-1607225.
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Background Anterior cervical diskectomy and fusion (ACDF) or posterior foraminotomy (PF) are standard treatment options for cervical radiculopathy due to disk prolapse. Which method produces superior results has not yet been established. One reason for the dilemma, among others, is a lack of detailed outcome analysis in previous studies. We quantified outcome to compare both methods in our retrospective single-center series. Method We conducted a retrospective analysis of 107 patients with cervical radiculopathy who were operated on via ACDF or via PF. Demographic data, symptoms, neurologic status, and pathology were recorded and correlated to outcome parameters such as Odom's criteria, visual analog scale values of radicular pain, Neck Disability Index values, and subjective satisfaction, which were also compared between both treatment groups. Intraoperative data, early and late complications, and reoperations were recorded and compared between both surgical groups. Results None of the recorded preoperative data were predictive for postoperative outcome parameters. Patients in the PF group reported better overall outcome (Odom's criteria) and greater relief of radicular and neck pain. Operative time and blood loss were less in the PF group. Both groups showed comparable early complication rates, but PF patients tended to have more late reoperations. Conclusion Due to a better overall outcome as well as greater relief of radicular and neck pain in our cohort, we consider PF the first-line treatment if morphology of the pathology is suitable.
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Kamel, George N., David Nash, Joshua Jacobson, Robin Berk, Karan Mehta, Teresa Benacquista, Lawrence B. Draper, Evan S. Garfein, and Katie E. Weichman. "Patient-Reported Satisfaction and Quality of Life in Postmastectomy Radiated Patients: A Comparison between Delayed and Delayed Immediate Autologous Breast Reconstruction in a Predominantly Minority Patient Population." Journal of Reconstructive Microsurgery 35, no. 06 (February 4, 2019): 445–51. http://dx.doi.org/10.1055/s-0039-1677798.
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Background Delayed immediate (DI) autologous breast reconstruction consists of immediate postmastectomy tissue expander placement, radiation therapy, and subsequent autologous reconstruction. The decision between timing of reconstructive methods is challenging and remains to be elucidated. We aim to compare patient reported outcomes and quality of life between delayed and DI reconstruction. Methods A retrospective review of all patients, who underwent autologous breast reconstruction at Montefiore Medical Center from January 2009 to December 2016, was conducted. Patients who underwent postmastectomy radiotherapy were divided into two cohorts: delayed and DI autologous breast reconstruction. Patients were mailed a BREAST-Q survey and their responses, demographic information, complications, and need for revisionary procedures were analyzed. Results A total of 79 patients met inclusion criteria: 34.2% (n = 27) in the delayed and 65.8% (n = 52) in the DI group. 77.2% (n = 61) of patients were a minority population. Patients in each cohort had similar baseline characteristics; however, the DI cohort was more likely to have bilateral reconstruction (46.2% [n = 24] vs. 7.4% [n = 2]; p = 0.0005) and to have major mastectomy flap necrosis (22.4% [n = 17] vs. 0.0% [n = 0]; p = 0.002). Premature tissue expander removal occurred in 17.3% (n = 9) of patients in the DI group. BREAST-Q response rates were 44.4% (n = 12) in the delayed group and 57.7% (n = 30) in the DI group. Responses showed similar satisfaction with their breasts, well-being, and overall outcome. Conclusion Delayed and DI autologous breast reconstruction yield similar patient-reported satisfaction; however, patients undergoing DI reconstruction have higher rates of major mastectomy necrosis. Furthermore, patients in the DI group risk premature tissue expander removal.
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Hardenbol, Alec Xander, Bram Knols, Mathijs Louws, Michiel Meulendijk, and Marjan Askari. "Usability aspects of medication-related decision support systems in the outpatient setting: A systematic literature review." Health Informatics Journal 26, no. 1 (November 30, 2018): 72–87. http://dx.doi.org/10.1177/1460458218813732.
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In this study, we evaluated the usability aspects of medication-related clinical decision support systems in the outpatient setting. Articles published between 2000 and 2016 in Scopus, PubMed and EMBASE were searched and classified into three usability aspects: Effectiveness, Efficiency and Satisfaction. Using Van Welie et al.’s usability model, we categorized usability aspects in terms of usage indicators and means. Out of the 1999 articles, 24 articles met the selection criteria of which the main focus was on reducing inappropriate medication, prescription rate and prescription errors. Evidence could mainly be found for Effectiveness and showed high rates of positive results in reducing medication errors. To date, the effects of Efficiency and Satisfaction of clinical decision support systems regarding medication prescription remain understudied. Usability aspects such as memorability, learnability, adaptability, shortcuts and consistency require more attention. Studies are needed for better insight into the user model and to design a knowledge/task model for clinical decision support systems regarding medication prescription.
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Berón, Mario, Hernán Bernardis, Enrique Miranda, Daniel Riesco, João Varanda-Pereira, and Rangel Henriques. "Measuring the understandability of WSDL specifications, web service understanding degree approach and system." Computer Science and Information Systems 13, no. 3 (2016): 779–807. http://dx.doi.org/10.2298/csis160124026b.
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Web Services (WS) are fundamental software artifacts for building service oriented applications and they are usually reused by others. Therefore they must be analyzed and comprehended for maintenance tasks: identification of critical parts, bug fixing, adaptation and improvement. In this article, WSDLUD a method aimed at measuring a priori the understanding degree (UD) of WSDL (Web Service Description Language) descriptions is presented. In order to compute UD several criteria useful to measure the understanding?s complexity of WSDL descriptions must be defined. These criteria are used by LSP (Logic Scoring of Preference), a multicriteria evaluation method, for producing a Global Preference value that indicates the satisfaction level of the WSDL description regarding the evaluation focus, in this case, the understanding degree. All the criteria information required by LSP is extracted from WSDL descriptions by using static analysis techniques and processed by specific algorithms which allow gathering semantic information. This process allows to obtain a priori information about the comprehension difficulty which proves our research hypotheses that states that it is possible to compute the understanding degree of a WSDL description.
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Nielsen, Cory, Ileana Ratiu, Mitra Esfandiarei, Angela Chen, and Elif Seda Selamet Tierney. "A Review of Psychosocial Factors of Marfan Syndrome: Adolescents, Adults, Families, and Providers." Journal of Pediatric Genetics 08, no. 03 (July 25, 2019): 109–22. http://dx.doi.org/10.1055/s-0039-1693663.
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AbstractThe purpose of this article was to review the current literature on psychosocial implications of Marfan syndrome (MFS) and its impact on adolescents, adults, their families and to provide important considerations for providers. Since the previous reviews in 2015, numerous studies have been published that are included in the current review. This literature review was conducted using PubMed, Medline, PsychINFO, ERIC, Web of Science, and Academic Search Premier databases and only articles that studied psychosocial factors that influence MFS patients as adolescents, adults, family members, or their interactions with providers were included in this review. Of the 522 articles reviewed, 41 were selected based on the inclusion and exclusion criteria. All articles were peer-reviewed. MFS has various implications that can impact one's life; studies have shown that MFS causes a negative impact on an individual's formative years, quality of life, reproductive decision-making, work participation, and satisfaction with life. Clinicians and multidisciplinary teams should be aware of these factors to provide support focusing on coping strategies for the patient and their family.
