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1.
Braz Oral Res ; 34: e001, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32022221

RESUMEN

This study analyzed the effect of prior application of copaiba oil (CO) emulsions as a dentin cleaning substance on microleakage and microtensile adhesive strength. Twenty-five premolars and sixty-four molars were used for microleakage and microtensile assays. For the microleakage assays, specimens with standard class V cavities were divided (n = 5), according to the tested CO emulsions: CO10%X, CO10%Y, and CO10%Z, as well as chlorhexidine 2% (CHX) and distilled water (DW), as positive and negative controls, respectively. Restorations were performed using the Adper Single Bond® and/or Clearfil SE Bond® systems. Cervical, occlusal, distal and mesial sections were assessed for tracer penetration degree at the composite/tooth interface. For the microtensile assay, healthy molars were divided into sixteen groups, in which artificial caries were induced in half of the groups. Dentin surfaces were treated with CO10%X and CO10%Y, CHX and DW. Microtensile bond strength was measured by fixing each sample to the plate of a universal testing machine operated at a speed of 0.5 mm/minute until failure. Dentin treated with CO10%X showed a lower infiltration rate than dentin treated with the other CO emulsions, CHX2% and DW. According to the microtensile assay, both healthy and affected dentin treated with CO10%X and Adper Single Bond® adhesive system presented higher adhesive strength. CO emulsion, used as a dentin biomodifier, interfered positively in microleakage and improved adhesive strength after acid etching in the Adper Single Bond® adhesive system, or before applying the Clearfil SE Bond® self-etching system.


Asunto(s)
Recubrimiento Dental Adhesivo/métodos , Recubrimientos Dentinarios/química , Dentina/efectos de los fármacos , Fabaceae/química , Aceites Vegetales/química , Análisis de Varianza , Clorhexidina/química , Resinas Compuestas/química , Cementos Dentales/química , Filtración Dental , Dentina/química , Emulsiones/química , Humanos , Ensayo de Materiales , Reproducibilidad de los Resultados , Cementos de Resina/química , Estadísticas no Paramétricas , Propiedades de Superficie , Resistencia a la Tracción
2.
Braz Oral Res ; 34: e004, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32022223

RESUMEN

The aim of this study was to analyze the structural, morphological and mechanical properties of two different lithium disilicate glass-reinforced ceramics for CAD-CAM systems (IPS e.max CAD and Rosetta SM). Five methodologies were used for both ceramics: microstructure (n = 2) was analyzed using x-ray diffraction (XRD); morphological properties (n = 2) were analyzed by scanning electron microscopy (SEM), with and without hydrofluoric etching; porosity (n = 3) was assessed using 3D micro-computed tomography (micro-CT); flexural strength was measured (n =1 0) using the three-point bending test; and bond strength was determined with self-adhesive resin cement (n = 10), using a microshear bond test. After performing all the tests, the data were analyzed using t-Student test and two-way ANOVA. All the tests used a significance level of α = 0.05. High peak positions corresponding to standard lithium metasilicate and lithium disilicate with similar intensities were observed for both ceramics in the XRD analysis. Morphological analysis showed that the crystalline structure of the two ceramics studied showed no statistical difference after acid etching. Additionally, no significant differences were recorded in the number or size of the pores for the ceramics evaluated. Moreover, no differences in flexural strength were found for the ceramic materials tested, or in the bond strength to ceramic substrates for the resin cements. Based on the study results, no significant differences were found between the two CAD-CAM lithium disilicate glass-reinforced ceramics tested, since they presented similar crystalline structures with comparable intensities, and similar total porosity, flexural strength and bond strength.


Asunto(s)
Cerámica/química , Diseño Asistido por Computador , Porcelana Dental/química , Vidrio/química , Análisis de Varianza , Recubrimiento Dental Adhesivo/métodos , Resistencia Flexional , Ensayo de Materiales , Microscopía Electrónica de Rastreo , Porosidad , Valores de Referencia , Reproducibilidad de los Resultados , Cementos de Resina/química , Resistencia al Corte , Propiedades de Superficie , Difracción de Rayos X
3.
Braz Oral Res ; 34: e005, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32022224

