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Abstract Objective To adapt the Scale of Perception of Respect for and Maintenance of the Dignity of the Inpatient (CuPDPH) to the Brazilian language and culture and to assess its psychometric properties. Results The scale was evaluated by 15 experts, and 239 patients from three tertiary hospitals in Rio de Janeiro. All participants signed a consent form. Data have shown adequacy of the model (KMO=0.839, Bartlett's test of sphericity: χ2(171) = 2241.3, p = 0.000010), good adjusted content validity (CVCa ≥ 0.90), internal consistency and reliability, such as α = 0.927. Discussion CuPDPH is a rating scale on observable professional attitudes. Illnesses change lives and impose adaptation to a new situation, perceived as depersonalization, leading patients to try to regain control of their lives. Patients expressed "ill will" to fill out the scale. Psychiatric patients' scale filling time was higher than others. A sample from three Rio de Janeiro third-level hospitals may not reflect the country's population; also, this adaptation may not comprise all linguistic variations of Brazilian Portuguese and Portuguese-speaking countries. Conclusion The Portuguese version of the Scale of Perception of Respect for and Maintenance of the Dignity of the Inpatient (CuPDPH), a 19-item, six-component version is a reliable instrument to measure the perception of internal medicine, surgical, and psychiatric patients on the maintenance of their dignity in Rio de Janeiro, Brazil. This knowledge could be used in advancing research on patients' perception of dignity, as well as professional ethical competencies, staff-patient relationship skills, and leadership development in medical and other healthcare professional education.
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In our daily lives, we have to perform multiple tasks in different areas. This leads people to two paths: carrying out the task as soon as possible or postponing it; the latter being part of the tendency to delay the start or completion of a task. This act also known as procrastination. procrastination is the characteristic or behavioural propensity to put off or delay completing a task or making decisions. Procrastination behavior is very common and a serious problem in the era we live in. Academic procrastination appears to be common in academic environments as students frequently put off their obligations without good reason and submit their work right up until the deadline. All levels of kids are impacted, and it may lead to major problems including declining grades and decreased wellbeing. The notion of academic procrastination, reasons why it occurs, negative effects of academic procrastination and several methods for dealing with it are all discussed in this article. It is suggested that some programs should be devised and executed to teach task-oriented coping strategies to students. For this one should reflect on the reasons why you procrastinate, your habits and thoughts that lead to procrastinating
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Introduction: Rheumatic mitral stenosis forms 88% of the heart diseases complicating pregnancy in the tertiary referral centre in India. Case report: 27 year old G4P2L2A1 with 39 weeks of gestation with Rheumatic Heart Disease with severe Mitral stenosis with moderate mitral regurgitation and tricuspid regurgitation was posted for elective caesarean delivery. After doing preanaesthetic evaluation patient was managed conservatively with iv diuretics and inj metoprolol and patient status improved from nyha iv to ii. After taking written high risk consent,the patient was taken on OT table with Pre op vitals PR-84/min, BP =110/67mmhg, Sp02=99% in room air and during Intraop course Induction was done after premedication with Inj Etomidate 12 mg IV and scoline 75mg IV and was intubated orotrachealy with RSI technique with ETT of 7.0mm Bilateral air entry confirmed and fixed at 19 cm at corner of mouth. Anaesthesia was maintained with O2 at 100%@5L/min and isoflurane at 0.4-0.6 and inj Atracurium 15+5+5 mg IV and Inj Fentanyl 40 µg IV. Inj.Esmolol 5 mg IV was given at regular intervals to control tachycardia. Tab sildenafil was given via ryles tube.After delivery of the baby,20 IU of oxytocin was given via IV infusion and Inj. Furosemide 40 mg IV was also given.Total fluid input was 300 ml and she had an output of 250 ml.She was also given usg guided b/l TAP block using 40 ml of 0.25% Ropivacaine.She was extubated after giving neostigmine 2.5mg and glycopyrrolate 0.5mg IV.she maintained SPO2 of 99% on room air and was shifted to recovery room and oxygen supplemented pos operatively @6L/minPost op vitals:PR=89/min,BP=120/74mmhg and SPO2=100% Conclusion: Rheumatic mitral stenosis complicating pregnancy is still a frequent cause of maternal death. A better understanding of the physiological changes in pregnancy and the pathological impact of mitral stenosis over pregnancy and a multidisciplinary approach in diagnosis and management reduce the mortality and morbidity
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Chinese patent medicine (CPM) is an important part of traditional and Chinese medicine (TCM). Its quality has direct impact on the safety and effectiveness of clinical use. The quality standard is the pivotal approach to guarantee the quality of CPM. Due to the complex material basis, multitudinous quality influencing factors and unveiled active ingredients, dose-effect relationship and action mechanism, the investigation on quality standard faces many difficulties. This paper surveys the current quality status of CPM and the general situation of CPM standards. At present, the dosing problem has the crucial impact on the quality of CPM. The current quality standard system of CPM is confirmed and the limitations are indicated. Based on the above analysis, the principles and considerations on investigation of quality standard are proposed as follows: ① Adhere to safety as the bottom line, strengthen the risk-control ability of the standard of CPM; ② Adhere to theory of TCM and comprehensive quality, improve the integrative control level of the CPM standard; ③ Emphasize technological development and innovation, promote the quality control competence of CPM standard; ④ Facilitate planning and coordination, optimize the management of the CPM standard system; ⑤ Reinforce investigation on evaluation method, develop grade evaluation standard, accelerate high-quality development of CPM. Finally, the future perspective on investigation of CPM quality standard is prospected.
