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1.
Hu Li Za Zhi ; 67(1): 81-88, 2020 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-31960399

RESUMO

BACKGROUND & PROBLEMS: Early rehabilitation after stroke is important for the recovery of bodily functions in stroke patients. However, the percentage of completion of early limb rehabilitation among stroke patients is only 16%. PURPOSE: Raise the early rehabilitation intervention rate to 88% for patients with stroke within 24 hours of hospitalization. RESOLUTION: We developed an education course on post-stroke rehabilitation and a related e-Learning course as well as organized an 'alliance for recovery' team. In addition, we established a standard for post-stroke relay rehabilitation and designed rehabilitation relay cards, Xbox rehabilitation games, and nine squares challenge for brain stroke care. RESULTS: The accuracy of the knowledge of nursing staff related to physical rehabilitation improved from 72.4% to 100%; the accuracy of their perceptions regarding early limb rehabilitation increased from 16% to 100%; and patient satisfaction increased from 68% to 98%. CONCLUSIONS: We deployed diverse and innovative strategies to assist limb rehabilitation in patients with stroke. Patients and caregivers should be encouraged to participate in early rehabilitation and related programs and should apply the skills and rehabilitation activities learned to daily life.


Assuntos
Extremidades/fisiopatologia , Reabilitação do Acidente Vascular Cerebral/métodos , Reabilitação do Acidente Vascular Cerebral/enfermagem , Acidente Vascular Cerebral/fisiopatologia , Difusão de Inovações , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Pesquisa em Avaliação de Enfermagem , Recursos Humanos de Enfermagem no Hospital/educação , Recursos Humanos de Enfermagem no Hospital/psicologia , Satisfação do Paciente/estatística & dados numéricos , Desenvolvimento de Programas
3.
Nat Rev Cardiol ; 17(1): 22-36, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31249403

RESUMO

Conventional right ventricular (RV) pacing, particularly RV apical pacing, can have deleterious effects on cardiac function. Long-term RV apical pacing has been associated with increased risk of atrial fibrillation, hospitalization for heart failure, pacing-induced cardiomyopathy and associated death. His bundle pacing (HBP) results in physiological ventricular activation and has generated tremendous research interest and enthusiasm. By stimulating the His-Purkinje network directly, HBP results in synchronized ventricular activation, which might translate into improved clinical outcomes compared with dyssynchronous ventricular activation with RV apical pacing. HBP can also overcome bundle branch block patterns, and data are accumulating on the benefit of HBP for cardiac resynchronization therapy. In this Review, we summarize the anatomy of the His bundle and early clinical observations, implantation techniques and available outcome data associated with permanent HBP. We also highlight the challenges with HBP and the need for additional tools and more randomized data before widespread application of permanent HBP.


Assuntos
Arritmias Cardíacas/terapia , Fascículo Atrioventricular/fisiopatologia , Estimulação Cardíaca Artificial/tendências , Insuficiência Cardíaca/terapia , Potenciais de Ação , Animais , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/mortalidade , Arritmias Cardíacas/fisiopatologia , Estimulação Cardíaca Artificial/efeitos adversos , Estimulação Cardíaca Artificial/mortalidade , Difusão de Inovações , Previsões , Insuficiência Cardíaca/diagnóstico por imagem , Insuficiência Cardíaca/mortalidade , Insuficiência Cardíaca/fisiopatologia , Frequência Cardíaca , Humanos , Fatores de Risco , Resultado do Tratamento
4.
J Clin Pathol ; 73(1): 1-6, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31308255

RESUMO

Traditionally, immunohistochemistry (IHC) is used by pathologists to localise specific proteins or peptides in tissue slides. In the era of personalised medicine, however, molecular tissue analysis becomes indispensable for correct diagnosis, prognosis and therapeutic decision, not only on the DNA or mRNA level but also on the protein level. Combining molecular information with imaging presents many advantages. Therefore, matrix-assisted laser desorption/ionisation imaging mass spectrometry (MALDI IMS) is a promising technique to be added to the armamentarium of the pathologist. Here, we focus on the workflow, advantages and drawbacks of both MALDI IMS and IHC. We also briefly discuss a few other protein imaging modalities and give examples of applications.


