scholarly journals Patient-generated Digital Images after Pediatric Ambulatory Surgery

2016 ◽  
Vol 07 (03) ◽  
pp. 646-652 ◽  
Author(s):  
Rachael Ross ◽  
Christina Voight ◽  
Heather Brouwer ◽  
Dean Karavite ◽  
Jeffrey Gerber ◽  
...  
Keyword(s):  
Digital Image ◽  
Ad Hoc ◽  
Ambulatory Surgery ◽  
Digital Images ◽  
Antibiotic Prescription ◽  
Clinical Care ◽  
Surgical Patients ◽  
High Level ◽  
Pediatric Healthcare

SummaryTo describe the use of digital images captured by parents or guardians and sent to clinicians for assessment of wounds after pediatric ambulatory surgery.Subjects with digital images of post-operative wounds were identified as part of an ongoing cohort study of infections after ambulatory surgery within a large pediatric healthcare system. We performed a structured review of the electronic health record (EHR) to determine how digital images were documented in the EHR and used in clinical care.We identified 166 patients whose parent or guardian reported sending a digital image of the wound to the clinician after surgery. A corresponding digital image was located in the EHR in only 121 of these encounters. A change in clinical management was documented in 20% of these encounters, including referral for in-person evaluation of the wound and antibiotic prescription.Clinical teams have developed ad hoc workflows to use digital images to evaluate post-operative pediatric surgical patients. Because the use of digital images to support follow-up care after ambulatory surgery is likely to increase, it is important that high-quality images are captured and documented appropriately in the EHR to ensure privacy, security, and a high-level of care. Citation: Miller MW; Ross RK; Voight C; Brouwer H; Karavite DJ; Gerber JS; Grundmeier RW; Coffin SE. Patient-generated Digital Images after Pediatric Ambulatory Surgery

scholarly journals Infections after pediatric ambulatory surgery: Incidence and risk factors

2019 ◽  
Vol 40 (2) ◽  
pp. 150-157 ◽  
Author(s):  
Jeffrey S. Gerber ◽  
Rachael K. Ross ◽  
Julia E. Szymczak ◽  
Rui Xiao ◽  
A. Russell Localio ◽  
...  
Keyword(s):  
Ambulatory Surgery ◽  
Multivariable Analysis ◽  
Surgical Site Infections ◽  
Patient Demographics ◽  
Additional Burden ◽  
Observational Cohort ◽  
Parental Interviews ◽  
Pediatric Healthcare ◽  
Surgery Incidence

AbstractObjectiveTo describe the epidemiology of surgical site infections (SSIs) after pediatric ambulatory surgery.DesignObservational cohort study with 60 days follow-up after surgery.SettingThe study took place in 3 ambulatory surgical facilities (ASFs) and 1 hospital-based facility in a single pediatric healthcare network.ParticipantsChildren <18 years undergoing ambulatory surgery were included in the study. Of 19,777 eligible surgical encounters, 8,502 patients were enrolled.MethodsData were collected through parental interviews and from chart reviews. We assessed 2 outcomes: (1) National Healthcare Safety Network (NHSN)–defined SSI and (2) evidence of possible infection using a definition developed for this study.ResultsWe identified 21 NSHN SSIs for a rate of 2.5 SSIs per 1,000 surgical encounters: 2.9 per 1,000 at the hospital-based facility and 1.6 per 1,000 at the ASFs. After restricting the search to procedures completed at both facilities and adjustment for patient demographics, there was no difference in the risk of NHSN SSI between the 2 types of facilities (odds ratio, 0.7; 95% confidence interval, 0.2–2.3). Within 60 days after surgery, 404 surgical patients had some or strong evidence of possible infection obtained from parental interview and/or chart review (rate, 48 SSIs per 1,000 surgical encounters). Of 306 cases identified through parental interviews, 176 cases (57%) did not have chart documentation. In our multivariable analysis, older age and black race were associated with a reduced risk of possible infection.ConclusionsThe rate of NHSN-defined SSI after pediatric ambulatory surgery was low, although a substantial additional burden of infectious morbidity related to surgery might not have been captured by standard surveillance strategies and definitions.

scholarly journals Clinical care for primary ciliary dyskinesia: current challenges and future directions

2017 ◽  
Vol 26 (145) ◽  
pp. 170023 ◽  
Author(s):  
Bruna Rubbo ◽  
Jane S. Lucas
Keyword(s):  
Primary Ciliary Dyskinesia ◽  
Clinical Care ◽  
Future Directions ◽  
Test Management ◽  
Research Findings ◽  
High Level ◽  
Specific Symptoms ◽  
Critical Overview ◽  
Ciliary Dyskinesia

Primary ciliary dyskinesia (PCD) is a rare genetic disease that affects the motility of cilia, leading to impaired mucociliary clearance. It is estimated that the vast majority of patients with PCD have not been diagnosed as such, providing a major obstacle to delivering appropriate care. Challenges in diagnosing PCD include lack of disease-specific symptoms and absence of a single, “gold standard”, diagnostic test. Management of patients is currently not based on high-level evidence because research findings are mostly derived from small observational studies with limited follow-up period. In this review, we provide a critical overview of the available literature on clinical care for PCD patients, including recent advances. We identify barriers to PCD research and make suggestions for overcoming challenges.

