scholarly journals Severe scalds sustained during steam inhalation therapy in an adult population: analysis of patient outcomes and the financial burden to healthcare services

JPRAS Open ◽  
2022 ◽  
Author(s):  
Alexander S. Dearden ◽  
Alexander S. North ◽  
Sanjay Varma
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yu Hyeon Choi ◽  
Min Sun Kim ◽  
Cho Hee Kim ◽  
In Gyu Song ◽  
June Dong Park ◽  
...  

Abstract Background The number of technology-dependent children (TDC) is increasing in South Korea, but available healthcare services after their discharge are poor. This study aimed to examine how TDC and caregivers live at home and identify their difficulties and needs regarding home care with few services to support them. Methods This cross-sectional study was conducted in a tertiary hospital for children in South Korea. A self-reported questionnaire was completed by primary caregivers of TDC who were younger than 19 years and had been dependent on medical devices for more than 3 months. Technologies included home mechanical ventilation, oxygen supplementation, suction equipment, enteral feeding tube, and home total parenteral nutrition. Patterns of healthcare use and home care of TDC and caregivers’ perception toward child were assessed. Results A total of 74 primary caregivers of TDC completed a self-reported questionnaire. About 60% children were aged under 5 years. There were 31.1% children who required both respiratory and nutritional support. On average, caregivers took care of a child for 14.4 (±6.1) hours, slept for 5.6 (±1.6) hours, and spent 2.4 h per day on personal activities. Children used hospital services for 41.3 (±45.6) days in 6 months, and most (78.1%) were transported through private car/ambulance. Participants (75.6%) reported taking more than an hour to get to the hospital. More than 80% of caregivers responded that child care is physically very burdensome. The only statistically significant relationships was between economic status and financial burden (p = 0.026). Conclusions Caregivers of TDC reported having significant time pressure regarding childcare-related tasks, insufficient time for personal activities, and inefficient hospital use because of inadequate medical services to support them in South Korea. Thus, it is necessary to support caregivers and develop a home care model based on current medical environment.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Igidbashian ◽  
F Caracci ◽  
P Bonanni ◽  
P Castiglia ◽  
M Conversano ◽  
...  

Abstract Introduction Invasive Meningococcal Disease (IMD) is one of the most severe vaccine-preventable disease, with high fatality rate and severe sequelae in up to 20% of survivors. MenB, MenC and MenACWY vaccines are available in Italy, but recommendations vary among Italian regions in terms of type of vaccines and targeted age groups. The aim of the study is to describe epidemiology of IMDs in order to provide the best vaccination strategy. Methods IMDs surveillance data in the period 2011-2017 from the Italian National Health Institute were explored. Excel was used to present trend analysis, stratifying by age and serogroups. Results In Italy, during the period 2011-2017, IMDs overall incidence increased from 0.25 cases/100,000 inhabitants in 2011 to 0.33 in 2017. Most cases after 2013 were caused by non-B serogroups (52%, 52%, 66%, 64%, 59% from 2013 to 2017). Although incidence is highest in 1 years old children, the number of cases is highest in the age range 25-64. The number of cases in this age-range had a steady increase after 2013 (36 cases in 2011, 79 in 2017), with serogroups C, W and Y present in more than 65% of cases in 25+ age ranges after 2012. Conclusions IMD is a rare but severe vaccine-preventable disease. The key role of public health is to monitor disease serogroups, trends and outbreaks and strengthen methodological evidence-based tools for decision-making processes, public health policies, planning of healthcare services and intervention measures, including immunization. The increase in incidence shown in the period 2011-2017 in Italy, although probably due to better surveillance, highlighted the high circulation also of non-B serogroups and the importance of the disease in the adult population. Based on our analysis we believe that anti-meningococcal vaccination plan in Italy should include the highest number of preventable serogroups and be aimed to the whole population through a multicohort strategy, including boosters in children and in adults. Key messages Anti-meningococcal vaccination plan in Italy should include all the preventable serogroups and be aimed to the whole population with a multicohort strategy including boosters in children and in adults. The increase in incidence of IMD in the period 2011-2017 in Italy highlighted the high circulation also of non-B serogroups and the importance of the disease in the adult population.


