scholarly journals Characteristics of patients presenting with septic wounds in selected hospitals in Kajiado County, Kenya

2021 ◽  
Author(s):  
Ruth Kaanto ◽  
John Kagira ◽  
Kenneth Waititu ◽  
Maina Ngotho ◽  
Naomi Maina ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Healthcare Access ◽  
Water Source ◽  
Lower Limbs ◽  
Wound Management ◽  
Individual Level ◽  
The Individual ◽  
Social And Cultural Factors

Background: Wound management is a serious global health problem. The objective of this study was to describe the characteristics of patients presenting with septic wounds in selected hospitals in Kajiado County, Kenya, and their association with selected factors.Methods: We purposively sampled 182 patients with septic wounds and collected data using questionnaires whose statistical relationship between various patients' characteristics, including the data collected Likert-scale design was assessed.Results: A majority (73.1%) of the patients presented with one wound. Most (54.4%) of the wounds were located on the lower limbs and mainly (23.1%) caused by road traffic accidents. The majority of the wounds had lasted for 1-2 weeks at the time of presentation, and the wound sizes were mainly >11 mm. We found a significant association (p<0.05) between number of wounds and age, marital status, and highest education level. The wound causes were significantly associated with gender, age, occupation, and sub-county of residence. Wound duration was significantly associated with understanding prescribed medication, adherence to dosage, water source, alcoholism, and cigarette smoking. Wound improvement was significantly associated with patients' understanding of the prescribed medication, adherence to dosage and water source, alcoholic status, and cigarette smoking.Conclusions: Individual patient, social and cultural factors were associated with septic wounds characteristics, suggesting that addressing them at the individual level using proper hygiene and cleanliness at home and workplaces is key. Policies to reduce traffic accidents, increase literacy, and promote healthcare access need to be promoted to reduce the wound sepsis burden.  

Patient and Physician Factors Associated With Adherence to Diabetes Medications

2012 ◽  
Vol 38 (3) ◽  
pp. 397-408 ◽  
Author(s):  
Antoinette M. Schoenthaler ◽  
Brian S. Schwartz ◽  
Craig Wood ◽  
Walter F. Stewart
Keyword(s):  
Medication Adherence ◽  
Primary Care Physicians ◽  
Medication Possession Ratio ◽  
Related Factors ◽  
Patient Beliefs ◽  
Individual Level ◽  
Physician Relationship ◽  
Oral Hypoglycemic Medications ◽  
The Individual ◽  
Main Effects

Purpose The purpose of this study was to examine the influence of patient and physician psychosocial, sociodemographic, and disease-related factors on diabetes medication adherence. These factors were also examined as effect modifiers of the association between quality of the patient-physician relationship and medication adherence. Methods Data were collected from 41 Geisinger Clinic primary care physicians and 608 of their patients with type 2 diabetes. Adherence to oral hypoglycemic medications was calculated using a medication possession ratio based on physician orders in electronic health records (MPREHR). MPREHR was defined as the proportion of total time in the 2 years prior to study enrollment that the patient was in possession of oral hypoglycemic medications. Linear regression was used to examine the influence of patient- and physician-level factors on adherence. Effect modification of the patient-physician relationship-adherence association was evaluated by adding the main effects of the individual-level factors and their cross-products to the models. Results In adjusted analyses, satisfaction with the physician’s patient education skills, patient beliefs about the need for their medications, and lower diabetes-related knowledge were associated with better adherence to oral hypoglycemic medications. Shorter duration of time with diabetes and taking only oral hypoglycemic medications were also associated with better adherence. Finally, the association between shared decision making and medication adherence was significantly modified by patients’ level of social support. Conclusions This study identified several patient-, physician-, and disease-related factors that should be targeted to maximize the potential for developing tailored adherence-enhancing interventions within the context of a collaborative patient-physician relationship.

scholarly journals ADAPTIVE DRIVER TRAINING WITH THE USE OF SIMULATOR SYSTEMS

2019 ◽  
Vol 74 (6) ◽  
pp. 84-95
Author(s):  
Руслан Валентинович Кузьменко
Keyword(s):  
Professional Training ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Individual Characteristics ◽  
Educational Training ◽  
Driver Training ◽  
Training Time ◽  
Information Program ◽  
Automated Information System ◽  
The Individual

