scholarly journals Two- and three-dimensional transvaginal ultrasound in assessment of the impact of selected obstetric risk factors on cesarean scar niche formation: the case-controlled study

2021 ◽  
Author(s):  
Joanna Budny-Winska ◽  
Aleksandra Zimmer-Stelmach ◽  
Michal Pomorski
Keyword(s):  
Risk Factors ◽  
Transvaginal Ultrasound ◽  
Three Dimensional ◽  
Controlled Study ◽  
Cesarean Scar ◽  
Niche Formation ◽  
The Impact

The Impact of Example Modality and Physical Interactions on Design Creativity

2014 ◽  
Vol 136 (9) ◽  
Author(s):  
Christine A. Toh ◽  
Scarlett R. Miller
Keyword(s):  
Engineering Design ◽  
Three Dimensional ◽  
Idea Generation ◽  
Controlled Study ◽  
First Year ◽  
Design Creativity ◽  
Physical Interactions ◽  
2D And 3D ◽  
The Impact

Interacting with example products is an essential and widely practiced method in engineering design, yet little information exists on how the representation (pictorial or physical) or interaction a designer has with an example impacts design creativity. This is problematic because without this knowledge we do not understand how examples affect idea generation or how we can effectively modify or develop design methods to support example usage practices. In this paper, we report the results of a controlled study with first year engineering design students (N = 89) developed to investigate the impact of a designer's interaction with either a two-dimensional (2D) pictorial image or a three-dimensional (3D) product (through visual inspection or product dissection activities) and the resulting functional focus and creativity of the ideas developed. The results of this study reveal that participants who interacted with the physical example produced ideas that were less novel and less functionally focused than those who interacted with the 2D representation. Additionally, the results showed that participants who dissected the product produced a higher variety of ideas than those that visually inspected it. These results contribute to our understanding of the benefits and role of 2D and 3D designer-product interactions during idea development. We use these findings to develop recommendations for the use of designer-product interactions throughout the design process.

scholarly journals Community Pharmacist-Provided Osteoporosis Screening and Education: Impact on Patient Knowledge

2015 ◽  
Vol 6 (3) ◽  
Author(s):  
Andrea L. Brookhart ◽  
K. Michelle Brown Fountain ◽  
Leticia R. Moczygemba ◽  
Jean-Venable R. Goode
Keyword(s):  
Risk Factors ◽  
Community Pharmacist ◽  
Controlled Study ◽  
Patient Knowledge ◽  
Preventive Strategies ◽  
Osteoporosis Screening ◽  
Group A ◽  
Group B ◽  
Knowledge Survey ◽  
The Impact

Objective: To evaluate the impact pharmacist-provided screening and education had on patient knowledge of osteoporosis and preventive strategies. Methods: A prospective, randomized, controlled study was conducted at 16 locations of a national supermarket chain pharmacy in the Richmond, Virginia area. Women 30 years and older with no history of osteoporosis were enrolled in the study. Patients self-selected into the study by agreeing to the bone density screening, pharmacist-provided education, and completion of a knowledge survey. Subjects were randomized to complete the osteoporosis-related knowledge survey either before (Group A) or after (Group B) the screening and education session. The survey was developed after guideline and literature evaluation and was pretested with a group of patients for content and clarity. The survey evaluated knowledge of osteoporosis, risk factors for the disease, appropriate age for testing, and preventive strategies. Groups A and B were compared using t-tests. Results: A total of 110 women were enrolled in the study. The mean (±SD) age was 52.5 ± 13.1 years in Group A (n=52) and 52.7 ± 11.5 years in Group B (n=58). Knowledge scores were higher in the group who received pharmacist-provided education prior to completing the survey in each category (knowledge of the disease, risk factors, preventive strategies, and appropriate age for testing) and overall (p<0.001). Conclusions: Community pharmacist-provided osteoporosis screening and education increased patient knowledge about osteoporosis and preventive strategies. Community pharmacist involvement with increasing patient knowledge may empower patients to engage in prevention strategies to improve bone mass.   Type: Original Research

scholarly journals 0689 Use Of An Automated Scanning System To Select A Patient Interface

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A263-A263
Author(s):  
W Hardy ◽  
J Jasko ◽  
R Bogan
Keyword(s):  
Selection Process ◽  
Three Dimensional ◽  
Controlled Study ◽  
Adherence Rate ◽  
Scanning System ◽  
3D Scanner ◽  
Open Label ◽  
Sleep Centers ◽  
Automated Scanning ◽  
The Impact