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High technology promotes the rapid development of the surgery. Various high and new technologies emerge to benefit patients and doctors. However, it is not surprising that there are unavoidable problems at the same time. Any situation needs to be analyzed from two aspects, which can be called the "double-edged sword" effects. Talking about and paying attention to these circumstances can promote the better application of high technology in the field of surgery.
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@#With the aging of the population and the increase in the number of edentulous patients, implant-supported fixed restorations have become more prevalent in clinical treatment. It is necessary to assess the patient's remaining bone and occlusal situation correctly; the upper jaw usually needs 6 to 8 implants, whereas the lower jaw needs 4 to 6 implants. Patients with severe alveolar bone atrophy can adopt the "all-on-4/6" treatment plan, short implants, and zygomatic and pterygomaxillary implants to avoid complex bone grafting and remain cautious when the surgical procedures require more surgical experience. According to the repair methods, the superstructure can be divided into one-piece repair and segmental repair. One-piece repair has a lower implant number, flexible location, and reasonable stress distribution but a high maintenance cost. Sectional repair easily achieves passive placement, convenient cleaning, and maintenance in the late stages, but implants need quantity and high requirements for alveolar bone. However, the requirements for alveolar bone and implant number are high. Mutually protected occlusion with minimal or no cantilever on provisional prosthesis is recommended.
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At present, the surgical treatment of upper gastric cancer, including esophago-gastric junction cancer, mainly includes the total gastrectomy and proximal gastrectomy. After total gastrectomy, the reconstruction of digestive tract is completed through the anastomosis of esophagus and jejunum. Patients undergoing total gastrectomy often face the risk of poor eating effect and malnutrition. Compared with total gastrectomy, the proximal gastrectomy can preserve part of the gastric tissue, but due to the loss of the normal physiological structure of the cardia, patients have a higher risk of postoperative reflux. In order to solve the problem of reflux, there are many improved operation methods of digestive tract reconstruction after proximal gastrectomy. At present, the choice of total gastrectomy or proximal gastrectomy and the operation methods of digestive tract reconstruction is still controversial. Because of the lack of sufficient theoretical research support. The authors comb the research progress and consider the concept and method of digestive tract reconstruction after total gastrectomy and proximal gastrectomy, in order to provide theoretical basis for clinical work.
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With the development of antibody manufacturing technology and improvement of new drug research in domestic industry, more innovative monoclonal antibody products submitted investigational new drug (IND) application. At the same time, monoclonal antibody products from abroad which have been approved marketing authorization and/or conducted clinical trials submitted IND applications in China. The National Medical Products Administration (NMPA) issued the "Guideline of Investigational New Drug Application" (No. 16, 2018) which emphasized the chemical, manufacturing, and control (CMC) regulatory, and dossier requirements in IND application, greatly promoted the application quality of innovative biological products. However, compared to the Food and Drug Administration (FDA) and European Medicines Agency (EMA), our particular guidelines are insufficient, such as guideline on virus safety evaluation of biotechnological investigational medicinal products. This review investigated the questions raised by sponsors from 2018 to 2020, including the end of production cell (EOPC) and/or unprocessed bulk (UPB) testing and virus removal or inactivation validation. Meanwhile, sponsors submitted different dossiers due to differences in understanding of stage requirements of guidelines from domestic and abroad. Based on the guidelines of virus safety from NMPA, FDA, and EMA, and the technical considerations, this review puts forward personal suggestions on the adventitious agents testing and virus removal or inactivation validation in manufacturing process, aim to ensure virus safety of innovative monoclonal antibody products in clinical trials.