2016 ◽  
Vol 34 (4) ◽  
pp. 1352-1356
Author(s):  
Ozlen Karabulut ◽  
Hatice Akay ◽  
Zulfu Karabulut ◽  
Hüseyin Özevren ◽  
Gunay Saka ◽  
...  

2016 ◽  
Vol 40 (2) ◽  
pp. 194 ◽  
Author(s):  
Lucylynn Lizarondo ◽  
Catherine Turnbull ◽  
Tracey Kroon ◽  
Karen Grimmer ◽  
Alison Bell ◽  
...  

Objective South Australia is taking an innovative step in transforming the way its healthcare is organised and delivered to better manage current and future demands on the health system. In an environment of transforming health services, there are clear opportunities for allied health to assist in determining solutions to various healthcare challenges. A recent opinion piece proposed 10 clinician-driven strategies to assist in maximising value and sustainability of healthcare in Australia. The present study aimed to seek the perspectives of allied health clinicians, educators, researchers, policy makers and managers on these strategies and their relevance to allied health. Methods A survey of allied health practitioners was undertaken to capture their perspectives on the 10 clinician-driven strategies for maximising value and sustainability of healthcare in Australia. Survey findings were then layered with evidence from the literature. Results Highly relevant across allied health are the strategies of discontinuation of low value practices, targeting clinical interventions to those getting greatest benefit, active involvement of patients in shared decision making and self-management and advocating for integrated systems of care. Conclusions Allied health professionals have been involved in the South Australian healthcare system for a prolonged period, but their services are poorly recognised, often overlooked and not greatly supported in existing traditional practices. The results of the present study highlight ways in which healthcare services can implement strategies not only to improve the quality of patient outcomes, but also to offer innovative solutions for future, sustainable healthcare. The findings call for concerted efforts to increase the utilisation of allied health services to ensure the ‘maximum value for spend’ of the increasingly scarce health dollar. What is known about the topic? In medicine, clinician-driven strategies have been proposed to minimise inappropriate and costly care and maximise highly appropriate and less expensive care. These strategies were developed based on clinical experiences and with supporting evidence from scientific studies. What does this paper add? Major changes to the health system are required to slow down the growth in healthcare expenditure. This paper describes opportunities in which allied health practitioners can implement similar strategies not only to improve the quality of patient outcomes, but also to offer cost-effective solutions for a sustainable healthcare. What are the implications for practitioners? Allied health practitioners can provide solutions to healthcare challenges and assist in the transformation of healthcare in Australia. However, for this to happen, there should be concerted efforts to increase recognition of and support for the use of allied health services.


2020 ◽  
Vol 163 (4) ◽  
pp. 785-790
Author(s):  
Rebecca C. Hoesli ◽  
Melissa L. Wingo ◽  
Brent E. Richardson ◽  
Robert W. Bastian

Objective To define the human papillomavirus (HPV) subtypes seen in a large adult population with traditionally defined recurrent respiratory papillomatosis. Study Design Retrospective review. Setting Tertiary care laryngology practice. Subjects and Methods All patients had a firm diagnosis of recurrent respiratory papillomatosis defined by (1) visually obvious papillomas, (2) recurrence requiring multiple surgeries, and (3) pathology diagnosis of “papilloma.” Each patient had also undergone HPV subtyping. Age, sex, presence of malignancy, and HPV subtypes were tabulated and correlated with long-term patient outcomes. Results A total of 184 patients were identified who fulfilled the above criteria. In total, 87.0% (160) had a low risk subtype; 9.2% had an alternative subtype. These consisted of subtypes 16, 18, 31, 44, 45, 55, and 70. Four patients (2.2%) had combinations of subtypes, with 1 patient with HPV 11 and 16, 1 patient with HPV 11 and 76, 1 patient with 11 and 84, and 1 patient with 18 and 45. Finally, 3.8% of patients were HPV negative, despite fulfilling all 3 criteria listed above. Conclusion In the patient population above, almost 10% of patients had an HPV subtype other than 6 and 11. This suggests that traditionally defined recurrent respiratory papillomatosis (RRP) can be caused by HPV subtypes other than 6 and/or 11. In addition, the clinical course of persons with this definition of RRP appears to vary by subtype, and this information may offer the ability to nuance follow-up instructions, reducing in particular the burden placed upon patients who have RRP caused by subtypes 6 and 11.