The article looks at certain aspects of using automated information systems in the professional training of drivers at Hetman Petro Sahaidachnyi National Army Academy, Ukraine. The importance of integrating the theoretical and practical components of learning and the linkage between learning outcomes and safety on the roads are emphasized. The modern educational-training equipment for training drivers (simulators) includes information program components that can be customized to suit students’ individual characteristics and priorities for consideration in real road-traffic conditions. Assessment of students' knowledge and skills with simulators is carried out by analyzing their errors on typical routes that simulate problematic traffic situations. The main types of errors correspond to the common causes of road-traffic accidents, in relation to which statistics according to regions and periods are available, which, while training, gives a possibility to quickly respond to changes in the structure of accidents in the recent years in view of their causes. The automated information system is configured by a teacher in the way of correction of penalty points for every type of error. Upon reaching the critical amount of such points, the student is directed to retake the course, which makes it possible to provide the proper level of mastering the material before starting classes in the conditions of a real road situation. In future, increasing the share of the training time on the stimulator, it will be possible to take into account the students’ individual features of assimilating the material. This can be realized by introducing increased coefficients for repetitive errors into the penalty function. For this purpose a linear model of the total penalty score is proposed in the paper, which takes into account the specific and general errors, moreover, in the latter the base price of the error is related to the share of accidents with severe consequences. The multiplier of the individual weight of the error allows increasing its value in case this type of mistake occurred earlier and the student did not heed it.

scholarly journals The Medication Adherence Score: A Predictive Analytic Tool

2020 ◽  
Author(s):  
Tom Brouwer ◽  
Reinoud E. Knops ◽  
Martin C. Burke ◽  
Vivek Y. Reddy
Keyword(s):  
Atrial Fibrillation ◽  
Medication Adherence ◽  
Clinical Outcomes ◽  
Adherence Behavior ◽  
Individual Level ◽  
Analytic Tool ◽  
Adherence Score ◽  
Study Results ◽  
High Adherence ◽  
The Individual

Abstract Background Poor medication adherence is wide-spread and associated with poor clinical outcomes. Herein, we introduce the Medication Adherence Score, a predictive analytic tool designed to provide clinicians insight into adherence behavior over the subsequent twelve months. The aim of the study was to demonstrate the feasibility of such scoring of patients at the individual level. Methods This is a single arm, non-randomized, 2-center, retrospective cohort study conducted among patients diagnosed with atrial fibrillation. The model, developed by Fair Isaac Corporation on pharmacy refill data, predicts adherence behavior to cardiovascular drugs using demographic, geographic and socio-economic predictors. The primary outcome was the number of patients that could be scored at the individual level without reliance on past individual refill behavior. The score was normalized between zero (lowest adherence score) and one (highest adherence score) and patients were grouped: low adherence < 0.6, intermediate adherence between 0.6 and 0.8, high adherence > 0.8. The institutional review board approved the study. Results A total of 1110 patients were included in the study with a median age of 71 (IQR 63, 79). Most patients (807, 73%) could be scored at the patient level, and the remaining patients (303, 27%) were scored based on characteristics associated with the geography of their home address. There were 488 patients (44%) with a high adherence score (score > 0.8), 382 (34%) with an intermediate adherence score (score between 0.6 and 0.8) and 240 patients (22%) with a low score. Younger patients had on average lower scores than older patients, and males also had higher scores. Conclusions The Medication Adherence Score was successfully applied to an unselected group of atrial fibrillation patients: nearly a quarter of the cohort were identified as at risk for non-adherence. Future studies are necessary to assess the association of this predictive analytic model with clinical outcomes.

The Psychology of (Pseudo)Science: Cognitive, Social, and Cultural Factors

Pseudoscience ◽  
2018 ◽  
Author(s):  
Emilio J. C. Lobato ◽  
Corinne Zimmerman
Keyword(s):  
Personal Identity ◽  
Scientific Community ◽  
Cultural Factors ◽  
Theoretical Frameworks ◽  
Individual Level ◽  
Psychology Of Science ◽  
The Social ◽  
The Individual ◽  
Social And Cultural Factors ◽  
Social Level

We review findings from the psychology of science that are relevant to understanding or explaining peoples’ tendencies to believe both scientific and pseudoscientific claims. We discuss relevant theoretical frameworks and empirical findings to support the proposal that pseudoscientific beliefs arise in much the same way as other scientific and non-scientific beliefs do. In particular, we focus on (a) cognitive and metacognitive factors at the individual level; (b) trust in testimony and judgments of expertise at the social level; and (c) personal identity and the public’s relationship with the scientific community at a cultural level.