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Teratogen is any agent that might interfere with the proper growth and development of the embryo or foetus. Teratogens usually involve radiation, cancer, chemicals, and drugs. Comprehension of teratogenic drugs is of great value to dental practitioners because they handle a wide range of drugs that cause teratogenicity in the care of patients with dental problems during pregnancy. The aim of this survey is to assess the awareness among dentists of teratogenic drugs. The study was conducted among 100 final year dental students and interns in Chennai City. 10 questions eliciting information on the knowledge and understanding of teratogenic drugs were framed and distributed. The responses obtained from the participants were compiled, processed further, and analyzed. 83% of the participants were aware of teratogenic drugs. This study concluded that knowledge about teratogenic drugs is adequate among dental students
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Abstract Consideration of future consequences is the extent to which people anticipate and are influenced by the potential future consequences of their current behavior. A well-established tool to measure this behavior is the 14-item Consideration of Future Consequences Scale (CFC-14). The CFC-14 has shown appropriate psychometric properties in several languages. This scale comprises two factors: the CFC-Immediate (CFC-I, 7 items) and the CFC-Future (CFC-F, 7 items). The main goal of this study was to assess the psychometric properties and internal consistency of the CFC-14 Scale in Spanish, using an Argentine sample. A second goal was to determine its convergent validity with impulsivity, and determine differences and invariance across gender and age groups. Using a web-based survey, data were collected from 512 participants (75.2% women) aged 13-74 years (M = 30.8). CFA showed a two-factor model as the best solution for the 13-items version (CFI .961, TLI .952, RMSEA .064 90%IC .054/.074, WRMR 0.979). Standardized regression weights (p ≤ .05) ranged from .50 to .66 for CFC-F and between .43 and .83 for CFC-I. Composite reliability was also adequate: CFC-F achieved p = .80 and CFC-I p = .82. There were no differences across gender and age, but there was a progressive invariance between these groups. The CFC-F and UPPS-P subscales correlations were negative and significant, highlighting the negative and moderate correlation between CFC-F and the lack of premeditation (r=-.41). Thus, CFC-14 has adequate psychometric properties in an Argentine population, although more studies are necessary to determine the robustness of these findings.
Resumen La consideración de las consecuencias futuras se define como el grado en el cual las personas anticipan y son influenciadas por las potenciales consecuencias futuras de su comportamiento actual, y una herramienta muy utilizada para medirla es la Escala de Consideración de las Consecuencias Futuras (CFC-14). Esta escala ha exhibido propiedades psicométricas adecuadas en varios idiomas y se encuentra conformada por dos factores: CFC-Inmediato (CFC-I, 7 ítems) y CFC-Futuro (CFC-F, 7 ítems). El objetivo principal de este estudio fue evaluar las propiedades psicométricas y la consistencia interna de la versión en español de la CFC-14 en una muestra argentina, además de identificar las evidencias de validez convergente con la Escala de Impulsividad y la invarianza en función del género y la edad de los participantes. Para esto, se evaluó mediante una encuesta online a 512 participantes (75.2 % mujeres) de 13 a 74 años (M = 30.8) y se realizó un AFC en el que se encontró un modelo de dos factores como aquel con mejor ajuste para una versión de la escala de 13 ítems (CFI = .961; TLI = .952; RMSEA = .064; IC 90 % = .054-.074; WRMR = 0.979). Específicamente, los pesos de regresión estandarizados (p ≤ .05) fueron de .50 a .66 para CFC-F y de .43 a .83 para CFC-I; los valores de confiabilidad compuesta fueron adecuados, con un p = .80 para CFC-F y un p = .82 para CFC-I; no se observaron diferencias estadísticamente significativas en función del sexo y la edad de los participantes, no obstante, hubo una invarianza progresiva entre estos grupos; y las correlaciones entre las subescalas de la Escala de Impulsividad (UPPPS-P) y la CFC-F fueron negativas y significativas, siendo llamativa la correlación negativa y moderada entre la falta de premeditación y la CFC-F (r = -.41). De este modo, la CFC-14 mostró propiedades psicométricas adecuadas en una muestra argentina, aunque se necesita de más estudios para determinar la robustez de estos resultados.