Assuntos
Ensaios de Triagem em Larga Escala , Imuno-Histoquímica , Serviço Hospitalar de Patologia , Patologia Clínica/métodos , Proteômica/métodos , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz , Difusão de Inovações , Humanos , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Fluxo de Trabalho
6.
Artigo em Russo | MEDLINE | ID: mdl-31880762

RESUMO

BACKGROUND: According to modern statistics, endometriosis is a disease that occupies the third place among the most problematic diseases of the female reproductive system, since it develops mainly in young women and, therefore, negatively affects their reproductive function. The paper presents the data obtained from a clinical trial of the combination treatment of Stages I-III endometriosis, including those using sanatorium-and-spa aftercare using radon tampons. OBJECTIVE: To identify the most effective treatment for endometriosis. MATERIAL AND METHODS: Examinations were made in 348 women of reproductive age (mean age 30±4 years) with Stages I-III endometriosis. According to the therapy received, the patients were divided into 2 groups: 1) 174 patients who used drug therapy and radon tampons; 2) 174 patients who received only drug therapy. RESULTS: Resultative positive changes were observed in Group 1 patients who received a combination of anti-inflammatory therapy, pathogenetic therapy of endometriosis, and sanatorium spa aftercare with radon tampons. The investigators excluded pain syndrome in 93.7% of cases, dysmenorrhea in 85.2%, and dyspareunia in 100%; menstrual blood loss decreased in 55.6% of patients; pregnancy occurred in 97.1% of women; the psychoemotional background improved in 100% of cases; in 96.2% of cases, subsequent recurrences were not observed (in the study period of 2014-2018). CONCLUSION: The results of the study showed that a comprehensive and stage approach to treating Stages I-III endometriosis is fundamental to success in women's reproductive health.


Assuntos
Terapia Combinada/métodos , Difusão de Inovações , Endometriose/terapia , Adulto , Feminino , Humanos , Gravidez , Resultado do Tratamento
7.
Br J Nurs ; 28(19): 1234-1238, 2019 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-31680571

RESUMO

INTRODUCTION: the NHS Long Term Plan has called for a reduction in the number of outpatient appointments to reduce pressure on hospital services and increase ease of access for patients. This article presents a service evaluation of an innovative, nurse-led telephone follow-up service for a group of elective bowel cancer patients following surgery. METHODS: the records of patients who underwent surgery over a 2-year period were accessed to determine the number of telephone follow-ups and other investigations. This was used to model the potential cost saving for commissioners against traditional clinic follow-up. Patient satisfaction was assessed by the European Organisation for Research and Treatment of Cancer questionnaire on Outpatient Satisfaction in 30 patients. RESULTS: feedback on the service was overwhelmingly positive, with patients praising the care received from the specialist nurses, but also commenting on increased continuity of care, ease of access and convenience. The service also potentially creates significant savings for commissioners as the agreed tariff for nurse telephone follow-up is significantly less than the outpatient tariff. DISCUSSION: this innovative follow-up system is well liked by patients and should provide savings for commissioners. The hospital also benefits from an increase in capacity to see new or more unwell patients, and a reduction in carbon emissions. Such a service, however, is dependent on people, and although it has functioned effectively in this department for approximately 20 years, it would only be generalisable to other units if staff had appropriate expertise.


Assuntos
Assistência ao Convalescente/organização & administração , Neoplasias Colorretais/cirurgia , Enfermeiras Especialistas , Telefone , Difusão de Inovações , Pesquisa sobre Serviços de Saúde , Humanos , Medicina Estatal/organização & administração , Reino Unido
8.
Prog Cardiovasc Dis ; 62(5): 375-383, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31733217