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Ledón-LLanes, Loraine, Irazú Contreras-Yáñez, Guillermo Guaracha-Basáñez, Salvador Saúl Valverde-Hernández, Anayanci González-Marín, Ángel de Jesús Ballinas-Sánchez, Marta Durand, and Virginia Pascual-Ramos. "Views of Mexican outpatients with rheumatoid arthritis on sexual and reproductive health: A cross-sectional study." PLOS ONE 16, no. 1 (January 28, 2021): e0245538. http://dx.doi.org/10.1371/journal.pone.0245538.
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Background Rheumatoid arthritis (RA) impacts sexual and reproductive health (SRH), which is a prominent component of a patient´s quality of life and highly influenced by the cultural background. The aim of the study was to explore the interest of Mexican outpatients with RA in SRH and to examine patient view on SRH. Methods This cross-sectional study surveyed 303 consecutive outpatients with RA on their perceptions of SRH importance, SRH satisfaction, access to SRH information, preferences regarding SRH communication with healthcare professionals, and understanding of SRH (qualitative open-ended descriptions). Descriptive statistics and inferential analysis were used. Patient knowledge of each dimension of SRH was rated based on pre-specified criteria. Two assessors assigned ten major themes to each patient´s description of both dimensions of SRH. Results Patients perceived their SRH as an important component of their general health and wished to address the topic, although few had access to such communication. Female patients assigned lesser importance to SRH, showed lesser degree of satisfaction with SRH, and expressed preference for a truthful physician. Age showed a linear association with individual survey responses, except for satisfaction with reproductive health dimension. There was a linear association between increased age and decreased years of formal education with a lower level of SRH knowledge. Ten major themes emerged for each of the two dimensions of the SRH construct, although most individual descriptions were assigned to one or two major themes. Conclusions Further education and assessment of SRH in Mexican patients with RA is warranted.
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Silva, Gustavo Maximiliano Dutra da, Sônia Maria Rolim Rosa Lima, Benedito Fabiano dos Reis, Carolina Furtado Macruz, and Sóstenes Postigo. "Evaluation of Obesity Influence in the Sexual Function of Postmenopausal Women: A Cross-Sectional Study." Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics 41, no. 11 (November 2019): 660–67. http://dx.doi.org/10.1055/s-0039-1700795.
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Abstract Objective The incidence of obesity, which is a chronic condition, has increased in recent years. The association between obesity and female sexual dysfunction remains unclear, particularly in postmenopausal women. In the present study, we evaluated whether obesity is a risk factor for sexual dysfunction in postmenopausal women. Methods This is a cross-sectional study that analyzed data from interviews of postmenopausal women at the Climacteric Outpatient Clinic from 2015 to 2018. After applying the inclusion and exclusion criteria, 221 women aged between 40 and 65 years old were selected and invited to participate in the study. Obesity was diagnosed according to body mass index (BMI). The participants were grouped into the following BMI categories: group 1, 18.5–24.9 kg/m2 (normal); group 2, 25.0–29.9 kg/m2 (overweight); and group 3, ≥30.0 kg/m2 (obese). Sexual function was assessed using the Female Sexual Function Index (FSFI) questionnaire. Cutoff points of ≥23 and ≥26.5 were adopted to define a diagnosis of female sexual dysfunction (FSD) based on the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision by the American Psychiatric Association (DSM-IV-TR). Results The desire and arousal scores were statistically higher in the normal BMI group than in the obese group (p = 0.028 and p = 0.043, respectively). The satisfaction scores were statistically higher in the normal BMI group than in the overweight and obese groups (p < 0.05). The total FSFI score statistically differed among the BMI categories (p = 0.027). Conclusion In the present study, obese and overweight postmenopausal women had higher total scores than women with normal BMI. Our results show that obese and overweight postmenopausal women had a higher index of dysfunction in desire and arousal and lower sexual satisfaction than normal-weight women.
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Lyell, Deirdre, Mariam Naqvi, Amy Wong, Renata Urban, and Brendan Carvalho. "Rectus Muscle Reapproximation at Cesarean Delivery and Postoperative Pain: A Randomized Controlled Trial." Surgery Journal 03, no. 03 (July 2017): e128-e133. http://dx.doi.org/10.1055/s-0037-1604074.
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Objective Rectus muscle reapproximation at cesarean delivery (CD) is performed frequently by some obstetricians; however, the effect on postoperative pain is unclear. To this end, we investigated whether rectus muscle reapproximation increases postoperative pain. Materials and Methods This is a prospective, double-blind, randomized controlled trial of women undergoing primary CD with singleton or twin pregnancy at >35 weeks' gestation. Women were randomized to rectus muscle reapproximation with three interrupted sutures or no reapproximation. Exclusion criteria were prior cesarean, prior laparotomy, vertical skin incision, active labor, chronic analgesia use, allergy to opioid or nonsteroidal anti-inflammatory drugs, and body mass index ≥ 40. Intra- and postoperative pain management was standardized within the study protocol. The primary outcome was a combined movement pain and opioid use score averaged over the 72-hour study period, called the Silverman integrated assessment. Movement pain scores were assessed at 24, 48, and 72 postoperative hours. Results In total, 63 women were randomized, of whom 35 underwent rectus muscle reapproximation and 28 did not. Demographic and obstetric variables were similar between groups. Silverman integrated assessment scores during the 72-hour postoperative period were higher in the rectus muscle reapproximation group (15 ± 100% vs. –31 ± 78% difference from the mean; p = 0.04). Operative times were similar between groups (63 ± 15 vs. 65 ± 15 minutes; p = 0.61), and there were no surgical complications in either group. Maternal satisfaction with analgesia at 72 hours was high in both groups (85% [73–90] rectus muscle reapproximation vs. 90% [75–100]; p = 0.16). Conclusion Rectus muscle reapproximation increased immediate postoperative pain without differences in operative time, surgical complications, or maternal satisfaction. Benefits of rectus muscle reapproximation should be weighed against increased postoperative pain, and analgesia should be planned accordingly.
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Lin, Guang-Xun, Cheul-Woong Park, Tsz-King Suen, Vit Kotheeranurak, Su-Gi Jun, and Jin-Sung Kim. "Full Endoscopic Technique for High-Grade Up-Migrated Lumbar Disk Herniation via a Translaminar Keyhole Approach: Preliminary Series and Technical Note." Journal of Neurological Surgery Part A: Central European Neurosurgery 81, no. 05 (February 11, 2020): 379–86. http://dx.doi.org/10.1055/s-0039-1700574.
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Abstract Background and Study Aims Technically and anatomically, accessing a high-grade migrated lumbar disk herniation (LDH) using traditional full endoscopic lumbar diskectomy (FELD) approaches (either transforaminal or interlaminar) is challenging. The objective of this study was to present an effective and safe surgical approach for high-grade up-migrated LDH by translaminar FELD. Patients and Methods Thirteen patients with soft high-grade up-migrated LDH treated with a translaminar FELD between May 2015 and July 2018 were reviewed in this study. Five of these patients had very high-grade up-migration. Clinical outcomes were assessed including preoperative and postoperative visual analog scale (VAS) for back and leg pain, Oswestry Disability Index (ODI), and MacNab criteria. Results Overall, 7 of the 13 patients had disk-fragment migration at L4–L5: three at L5–S1, two at L3–L4, and the remaining one at L2–L3. In all cases, the highly up-migrated LDH was removed successfully through the translaminar approach, as confirmed by postoperative magnetic resonance imaging. The improvements of VAS for back and leg pain were 4.5 ± 0.9 to 1.3 ± 1.3 and 7.1 ± 1.0 to 1.6 ± 0.7, respectively (both p < 0.05). The ODI decreased from preoperative 41.9 ± 6.0 to postoperative 13.0 ± 4.1 (p < 0.05). According to the MacNab criteria, the satisfaction rate was 92.3% (excellent or good outcomes). None of the patients experienced any perioperative complications or recurrence during the follow-up period. Conclusion Although full endoscopic technique via the translaminar keyhole route may not be used as a routine surgical approach, it could serve as a feasible alternative method for patients with highly up-migrated disk herniation.