RESUMEN

The purpose of this study was to evaluate the effect of ionizing radiation from high energy X-ray on fluoride release, surface roughness, flexural strength, and surface chemical composition of the materials. The study groups comprised five different restorative materials: Beautifil II, GCP Glass Fill, Amalgomer CR, Zirconomer, and Fuji IX GP. Twenty disk-shaped specimens (8x2 mm) for fluoride release and 20 bar-shaped specimens (25 x 2x 2 mm) for flexural strength were prepared from each material. Each material group was divided into two subgroups: irradiated (IR) and non-irradiated (Non-IR). The specimens from IR groups were irradiated with 1.8 Gy/day for 39 days (total IR = 70.2 Gy). The amount of fluoride released into deionized water was measured using a fluoride ion-selective electrode and ion analyzer after 24 hours and on days 2, 3, 7, 15, 21, 28, 35, and 39 (n = 10). The flexural strength was evaluated using the three-point bending test (n = 10). After the period of measurement of fluoride release, seven specimens (n = 7) from each group were randomly selected to evaluate surface roughness using AFM and one specimen was randomly selected for the SEM and EDS analyses. Data were analyzed with two-way ANOVA and Tukey tests (p = 0.05). The irradiation significantly increased fluoride release and surface roughness for Amalgomer CR and Zirconomer groups (p < 0.05). No significant change in flexural strength of the materials was observed after irradiation (p > 0.05). The ionizing radiation altered the amount of fluoride release and surface roughness of only Amalgomer CR and Zirconomer. The effect could be related to the chemical compositions of materials.


Asunto(s)
Apatitas/efectos de la radiación , Bisfenol A Glicidil Metacrilato/efectos de la radiación , Resinas Compuestas/efectos de la radiación , Fluoruros/química , Cementos de Ionómero Vitreo/efectos de la radiación , Radiación Ionizante , Circonio/efectos de la radiación , Análisis de Varianza , Apatitas/química , Bisfenol A Glicidil Metacrilato/química , Resinas Compuestas/química , Resistencia Flexional , Cementos de Ionómero Vitreo/química , Ensayo de Materiales , Microscopía Electrónica de Rastreo , Valores de Referencia , Reproducibilidad de los Resultados , Espectrometría por Rayos X , Estadísticas no Paramétricas , Propiedades de Superficie/efectos de la radiación , Factores de Tiempo , Circonio/química
4.
Zhonghua Yi Xue Za Zhi ; 100(3): 220-224, 2020 Jan 21.
Artículo en Chino | MEDLINE | ID: mdl-32008290

RESUMEN

Objective: To investigate the value of bedside pulmonary ultrasound in the diagnosis and treatment of atelectasis in patients after cardiac surgery. Methods: A total of 45 patients developed respiratory failure within 1 week after cardiovascular surgery from April 2017 to April 2018 were enrolled in this study. Among them, 27 were male and 18 were female, mean age was (47±5) years. The postoperative pulmonary ultrasound and chest CT findings were collected, and the consistency, efficacy evaluation, timeliness and safety value of pulmonary ultrasound and chest CT diagnosis were compared. The consistency of the two diagnostic methods was checked based on the Kappa consistency test. Results: A total of 87 foci of atelectasis were diagnosed in 45 patients, including 29 foci of complete atelectasis and 58 foci of incomplete atelectasis. Thoracic CT examination confirmed 44 cases of atelectasis (positive rate 97.8%), and 42 cases (93.3%) were found with atelectasis with ultrasound test. The two methods were consistent in the diagnosis of atelectasis (Kappa value was 0.741, P<0.05). In the evaluation of the atelectasis, the results of the two examination methods were completely consistent, and the pulmonary ultrasound couldcheck the lung recruitment in real time. Ultrasound examination after lung recruitment showed that the total ventilation score of 42 patients decreased significantly when compared with that before treatment ((18.3±3.6) vs (26.6±3.8), t=10.229, P<0.05). There was no significant difference in the safety between the two examination methods. The time the bedside pulmonary ultrasound used was significantly shorter than that in the chest CT. Conclusions: The accuracy of bedside pulmonary ultrasound in assessing atelectasis after cardiovascular surgery is consistent with chest CT, it brings dynamic monitoring of lung status and assessment of lung recruitment by changes in lung ventilation scores. The inspection takes a short time and is worth promoting.