RESUMO

The authors review more than three decades of progress in providing clinicians and patients with guidance on risk assessment, patient evaluation and cholesterol management. Beginning with the National Cholesterol Education Program's Initial Adult Treatment Panel report, the cholesterol guidelines increasingly reflect the progress made in understanding the benefits of improved lifestyle and nutrition to improve lipid profiles, major risk factors and reduce ASCVD risk. Moreover, they now provide qualitative and quantitative assessment tools to guide appropriate risk reduction LDL-C lowering therapy. Use of the Pooled Cohort Equations to determine Low, Borderline, Intermediate and High 10-year ASCVD risk is now joined by recognition of conditions and biomarkers that enhance ASCVD risk. This personalizes the risk discussion for the patient. An important addition is the selective use of coronary artery calcium (CAC) scoring to reclassify risk in patients at borderline or intermediate risk, but for whom a risk decision regarding statin therapy is uncertain. In secondary prevention, current guidelines provide criteria for determining a "very high" risk group in whom risk is especially high and in whom aggressive LDL-C lowering can be shown to provide increased absolute benefit. Current guidelines provide a comprehensive look at children and adolescents, young adults, elderly, women and issues specific to women through the life course. They provide guidance for those adults at risk due to severe hypercholesterolemia, persistent hypertriglyceridemia after secondary causes have been addressed, those with inflammatory disorders and HIV, those adults with chronic kidney disease, and those affected by issues of race/ethnicity. They conclude with a brief summary of recommendations emphasizing important concepts for providing safety with LDL-C lowering therapy. This combination of best external evidence and clinical expertise from the expert panel should provide a solid foundation for lipid management of patients at risk for or with clinical ASCVD.


Assuntos
Anticolesterolemiantes/uso terapêutico , Doenças Cardiovasculares/prevenção & controle , Colesterol/sangue , Dislipidemias/tratamento farmacológico , Medicina Baseada em Evidências , Guias de Prática Clínica como Assunto , Anticolesterolemiantes/efeitos adversos , Biomarcadores/sangue , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Difusão de Inovações , Dislipidemias/sangue , Dislipidemias/epidemiologia , Dislipidemias/história , Medicina Baseada em Evidências/história , Medicina Baseada em Evidências/tendências , Previsões , História do Século XX , História do Século XXI , Humanos , Fatores de Proteção , Fatores de Risco , Resultado do Tratamento
10.
BMC Public Health ; 19(1): 1335, 2019 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-31640625

RESUMO

BACKGROUND: Australia is committed to eliminating the hepatitis C virus (HCV) by 2030. Despite regulations in Australia that enable the prescription of subsidised direct acting antiviral (DAA) by primary health care providers, the number of providers who treat patients for HCV remains low and this limits the prospect of HCV elimination. The Prince Charles Hospital, Brisbane, Australia, implemented an innovative program called Cure-It aimed at engaging primary care providers in community-based HCV treatment. This paper aims to describe initial experiences and short-term patient outcomes of this program. METHODS: A formative evaluation was conducted using program data for the period March 2016 to April 2018. Descriptive statistics were used to report the number of engaged primary care providers, patients' baseline characteristics, treatment plans, and treatment outcomes. RESULTS: Thirty primary care providers from different settings were engaged in HCV treatment. Among 331 patients eligible for community-based treatment, 315 (95.2%) commenced treatment, the completion rate was 92.4 and 66.5% achieved sustained virological response at 12 weeks (SVR12). The SVR12 had not been documented for 26.8% of patients. Among patients whose SVR12 was documented, 98.2% achieved SVR12. Only 1.3% of patients experienced treatment failure. CONCLUSION: A flexible tertiary-led model can improve primary care providers and patients' engagement with provision of HCV treatment. Tertiary centres need to play their role to improve the accessibility of HCV treatment through providing training and on-going support for primary care providers while enabling those providers to become more confident in providing treatment independently.