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Rodriguez, Marlene Alvarado, and Neyda Ma Mendoza-Ruvalcaba. "Subjective Successful Aging: Factors Related to a Self-Rated Perception." Innovation in Aging 4, Supplement_1 (December 1, 2020): 424. http://dx.doi.org/10.1093/geroni/igaa057.1368.
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Abstract Introduction Theoretical successful aging definitions may not consider the older adults perception′s on their own aging. The aim of this study is to analyze factors related to subjective perception of successful aging. Methods: Population based, random sample included n=401 community-dwelling older adults 60-years and older (mean age=72.51,SD=8.11 years,59.4% women). For measurement of subjective successful aging (S-SA), participants were asked to self-rate SA in a Likert scale: “do you believe/feel you are aging well?” Objective Successful aging (O-SA) was operationalized in accordance with Rowe & Kahn definition (no important disease, no disability, physical functioning, cognitive functioning, and being actively engaged). Sociodemographic and health data were also asked. Data were analyzed in SPSSv24. Results: In total 11% were successful agers according to objective measures, while 77.6% rated themselves as successful agers. In the Likert scale of S-SA, specifically 23.4% considered themselves as very much successful agers, 54.1% much, 20.2% somewhat, and only 2.2% said that not at all think they are aging successfully. Education was related to a better perception of S-SA, as well as life satisfaction (p=.000), better subjective health (p=.000), being a spiritual person (p=.000), and not feeling alone (p=.000). Age, marital status, sex, and life-long learning activities were not related to S-SA. Conclusion There is a disparity between subjective and objective successful aging rates Being a successful ager may have a different meaning for each person, and not necessarily involves established criteria. Criteria generated by older adults should be added in theoretical definitions and measures.
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Staccini, P., and L. Fernandez-Luque. "Secondary Use of Recorded or Self-expressed Personal Data: Consumer Health Informatics and Education in the Era of Social Media and Health Apps." Yearbook of Medical Informatics 26, no. 01 (August 2017): 172–75. http://dx.doi.org/10.1055/s-0037-1606498.
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Summary Objective: To summarize the state of the art during the year 2016 in the areas related to consumer health informatics and education with a special emphasis in secondary use of patient data. Methods: We conducted a systematic review of articles published in 2016, using PubMed with a predefined set of queries. We identified over 320 potential articles for review. Papers were considered according to their relevance for the topic of the section. Using consensus, we selected the 15 most representative papers, which were submitted to external reviewers for full review and scoring. Based on the scoring and quality criteria, five papers were finally selected as best papers Results: The five best papers can be grouped in two major areas: 1) methods and tools to identify and collect formal requirements for secondary use of data, and 2) innovative topics highlighting the interest of carrying on “secondary” studies on patient data, more specifically on the data self-expressed by patients through social media tools. Regarding the formal requirements about informed consent, the selected papers report a comparison of legal aspects in European countries to find a common and unified grammar around the concept of “data donation”. Regarding innovative approaches to value patient data, the selected papers report machine learning algorithms to extract knowledge from patient experience and satisfaction with health care delivery, drug and medication use, treatment compliance and barriers during cancer disease, or acceptation of public health actions such as vaccination. Conclusions: Secondary use of patient data (apart from personal health care record data) can be expressed according to many ways. Requirements to allow this secondary use have to be harmonized between countries, and social media platforms can be efficiently used to explore and create knowledge on patient experience with health problems or activities. Machine learning algorithms can explore those massive amounts of data to support health care professionals, and institutions provide more accurate knowledge about use and usage, behaviour, sentiment, or satisfaction about health care delivery.
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Vladykina, Elena, and Abdulkadir Goksel. "Oblique Turnover Flap for Repositioning and Flattening of the Lateral Crura: A Novel Technique to Manage Cephalic Malposition of Lower Lateral Cartilage." Facial Plastic Surgery 33, no. 05 (September 29, 2017): 491–98. http://dx.doi.org/10.1055/s-0037-1606824.
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AbstractMalposition of the lower lateral cartilage (LLC) is a relatively common anatomical variation, described as any displacement of the lateral crura from the usual parallel direction with the nostril rims. Cephalic malpositioned LLC has the following characteristics: abnormal axes of the lateral crura, bulbous and broad nasal tip, parenthesis deformity, long alar creases, alar wall hollows, nostril deformities, and incompetence of the external valve. Numerous techniques were founded to correct this aesthetic and functional unpleasant variation, although all of them have some limitations. The authors described and evaluated the efficacy of the oblique turnover flap (OTOF) technique in the management of cephalic malposition of LLC (CMLLC). The advantages of this technique are: it does not need any additional grafting; it is quick and safe to perform; it has stable results. In the present study, 24 primary rhinoplasties using OTOF technique were performed between January 2014 and September 2016. There were 21 females (87.5%) and 3 males (12.5%), with age ranging from 23 to 46 years. The mean follow-up period was 12.1 months (range: 8–28 months). All patients were treated by the senior author (A.G.) in the RinoIstanbul Clinic. Three parameters were measured and compared pre- and postoperatively, using a t-test and a p value criteria of 0.05. The difference was found to be statistically significant: the angle between the central axis of the lateral crura and the septum on each side, satisfaction scale rating of the patients' nasal tip appearance and the satisfaction scale rating of patients' nose breathing. The angle of the central axis of lateral cruras to the midline significantly increased, the mean satisfactory scale ratings of nasal tip appearance and breathing quality were also significantly improved. OTOF is a quick, useful, efficient technique for repositioning and flattening of the lateral cruras of CMLLC with a good, predictable, and stable long-term results in our hands if used on right candidates.
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Faour, Mhamad, Nipun Sodhi, Anton Khlopas, Nicolas Piuzzi, Kim Stearns, Viktor Krebs, Carlos Higuera, and Michael Mont. "Knee Position during Surgical Wound Closure in Total Knee Arthroplasty: A Review." Journal of Knee Surgery 31, no. 01 (November 22, 2017): 006–12. http://dx.doi.org/10.1055/s-0037-1608838.
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AbstractStudy areas concerning maximizing knee range of motion (ROM) following total knee arthroplasty (TKA) have come under focus by surgeons. Among the perioperative factors that were identified to affect ROM after TKAs is knee position during surgical wound closure. Therefore, the aim of this study was to review the impact of knee position during TKA wound closure on: (1) postoperative ROM, (2) wound-related complications, (3) Knee Society Score (KSS), (4) postoperative pain, and (5) muscle strength and home functional recovery. A literature search was performed using PubMed, Ovid, and Google Scholar using various combinations of the following search terms: “wound closure,” “knee position,” “surgical closure,” and “knee arthroplasty.” The studies were evaluated for outcomes after TKA and stratified based on the knee position at surgical closure. After application of inclusion and exclusion criteria, seven studies were analyzed. The total number of patients included was 516 patients (259 patients in the flexion group and 257 patients in the full extension group). Based on the reviewed literature, wound closure in flexion was associated with significant improvement in ROM recovery at earlier follow-ups after TKA (four positive and three neutral studies), better early postoperative pain scores (two positive and one neutral study), and faster physical recovery (two positive studies) (better muscle strength and early achievement of physical therapy milestones) compared with wound closure in extension. No difference was found between wound closure in flexion compared with closure in extension in terms of long-term ROM recovery, long-term postoperative pain scores, wound-related complications (seven neutral studies), knee function measured by KSS (five neutral studies), or patient satisfactions after TKA. Although the current review is limited by the number of studies that are available in the literature, it demonstrates that overall, compared with extension, surgical wound closure in flexion may provide better ROM, faster recovery, comparable patient satisfaction, and no risk of higher wound complications.
