Meaning of critical traumatic injury for a patient’s body and self

2021 ◽  
pp. 096973302098833
Author(s):  
Yu-Lun Tsai ◽  
Hsien-Hsien Chiang ◽  
Yu-Ju Chen ◽  
Hui-Hsun Chiang ◽  
Yuan-Hao Chen ◽  
...  
Keyword(s):  
Intensive Care ◽  
Medical Center ◽  
Traumatic Injury ◽  
Phenomenological Approach ◽  
The Body ◽  
Physical Trauma ◽  
Institutional Review ◽  
Life Saving ◽  
The Impact ◽  
The Relationship

Background: Patients with a traumatic injury often require intensive care for life-saving treatments. Physical suffering and emotional stress during critical care can be alleviated by ethical caring provided by nurses. The relationship between body and self are fundamentally inseparable. Nurses need to understand the impacts of traumatic injury on a patient’s body and self. Aim: To understand the meaning of traumatic injury for body and self for patients receiving intensive care. Research design: A qualitative descriptive study using Giorgi’s phenomenological approach. Participants and research context: Patients receiving intensive care for physical trauma were selected by purposive sampling (N = 15) from a medical center in Taiwan. Individual in-depth, face-to-face audiotaped interviews, guided by semi-structured questions, were used to collect data. Each interview lasted 30–60 min. Audiotaped interviews were transcribed and analyzed. Ethical considerations: This study was approved by the Institutional Review Board of the medical center. Findings: The impact of the experience of traumatic injury on participants’ body and self was described by three main themes: (1) Searching for the meaning of the injured body, (2) Feeling trapped in the bed, and (3) The carer and the cared-for. Discussion and conclusion: The implications of the three themes described in the findings are as follows: Trauma as a source of meaning; Body and self are mutually limiting or mutually enabling; and Ethical relationships. The experience of needing intensive care following a traumatic injury on the body and self was dynamic and mutual. The experience of the injury changed the relationship between body and self, and gave new meaning to life. Nurses play a crucial role in continuity of care by understanding the meaning of a traumatic injury for patient’s body and self that facilitates ethical care and recovery from injury.

The association of psychiatric and neurological comorbidities with outcomes in traumatic injury patients

2021 ◽  
pp. 009121742198914
Author(s):  
Jennifer Brady ◽  
R David Hayward ◽  
Elango Edhayan
Keyword(s):  
Length Of Stay ◽  
Psychiatric Illness ◽  
Traumatic Injury ◽  
Lower Mortality ◽  
Linear Modeling ◽  
Psychiatric Comorbidities ◽  
Trauma Outcomes ◽  
Hospital Stays ◽  
The Impact ◽  
The Relationship

Introduction Mental illness is a well-known risk factor for injury and injury recidivism. The impact of pre-existing psychiatric illness on trauma outcomes, however, has received less attention. Our study examines the relationship of pre-existing psychiatric illness on trauma outcomes including length of stay, cost, and mortality. Methods Patient data were obtained from the Healthcare Cost and Utilization Project’s State Inpatient Database. All patients admitted for trauma in the Detroit metropolitan area from 1/1/2006 to 12/31/2014 were included. The relationship between individual psychiatric comorbidities (depression, psychosis, and other neurological disorders) and outcomes were evaluated with logistic regression (mortality) and generalized linear modeling (length of stay and cost). Results Over 260,000 records were reviewed. Approximately one-third (29.9%) of patients had one or more psychiatric diagnoses. Patients with depression had longer hospital stays (RR = 1.12, p < 0.001) and higher costs (RR = 1.07, p < 0.001), but also lower mortality (OR = 0.69, p < 0.001). Patients with psychosis had longer stays (RR = 1.18, p < 0.001), higher costs (RR = 1.02, p = 0.002), and lower mortality (OR = 0.61, p < 0.001). Patients with other neurological comorbidities had higher mortality (OR = 1.23, p < 0.001), longer stays (RR = 1.29, p < 0.001), and higher costs (RR = 1.10, p < 0.001). Conclusion Patients with a psychiatric disorder required longer care and incurred greater costs, whereas mortality was higher for only those with a neurological disorder. Identifying patients’ psychiatric comorbidities at the time of admission for trauma may help optimize treatment. Addressing these conditions may help reduce the cost of trauma care.

