RESUMO
The extent to which culture moderates the effects of need for approval from others on a person's handling of interpersonal conflict was investigated. Students from 24 nations rated how they handled a recent interpersonal conflict, using measures derived from face-negotiation theory. Samples varied in the extent to which they were perceived as characterised by the cultural logics of dignity, honour, or face. It was hypothesised that the emphasis on harmony within face cultures would reduce the relevance of need for approval from others to face-negotiation concerns. Respondents rated their need for approval from others and how much they sought to preserve their own face and the face of the other party during the conflict. Need for approval was associated with concerns for both self-face and other-face. However, as predicted, the association between need for approval from others and concern for self-face was weaker where face logic was prevalent. Favourable conflict outcome was positively related to other-face and negatively related to self-face and to need for approval from others, but there were no significant interactions related to prevailing cultural logics. The results illustrate how particular face-threatening factors can moderate the distinctive face-concerns earlier found to characterise individualistic and collectivistic cultural groups.
Assuntos
Comparação Transcultural , Relações Interpessoais , Humanos , Conflito Psicológico , Negociação , IndividualidadeRESUMO
BACKGROUND: Tibial crest osteotomy is an established extensile knee approach. Complications include mal-union, non-union, and fixation problems.We have designed a technique aimed at reducing complications through the principles of low-energy osteotomy and suture repair. METHODS: We reviewed our clinical and radiological results in 159 consecutive patients 181 osteotomies with a mean age of 66 years, and an average follow up of 22 months. RESULTS: Union occurred in all osteotomies (100%) at a mean period of 11 weeks. Proximal migration averaging 11.5 mm occurred in 6 osteotomies (3%). Crest fragmentation occurred in 11 osteotomies (6%), with all cases resulting in uncomplicated union. No extensor mechanism failure or complications related to the suture material occurred. CONCLUSION: We conclude that this technique results in satisfactory outcomes whilst avoiding hardware-related problems.
Assuntos
Artroplastia do Joelho , Articulação do Joelho/cirurgia , Osteotomia/métodos , Tíbia/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Artroplastia do Joelho/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Amplitude de Movimento Articular , Reoperação , Estudos Retrospectivos , Técnicas de SuturaRESUMO
BACKGROUND: Periprosthetic infection following total knee arthroplasty is a devastating complication, which is not always satisfactorily resolved by revision surgery. Arthrodesis is a salvage alternative to above-knee amputation or permanent resection arthroplasty. Fixation options include internal compression plating, external fixation, and intramedullary nails. METHODS: We retrospectively reviewed twelve consecutive cases (9 males, 3 females; mean age, 67 years) of knee arthrodesis with a long intramedullary nail, performed at a single institution between 2003 and 2014. Desired outcomes were the ability to mobilize without pain, solid radiographic fusion, and the eradication of infection. RESULTS: Mean follow-up was 48.5 months (range, 9-120 months). Eleven patients (92 %) demonstrated stable fusion, ten patients (83 %) were ambulatory without pain, and ten patients (83 %) remained without infection at most recent follow-up. Eight patients (67 %) achieved union at an average of 12 months; three required repeat procedures, achieving union at an average of 9 months. There was a significant difference (P < 0.01) between the numbers of previous operations amongst the eight patients who initially achieved union (mean, 3.25) and three who subsequently required repeat procedures (mean, 8.33). CONCLUSIONS: In contrast to similar studies, we performed a single-stage exchange where possible, while comparable ambulatory and fusion rates were observed. Numerous previous attempts at revision arthroplasty, co-morbidities, and infections with highly resistant organisms have been associated with further complications. Although technically challenging, knee arthrodesis with a long intramedullary nail offers an acceptable limb salvage procedure for carefully selected patients with complex periprosthetic infections.
Assuntos
Artrodese , Artroplastia do Joelho/efeitos adversos , Pinos Ortopédicos , Fixação Intramedular de Fraturas , Salvamento de Membro , Reoperação , Idoso , Amputação Cirúrgica/métodos , Artrodese/instrumentação , Artrodese/métodos , Artroplastia do Joelho/métodos , Feminino , Fixação Intramedular de Fraturas/instrumentação , Fixação Intramedular de Fraturas/métodos , Humanos , Articulação do Joelho/diagnóstico por imagem , Salvamento de Membro/instrumentação , Salvamento de Membro/métodos , Masculino , Infecções Relacionadas à Prótese/diagnóstico , Infecções Relacionadas à Prótese/etiologia , Infecções Relacionadas à Prótese/cirurgia , Reoperação/instrumentação , Reoperação/métodos , Estudos Retrospectivos , Resultado do Tratamento , Reino UnidoRESUMO
Periprosthetic knee fractures and their complications are expected to increase as the numbers of knee arthroplasties continue to rise. We report our experience with revision knee arthroplasty for failure of primary fracture treatment. Five periprosthetic knee non-unions and 1 mal-union in 6 patients, with ages ranging from 65 to 83years (average 74.6years) were treated with revision total knee arthroplasty, and were followed up for 3 to 10years (average 4.5years). Union occurred in 8 to 18weeks (average 12.5weeks). All patients were ambulatory at the latest follow-up, with a range of motion averaging 84.2° (P = 0.03), and an Oxford Knee Score averaging 35 (P = 0.03). We conclude that union complications of periprosthetic knee fractures can be satisfactorily addressed with revision arthroplasty.