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Stepina, N. A. "Service technologies in academic libraries (case study of I. S. Turgenev Orel State University Scientific Library)." Scientific and Technical Libraries, no. 2 (February 25, 2019): 42–51. http://dx.doi.org/10.33186/1027-3689-2019-2-42-51.
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Innovative technologies for providing the scope of library information services are discussed. Users satisfaction with the products/services quality within the services strategy of Orel State University Scientific Library was monitored. The study goals were to investigate into the new format of staff operation, to refine criteria and evaluation indicators, and to specify services and practices.The quality features were measured and compared to the ideal model of library and information services. It is found that the service dominant idea is consonant with the staff’s and users’ orientation toward open, secure, friendly working environment. The author remarks to the staff's business activity, increasing the Library’s rates in the external environment. She proves that the service technologies make the efficient instrument of the humanistic mission rather than obtaining of the maximum extrabudgetary funding.The author proposes several key management solutions, i.e. stimulation of staff’s culture; development of corporate professional cooperation in information exchange; generation of inhouse intellectual content; intensification of user awareness forms; methodological support; monitoring; promotion of the existing resources and dissemination of information products.The obtained empirical data make the foundation for increasing effectiveness of services.
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Lambán-Mascaray, Noemí, Eduardo Blanco-Baiges, Pedro Marquina-Sola, Jesús Barco-Marcellán, Samuel Pajares-Cabanillas, and Jesús Gómez-Vallejo. "Metacarpal Enlargement of the Amputated Thumb using Callotaxis: An Observational Study." Revista Iberoamericana de Cirugía de la Mano 45, no. 01 (May 2017): 003–11. http://dx.doi.org/10.1055/s-0037-1602805.
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Purpose To confirm the effectiveness of bone elongation through callus distraction of the first metacarpal as a functional alternative in active patients with a thumb amputation. Methods The study population consisted of patients who suffered a nonreplantable amputation of the thumb and failed to meet the criteria for a microsurgical transfer at our hospitals between 1995 and 2014. We performed an observational cohort study for the incidence analysis and a cross-sectional design for the analysis of the correlations among the variables. Results We presented 23 callus distractions of the first metacarpal, with an elongation time between surgeries of approximately 104.7 days (standard deviation [SD]: 3.2), with a miniRail external mini-fixator, and an average elongation of 25.5 mm (SD: 0.54). All patients achieved a functional grip, but five of them had to find new jobs. The degree of satisfaction was high, except in two patients, and was significantly related to the time of the elongation. Conclusions Callus distraction allows for a reconstruction of the thumb with few complications. We recommend associating it with a commissuroplasty and an adductor transposition. Patients give more importance to the comfort of the procedure than to the elongated length, provided that adequate function is achieved.
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Syurya Handini, Haspita Rizki, Lita Angelina Saputri, and Yuliva Yuliva. "Application-Based Medical Eligibility Criteria Model of Contraception Use." Global Journal of Health Science 12, no. 1 (December 30, 2019): 158. http://dx.doi.org/10.5539/gjhs.v12n1p158.
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Masalah kesehatan reproduksi termasuk keluarga berencana merupakan salah satu permas alahan yang belum terselesaikan pada MDG's .Reproduction health problem including family planning is one of the unresolved issues in MDG's.Menurut SDKI 2012 penggunaan According to the Indonesia Health and Demography Survey in 2012, the usekontrasepsi of modern contraceptioncara modern hanya was only57,9% dan unmet need 8,5%. 57.9% and unmet need reached 8.5%.Salah satu penyebab tingginya unmet One of the causes of high unmetneed dan drop need and dropout adalah keterbatasan layanan kontrasepsi. out was the limitation of contraceptive services.Pemanfaatan Alat Bantu Pengambila n Keputusan (ABPK) berupa lembar balik dalam pelayanan kontrasepsi The use of decision making aids (ABPK) with flip chart form in contraceptive service wasdipandang kurang praktis. seen as less practical.Kemajuan teknologi memungkinkan penggunaan aplikasi dalam berbagai keperluan termasuk pelayanan kesehatan. The advance of technology allows the use of applications in various purposes including health services.Tujuan penelitian ini adalah untuk mengetahui m odel k riteria k elayakan m edis p enggunaan k ontrasepsi b erbasis a plikasi. The purpose of this study was to determine the Application-based Medical Eligibility Criteria Model of Contraceptive Use.Jenis penelitian ini adalah research and development . This study was research and development (RnD). Populasi pada penelitian ini adalah bidan yang melakukan praktik mandiri di Kota Padang yang diambil secara purposive sampling .The population in this study were midwives in independent practice in Padang, with purposive sampling technique. Data dianalisis secara kualitatif dan kuantitatifData were analyzed qualitatively and quantitativelyuntuk to determine the respondent’stingkat level ofkepuasan satisfactionresponden teabout theaplikasi . application based model.Hasil penelitian menunjukkan sebagian responden meng harapkan ABPK lebih The results showed that most respondents expected the decision making aids to be simple, systematic, not in “back and forth” form and pictures included. Hasil uji preliminary field testing menunjukkan bahwa 56,2% responden memiliki tingkat kepuasan yang tinggi terhadap aplikasi.The results of the preliminary field testing showed that 56.2% of respondents performed high level of satisfaction about the application-based model.Pada main product revision , dilakukan perbaikan dengan penambahan informasi dan gambar tentang metode kontrasepsi. In main product revision, improvements were made by adding information and images about contraceptive methods. PenelitianThis researchini invent the design of application based medical eligibility model of contraceptive use titled “Application of Clinical Decision Making System of Contraceptive Use”.
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Lopez, Christopher D., Franca Kraenzlin, Christopher Frost, Halley Darrach, Pathik Aravind, and Justin M. Sacks. "Latissimus Denervation: A Review of Evidence." Journal of Reconstructive Microsurgery 35, no. 08 (May 8, 2019): 609–15. http://dx.doi.org/10.1055/s-0039-1688748.
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Abstract Background Breast reconstruction is becoming an increasingly important and accessible component of breast cancer care. Among the many reconstructive options available, the latissimus dorsi flap has experienced a renewal in popularity because of its favorable properties and outcomes when used for breast reconstruction. However, a limitation unique to latissimus-based reconstruction is inappropriate breast animation postoperatively, due to persistent thoracodorsal innervation of the latissimus dorsi muscle after transfer to the mastectomy site. Methods A comprehensive literature search of PubMed and MEDLINE was conducted for studies investigating the role of thoracodorsal denervation in latissimus-based breast reconstruction. Data on surgical techniques, type of intervention, objective outcome measurements, and patient satisfaction-based outcomes were reported. Additional data included patient sample size, follow-up length, and treatment of thoracodorsal nerve (e.g., resection versus transection and length of transection) when applicable. Results Sixty-six search results were reviewed for inclusion and nine qualified after exclusion criteria for a total of 361 patients undergoing either unilateral or bilateral latissimus flap reconstruction. Successful thoracodorsal denervation rates were included in most studies and outcomes measurements were heterogeneous. Eight out of nine studies included patient-reported symptoms of breast animation postoperatively. Based on these findings, a systematic approach is presented. Conclusion We present this review to elucidate successful practices, identify current gaps in knowledge, and offer a systematic approach to this clinical challenge.