Asunto(s)
Procedimientos Quirúrgicos Cardíacos , Atelectasia Pulmonar/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Ultrasonografía/métodos , Adulto , Femenino , Humanos , Pulmón/diagnóstico por imagen , Pulmón/fisiopatología , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/diagnóstico por imagen , Periodo Posoperatorio , Valor Predictivo de las Pruebas , Atelectasia Pulmonar/patología , Atelectasia Pulmonar/terapia , Reproducibilidad de los Resultados , Sensibilidad y Especificidad
5.
Rev Med Liege ; 75(2): 83-88, 2020 Feb.
Artículo en Francés | MEDLINE | ID: mdl-32030931

RESUMEN

Facing the aging of primary care practitioners and their still increasing duties, we implemented a new and original solution to maintain the continuity of primary care in the area surrounding of our university hospital. Thereby, we created a new model of nurse telephone triage for the regulation of out-of-hours primary care calls, the SALOMON algorithm ("Système Algorithmique Liégeois d'Orientation pour la Médecine Omnipraticienne Nocturne"). Following the nurse telephone triage and the assessment of the illness severity, the patient is referred to four potential orientations : Emergency Medical Services (EMS), Emergency Department Referred Consultation (EDRC), Primary Care Physician Home visit (PCPH) and Primary Care Physician Delayed visit (PCPD). In this article, we aim to describe the SALOMON model and present a 12-month feasibility study in order to determine the safety of the tool. We can also notice nurse and general practitioner satisfaction about this approach with a positive impact on the global primary care out-of-hour organization. Currently, SALOMON seems to be full of promise. Further investigations on a larger cohort are needed to determine more precisely the reliability of the algorithm.


Asunto(s)
Servicio de Urgencia en Hospital , Atención Secundaria de Salud , Triaje , Urgencias Médicas , Humanos , Reproducibilidad de los Resultados , Teléfono
7.
Am J Orthod Dentofacial Orthop ; 157(2): 228-239, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32005475

RESUMEN

INTRODUCTION: The objective of this study was to assess the reproducibility of cervical vertebral maturation (CVM) method based on the type of radiographic image and the level of experience and level of training of the evaluator. METHODS: Ten evaluators (5 orthodontic residents and 5 faculty members) were randomly divided into 2 groups: trained and untrained. All participants evaluated 80 radiographic images previously acquired in 4 different formats: (1) 2-dimensional (2D) digital (2D-digital), (2) 2D digitized hard copy from the Iowa Facial Growth Study (American Association of Orthodontists Foundation Craniofacial Growth Legacy Collection), (3) 2D digital reconstructed from a 3-dimensional (3D) radiograph (2D-from 3D), and (4) 3D cone-beam computerized tomographic (3D-CBCT) images. Agreement among evaluators on the morphology of the cervical vertebrae (CV) and the CVM stage of each radiographic image was assessed using Randolph's kappa statistic and Kendall's W coefficient of concordance. RESULTS: Interobserver agreement on the determination of a curvature on the inferior border of the CV was substantial to perfect, whereas agreement on shape was fair to moderate. Overall, the level training in all image types, except 3D-CBCTs, but not the level of experience affected the agreement for shape and curvature of the CVs. Interobserver agreement on CVM staging for all combined images was substantial at 0.72. Faculty had a higher level of agreement than residents except for 2D-digital and 3D-CBCT images, whereas trained evaluators had an overall higher level of agreement than untrained evaluators except for 3D-CBCT images. CONCLUSIONS: Interobserver agreement in determining CVM stage was substantial for all images evaluated; experience and training resulted in higher level of agreement for some image types. The 3D-CBCT images did not provide increased interobserver agreement over current 2D-digital lateral cephalograms in determining CVM staging or shape of the CV. The highest agreement in CVM staging was obtained on 2D-digital lateral cephalograms with training.


Asunto(s)
Cefalometría , Vértebras Cervicales , Tomografía Computarizada de Haz Cónico , Ortodoncia/educación , Vértebras Cervicales/diagnóstico por imagen , Competencia Clínica , Humanos , Imagen Tridimensional , Iowa , Variaciones Dependientes del Observador , Reproducibilidad de los Resultados
9.
Isr Med Assoc J ; 22(2): 94-99, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32043326