Assuntos
Antivirais/uso terapêutico , Difusão de Inovações , Hepatite C/tratamento farmacológico , Médicos de Atenção Primária/psicologia , Atenção Terciária à Saúde/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Austrália , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
11.
Tech Vasc Interv Radiol ; 22(3): 119-124, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31623750

RESUMO

Endoscopy is an underutilized technique in the practice of interventional radiology. The objectives of this article are to discuss potential uses of interventional radiology-operated endoscopy and to outline basic endoscopy setup and equipment uses. Endoscopy represents a new frontier to the fluoroscopically-guided procedures in biliary, gastrointestinal, and genitourinary disease that interventional radiologists commonly perform. It shows promise to improve interventional radiology procedure success rates and reduce procedure-associated risk for patients. Endoscopy has been traditionally performed by gastroenterologists and urologists and is relatively new in the practice of interventional radiology. The hand-eye coordination and manual dexterity required to perform standard image-guided procedures places interventional radiologists in a unique position to introduce endoscopy into standard practice. A focused and collaborative effort is needed by interventional radiologists to learn the techniques required to successfully integrate endoscopy into practice.


Assuntos
Doenças Biliares/terapia , Endoscopia/tendências , Doenças Urogenitais Femininas/terapia , Gastroenteropatias/terapia , Doenças Urogenitais Masculinas/terapia , Radiografia Intervencionista/tendências , Doenças Biliares/diagnóstico por imagem , Competência Clínica , Difusão de Inovações , Endoscópios/tendências , Endoscopia/instrumentação , Endoscopia Gastrointestinal/tendências , Feminino , Doenças Urogenitais Femininas/diagnóstico por imagem , Gastroenteropatias/diagnóstico por imagem , Humanos , Masculino , Doenças Urogenitais Masculinas/diagnóstico por imagem , Destreza Motora , Radiografia Intervencionista/instrumentação , Radiologistas
12.
Rev Infirm ; 68(254): 42-43, 2019 Oct.
Artigo em Francês | MEDLINE | ID: mdl-31587853

RESUMO

The health service, which came into effect in September 2018, concerns all health-care students. Nursing students were among the first to get involved in nursing fields in a variety of settings where the population could get involved in raising awareness of healthy behaviours. A group of nursing students from a school in Île-de-France attests to their involvement in this innovation.


Assuntos
Serviços de Saúde , Estudantes de Enfermagem/psicologia , Difusão de Inovações , França , Humanos , Escolas de Enfermagem
14.
Br J Nurs ; 28(19): 1134-1138, 2019 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-31647733

RESUMO

INTRODUCTION: the NHS Long Term Plan has called for a reduction in the number of outpatient appointments to reduce pressure on hospital services and increase ease of access for patients. This article presents a service evaluation of an innovative, nurse-led telephone follow-up service for a group of elective bowel cancer patients following surgery. METHODS: the records of patients who underwent surgery over a 2-year period were accessed to determine the number of telephone follow-ups and other investigations. This was used to model the potential cost saving for commissioners against traditional clinic follow-up. Patient satisfaction was assessed by the European Organisation for Research and Treatment of Cancer questionnaire on Outpatient Satisfaction in 30 patients. RESULTS: feedback on the service was overwhelmingly positive, with patients praising the care received from the specialist nurses, but also commenting on increased continuity of care, ease of access and convenience. The service also potentially creates significant savings for commissioners as the agreed tariff for nurse telephone follow-up is significantly less than the outpatient tariff. DISCUSSION: this innovative follow-up system is well liked by patients and should provide savings for commissioners. The hospital also benefits from an increase in capacity to see new or more unwell patients, and a reduction in carbon emissions. Such a service, however, is dependent on people, and although it has functioned effectively in this department for approximately 20 years, it would only be generalisable to other units if staff had appropriate expertise.


Assuntos
Assistência ao Convalescente/organização & administração , Neoplasias Colorretais/cirurgia , Enfermeiras Especialistas , Telefone , Difusão de Inovações , Pesquisa sobre Serviços de Saúde , Humanos , Medicina Estatal/organização & administração , Reino Unido
16.
Soins ; 64(838): 33-35, 2019 Sep.
Artigo em Francês | MEDLINE | ID: mdl-31542117

RESUMO

Artificial intelligence (AI) is rapidly being extended across health systems with multiple cases of its use already reported. The most operational technique is machine learning with image recognition in imaging. Solutions derived from this approach, as well as other applications of AI, are presented in two major fields: cancer management and geriatric care.