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Ren, Xiaosong, Sha Sun, and Rong Yuan. "A Study on Selection Strategies for Battery Electric Vehicles Based on Sentiments, Analysis, and the MCDM Model." Mathematical Problems in Engineering 2021 (August 17, 2021): 1–23. http://dx.doi.org/10.1155/2021/9984343.
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Under the goal of carbon peak and carbon neutrality, developing battery electric vehicles (BEVs) is an important way to reduce carbon emissions in the transportation sector. To popularize BEVs as soon as possible, it is necessary to study selection strategies for BEVs from the perspective of consumers. Therefore, the Latent Dirichlet Allocation (LDA) model based on fine-grained sentiment analysis is combined with the multi-criteria decision-making (MCDM) model to assess ten types of BEV alternatives. Fine-grained sentiment analysis is applied to find the vehicle attributes that consumers care about the most based on the word-of-mouth data. The LDA model is suggested to divide topics and construct the indicator system. The MCDM model is used to rank vehicles and put forward the corresponding optimization path to increase consumer purchases of BEVs in China. The results show that (a) via the LDA model based on fine-grained sentiment analysis, attributes that consumers care most about are divided into five topics: dynamics, technology, safety, comfort, and cost; (b) based on the DEMATEL technique, the dimensions in the order of importance are as follows: safety, technology, dynamics, comfort, and cost; (c) the price is the most important criteria that affect customers’ satisfaction by the DANP model; and (d) based on the VIKOR model, the selection strategies present that Aion S is highlighted as the best choice, and the optimization path is discussed to promote the performance of BEVs to increase customers’ satisfaction. The findings can provide a reference for improving the sustainable development of the automobile industry in China. The proposed framework serves as the basis for further discussion of BEVs.
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Chu, Yin Man, and Kup Sze Choi. "Effectiveness of patient education in acute stroke: a comparison between a customised computer system and a pictorial information booklet." BMJ Health & Care Informatics 27, no. 3 (August 2020): e100144. http://dx.doi.org/10.1136/bmjhci-2020-100144.
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BackgroundPatients who develop acute stroke are at high risk for deterioration in the first 48–72 hours after admission. An effective educational intervention is needed.ObjectiveThis study aimed to examine the applicability of the customised interactive computer education system (CICS) in patients who had a stroke in the early acute phase in order to determine the efficacy of the education system in (1) information satisfaction and (2) physiological related management compliance.MethodsThe prospective non-blinded randomised controlled study was conducted in an acute stroke unit of a local hospital in Hong Kong from March to August 2019. Chinese participants were selected if they were at least 18 years of age, experienced a minor stroke within 3 days. The exclusion criteria were communication problem and comorbidity with another acute disease. On the first day of admission, participants were allocated to the CICS and booklet groups, with each group comprising 50 participants. On the third day, the primary outcome, Modified Information Satisfaction Questionnaire for Acute Stroke (MISQ-S), was assessed.ResultsThere was a significant difference in ‘the need to improve information measures’ of the MISQ-S (p=0.04) between the CICS and booklet groups. The management compliance of these two groups did not have difference, but the CICS group had better clinical outcome, though not significant (p=0.387).ConclusionPatient education was needed and feasible in the early acute phase, and the CICS was more efficacious than the booklet. The positive results provided insights into and give a direction to the use of information technology in patient education.
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De Cassai, Alessandro, Federico Geraldini, Annalisa Boscolo, Laura Pasin, Tommaso Pettenuzzo, Paolo Persona, Marina Munari, and Paolo Navalesi. "General Anesthesia Compared to Spinal Anesthesia for Patients Undergoing Lumbar Vertebral Surgery: A Meta-Analysis of Randomized Controlled Trials." Journal of Clinical Medicine 10, no. 1 (December 30, 2020): 102. http://dx.doi.org/10.3390/jcm10010102.
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Vertebral lumbar surgery can be performed under both general anesthesia (GA) and spinal anesthesia. A clear benefit from spinal anesthesia (SA) remains unproven. The aim of our meta-analysis was to compare the early analgesic efficacy and recovery after SA and GA in adult patients undergoing vertebral lumbar surgery. A systematic investigation with the following criteria was performed: adult patients undergoing vertebral lumbar surgery (P); single-shot SA (I); GA care with or without wound infiltration (C); analgesic efficacy measured as postoperative pain, intraoperative hypotension, bradycardia, length of surgery, blood loss, postoperative side effects (such as postoperative nausea/vomiting and urinary retention), overall patient and surgeon satisfaction, and length of hospital stay (O); and randomized controlled trials (S). The search was performed in Pubmed, the Cochrane Central Register of Controlled Trials, and Google Scholar up to 1 November 2020. Eleven studies were found upon this search. SA in vertebral lumbar surgery decreases postoperative pain and the analgesic requirement in the post anesthesia care unit. It is associated with a reduced incidence of postoperative nausea and vomiting and a higher patient satisfaction. It has no effect on urinary retention, intraoperative bradycardia, or hypotension. SA should be considered as a viable and efficient anesthetic technique in vertebral lumbar surgery.
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Ferichani, Minar, Darsono Darsono, and Supanggyo Supanggyo. "INOVASI PRODUK ES KRIM SUSU KAMBING ETAWA-UBI UNGU." Caraka Tani: Journal of Sustainable Agriculture 27, no. 1 (September 11, 2017): 35. http://dx.doi.org/10.20961/carakatani.v27i1.14350.
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<p>This productive research about “The Producing of Ettawa Goat Milk-Sweet Purple Potato Ice Cream” aimed to create a product made from ettawa goat milk which is delicious, nutritious, enjoyable, and marketable. The research in corporation with ettawa goat livestock owner’s wives which is united as KUBE (Corporative Business Association) Adi Jaya at Sayegan Sub-District, Sleman District, Yogyakarta, also partner with Jomint Company, was done in 2011. Research included program socialization to KUBE Adi Jaya officials; producing to get advance product; laboratory test at Lab. of Food Technology and Agricultural Product, Faculty of Agricultural Engineering, Gadjah Mada University; product packaging; disseminating to women as members of KUBE Adi Jaya and neighborhood; measuring of satisfaction to the product; and marketing. Quality measurement was done to measure satisfaction to product consisted of 4 indicators, those were taste, appearance, packaging, and contents (nutrition ingredient). The formula that was used was S = P/E which was a comparison among the expecting product (E) and the fact of product/product performance (P), in this case about how product showed the performance as real to compete with E. This formula was a modified concept by Kotler that states S = f(E,P). The criteria which was used was if S or Sav ≥ 1, it mean the product had high level of satisfaction; moderate if 0.7 < x < 1; and low if ≤ 0.7. Competitor product as E was an establish product, it was Walls ice cream as a product which was produced by Unilever Company, and our advance product as P. The research results show that the product contents complete nutrition. Contents of Cvitamin, protein and fiber function to protect and increase consumer’s healthy. Product also contents carotene, antioxidant and antocyanin that function to prevent cancer and cell degenerative process. Based on perspective about contents, the product is “ready” to be competed with ice cream which has established. The highest value of Sav is gained on contents (1,24), followed appearance (0,997), taste (0,983), and packaging (0,974). Level of respondent satisfaction to contents of etawa goat milk – sweet purple potato ice cream included high caused > 1, while to three others elements included moderate-high caused close to 1. Totally, Sav value that is achieved is 1.038, it means the product can satisfy the consumers in high level caused > 1. The product has capacity to compete even more satisfy than Walls ice cream based on product perspective (element of marketing mix). The product gets positive responses from members of KUBE Adi Jaya and others dissemination participants, also shops as partners of Jomint.</p>
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Aksah, Hasnizan, Suhana Johar, Ismar Ms Usman, and Adi Irfan Che Ani. "Design and Implementation of Content Validity: Instrument Development for Evaluating Functional Building Performance." WSEAS TRANSACTIONS ON ENVIRONMENT AND DEVELOPMENT 17 (September 7, 2021): 973–82. http://dx.doi.org/10.37394/232015.2021.17.90.