scholarly journals Hyaluronan and the Fascial Frontier

2021 ◽  
Vol 22 (13) ◽  
pp. 6845
Author(s):  
Rebecca L. Pratt
Keyword(s):  
Nerve Fibers ◽  
The Body ◽  
Water Volume ◽  
Cell Behavior ◽  
Connective Tissues ◽  
Wide Range ◽  
The World ◽  
Extracellular Microenvironment ◽  
The Impact ◽  
The Relationship

The buzz about hyaluronan (HA) is real. Whether found in face cream to increase water volume loss and viscoelasticity or injected into the knee to restore the properties of synovial fluid, the impact of HA can be recognized in many disciplines from dermatology to orthopedics. HA is the most abundant polysaccharide of the extracellular matrix of connective tissues. HA can impact cell behavior in specific ways by binding cellular HA receptors, which can influence signals that facilitate cell survival, proliferation, adhesion, as well as migration. Characteristics of HA, such as its abundance in a variety of tissues and its responsiveness to chemical, mechanical and hormonal modifications, has made HA an attractive molecule for a wide range of applications. Despite being discovered over 80 years ago, its properties within the world of fascia have only recently received attention. Our fascial system penetrates and envelopes all organs, muscles, bones and nerve fibers, providing the body with a functional structure and an environment that enables all bodily systems to operate in an integrated manner. Recognized interactions between cells and their HA-rich extracellular microenvironment support the importance of studying the relationship between HA and the body’s fascial system. From fasciacytes to chronic pain, this review aims to highlight the connections between HA and fascial health.

Antecedents of horizontal logistics collaboration in agri-food supply chains

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Ismail Badraoui ◽  
Ivo van der Lans ◽  
Youssef Boulaksil ◽  
Jack G.A.J. van der Vorst
Keyword(s):  
Supply Chains ◽  
Food Supply ◽  
Structural Equation ◽  
The Body ◽  
Equation Modeling ◽  
Content Type ◽  
Operational Conditions ◽  
Food Supply Chains ◽  
The Impact ◽  
The Relationship

PurposeThis study investigates the impact of agri-food supply chains (AFSCs) characteristics on the antecedents of horizontal logistics collaboration (HLC). Specifically, the study compares the relationship between collaboration activities and outcomes for companies in and outside AFSCs.Design/methodology/approachFirst, a survey was used to collect data from different industries. Second, confirmatory factor analysis and structural equation modeling were applied to compare the measurement and structural models from different industry categories.FindingsThe results support the premise that collaboration improves trust and commitment in the relationship, which in turn enhance satisfaction. The results also show the existence of a minor influence of AFSCs characteristics on HLC antecedents, in the form of an indirect impact of dedicated investments on commitment.Practical implicationsThe factors having a significant influence on the collaboration outcomes and their respective effects are generally similar across food and nonfood supply chains, providing opportunities for interdisciplinary and collaboration experiences.Originality/valueThis research contributes to the body of knowledge on interfirm collaboration by considering the specificities of HLC. It also highlights the importance of conducting contingency research on collaborative experiences, as firms from different industry contexts operate under distinct operational conditions.

scholarly journals An Examination of Individualism within Employee Help-Seeking Networks

2018 ◽  
Vol 8 (4) ◽  
pp. 1
Author(s):  
Randall P. Settoon ◽  
Sang H. Lee
Keyword(s):  
Help Seeking ◽  
Medical Center ◽  
Future Research ◽  
Dense Networks ◽  
Helping Others ◽  
Regional Medical ◽  
Regional Medical Center ◽  
The Impact ◽  
The Relationship

Prior research focusing on the impact of individualistic orientations on the performance of cooperative behaviors has produced mixed results. Researchers have concluded that the self-focused orientation of individualists will lead them to be less cooperative than others. On the other hand, some scholars have argued that helping others is core to individualists’ self-concept and that competently assuming the role of help-giver is a source of intrinsic satisfaction. In this study, we test this proposition by examining individualistic orientations within employee help-seeking networks. Results from a sample of 107 employees within a regional medical center indicate that the level of individualism in helping-seeking networks is positively associated with help-seekers’ perceptions of support. Further, the results suggest that the relationship is stronger in dense networks. Implications of this work and directions for future research are discussed.