A Questionnaire Survey of Current Rehabilitation Practices for Adults With Normal Hearing Sensitivity Who Experience Auditory Difficulties

2020 ◽  
Vol 29 (4) ◽  
pp. 738-761
Author(s):  
Tess K. Koerner ◽  
Melissa A. Papesh ◽  
Frederick J. Gallun
Keyword(s):  
Hearing Aids ◽  
Questionnaire Survey ◽  
Patient Population ◽  
Clinical Care ◽  
Normal Hearing ◽  
Auditory Training ◽  
Training Methods ◽  
Hearing Sensitivity ◽  
Considerable Benefit ◽  
High Level

Purpose A questionnaire survey was conducted to collect information from clinical audiologists about rehabilitation options for adult patients who report significant auditory difficulties despite having normal or near-normal hearing sensitivity. This work aimed to provide more information about what audiologists are currently doing in the clinic to manage auditory difficulties in this patient population and their views on the efficacy of recommended rehabilitation methods. Method A questionnaire survey containing multiple-choice and open-ended questions was developed and disseminated online. Invitations to participate were delivered via e-mail listservs and through business cards provided at annual audiology conferences. All responses were anonymous at the time of data collection. Results Responses were collected from 209 participants. The majority of participants reported seeing at least one normal-hearing patient per month who reported significant communication difficulties. However, few respondents indicated that their location had specific protocols for the treatment of these patients. Counseling was reported as the most frequent rehabilitation method, but results revealed that audiologists across various work settings are also successfully starting to fit patients with mild-gain hearing aids. Responses indicated that patient compliance with computer-based auditory training methods was regarded as low, with patients generally preferring device-based rehabilitation options. Conclusions Results from this questionnaire survey strongly suggest that audiologists frequently see normal-hearing patients who report auditory difficulties, but that few clinicians are equipped with established protocols for diagnosis and management. While many feel that mild-gain hearing aids provide considerable benefit for these patients, very little research has been conducted to date to support the use of hearing aids or other rehabilitation options for this unique patient population. This study reveals the critical need for additional research to establish evidence-based practice guidelines that will empower clinicians to provide a high level of clinical care and effective rehabilitation strategies to these patients.

Authentication of Digital Image using Exif Metadata and Decoding Properties

2018 ◽  
pp. 335-341 ◽  
Author(s):  
D. P. Gangwar ◽  
Anju Pathania
Keyword(s):  
Digital Image ◽  
Digital Images ◽  
Software Tools ◽  
Robust Analysis

This work presents a robust analysis of digital images to detect the modifications/ morphing/ editing signs by using the image’s exif metadata, thumbnail, camera traces, image markers, Huffman codec and Markers, Compression signatures etc. properties. The details of the whole methodology and findings are described in the present work. The main advantage of the methodology is that the whole analysis has been done by using software/tools which are easily available in open sources.

PERBANDINGAN METODE MD4 DAN SHA 384 UNTUK MENDETEKSI ORISINALITAS CITRA DIGITAL

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Lemcia Hutajulu ◽  
Hery Sunandar ◽  
Imam Saputra
Keyword(s):  
Digital Image ◽  
Detrimental Effect ◽  
Digital Images ◽  
Computer Crime ◽  
The Other ◽  
Image Manipulation ◽  
The Internet ◽  
Secret Key

Cryptography is used to protect the contents of information from anyone except those who have the authority or secret key to open information that has been encoded. Along with the development of technology and computers, the increase in computer crime has also increased, especially in image manipulation. There are many ways that people use to manipulate images that have a detrimental effect on others. The originality of a digital image is the authenticity of the image in terms of colors, shapes, objects and information without the slightest change from the other party. Nowadays many digital images circulating on the internet have been manipulated and even images have been used for material fraud in the competition, so we need a method that can detect the image is genuine or fake. In this study, the authors used the MD4 and SHA-384 methods to detect the originality of digital images, by using this method an image of doubtful authenticity can be found out that the image is authentic or fake.Keywords: Originality, Image, MD4 and SHA-384

Biomarkers of Acromegaly and Growth Hormone Action

2020 ◽  
Vol 27 (12) ◽  
pp. 1231-1245
Author(s):  
Filippo Maffezzoni ◽  
Teresa Porcelli ◽  
Andrea Delbarba ◽  
Letizia Pezzaioli ◽  
Carlo Cappelli ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Biological Markers ◽  
Clinical Care ◽  
Hormone Deficiency ◽  
Surrogate Outcomes ◽  
Current State ◽  
Growth Hormone Action ◽  
Igf I ◽  
Definition Of

: Biological markers (biomarkers) play a key role in drug development, regulatory approval and clinical care of patients and are linked to clinical and surrogate outcomes. : Both acromegaly and Growth Hormone Deficiency (GHD) are pathological conditions related to important comorbidities that, in addition to having stringent diagnostic criteria, require valid markers for the definition of treatment, treatment monitoring and follow-up. GH and insulin-like growth factor-I (IGF-I) are the main biomarkers of GH action in children and adults while, in acromegaly, both GH and IGF-I are established biomarkers of disease activity. : However, although GH and IGF-I are widely validated biomarkers of GHD and acromegaly, their role is not completely exhaustive or suitable for clinical classification and follow-up. Therefore, new biological markers for acromegaly and GH replacement therapy are strongly needed. : The aim of this paper is to review and summarize the current state in the field pointing out new potential biomarkers for acromegaly and GH use/abuse.