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The research aim is to critically evaluate the content validity of the functional building performance evaluation criteria using the Content Validity Index (CVI) and modified kappa statistic. The selection of relevant criteria for functional building performance evaluation should be managed effectively by the building management team because it is strongly related to the achievement of organizational objectives and the building occupants’ satisfaction. Studies over the past decades have shown that the criteria vary, relying on the intention of conducting the performance evaluation and the types of building. These selection criteria have a direct impact on the functional building performance and need to be done systematically. Thus, the content validity of the functional building performance evaluation criteria is a necessary step in instrument development. To achieve this research aim, the instrument has been developed based on numerous construct items that have been obtained from previous studies by various authors and established rating tools or standards. The sample of the respondents for content validation comprises of seven (7) expert panels in the area of historic building management and building performance evaluation, such as from the local municipality, related government agencies, academician and building management team. The panels reviewed and rated the instrument to ensure its relevance and the representativeness of each item. The result shows that a total of 39 items are valid and are considered to be retained, and will be further tested in the next study. The result has also shown that the Scale level – CVI/ Averaging calculation method (S-CVI/ Ave) for all items has met the criterion of 0.90. Significantly, content validity should be treated as important because it provides adequate and acceptable items of the content domain
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Panayi, Adriana, Riaz Agha, Brady Sieber, and Dennis Orgill. "Impact of Obesity on Outcomes in Breast Reconstruction: A Systematic Review and Meta-Analysis." Journal of Reconstructive Microsurgery 34, no. 05 (March 6, 2018): 363–75. http://dx.doi.org/10.1055/s-0038-1627449.
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Background Increased rates of both breast cancer and obesity have resulted in more obese women seeking breast reconstruction. Studies demonstrate that these women are at increased risk for perioperative complications. A systematic review was conducted to assess the outcomes in obese women who underwent breast reconstruction following mastectomy. Methods Cochrane, PUBMED, and EMBASE electronic databases were screened and data were extracted from included studies. The clinical outcomes assessed were surgical complications, medical complications, length of postoperative hospital stay, reoperation rate, and patient satisfaction. Results Out of 33 studies met the inclusion criteria for the review and 29 provided enough data to be included in the meta-analysis (71,368 patients, 20,061 of whom were obese). Obese women (body mass index > 30 kg/m2) were 2.29 times more likely to experience surgical complications (95% confidence interval (CI) 2.19–2.39; p < 0.00001), 2.89 times more likely to have medical complications (95% CI 2.50–3.35; p < 0.00001), and had a 1.91 times higher risk of reoperation (95% CI 1.75–2.07; p < 0.00001). The most common complication, wound dehiscence, was 2.51 times more likely in obese women (95% CI 1.80–3.52; p < 0.00001). Sensitivity analysis confirmed that obese women were more likely to experience surgical complications (risk ratio 2.36, 95% CI 2.22–2.52; p < 0.00001). Conclusions This study provides evidence that obesity increases the risk of complications in both implant-based and autologous reconstruction. Additional prospective and observational studies are needed to determine if the weight reduction prior to reconstruction reduces the perioperative risks associated with obesity.
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Seidel, Geoffrey K., Salma Al Jamal, Eric Weidert, Frederick Carington, Michael T. Andary, Scott R. Millis, and Brian G. Loder. "Predictive Outcome Modeling of Preoperative Clinical Symptoms and Electrodiagnostic Data in Tarsal Tunnel Surgery." Journal of Brachial Plexus and Peripheral Nerve Injury 16, no. 01 (January 2021): e37-e45. http://dx.doi.org/10.1055/s-0041-1731747.
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Abstract Background The relationship between tarsal tunnel syndrome (TTS), electrodiagnostic (Edx) findings, and surgical outcome is unknown. Analysis of TTS surgical release outcome patient satisfaction and comparison to Edx nerve conduction studies (NCSs) is important to improve outcome prediction when deciding who would benefit from TTS release. Methods Retrospective study of 90 patients over 7 years that had tarsal tunnel (TT) release surgery with outcome rating and preoperative tibial NCS. Overall, 64 patients met study inclusion criteria with enough NCS data to be classified into one of the following three groups: (1) probable TTS, (2) peripheral polyneuropathy, or (3) normal. Most patients had preoperative clinical provocative testing including diagnostic tibial nerve injection, tibial Phalen's sign, and/or Tinel's sign and complaints of plantar tibial neuropathic symptoms. Outcome measure was percentage of patient improvement report at surgical follow-up visit. Results Patient-reported improvement was 92% in the probable TTS group (n = 41) and 77% of the non-TTS group (n = 23). Multivariate modeling revealed that three out of eight variables predicted improvement from surgical release, NCS consistent with TTS (p = 0.04), neuropathic symptoms (p = 0.045), and absent Phalen's test (p = 0.001). The R 2 was 0.21 which is a robust result for this outcome measurement process. Conclusion The best predictors of improvement in patients with TTS release were found in patients that had preoperative Edx evidence of tibial neuropathy in the TT and tibial nerve plantar symptoms. Determining what factors predict surgical outcome will require prospective evaluation and evaluation of patients with other nonsurgical modalities.
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WU, Adhan Amenomori, Jaqueline Ribeiro de BARROS, Madhoor RAMDEEN, Julio Pinheiro BAIMA, Rogerio SAAD-HOSSNE, and Ligia Yukie SASSAKI. "FACTORS ASSOCIATED WITH PATIENT´S PREFERENCE IN CHOOSING THEIR THERAPY FOR INFLAMMATORY BOWEL DISEASE IN BRAZIL." Arquivos de Gastroenterologia 57, no. 4 (December 2020): 491–97. http://dx.doi.org/10.1590/s0004-2803.202000000-86.
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BACKGROUND: Biological therapy and new drugs have revolutionized the treatment of inflammatory bowel disease. Ideally, the choice of medication should be a shared decision with the patient, aiming at greater satisfaction, compliance, and consequently, favorable clinical outcome. OBJECTIVE: This study aims to evaluate patient’s preferences in the choice of their therapy and the factors that influence this choice. METHODS: This cross-sectional study enrolled 101 outpatients with Crohn’s disease or ulcerative colitis. The inclusion criteria were age ≥18 years and no previous exposure to biological therapy. Patients’ preferences were assessed through questions that addressed the preferred mode of administration (oral, subcutaneous, or intravenous) and the factors that determined the choice of medication (efficacy, medical indication, fear of medication, convenience, mode of application, and personal doctors’ indication). RESULTS: The mean age was 43.6±13.5 years, 75.3% were female, and 81.2% were cases of ulcerative colitis. Regarding the mode of administration, the majority of patients preferred oral (87.1%), followed by intravenous (6.93%) and subcutaneous (5.94%) medications. The reasons were “I prefer to take it at home” (42.57%), “I have more freedom” (36.63%), “I don’t like self-application” (29.70%), and “I believe it works better” (19.80%). Younger patients and patients in clinical disease activity preferred intravenous mode compared to the oral route (P<0.05). Doctor’s opinion (98%) was an important factor associated with the medication choice. CONCLUSION: Oral route was the preferred mode of administration and most patients took their physician’s opinion into account in their choice of medication.