Assuntos
Artroplastia do Joelho/efeitos adversos , Fraturas do Fêmur/etiologia , Articulação do Joelho , Fraturas Periprotéticas/cirurgia , Fraturas da Tíbia/cirurgia , Idoso , Idoso de 80 Anos ou mais , Feminino , Fraturas do Fêmur/cirurgia , Fixação de Fratura/efeitos adversos , Fraturas Mal-Unidas/etiologia , Fraturas Mal-Unidas/cirurgia , Fraturas não Consolidadas/etiologia , Fraturas não Consolidadas/cirurgia , Humanos , Masculino , Fraturas Periprotéticas/etiologia , Reoperação , Estudos Retrospectivos , Fraturas da Tíbia/etiologiaRESUMO
These datasets contain measures from multi-modal data sources. They include objective and subjective measures commonly used to determine cognitive states of workload, situational awareness, stress, and fatigue using data collection tools such as NASA-TLX, SART, eye tracking, EEG, Health Monitoring Watch, a survey to assess training, and a think-aloud situational awareness assessment following the SPAM methodology. Also, data from a simulation formaldehyde production plant based on the interaction of the participants in a controlled control room experimental setting is included. The interaction with the plant is based on a human-in-the-loop alarm handling and process control task flow, which includes Monitoring, Alarm Handling, Recovery planning, and intervention (Troubleshooting, Control and Evaluation). Data was collected from 92 participants, split into four groups while they underwent the described task flow. Each participant tested three scenarios lasting 15-18 min with a -10-min survey completion and break period in between using different combinations of decision support tools. The decision support tools tested and varied for each group include alarm prioritisation vs. none, paper-based vs. Digitised screen-based procedures, and an AI recommendation system. This is relevant to compare current practices in the industry and the impact on operators' performance and safety. It is also applicable to validate proposed solutions for the industry. A statistical analysis was performed on the dataset to compare the outcomes of the different groups. Decision-makers can use these datasets for control room design and optimisation, process safety engineers, system engineers, human factors engineers, all in process industries, and researchers in similar or close domains.
RESUMO
BACKGROUND: Frontline clinical staff play a crucial role in shaping patient experience and, therefore, require adequate training and education to deliver exceptional service. This study aimed to assess the impact of a service excellence and quality training program on frontline clinical staff's knowledge, perception, and attitude toward patient experience and service excellence. We also examined the effect of this intervention on patient experience scores. METHODS: This study utilized a pre-post intervention design, where frontline clinical staff completed a questionnaire to establish baseline "knowledge and perception scores" and "attitude scores" related to patient experience. The same questionnaire was administered after the training program to measure any changes in scores. Patient experience scores were collected from existing data, comparing results from different quarters before and after the intervention. The training and education program covered various components, including effective communication, empathy, service standards, and service recovery. RESULTS: A total of 256 staff members, including nurses, physicians, and allied healthcare professionals, participated in the training program. The study found statistically significant improvements in all components of staff knowledge, perception, and attitude. Specifically, there was a median improvement in knowledge and perception scores, which increased from 77.2% to 96.5%. Additionally, attitude scores showed a median improvement from 73.8% to 92.5%. Moreover, the overall patient experience score increased from 62% to 72.4%. CONCLUSION: The study revealed significant improvements in staff knowledge, perception, and attitude, along with enhanced patient experience scores. These findings suggest a potential role for targeted interventions in enhancing patient experience and supporting ongoing quality improvement in primary healthcare settings.
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A woman in her mid-30s presented to the orthopaedic team, unable to mobilise, shortly after her caesarean section. On questioning, she reported 10 weeks of atraumatic right hip pain. A radiograph revealed a displaced right subcapital neck of femur fracture. An MRI confirmed this, as well as identifying a minimally displaced left subcapital neck of femur fracture. She underwent a right total hip replacement and internal fixation of the left hip. A dual energy X-ray absorptiometry (DEXA) scan showed severe osteoporosis, and a diagnosis of transient osteoporosis of the hip was made. She was seen by the bone metabolism team and given calcium and vitamin D medication. Although atraumatic hip fractures are rare in young patients, disproportionate or persisting hip pain in pregnant patients should raise the index of suspicion and prompt further investigation in the form of an MRI. This will allow timely management of hip fractures and improve patient outcomes.
Assuntos
Fraturas do Fêmur , Fraturas do Colo Femoral , Fraturas do Quadril , Osteoporose , Cálcio , Cesárea , Feminino , Fraturas do Colo Femoral/diagnóstico por imagem , Fraturas do Colo Femoral/etiologia , Fraturas do Colo Femoral/cirurgia , Fraturas do Quadril/diagnóstico por imagem , Fraturas do Quadril/etiologia , Fraturas do Quadril/cirurgia , Humanos , Osteoporose/complicações , Osteoporose/diagnóstico por imagem , Dor , Gravidez , Vitamina DRESUMO
The presented data shows how cornstarch can be modified to a material that can effectively remove organics pollutants from a real wastewater. A low-cost adsorbent obtained from cornstarch by the crosslinking with epichlorohydrin. The prepared crossed linked starch (CLS) adsorbent characterized by X-ray diffraction, zeta potential, Fourier-transform infrared spectroscopy, atomic force microscopy, scanning electron microscopy, and Brunauer-Emmett-Teller surface area. The effects of initial chemical oxygen demand of the real wastewater, temperature and time of the adsorption of the organics on the prepared CLS were analyzed. The removal of the highest organics concentration was 89.85%. Langmuir and Freundlich isotherm models have been applied to investigate the adsorption equilibrium. The maximum adsorption capacity of the organics pollutants on the prepared CLS was 256.41â¯mg/g. Thermodynamic parameters show that the adsorption process of organics on CLS is more favorable at low temperature.