The Impact of Delayed Symptomatic Treatment Implementation in the Intensive Care Unit

Healthcare ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 35
Author(s):  
Lesley Meng ◽  
Krzysztof Laudanski ◽  
Mariana Restrepo ◽  
Ann Huffenberger ◽  
Christian Terwiesch
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Medical Center ◽  
Academic Medical Center ◽  
Symptomatic Treatment ◽  
Medication Administration ◽  
Average Delay ◽  
Treatment Implementation ◽  
Medication Delivery ◽  
The Impact

We estimated the harm related to medication delivery delays across 12,474 medication administration instances in an intensive care unit using retrospective data in a large urban academic medical center between 2012 and 2015. We leveraged an instrumental variables (IV) approach that addresses unobserved confounds in this setting. We focused on nurse shift changes as disruptors of timely medication (vasodilators, antipyretics, and bronchodilators) delivery to estimate the impact of delay. The average delay around a nurse shift change was 60.8 min (p < 0.001) for antipyretics, 39.5 min (p < 0.001) for bronchodilators, and 57.1 min (p < 0.001) for vasodilators. This delay can increase the odds of developing a fever by 32.94%, tachypnea by 79.5%, and hypertension by 134%, respectively. Compared to estimates generated by a naïve regression approach, our IV estimates tend to be higher, suggesting the existence of a bias from providers prioritizing more critical patients.

Be[ing] You

2015 ◽  
pp. 18-32
Author(s):  
Lorna Ann Moore
Keyword(s):  
Digital Media ◽  
The Body ◽  
Mirror Stage ◽  
Head Mounted Display ◽  
Personal Accounts ◽  
The One ◽  
The Impact ◽  
The Relationship ◽  
The Way ◽  
Video Performance

This chapter discusses the one-to-one interactions between participants in the video performance In[bodi]mental. It presents personal accounts of users' body swapping experiences through real-time Head Mounted Display systems. These inter-corporeal encounters are articulated through the lens of psychoanalyst Jacques Lacan and his work on the “Mirror Stage” (1977), phenomenologist Maurice Merleau-Ponty (1968) and his writings on the Chiasm, and anthropologist Rane Willerslev's (2007) research on mimesis. The study of these positions provides new insights into the blurred relationship between the corporeal Self and the digital Other. The way the material body is stretched across these divisions highlights the way digital media is the catalyst in this in[bodied] experience of be[ing] in the world. The purpose of this chapter is to challenge the relationship between the body and video performance to appreciate the impact digital media has on one's perception of a single bounded self and how two selves become an inter-corporeal experience shared through the technology.

Education and the Curious Case of Conservative Compromise

2019 ◽  
pp. 106591291986650
Author(s):  
James M. Glaser ◽  
Jeffrey M. Berry ◽  
Deborah J. Schildkraut
Keyword(s):  
Political Attitudes ◽  
Body Politic ◽  
Democratic Governance ◽  
The Body ◽  
Attitudes And Behaviors ◽  
Political Compromise ◽  
And Behaviors ◽  
Relationship Of ◽  
The Impact ◽  
The Relationship

“Education,” notes Philip Converse, “is everywhere the universal solvent.” Whatever the ill of the body politic, many believe that greater education improves the condition. Much scholarship explores the impact of education on political attitudes and behaviors, but scholars have not examined the relationship of education to support for political compromise. This is especially topical, as compromise between parties seems harder than ever to achieve, yet compromise is necessary for democratic governance. We examine whether higher levels of education lead to support for compromise and find that education does matter, but the relationship is conditional. For liberals and moderates, more education promotes greater support for compromise. For conservatives, those with more education are not more likely to support compromise than those with less education. We argue that for conservatives, education matters for compromise support, but it also leads to better understanding of bedrock ideological principles that inhibit approval of compromise.

Does Travel Distance Affect Readmission Rates after Cardiac Surgery?