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Bregant, Luigi, Flavia D'Agostin, and Martina Lorenzino. "Are on board comfort classes noise and vibration levels really suitable?" INTER-NOISE and NOISE-CON Congress and Conference Proceedings 263, no. 5 (August 1, 2021): 1206–14. http://dx.doi.org/10.3397/in-2021-1777.
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In shipbuilding industry, comfort is a relevant issue both for crew members and passengers. A comfortable environment enables crew members to perform accurately their tasks and it is an effective factor contributing to the satisfaction of passengers. Noise and vibration, as environmental parameters, play an important role in subjects' comfort. Naval Classification Societies established series of noise/vibration comfort level criteria, which, however, did not take into account some aspects: 1) noise/vibration recordings are carried out during time periods shorter than the exposure time of passengers; 2) the subjective mood is not investigated. In the present study, we studied comfort perception by measuring heart rate variability and mood. We exposed participants to four levels of acoustic noise [from 45 to 55 dB(A)] and three levels of vibration (1.5, 1.8, 2 mm/s) inside a full-scale mock-up of a cruise ship cabin. We found that the increase of noise/vibration intensity determines an increase of heart rate variability and negative mood. However, changes in comfort responses did not occur for the noise/vibration comfort thresholds identified by the Classification Societies. Our results evidence the importance to include psychophysiological measure of comfort when defining comfort criteria on board.
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Chowdhary, Sajeel A., Barbara Ann Given, Charles W. Given, Cindy Majeske, Paul D. Decker, and Brian Decker. "Small business technology transfer (STTR) phase I study (1 R41 MD006148-01) of an automated voice response (AVR) system to improve symptom management in neuro-oncology patients." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): e12500-e12500. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e12500.
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e12500 Background: This STTR Phase 1 study focused on enhancing and improving the technology of a prior AVR system (Grant #R01 CA30724) to manage symptoms in cancer patients. Neuro-Oncology patients were enrolled to test our proof of concept (POC). Methods: Previous AVR function was replicated using Asterisk software enhancing the branching logic, configurability and operational capacity on multiple operating systems; limitations of the previous AVR. Eligibility criteria: access to a telephone; actively on chemotherapy. Nurse recruiters provided detailed information about the study and answered questions. Following signed consent patients provided a preferred phone number and chose a day and time of the week to receive AVR calls. Patients received a Symptom Management Guide (SMG) at time of consent. Patients were contacted a total of 4 times over a 4 week period by the AVR. At each contact patients were asked to rate 17 symptoms on a scale of 1-9 for severity and interference with 4 domains of quality of life on a 1-5 scale. Patient’s reporting a 4 or higher severity level were directed by the AVR to reference their SMG for self-care strategies to manage their symptoms. At the end of the study patients completed a satisfaction survey. Results: Ten patients were enrolled. The AVR placed 38 of 40 scheduled calls. No errors in survey branching were evident with confirmation. Patient satisfaction surveys were completed with 70% of patients. One patient did not complete any scheduled calls and was not contacted, two patients were unreachable. All patients reported satisfaction. 86% reported they would recommend this system to their oncology provider. 71% felt it was helpful in individualized monitoring of symptoms between visits. 57% liked knowing their symptom(s) were being checked regularly. One indicated the system was too overwhelming. Complaints included: not being able to change responses (1) and not allowing them to answer questions as fast as they wanted (2). Conclusions: Patient satisfaction results and system performance confirmed that the POC was feasible and that this system should be studied in larger groups of oncology patients.
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Obourn, Chelsea, and John Frodel. "The Extended Purse-String Rhytidectomy." Facial Plastic Surgery 34, no. 05 (September 18, 2018): 539–44. http://dx.doi.org/10.1055/s-0038-1672176.
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AbstractFacelifts remain a critical part of a facial plastic surgeon's cosmetic practice. Techniques continue to evolve, while at the same time patients demand less invasive procedures with less morbidity. The authors present a facelift plication technique using wide purse-string sutures placed into the superficial musculoaponeurotic system and platysma. This is a retrospective review with a level of evidence 3 set at a medical spa and tertiary referral center designed to assess a purse-string suture technique using an inner followed by an outer purse-string, with refinements being made during the timeframe of the review. One hundred and eighteen patients were reviewed and 95 were included in the study given the inclusion criteria of a minimum of 1-year follow-up. Based on the subjective judgment of the primary surgeon, 37 patients were found to have excellent results, while 43 patients were judged as having good results. The judgment was based on the physical exam improvement of the aging aspects of the patient, and patient satisfaction. Ten patients displayed fair results (the patients were marginally happy), and five patients were noted to have poor results (they were notably unhappy). Complications included eight hematomas, five patients with prominent scars, and one patient with skin loss in the temple region. There were no cases of facial nerve injury. The extended purse-string rhytidectomy is a good alternative to traditional facelift techniques. This offers a plication method that results in the vertical vector that is now considered of paramount importance with all facelifts. The authors feel that it is a valuable tool that can be considered in most patients presenting for aging face surgery.
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Stefani, Giacomo, Valerio Mattiuzzo, and Greta Prestini. "Revision Total Knee Arthroplasty with Metaphyseal Sleeves without Stem: Short-Term Results." Joints 05, no. 04 (October 30, 2017): 207–11. http://dx.doi.org/10.1055/s-0037-1607427.
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Purpose The aim of this study was to evaluate the efficacy of revision total knee arthroplasty (TKA) with cementless metaphyseal sleeves without stems either in the femoral or tibial side or in both. Methods In this retrospective study, 51 patients (51 knees) operated in the period 2010 to 2015 met the above-mentioned criteria and were invited to a medical examination including X-rays. Forty-six were available for the study. Mean follow-up was 37 months. Knee Society score (KSS) (objective knee score), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and range of motion (ROM) were used as outcome scores and compared with baseline values. X-rays were also examined and compared with postoperative exams to evaluate the presence of loosening, radiolucent lines, and bone ingrowth. Satisfaction of the patients was also investigated using a linear scale from 1 to 10. Results KSS improved from 39 to 77 (p < 0.01); WOMAC score improved from 76 to 41 (p < 0.01). Twenty-four (52%) patients were satisfied, 15 (32%) were partially satisfied, and 7 (16%) were unsatisfied. ROM improved from 93 to 96 degrees (nonsignificant difference). X-rays showed no loosening of the implants, radiolucent lines in 4 patients (3 of them were asymptomatic) and bone ingrowth in 43 out of 46 patients. Conclusion In this short-term retrospective study, the use of sleeves without stem was a safe and effective procedure in revision TKA. We found a significant improvement in clinical results compared with baseline values and no signs of implant loosening. Level of Evidence Level IV, therapeutic case series.