Assuntos
Inteligência Artificial , Assistência à Saúde/organização & administração , Difusão de Inovações , Humanos , Aprendizado de Máquina
17.
Soins ; 64(838): 45-47, 2019 Sep.
Artigo em Francês | MEDLINE | ID: mdl-31542121

RESUMO

While the use of digital technology has developed in nursing practice in the hospital setting, this movement is late to arrive in homecare. Structural factors can explain these disparities, which are also due to insufficient training of private practice professionals and the fact that digital tools are not always suited to their mode of practice. However, there are adapted and innovative solutions, such as platforms for the organisation of homecare.


Assuntos
Tecnologia Biomédica , Assistência Domiciliar , Serviço Hospitalar de Enfermagem , Difusão de Inovações , Disparidades em Assistência à Saúde , Humanos
18.
Infect Dis Poverty ; 8(1): 81, 2019 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-31514738

RESUMO

BACKGROUND: Despite great medical advances and scientific progress over the past century, one billion people globally still lack access to basic health care services. In the context of the 2030 Agenda for Sustainable Development social innovation models aim to provide effective solutions that bridge the health care delivery gap, address equity and create social value. This commentary highlights the roles of multilateral organizations and governments in creating an enabling environment where social innovations can more effectively integrate into health systems to maximize their impact on beneficiaries. MAIN TEXT: The integration of social innovations into health systems is essential to ensure their sustainability and the wide dissemination of their impact. Effective partnerships, strong engagement with and endorsement by governments and communities, regulations, trust and sometimes willingness are key factors to enhance system integration, replication and dissemination of the models. Three examples of social innovations selected by the Social Innovation in Health Initiative illustrate the importance of engaging with governments and communities in order to link, integrate and synergize their efforts. Key challenges that they encountered, and lessons learnt are highlighted. Multilateral organizations and governments increasingly engage in promoting and supporting the development, testing and dissemination of social innovations to address the health care delivery gap. They play an important role in creating an enabling environment. This includes promoting the concept of social innovation in health care delivery, spreading social innovation approach and lessons learnt, fostering partnerships and leveraging resources, convening communities, health system actors and various stakeholders to work together across disciplines and sectors, and nurturing capacity in countries. CONCLUSIONS: Multilateral organizations and local and national governments have a critical role to play in creating an enabling environment where social innovations can flourish. In supporting and disseminating social innovation approach, multilateral organizations and governments have a great opportunity to accelerate Universal Health Coverage and the achievement of the Sustainable Development Goals.


Assuntos
Assistência à Saúde/métodos , Difusão de Inovações , Governo , Agências Internacionais/estatística & dados numéricos , Assistência à Saúde/legislação & jurisprudência , Assistência à Saúde/estatística & dados numéricos , Humanos
20.
Artigo em Inglês | MEDLINE | ID: mdl-31514312

RESUMO

In real life, garbage has caused great pollution to the environment. A garbage classification system is an effective way to manage this issue, and is an innovation in Shanghai, China. Innovation diffusion is the topic of this paper. This study uses a mathematical statistics method to formulate individual bounded rationality, and uses the specific graph structure of a scale-free network to characterize group structure. Then, a model of group behavior is constructed and the simulation experiment is run on the Python platform. The results show that: (1) In the case of general cognitive ability and high value innovation, most individuals in the group will accept the innovation in the process of innovation dissemination in a garbage classification system after several rounds of the game; (2) it is more helpful to improve the cognitive ability of individuals and the true value of innovation for the diffusion of innovation; and (3) the larger a group, the greater the scope of innovation diffusion and the more time is needed. It is helpful to expand the scope and reduce the time of innovation diffusion by increasing connections among individuals. The innovation of this study is the characterization of individual bounded rationality, which has a certain theoretical value. Meanwhile, the research results of this paper have important practical significance for the promotion of garbage classification, which can be used to popularize the concept of garbage classification.


Assuntos
Cognição , Difusão de Inovações , Processos Grupais , Modelos Teóricos , Gerenciamento de Resíduos , China , Poluição Ambiental/prevenção & controle , Resíduos de Alimentos , Humanos , Comportamento Social
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