2021 ◽  
Author(s):  
Paweł Krzemień ◽  
Sławomir Kasperczyk ◽  
Maciej Banach ◽  
Aleksandra Kasperczyk ◽  
Michał Dobrakowski ◽  
...  

Abstract Objectives: Diagnosis of Systemic Autoimmune Rheumatic Diseases using antinuclear autoantibodies (ANA) is dependent on many factors and varies between populations, such that the screening dilution used for indirect immunofluorescence assay (IIFA) should be defined locally for each population. The aim of the study was firstly, to assess the prevalence of ANA in the Polish adult population depending on age, sex and the cut-off threshold used for the results obtained. Second, we estimated the occurrence of individual types of ANA staining patterns.Methods: The tested material included serum samples from 1731 participants (1043 women and 688 men) that were tested with the commercially available IIFA using two cut-off thresholds 1:100 and 1:160.Results: We found ANA in 260 participants (15.0%), but the percentage of positive results strongly depended on the cut-off level. For a cut-off threshold 1:100, the positive population was 19.5% and for the 1:160 cut-off threshold, it was 11.7%. The most prevalent ANA staining pattern was AC-2 Dense Fine speckled (50%), followed by AC-21 Reticular/AMA (14.38%) ANA were more common in women (72%); 64% of ANA positive patients were over 50 years of age.Conclusion: ANA prevalence in the Polish population is at a level observed in other highly developed countries. ANA were more prevalent in women and elderly individuals. In order to reduce the number of positive results released, we suggest that Polish laboratories should set 1:160 as the cut-off threshold.


2019 ◽  
Vol 8 (2S8) ◽  
pp. 1809-1812

The significance of Internet of Things (IoT) makes different objects connected and it has also been known as the tech revolution. One of the many applications of IoT is in healthcare to examine the patient’s health report, internet of things makes medical technology more efficient and less complicated by giving access to real-time analysis of the patient’s health, in which it focuses on acquiring the data regarding the patient’s health and eliminate the possible human flaws. In the internet of things, a patient’s health statistics get transmitted through various medical equipment through a gateway, where they are stored and monitored. The main challenges in the implementation of the internet of things for healthcare services are checking all patients from different places. Therefore, the internet of things in the healthcare field gives the basic solutions for effective patient monitoring at less cost and also reduces the tensions between patient outcomes and disease management. This paper gives emphases on the different techniques used to monitor the patients while working for the healthcare department.


Author(s):  
Zuber Mujeeb Shaikh

Practice of hand hygiene is a very ancient concept of personal cleanliness which reflects in several religious and practiced in numerous cultures. It is worth to consider the grounds of religious and cultural issues in promoting hand hygiene in healthcare services in order to be more effective. Objectives: To study the review of literature of religious and cultural aspects of hand hygiene in healthcare accreditations. Methods: It is a descriptive study in which the several literatures on religious and cultural aspects of hand hygiene in healthcare accreditations were studied. Significance of Research: Healthcare Associated Infections (HCAI) are major threat to patient safety which increases the length of stay, long-term disability, increased resistance of microorganisms to antimicrobials, massive additional financial burden, high costs for patients and their families, and excess deaths. Data Collections: The data was collected from relevant published journals, articles, research papers, academic literature and web portals. Conclusion: Community behaviour influences health care worker’s professional behaviour has been supported by insufficient scientific facts until now. There are no data existing on the impact of religious customs on hand hygiene observance in health-care settings where religion is very deep-seated.


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