2017 ◽  
Vol 83 (10) ◽  
pp. 1170-1173
Author(s):  
Yen-yi Juo ◽  
Alexis Woods ◽  
Ryan Ou ◽  
Gianna Ramos ◽  
Richard Shemin ◽  
...  
Keyword(s):  
Medical Center ◽  
Surgical Care ◽  
Hospital Length ◽  
Travel Distance ◽  
Hospital Length Of Stay ◽  
Readmission Rates ◽  
Logistic Regression Models ◽  
Caucasian Race ◽  
The Impact ◽  
The Relationship

With emphasis on value-based health care, empiric models are used to estimate expected read-mission rates for individual institutions. The aim of this study was to determine the relationship between distance traveled to seek surgical care and likelihood of readmission in adult patients undergoing cardiac operations at a single medical center. All adults undergoing major cardiac surgeries from 2008 to 2015 were included. Patients were stratified by travel distance into regional and distant travel groups. Multivariable logistic regression models were developed to assess the impact of distance traveled on odds of readmission. Of the 4232 patients analyzed, 29 per cent were in the regional group and 71 per cent in the distant. Baseline characteristics between the two groups were comparable except mean age (62 vs 61 years, P < 0.01) and Caucasian race (59 vs 73%, P < 0.01). Distant travel was associated with a significantly longer hospital length of stay (11.8 vs 10.5 days, P < 0.01) and lower risk of readmission (9.5 vs 13.4%, P < 0.01). Odds of readmission was inversely associated with logarithm of distance traveled (odds ratio 0.75). Travel distance in patients undergoing major cardiac surgeries was inversely associated with odds of readmission.

The impact of formulary restriction on the relative consumption of carbapenems in intensive care units at an academic medical center

2019 ◽  
Vol 40 (9) ◽  
pp. 1056-1058
Author(s):  
Jacob W. Pierce ◽  
Andrew Kirk ◽  
Kimberly B. Lee ◽  
John D. Markley ◽  
Amy Pakyz ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Medical Center ◽  
Academic Medical Center ◽  
Interrupted Time Series ◽  
Interrupted Time Series Analysis ◽  
Surgical Intensive Care ◽  
Academic Medical ◽  
The Impact ◽  
Formulary Restriction

AbstractAntipseudomonal carbapenems are an important target for antimicrobial stewardship programs. We evaluated the impact of formulary restriction and preauthorization on relative carbapenem use for medical and surgical intensive care units at a large, urban academic medical center using interrupted time-series analysis.

A mixed method analysis of the Better Business Bureau’s third-party seal and the extent to which it inculcates trust among consumers

2015 ◽  
Vol 9 (3) ◽  
pp. 214-238 ◽  
Author(s):  
John Lee West
Keyword(s):  
Mixed Method ◽  
Binary Logistic Regression ◽  
Phenomenological Approach ◽  
Service Industries ◽  
The Body ◽  
Third Party ◽  
Internet Applications ◽  
Content Type ◽  
Home Service ◽  
The Impact

Purpose – The paper aims to answer the central question: to what extent does the Better Business Bureau (BBB)’s policy of providing a third-party seal inculcate consumer trust from consumers to BBB-accredited business members? Design/methodology/approach – For this mixed-methods study, the qualitative section used a phenomenological approach with three focus groups of consumers and business owners. The quantitative section utilized binary logistic regression from consumer survey data conducted in Colorado. Additionally, document analysis was conducted to understand BBB history and policy details. Findings – Consumers who notice the BBB logo are 4.7 times more likely to trust a real estate sales business than if they do not notice the BBB logo. Furthermore, consumers who notice the BBB logo are 17 times more likely to trust an auto and boat sales business when they notice the BBB logo. Research limitations/implications – A main limitation of the study was the inconclusive data that appeared between the qualitative and quantitative data regarding the impact of the BBB seal and trusting home service industries. Researchers are encouraged to further explore how the BBB logo affects trust with home service businesses. Practical implications – The BBB logo retains potency as a proof source of trust in the marketplace. However, the BBB is less relevant to the millennial generation. The BBB should explore ways to incorporate technology through social media and Internet applications. Originality/value – This work has value as the only mixed-method study on this topic, and these findings add to the body of marketing literature by Kimery and McCord, Cook and Luo and Garrett.

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