RESUMEN

BACKGROUND: Internal thoracic impedance (ITI) measurement is a sensitive method for detecting preclinical pulmonary edema and pleural effusion. OBJECTIVES: To investigate the efficacy of this non-invasive method for detecting early pleural effusion among geriatric patients and to monitor increased ITI during its resolution. METHODS: This prospective, controlled study was conducted between July 2012 and August 2015. The study comprised 70 patients aged 65 to 94 years; and 39 of the patients had pleural effusion. ITI was measured continuously with a RS-207 monitor. The predictive value of ITI monitoring was determined based on a total of eight measurements taken at 12-hour intervals over 84 hours. RESULTS: As a result of medical treatment, the median ITI of the study group increased from 31 (interquartile range [IQR] 28-33 ohms) to 41 ohms (IQR 38-41 ohms; P < 0.001) compared to non-significant changes in the control group. Average respiratory rate (per minute) in the study group decreased from 29 (IQR 28-34) to 19 (IQR 18-20). CONCLUSIONS: ITI monitoring is efficient for diagnosis and for ongoing clinical evaluation of the treatment of elderly patients with pleural effusion. Timely treatment may prevent serious complications of effusions avoiding extended hospitalization.


Asunto(s)
Pletismografía de Impedancia/métodos , Derrame Pleural , Anciano , Diagnóstico Precoz , Femenino , Evaluación Geriátrica/métodos , Humanos , Israel , Masculino , Monitoreo Fisiológico/métodos , Derrame Pleural/diagnóstico , Derrame Pleural/etiología , Derrame Pleural/fisiopatología , Pruebas en el Punto de Atención , Recurrencia , Reproducibilidad de los Resultados
10.
Medicine (Baltimore) ; 99(6): e18922, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32028399

RESUMEN

The validity of the 8th edition of the Union for International Cancer Control (UICC) staging system for gastric cancer has been evaluated only in Asian cohorts and not in European cohorts. The aim of this study was to evaluate the prognostic performance of the 8th edition of the UICC staging system in German and Korean cohorts independently and compare it with that of the 7th edition.A total of 6121 patients (526 from Germany and 5595 from Korea) who underwent upfront surgery for gastric cancer were retrospectively reclassified according to the 8th edition. Survival according to the UICC stages was estimated by the Kaplan-Meier method and compared by log-rank tests. A Cox proportional hazards model was fitted after adjusting for clinicopathological factors, and receiver operating characteristics analysis was conducted.The 8th edition showed significant differences in survival between each adjacent stage in the Korean cohort but not in the German cohort. Multivariate analyses revealed that the 8th edition staging was an independent prognostic factor, and its C-statistics were >0.76 in both German and Korean patients. The results were comparable to those observed with the UICC seventh edition (C-statistics was 0.768 vs 0.767 in the German cohort and 0.789 vs 0.785 in the Korean cohort for the 7th vs the 8th edition).The 8th edition showed prognostic value in predicting the survival of gastric cancer patients in both German and Korean cohorts. However, the predictive ability of the 8th and 7th edition was similar.


Asunto(s)
Estadificación de Neoplasias , Neoplasias Gástricas/mortalidad , Anciano , Bases de Datos Factuales , Femenino , Alemania , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Prospectivos , Reproducibilidad de los Resultados , República de Corea , Neoplasias Gástricas/patología , Análisis de Supervivencia
11.
Gerodontology ; 37(1): 87-92, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31943327

RESUMEN

BACKGROUND AND OBJECTIVE: Ageism is a major barrier for age-appropriate care. The aim of this study was to translate and perform a preliminary validation of an ageism scale for dental students (ASDS) in Brazil (ASDS-Braz). METHODS: The 27-item original ageism scale was translated from English into Brazilian Portuguese. A panel of five Brazilian dental educators revised the scale to establish content validity. The translated version was completed by 156 dental students in the Federal University of Pelotas in Brazil. Principal component analysis, internal consistency reliability and discriminant validity were estimated. RESULTS: All items in the Brazilian Portuguese version received a content validity index score ≥0.80 indicating that they were relevant to the topic. The principal component analysis produced a 12-item scale with three components that accounted for 51% of the overall variance. The first component contained six items associated with a negative view of older adults; the second component contained three items dealing with the complexity of providing care for older adults; and the third component contained three items associated with a positive view of older people. Discriminant validity did not show any differences related to demographic factors, the semester of studies and history of living with older people. CONCLUSIONS: The preliminary validation of the ASDS-Braz produced a 12-item scale with three components with acceptable validity and reliability. Future research in a larger, multi-institutional sample is now warranted.