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Abstract Episodic foresight (EF) refers to the ability to anticipate future states of the self. Despite almost two decades of research, no studies explored how family context variables relate to the development of this ability. The objectives of this study were to explore the association of socioeconomic status (SES), parental consideration of future consequences (CFC), and family environment quality on the development of episodic foresight and to compare the magnitude of the effects of these same variables on delay of gratification and planning. Sixty-four dyads composed by 4-year-old Uruguayan children and their main caregiver participated in the study. Children were administered experiments on episodic foresight, delay of gratification, planning, and receptive language. Parents reported socioeconomic status, family environment, and their consideration of future consequences. Even though parents' limit setting was associated to higher EF in children and parental CFC-I was a predictor in multiple regression analysis, these effects ceased to be significant when controlled by child's receptive language and caregiver education, being these the main predictors of EF. Results also indicate that SES significantly distinguishes the performance in future-oriented skills and language, being the magnitude of the effect higher for EF in comparison with planning and delay of gratification. This study supports that EF is related to SES to a greater extent than other variables traditionally assessed in studies of poverty and child development. We discuss implications of low SES and language skills in the light of EF development and immediate-oriented behavior in contexts of deprivation. (AU)
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Humans , Male , Female , Child, Preschool , Social Class , Time , Child Development , Cognition , Family Relations , UruguayABSTRACT
A review is made on the hospital′s practices in discipline tree cultivation strategy. These approaches include contests in disciplinary development, encouragement of technology innovation, optimizing talents echelons, strengthening team learning, advocating medical translation, and setting up disciplinary construction management cycle among others. The authors proposed to insist in the principles of justice and equity, parallel development of technology and management for discipline leaders, development within capabilities, and upholding both inheritance and innovation.
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@#Cracked tooth is a common type of tooth fracture with diverse symptoms, different treatment principles and unpredictable prognosis. The available remedies for immediate, intermediate and definitive managements include occlusal adjustment, orthodontic band, bonded composite resin, onlay, full crown and so on. For teeth with localized crack and vital pulp, bonded composite resin and onlay with cuspal coverage are also protective remedies besides traditional full-crown restoration. Once pulpal infection occurs, root canal therapy and full-crown restoration is indicated. Clinical determination should be made with comprehensive consideration of the location and depth of the crack, risk of extension and pulpal condition. This review will focus on the traits and prognosis of various therapy options, so as to provide evidence-based treatment planning of cracked tooth.
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The problem about whether or not retirees should pay for basic medical insurance is not only a poli-cy problem,but also one of the focus of theoretical controversy in China. The risk of fund shortage for medical insur-ance or the limited income of the retired workers is the practical issue to be considered when assessing whether the current medical insurance premium policy should be changed or not,but do not constitute a decisive factor in evalua-ting whether it is or not to affordable for the retired workers. The nature of the system and the inherent rights and obli-gations are the fundamental reasons for the decision. Because of the obligations for medical insurance payment,the a-bility to pay and how to undertake are all belong to the problems at different levels,it should be discussed separately. In view of the internal mechanism for medical insurance system and the change of the external environment of social economy,retired workers bearing the obligation of payment is a necessary requirement. In addition,while implemen-ting the principle of universal payment obligation,for the employees who are economically challenged and unable to pay their insurance premiums,can solutions such as lighten burden,through paying duty exemptions,individual gov-ernment subsidies and other ways.
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OBJECTIVE:To improve response capacity of China to deal with intellectual property rights protection standard terms (Trips-plus terms) beyond the regulations of Agreement on Trade-related Aspects of Intellectual Property Rights (TRIPS), and to provide reference for improving national intellectual property rights protection policy. METHODS:Trips-plus terms and their common types were introduced to analyze their characteristics and consider about their adverse effects. RESULTS & CONCLU-SIONS:Common TRIPS-plus terms involve data protection,patent interlinkage,patent period extension,limitation of compulsory licensing and parallel importation,etc. These terms pose a significant challenge to developing countries,resulting in delaying entry of generics,increasing drug price,influencing drug accessibility and posing a great threat to public health. China,as the largest de-veloping country mostly relying on generic drugs,should scientifically assess the effects of TRIPS-plus on public health,drug ac-cessibility and pharmaceutical industry in the process of domestic legislation and negotiating a free trade agreement,and make effec-tive use of the TRIPS flexibility to protect the public health.