SBA MCQs for the MRCS Part A

2012 ◽  
Author(s):  
Sri G. Thrumurthy ◽  
Tania Samantha De Silva ◽  
Zia Moinuddin ◽  
Stuart Enoch
Keyword(s):  
Clinical Case ◽  
Multiple Choice ◽  
Surgical Anatomy ◽  
Surgical Patients ◽  
Multiple Choice Questions ◽  
Basic Sciences ◽  
Self Assessment ◽  
High Level ◽  
Factual Recall ◽  
Selection Of

Specifically designed to help candidates revise for the MRCS exam, this book features 350 Single Best Answer multiple choice questions, covering the whole syllabus. Containing everything candidates need to pass the MRCS Part A SBA section of the exam, it focuses intensively on the application of basic sciences (applied surgical anatomy, physiology, and pathology) to the management of surgical patients. The high level of detail included within the questions and their explanations allows effective self-assessment of knowledge and quick identification of key areas requiring further attention. Varying approaches to Single Best Answer multiple choice questions are used, giving effective exam practice and guidance through revision and exam technique. This includes clinical case questions, 'positively-worded' questions, requiring selection of the most appropriate of relatively correct answers; 'two-step' or 'double-jump' questions, requiring several cognitive steps to arrive at the correct answer; as well as 'factual recall' questions, prompting basic recall of facts.

scholarly journals The importance of maternal pregnancy vitamin D for offspring bone health: learnings from the MAVIDOS trial

2021 ◽  
Vol 13 ◽  
pp. 1759720X2110069
Author(s):  
Rebecca J. Moon ◽  
Elizabeth M. Curtis ◽  
Stephen J. Woolford ◽  
Shanze Ashai ◽  
Cyrus Cooper ◽  
...  
Keyword(s):  
Vitamin D ◽  
Bone Development ◽  
Controlled Trial ◽  
Clinical Care ◽  
Later Life ◽  
Vitamin D Supplementation ◽  
Public Health Policies ◽  
Positive Effects

Optimisation of skeletal mineralisation in childhood is important to reduce childhood fracture and the long-term risk of osteoporosis and fracture in later life. One approach to achieving this is antenatal vitamin D supplementation. The Maternal Vitamin D Osteoporosis Study is a randomised placebo-controlled trial, the aim of which was to assess the effect of antenatal vitamin D supplementation (1000 IU/day cholecalciferol) on offspring bone mass at birth. The study has since extended the follow up into childhood and diversified to assess demographic, lifestyle and genetic factors that determine the biochemical response to antenatal vitamin D supplementation, and to understand the mechanisms underpinning the effects of vitamin D supplementation on offspring bone development, including epigenetics. The demonstration of positive effects of maternal pregnancy vitamin D supplementation on offspring bone development and the delineation of underlying biological mechanisms inform clinical care and future public-health policies.

scholarly journals Strategies to Integrate Genomic Medicine into Clinical Care: Evidence from the IGNITE Network

2021 ◽  
Vol 11 (7) ◽  
pp. 647
Author(s):  
Nina R. Sperber ◽  
Olivia M. Dong ◽  
Megan C. Roberts ◽  
Paul Dexter ◽  
Amanda R. Elsey ◽  
...  
Keyword(s):  
Precision Medicine ◽  
Program Implementation ◽  
Clinical Care ◽  
Genomic Medicine ◽  
Implementation Strategies ◽  
Clinical Decision ◽  
Implementing Change ◽  
Implementation Outcomes ◽  
Planning Framework

The complexity of genomic medicine can be streamlined by implementing some form of clinical decision support (CDS) to guide clinicians in how to use and interpret personalized data; however, it is not yet clear which strategies are best suited for this purpose. In this study, we used implementation science to identify common strategies for applying provider-based CDS interventions across six genomic medicine clinical research projects funded by an NIH consortium. Each project’s strategies were elicited via a structured survey derived from a typology of implementation strategies, the Expert Recommendations for Implementing Change (ERIC), and follow-up interviews guided by both implementation strategy reporting criteria and a planning framework, RE-AIM, to obtain more detail about implementation strategies and desired outcomes. We found that, on average, the three pharmacogenomics implementation projects used more strategies than the disease-focused projects. Overall, projects had four implementation strategies in common; however, operationalization of each differed in accordance with each study’s implementation outcomes. These four common strategies may be important for precision medicine program implementation, and pharmacogenomics may require more integration into clinical care. Understanding how and why these strategies were successfully employed could be useful for others implementing genomic or precision medicine programs in different contexts.

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