Asunto(s)
Ageísmo , Estudiantes de Odontología , Anciano , Anciano de 80 o más Años , Brasil , Humanos , Psicometría , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
12.
J Oral Sci ; 62(1): 28-31, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31996519

RESUMEN

This study attempted to determine the minimum number of cells required to conduct DNA analyses effectively. Oral mucosal cells obtained from eight persons were suspended and individually collected by using micromanipulation technique. DNA was extracted and amplified by whole-genome amplification (WGA). Nuclear DNA was extracted to evaluate the feasibility of autosomal short tandem repeat (STR) polymorphism and Y-chromosomal STR polymorphism analyses. Tests were conducted with 20 and 30 cells, to determine the minimum number of cells required for each DNA analysis. Tests with 20 cells were repeated 5 times, to examine reproducibility. When five or 10 cells were used, loci could not be identified for most alleles. Furthermore, DNA polymorphism analyses of a single cell transferred directly to a polymerase chain reaction solution were unsuccessful. The present findings suggest that, in forensic identification, 20 or more cells are required in order to obtain clear results from autosomal and Y-chromosomal STR polymorphism analyses. Furthermore, the feasibility of sample preservation and reexamination was also confirmed by DNA amplification with WGA.


Asunto(s)
Repeticiones de Microsatélite , Técnicas de Amplificación de Ácido Nucleico , ADN , Micromanipulación , Reproducibilidad de los Resultados
13.
J Nurs Adm ; 50(2): 104-108, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31929344

RESUMEN

OBJECTIVE: The aim of this study was to develop a valid, reliable instrument to measure the effectiveness of shared governance councils BACKGROUND: The work of shared governance, that is, the decisions, takes place in its structures, notably, the councils. A literature search yielded no formal instrument for evaluating how these councils function. METHODS: A 4-phase process was used to generate valid items to measure shared governance council effectiveness, including content validity by experts, a pilot for feasibility, a larger pilot for internal consistency, and an exploratory factor analysis to delineate a final instrument. RESULTS: More than a dozen experts and participants from nearly 30 healthcare organizations contributed to the final development of the 25-item Council Health Survey instrument. Items for measuring council effectiveness at either the unit or division level were grouped in areas of structure, activities, and membership. CONCLUSIONS: When evaluating shared governance, nurses should focus on councils themselves, in which much of the work of shared governance occurs.


Asunto(s)
Gestión Clínica/organización & administración , Eficiencia Organizacional , Consejo Directivo/organización & administración , Colaboración Intersectorial , Atención de Enfermería/organización & administración , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Psicometría , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
14.
Artículo en Chino | MEDLINE | ID: mdl-31954386

RESUMEN

Objective: The consistency of 24-hour oropharyngeal Dx-pH monitoring and proton pump inhibitor(PPI) test in the diagnosis of laryngopharyngeal reflux disease (LPRD) was investigated. Methods: Sixty patients with laryngopharyngeal reflux (LPR) related symptoms who had never received PPI treatment were assessed by reflux symptom index (RSI) and reflux finding score (RFS) between October 2017 and October 2018, including 28 males and 38 females, aged from 16 to 72 years, with a medium age of 38 years. Prior to treatment, all patients were evaluated with 24 hours oropharyngeal Dx-pH monitoring(Restech). After empiric therapy with PPI twice-daily for 8 weeks, the efficacy was evaluated according to posttreatment RSI score.The data was analysed with Kruskal-Wallis test, Student Newman Keuls test and consistency check. Results: (1)Among all 60 patients,13 patients (21.7%) had pathologic Ryan score and all resulted responsive to PPI;27 patients (45.0%) with a negative Ryan score were unresponsive to PPI; 20 patients (33.3%) despite a negative Ryan score resulted responsive to PPI therapy. Considering responsiveness to PPI therapy as the gold standard for the diagnosis of LPRD, the sensitivity, specificity, positive predictive value and negative predictive value of Ryan score were 39.4%, 100%, 100% and 57.4% respectively. The Kappa value was 0.369 (P<0.01). (2)Among 34 patients (56.7%) with positive Dx-pH results (24-hour oropharyngeal acid reflux events≥ 3 times), 29 patients were positive and 5 patients were negative in PPI test. Among 26 patients with negative Dx-pH results (24-hour oropharyngeal acid reflux events<3 times), 4 patients were positive and 22 patients were negative in PPI test. Considering responsiveness to PPI therapy as the gold standard for the diagnosis of LPRD, the sensitivity, specificity, positive predictive value and negative predictive value of 24-hour oropharyngeal acid reflux events were 87.9%, 81.5%, 85.3% and 84.6% respectively. The Kappa value was 0.696(P<0.01). Conclusions: There is a positive correlation between 24-hour oropharyngeal Dx-pH monitoring positive results (24-hour oropharyngeal acid reflux events≥3 times) and PPI test in the diagnosis of LPRD. The 24-hour oropharyngeal Dx-pH monitoring can be a promising tool for the diagnosis of suspected LPRD patients, and more sensitive and accurate Dx-pH diagnostic index will be required in the clinic.