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This study was aimed to select the best preparation form of medicinal in camellia cake,based on the optimal antithrombotic agents in oil tea camellia defatted cake to establish the foundation of research.The content of effective index component of the oil tea camellia defatted cake preparation was detected by HPLC-PDA.The quality of medicinal preparation from oil tea camellia defatted cake was characterized based on the content,relative quantity,relative ratio of content,yield rate and antithrombotic effect.The results showed that the effect of antithrombotic of three medicinal preparations from oil tea camellia defatted cake was listed in the following descending order of enrichment,ethanol extract,and water extract.The enrichment was the best preparation form of medicinal in oil tea camellia defatted cake preparation with the highest content of effective index components,the lowest extract rate and the lowest dosage.But it had the best effect of antithrombotic.It was concluded that the significant improvement of efficacy was due to the increase of the content of the components in the preparation and the rationality of the proportion.At the same time,analysis of component quality based on basic composition of drug system through the consideration of effective components of type and quantity,composition and other quality factors can further guide the preparation of drugs.
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With the rapid development of molecular biology,molecular targeted therapy has become an important tumor therapy after surgery,radiotherapy and chemotherapy.It plays an increasingly important role in tumor therapy.Molecular targeted therapy reflects that the clinical medicine tends to precision,but also contains a profound philosophical thought and philosophical basis.On the one hand,the clinical application of molecular targeted therapy reflects the profound philosophical thoughts of the universality of the connection,the universality and theparticularity,and the whole and the part.On the other hand,the further application and development of molecular targeted therapy also need the guidance of philosophical theory.
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ABSTRACT: Orally disintegrating tablets (ODTs) disintegrate rapidly in the mouth in seconds when placed at the tongue. The introduction of ODTs for dogs can address many needs, ranging from convenient dosing for dogs with dysphagia to extending life cycle of drugs. Now, different technologies are widely combined for developing ODTs. The combination makes ODTs have more properties, obtaining orally disintegrating sustained release tablets or orally disintegrating enteric tablets or enhancing the dissolution rate and bioavailability of poorly water-soluble drugs and so on. The aim of this article is to give a comprehensive prospect to the application of ODTs to dogs, including ideal properties of drugs, indications of ODTs, considerations in developing ODTs and development trends of ODTs for dogs.
RESUMO: Os comprimidos de desintegração oral (ODTs) se desintegram rapidamente na boca em questão de segundos, quando colocados na língua. A introdução de ODTs para cães pode resolver muitas necessidades, que vão desde a dosagem conveniente para cães com disfagia à extensão do ciclo de vida de drogas. Hoje, diferentes tecnologias são amplamente usadas para desenvolver ODTs. A combinação torna ODTs com mais propriedades e obter comprimidos de desintegração oral de libertação sustentada ou comprimidos de desintegração oral entéricos ou melhorar a velocidade de dissolução e biodisponibilidade de drogas pouco solúveis em água e assim por diante. O objetivo deste artigo é dar uma perspectiva abrangente para a aplicação de ODTs para cães, incluindo a indicação das ODTs, considerações em ODTs em desenvolvimento, desenvolvimentos de ODTs para cães.
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By referring to the domestic and foreign relevant regulatory guidelines, this paper analyzed and sum-marized the ethical point in the design phase in the perspective of relevant regulations of clinical waste sample man-agement and biological sample management. It also analyzed the focus problems including the difference in sample library and clinical laboratory remaining sample as well as the ownership of the sample, to provide theoretical basis for ethics committee to review this kind of protocols.
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Through the brief introduction of the concept of the mobile medical , this paper pointed out that the ethical issues that exist:health data reliability problems , the patient′s privacy protection , the protection of intellec-tual property rights issues , is involved in the problem of illegal practice medicine , online consulting the legal re-sponsibility of the doctor -patient relationship to define problems , make the reductionism , highlighted the defect of mind-body dualism and instrumental rationality overflow problem .And from the technical level , the law , the poli-cy level and consciousness discusses the related countermeasures .