Spinal cord injury and its management

2010 ◽  
pp. 5045-5054
Author(s):  
M P Barnes
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Sports Injuries ◽  
Spine Injury ◽  
Neutral Position ◽  
Road Traffic Accidents ◽  
Cord Injury ◽  
The Individual

Spinal cord injury most commonly affects young men as a consequence of road traffic accidents, violence, and sports injuries; falls are a common cause in older patients. Appropriate management of the individual at the scene of an accident is vital to avoid unnecessary worsening of a spinal cord injury. Those who are unconscious should be assumed to have a cervical spine injury until proven otherwise, with (1) the head and neck held firmly (as far as possible) in a neutral position using (if available) a semi-rigid collar, and (2) transportation on a spinal board with a head immobilizer....

Intensive, Extensive, Expensive: Management of Distal Limb Shearing Injuries in Cats

2009 ◽  
Vol 11 (9) ◽  
pp. 747-757 ◽  
Author(s):  
Sandra Corr
Keyword(s):  
Soft Tissue ◽  
Traffic Accidents ◽  
Soft Tissues ◽  
Road Traffic ◽  
Skin Grafting ◽  
Soft Tissue Injuries ◽  
Wound Management ◽  
Prolonged Treatment ◽  
Distal Limb ◽  
Superficial Skin

Practical relevance Cats often present with distal limb shearing injuries as a result of road traffic accidents (RTAs). Many apparently unsalvageable limbs can be saved through intensive and appropriate early treatment if the basic principles of good wound management are followed. Clinical challenges When a limb is crushed under the wheel of a car, the skin, soft tissues and bone can be injured in a variety of ways, and the wounds are invariably heavily contaminated. Management of such cases is intensive, extensive and expensive. As well as the client's financial constraints, the ethics of prolonged treatment versus the alternative of amputation should be carefully considered. This article reviews the priorities for managing these cases, and presents a logical approach for achieving optimal outcomes. Patient group Any cat allowed access to the outdoors is potentially at risk of sustaining RTA injuries, young cats particularly so. Evidence base Many textbooks and original articles have been published on aspects of managing soft tissue injuries and skin grafting. To the author's knowledge, only two peer-reviewed papers have dealt specifically with shearing injuries, both presenting a retrospective analysis of cases in dogs. The prognosis is rarely determined by the extent of superficial skin loss, but rather by the underlying soft tissue and bone damage.

scholarly journals Associations of changes in neighbourhood walkability with changes in walking activity in older adults: a fixed effects analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Erik J. Timmermans ◽  
Marjolein Visser ◽  
Alfred J. Wagtendonk ◽  
J. Mark Noordzij ◽  
Jeroen Lakerveld
Keyword(s):  
Older Adults ◽  
Fixed Effects ◽  
Road Traffic ◽  
Traffic Noise ◽  
Road Traffic Noise ◽  
Buffer Zones ◽  
Individual Level ◽  
Neighbourhood Walkability ◽  
Walking Activity ◽  
The Individual

Abstract Background Supporting older adults to engage in physically active lifestyles requires supporting environments. Walkable environments may increase walking activity in older adults, but evidence for this subgroup is scarce, and longitudinal studies are lacking. This study therefore examined whether changes in neighbourhood walkability were associated with changes in walking activity in older adults, and whether this association differed by individual-level characteristics and by contextual conditions beyond the built environment. Methods Data from 668 participants (57.8–93.4 years at baseline) across three waves (2005/06, 2008/09 and 2011/12) of the Longitudinal Aging Study Amsterdam (LASA) were used. These individuals did not relocate during follow-up. Self-reported outdoor walking activity in minutes per week was assessed using the LASA Physical Activity Questionnaire. Composite exposure measures of neighbourhood walkability (range: 0 (low)-100 (high)) within 500-m Euclidean buffer zones around each participant’s residential address were constructed by combining objectively measured high-resolution Geographic Information System data on population density, retail and service destination density, land use mix, street connectivity, green space density, and sidewalk density. Fixed effects linear regression analyses were applied, adjusted for relevant time-varying confounders. Results Changes in neighbourhood walkability were not statistically significantly associated with changes in walking activity in older adults (β500m = − 0.99, 95% CI = -6.17–4.20). The association of changes in neighbourhood walkability with changes in walking activity did not differ by any of the individual-level characteristics (i.e., age, sex, educational level, cognitive impairment, mobility disability, and season) and area-level characteristics (i.e., road traffic noise, air pollution, and socioeconomic status). Conclusions This study did not show evidence for an association between changes in neighbourhood walkability and changes in walking activity in older adults. If neighbourhood walkability and walking activity are causally linked, then changes in neighbourhood walkability between 2005/06 and 2011/12 might have been not substantial enough to produce meaningful changes in walking activity in older adults.