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Kontis, Dimitrios, Eirini Theochari, Alexandros Giannoulis, Fedra Louki, and Eleftheria Tsaltas. "T92. POSSIBLE COMBINATIONS OF DSM-IV AND DSM-5 CRITERIA IN SCHIZOPHRENIA AND SCHIZOAFFECTIVE DISORDER VERSUS MAJOR DEPRESSIVE AND MANIC EPISODES." Schizophrenia Bulletin 46, Supplement_1 (April 2020): S266—S267. http://dx.doi.org/10.1093/schbul/sbaa029.652.
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Abstract Background Psychiatric disorders diagnoses are based on the satisfaction of specific symptoms criteria. Although this categorical method of classification, which is based on the identification of clinical syndromes, has proven useful in terms of treatment, its validity has been criticized. The possible symptoms combinations for major psychotic and mood disorder diagnoses could be calculated using combinatorial mathematics and the results could provide indices of diagnostic heterogeneity. Methods Our calculations were conducted using the binomial coefficient. In mathematics, this coefficient calculates the number of an unordered and unrepetitive selection of k items from a set S (a subset of k items from S) with the following formula: n!/k!(n-k)!. We calculated the possible number of combinations of symptoms required for diagnosing a) two major psychotic disorders (a1. Schizophrenia-SCZ and a2. schizoaffective disorder-SAD), and b) two major mood disorders-episodes (b1. Major Depressive Episode-MDE and b2. Manic Episode- ME), implementing the DSM-5 and DSM-IV diagnostic criteria. For each diagnosis, k corresponds to the number of the necessary symptoms, where S to the total number of symptoms described in the relevant criteria. The following calculations were conservative, since they did not take into account all the possible combinations within each criterion, the effect of specifiers or the effect of SCZ, or SAD subtypes. Results We found the following combinations: DSM-5: SCZ=25, SAD=12,225, MDE=163, ME=326. DSM-IV: SCZ=74, SAD=2,762,198, MDE=163, ME=163. According to DSM-IV (but not to DSM-5), Criterion A for Schizophrenia could coexist with a mixed mood episode in SAD. Interestingly, the possible symptoms combinations for a mixed episode was 37,001. The possible symptoms combinations for the diagnosis of schizophrenia has been slightly reduced in DSM-5 as compared with DSM-IV, but the reduction in the number of relevant combinations for the diagnosis of SAD has been impressive. This reduction was driven by the removal of mixed mood episodes in DSM-5. The possible combinations in SCZ, albeit not in SAD, were fewer than those required for the diagnosis of a MDE and a ME. Discussion The above results indicated that the diagnostic heterogeneity of psychotic disorders differed from that of mood disorders. SAD appeared to be the most heterogeneous disorder. DSM-5 criteria have limited the possible combinations of symptoms and have therefore improved the heterogeneity of SCZ and SAD, but not that of major mood disorders. The extent and the clinical implications of diagnostic heterogeneity in different psychotic and mood disorders remain to be elucidated by future research.
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Firlej, Ewelina, Mariola Janiszewska, Katarzyna Sidor, Anna Sokołowska, Agnieszka Barańska, and Paweł Chruściel. "Health Evaluation in the Context of Satisfaction with Medical Services among Patients with Osteoarthritis: Descriptive Cross-Section Survey." International Journal of Environmental Research and Public Health 17, no. 1 (December 18, 2019): 9. http://dx.doi.org/10.3390/ijerph17010009.
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Osteoarthritis (OA) is one of the most common causes of rehabilitation benefits and senior disability. It generates high costs of treatment and increasing demand for medical staff and care of geriatric profile. The aim of the study was to determine the relationship between health evaluation and satisfaction with medical services among individuals with OA in rehabilitation outpatient clinics. The survey was carried out from June 2017 to May 2018, among patients being provided with services of five outpatient rehabilitation clinics in Lublin. The surveyed group comprised 328 respondents. The following tools were utilized: the List of Health Criteria (LHC), the Multidimensional Health Locus of Control Scale (version B) (MHLC), the authors’ own questionnaire compiled for the study, and the Servperf Method. According to the respondents, the most important health criterion is “not to experience any ailments” (M = 1.56). In an assessment of a clinic, the respondents rated neatness (cleanliness) of the staff highest (M = 4.38) and the appearance of a building where a clinic is located lowest (M = 3.42). The better the evaluation of medical services in an outpatient rehabilitation clinic in comparison to other settings, the better the evaluation of the quality of service (rho S = 0.593; p < 0.000). The study conducted in outpatient rehabilitation clinics showed great demand for outpatient specialist care of geriatric profile. Undoubtedly, there is need for continuation and expansion of studies on patients with OA in other rehabilitation settings.
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Bertagnoli, Rudolf, James J. Yue, Regina Nanieva, Andrea Fenk-Mayer, Daniel S. Husted, Rahul V. Shah, and John W. Emerson. "Lumbar total disc arthroplasty in patients older than 60 years of age: a prospective study of the ProDisc prosthesis with 2-year minimum follow-up period." Journal of Neurosurgery: Spine 4, no. 2 (February 2006): 85–90. http://dx.doi.org/10.3171/spi.2006.4.2.85.
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Object The authors conducted a prospective longitudinal study to obtain outcome (minimum follow-up period 2 years) regarding the safety and efficacy of single-level lumbar disc (ProDisc prosthesis) replacement in patients 60 years of age or older. Methods This prospective analysis involved 22 patients treated in whom the lumbar ProDisc prosthesis was used for total disc arthroplasty. All patients presented with disabling discogenic low-back pain (LBP) with or without radicular pain. The involved segments ranged from L-2 to S-1. Patients in whom there was no evidence of radiographic circumferential spinal stenosis and with minimal or no facet joint degeneration were included. Patients were assessed preoperatively and outcome was evaluated postoperatively at 3, 6, 12, and 24 months by administration of standardized tests (the visual analog scale [VAS], Oswestry Disability Index [ODI], and patient satisfaction). Secondary parameters included analysis of pre- and postoperative radiographic results of disc height at the affected level, adjacent-level disc height and motion, and complications. Twenty-two (100%) fulfilled all follow-up criteria. The median age of all patients was 63 years (range 61–71 years). There were 17 single-level cases, four two-level cases, and one three-level case. Statistical improvements in VAS, ODI, and patient satisfaction scores were observed at 3 months postoperatively. These improvements were maintained at 24-month follow-up examination. Patient satisfaction rates were 94% at 24 months (compared with 95% reported in a previously reported ProDisc study). Radicular pain also decreased significantly. Patients in whom bone mineral density was decreased underwent same-session vertebroplasty following implantation of the ProDisc device(s). There were two cases involving neurological deterioration: unilateral foot drop and loss of proprioception and vibration in one patient and unilateral foot drop in another patient. Both deficits occurred in patients in whom there was evidence preoperatively of circumferential spinal stenosis. There were two cases of implant subsidence and no thromboembolic phenomena. Conclusions Significant improvements in patient satisfaction and ODI scores were observed by 3 months postoperatively and these improvements were maintained at the 2-year follow-up examination. Although the authors’ early results indicate that the use of ProDisc lumbar total disc arthroplasty in patients older than 60 years of age reduces chronic LBP and improves clinical functional outcomes, they recommend the judicious use of artificial disc replacement in this age group. Until further findings are reported, the authors cautiously recommend the use of artificial disc replacement in the treatment of chronic discogenic LBP in patients older than age 60 years in whom bone quality is adequate in the absence of circumferential spinal stenosis.