Asunto(s)
Monitorización del pH Esofágico/métodos , Reflujo Laringofaríngeo/diagnóstico , Inhibidores de la Bomba de Protones/uso terapéutico , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Adulto Joven
15.
J Environ Manage ; 258: 110040, 2020 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-31929074

RESUMEN

Measures to protect irrigation water supplies for food security continue to receive international attention to address growing water scarcity when faced by increased food demands combined with reduced water supply reliability. Yet, a common problem where water is delivered with earthen canals is delivery inefficiency combined with low economic values per unit of water. In many of the world's arid regions, climate stressed water shortages have raised the importance of discovering measures to improve irrigation delivery efficiency. However, little research grade work to date has presented an integrated analysis of the economic performance of irrigation delivery improvements faced by drought and climate stressed regions. This paper's unique contribution is to investigate the economic performance of water conservation infrastructure combined with dynamically optimized use of saved water. We develop a state-of-the arts empirical dynamic optimization model to discover land and water use patterns that optimize sustained farm income. Results from the upper watershed irrigation region of the Canadian Basin in the southwestern US show that canal and delivery system lining can raise the sustained economic value of water for crop irrigation. The saved water can see immediate use in dry years. It can also be stored in wet years to mitigate the most adverse impacts of future climate water stress. This double dividend is especially important in rain-fed watersheds for which surface water supplies for irrigation are difficult to forecast accurately. Findings light a path for water managers and other stakeholders who bear responsibility of finding economically responsible measures to improve irrigation water productivity in the world's dry regions.


Asunto(s)
Conservación de los Recursos Hídricos , Riego Agrícola , Canadá , Conservación de los Recursos Naturales , Ambiente , Reproducibilidad de los Resultados , Abastecimiento de Agua
17.
Artículo en Alemán | MEDLINE | ID: mdl-31950230

RESUMEN

The concept of digital health literacy can be regarded as the result of the increasing social permeation of digital media and their use in everyday life. Due to increasing accessibility and ubiquity, there is an increasing need not only for searching and finding, but especially for assessing the reliability as well as selecting and applying health information for one's own health concerns. In the context of digitization, it needs to be emphasized that users are not just passive recipients, but rather actively participate in the communication process by interacting with existing content or by sharing their own health-related information.With particular focus on children and adolescents, this paper provides an overview of the current state of research on digital health literacy. In addition to its terminological and conceptual foundations and its links with media literacy, the relationship between digital health literacy and social and health inequality is discussed. Inequalities are not only generated by access to digital media but, above all, by the skills required for their use. After an overview of available instruments is provided, initial reflections on how to promote the individual and structural dimension of digital health literacy with focus on school settings is given.


Asunto(s)
Alfabetización en Salud , Promoción de la Salud , Disparidades en el Estado de Salud , Adolescente , Niño , Alemania , Humanos , Internet , Reproducibilidad de los Resultados
18.
Hautarzt ; 71(2): 91-100, 2020 Feb.
Artículo en Alemán | MEDLINE | ID: mdl-31965205

RESUMEN

The skin is a complex organ that performs a number of vital functions, including forming a physical barrier that protects our body from the penetration of pathogens and irritants and from excessive transepidermal water loss. In addition to its passive properties, the skin is also actively involved in the immune process. A complex structure of different cell types and structures allows the skin to fulfil these functions. In vitro research often faces the problem that simple 2D cell cultures are not able to adequately map these functions. Here 3D skin models offer a possible solution. In recent years, there has been significant development in this field; the reproducibility of the method as well as the physiological structure and tissue architecture of the 3D skin models have been improved. Depending on the research question, protocols for 3D skin models have been published, ranging from simple multilayer epidermis models to highly complex vascularized 3D full skin models.