scholarly journals Injury pattern and outcome of road traffic accidents victims attending major referral institutions of the Kashmir valley

2020 ◽  
Vol 7 (3) ◽  
pp. 958
Author(s):  
Manzoor Ahmad Bhat ◽  
Qazi Mohammad Iqbal
Keyword(s):  
Cause Of Death ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Public Health Problem ◽  
Injury Pattern ◽  
The Body ◽  
Lower Limbs ◽  
Global Public Health ◽  
Road Traffic Accidents ◽  
Kashmir Valley

Background: Road traffic accidents (RTAs) have emerged as a major global public health problem of this century. WHO global burden of disease study, shows it as the 10th leading cause of death in South-East Asia. In India, according to WHO, road traffic accident is the 6th leading cause of death. The present study aims to assess the magnitude and injury pattern of RTA victims attending three major referral institution of the Kashmir valley.Methods: This prospective observational study was conducted for a period of one year in three major referral institutions of Kashmir valley. Burden of RTA victims was studied from hospital records. For studying detailed injury patterns, the accident victims fulfilling the inclusion criteria and admitted in the wards of these hospitals formed the main study group.Results: RTAs constituted 3% of the total admissions. Most (82.7%) of the studied victims were males. Most (40.3%) of the RTA victims were pedestrians. Head on collision was the most common type of accident (62.9%). 97.6% victims were grievously hurt and head (59.9%) was the most affected part of the body. 88.3% of RTA victims survived while 11.7% died.Conclusions: Young males are the predominant victims of RTAs and head on collision (63%) remains the commonest type of accident. Almost all (97.6%) RTA victims were grievously hurt with 60% having head injuries followed by lower limbs 59.4% and upper limbs 26.8% injuries and 47% victims had multiple injuries.

scholarly journals Epidemiology of Fractures in a Tropical Country

2017 ◽  
Vol 13 (24) ◽  
pp. 416
Author(s):  
Pascal Chigblo ◽  
Éric Lawson ◽  
Iréti Fiacre Tidjani ◽  
Adébola Padonou ◽  
Christian Térance Nezien ◽  
...  
Keyword(s):  
Road Safety ◽  
Traffic Accident ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Lower Limbs ◽  
Road Traffic Accidents ◽  
Road Accidents ◽  
Tropical Country ◽  
Surgical Emergencies ◽  
Wheeled Vehicles

Introduction: The increasing number of vehicles and the proliferation of two-wheeled vehicles accentuate the frequency of fractures in our country. The aim of this study is to describe the epidemiology of fractures in Cotonou. Materials and Methods: This prospective two-year study focused on all patients admitted to the emergency department of the National Teaching Hospital of Cotonou for a fracture injury. Results: 1794 fractures were collected in 1432 patients. Fractures accounted for 24.9% of surgical emergencies. The average age was 33.7 years (29 days - 90 years). The dominance was male with a sex ratio of 3.62. Etiological circumstances were dominated by road traffic accidents (75.8%), The etiological circumstances were dominated by road accidents (75.8%), motorcyclists being the most affected (48.5%). The admission average was 27.33 hours (15 minutes - 29 days). Fractures preferentially sat on the lower limbs (64.4%). In descending order of frequency, were distinguished the fractures of leg (32.2%), of the femur (19.8%) and of the forearm (14.8%). Conclusion: fractures are common. The etiologies are dominated by traffic accident. The lesions predominate in the lower limb. The establishment of good road safety policy (improving track conditions, extension of the highway code ...) would reduce their frequency.

Emergency medicine

2016 ◽  
pp. 762-795
Author(s):  
Andrew Baldwin ◽  
Nina Hjelde ◽  
Charlotte Goumalatsou ◽  
Gil Myers
Keyword(s):  
Emergency Medicine ◽  
Traffic Accidents ◽  
Life Support ◽  
Road Traffic ◽  
Wound Management ◽  
Pelvic Injury ◽  
Advanced Trauma Life Support ◽  
Inappropriate Use ◽  
Trauma Networks ◽  
Trauma In Pregnancy

This chapter explores emergency medicine, including appropriate and inappropriate use of emergency departments (EDs), as well as burns, drowning, electric shock injuries, high altitude medicine, wound management, bites, stings, and foreign bodies, major trauma, the Glasgow Coma Score, trauma networks, choking, advanced trauma life support, shock in the trauma patient, road traffic accidents, chest injury, blast injuries, head injury, abdominal injury, radiology in trauma, pelvic injury, and trauma in pregnancy.

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