Asunto(s)
Técnicas de Cultivo de Célula , Dermatología , Modelos Biológicos , Técnicas de Cultivo de Célula/métodos , Epidermis , Humanos , Reproducibilidad de los Resultados , Piel
19.
Br J Nurs ; 29(2): S35-S40, 2020 Jan 23.
Artículo en Inglés | MEDLINE | ID: mdl-31972107

RESUMEN

BACKGROUND: The DIVA score is validated for predicting success of the initial attempt at peripheral intravenous insertion by nurses and physicians. A score of 4 or greater is 50% to 60% likely to have a failed first attempt. The study objective was to assess the validity of this score for emergency department technicians. METHODS: This study used a prospective convenience sample of 181 children presenting to the emergency department with intravenous access attempt by one of 29 emergency department technicians. DIVA score, total number of attempts, and median time to successful intravenous cannulation were obtained. RESULTS: Comparing patients with a DIVA score <4 to ≥4, first-time IV placement failure rates were lower (9% [95% CI, 3-24] vs. 41% [95% CI, 33-49]) and median time to IV placement was shorter (75 [interquartile range (IQR) 42-157] vs. 254 [IQR 91-806]) seconds. In patients with scores ≥4, emergency department technicians with ≥5 years of experience were significantly more likely to be successful on the first attempt (OR 2.8; 95% CI, 1.03-7.63). For every year of technician experience, the time to catheter placement, adjusted for DIVA score, decreased by 25 minutes (P≤0.05, R2=0.05). Comparing our receiver operating curve to the derivation study, the areas were similar (0.67 vs. 0.65). CONCLUSIONS: This study provides preliminary evidence for the validity of the DIVA score when applied to IVs placed by emergency department technicians. For patients with high DIVA scores, ≥5 years of IV experience was associated with higher odds of successful first-time IV placement and shorter time to placement. HIGHLIGHTS The difficult intravenous access (DIVA) score may be generalizable to IVs placed by experienced emergency department technicians (EDTs) Higher odds of first-time success in difficult patients with ≥5 years EDT experience Early identification of difficult access may allow for aid of alternative technology Likely first study to evaluate EDTs IV skills in patients with varying DIVA scores.


Asunto(s)
Cateterismo Periférico , Toma de Decisiones Clínicas , Técnicas de Apoyo para la Decisión , Auxiliares de Urgencia , Preescolar , Servicio de Urgencia en Hospital , Humanos , Lactante , Estudios Prospectivos , Reproducibilidad de los Resultados
20.
Head Face Med ; 16(1): 1, 2020 Jan 27.
Artículo en Inglés | MEDLINE | ID: mdl-31987041

RESUMEN

INTRODUCTION: Cone-Beam Computed Tomography (CBCT) images can be superimposed, allowing three-dimensional (3D) evaluation of craniofacial growth/treatment effects. Limitations of 3D superimposition techniques are related to imaging quality, software/hardware performance, reference areas chosen, and landmark points/volumes identification errors. The aims of this research are to determine/compare the intra-rater reliability generated by three 3D superimposition methods using CBCT images, and compare the changes observed in treated cases by these methods. METHODS: Thirty-six growing individuals (11-14 years old) were selected from patients that received orthodontic treatment. Before and after treatment (average 24 months apart) CBCTs were analyzed using three superimposition methods. The superimposed scans with the two voxel-based methods were used to construct surface models and quantify differences using SlicerCMF software, while distances in the landmark-derived method were calculated using Excel. 3D linear measurements of the models superimposed with each method were then compared. RESULTS: Repeated measurements with each method separately presented good to excellent intraclass correlation coefficient (ICC ≥ 0.825). ICC values were the lowest when comparing the landmark-based method and both voxel-based methods. Moderate to excellent agreement was observed when comparing the voxel-based methods against each other. The landmark-based method generated the highest measurement error. CONCLUSIONS: Findings indicate good to excellent intra-examiner reliability of the three 3D superimposition methods when assessed individually. However, when assessing reliability among the three methods, ICC demonstrated less powerful agreement. The measurements with two of the three methods (CMFreg/Slicer and Dolphin) showed similar mean differences; however, the accuracy of the results could not be determined.


Asunto(s)
Tomografía Computarizada de Haz Cónico , Imagen Tridimensional , Diente , Adolescente , Cefalometría , Niño , Atención Odontológica , Humanos , Ortodoncia , Reproducibilidad de los Resultados , Diente/diagnóstico por imagen
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