Abstract Introduction There is no universal process for selecting mask style, size, and fit, and there is considerable variance in clinician and patient mask preference and patient anatomy. Poor mask fit may negatively affect adherence. A three-dimensional (3D) facial scanner and proprietary analytical software were developed to bring efficiencies to mask selection. This study explored the impact of that system on initial mask success compared to standard practice. Methods This was an open-label, randomized-controlled study. Participants provided written informed consent. 3D Scanner Arm (3DA): Participants answered questions about sleeping habits then had 3D facial images taken. Proprietary software recommended a hierarchy of up to four Philips Respironics masks and sizes. Traditional Fitting Arm (TFA): A designated clinician selected and fit masks using their standard methods. Mask selection was assessed by applying therapy and soliciting patient and clinician feedback. Mask refits and adherence were tracked through 90 days. Five sleep centers recruited 115 participants into the 3DA (61 males, 51.1±13.4 years, BMI 35.2±7.0, diagnostic AHI 26.2±21.9) and 123 into the TFA (79 males, 51.1±11.9 years, BMI 35±7.9, diagnostic AHI 26.9±22.6). Results A significantly higher percentage of 3DA patients required only one mask fitting (with no refits) compared to TFA during the initial setup (89.6% vs. 54.5%, p&lt;0.001) and through 90 days (62.6% vs 37.4%, p&lt;0.001). 3DA subjectively rated confidence in and satisfaction with the scanner-selected mask significantly higher than TFA. Mask leak was lower in the 3DA compared to TFA (29.4±10.6 vs 32.3±11.4 L/M, p= 0.043). The CMS adherence rate tended to favor 3DA vs. TFA (66.7% vs. 55.3, p=0.083). There were no significant differences in AHI or other adherence metrics. Conclusion The 3D scanner system was successful in mask selection with lower mask leak and greater patient satisfaction and confidence. This tool may bring about operational efficiencies to the mask selection process. Support This study was sponsored by Philips Respironics

scholarly journals Cesarean Scar Hysterotomy: Assessment by Three-dimensional Transvaginal Ultrasound Scan

2017 ◽  
Vol 11 (1) ◽  
pp. 82-87
Author(s):  
MT Clavijo ◽  
José Bajo-Arenas ◽  
JM Troyano ◽  
I Martinez-Wallin ◽  
A Molina Betancor ◽  
...  
Keyword(s):  
Transvaginal Ultrasound ◽  
Recovery Period ◽  
Three Dimensional ◽  
Wound Dehiscence ◽  
Well Being ◽  
Background Information ◽  
Ultrasound Scan ◽  
Cesarean Scar ◽  
Uterine Scar ◽  
Transvaginal Ultrasound Scan

ABSTRACT Objective The combined study of two-dimensional (2D) and three-dimensional (3D) sonographic records may be useful to diagnose wound dehiscence from hysterotomy and forecast the well-being of future gestations. In that respect, irregular cicatrization patterns can be identified from the early puerperium over the whole postparturition recovery period, and may encourage the need for further cesarean in new pregnancies to come. Subjects and Methods A random sample of 42 female patients were subjected to transvaginal sonographic exploration at three sampling times, namely 4 days, 4 months, and 1 year following hysterotomy. All of these women recovered successfully from their cesarean and were discharged from hospital 5 days after parturition.  The 2D and 3D surveys were subsequently undertaken at each of the three study times. Four days after surgery, the 2D ultrasound scan aimed at evaluating the early evolution of the uterine scar. On the contrary, 3D echographies were implemented frame-to-frame, in a transverse direction, from the right to left sides of the uterus. Results The 3D sonographic records from those dehiscent wounds displayed at this time a wide, irregular hypoechogenic area crossed over by linear structures representing the suture material (Vycril). Such a record was called a “shark bite” pattern.  The latter puerperal dehiscence pattern persisted in the isthmic region for 4 months and 1 year after delivery. It consistently featured a notch between the scar borders that run perpendicular to the complete extent of the internal myometrium layer and bordered the anterior uterine wall.  By considering the length of the hysterotomy-derived notch over the whole study period, two types of scars could be differentiated through 2D sonographic surveys, scar notches >2/3 (n=9) or ≤1/3 (n=4) of the total scar lengt. Six of the 13 wound-dehiscent women monitored in this study became pregnant within 2 years after their former cesarean.  All were subjected to a second hysterotomy, before which an in situ examination of the previous uterine scar could be made.  Early puerperal ultrasound scan focusing on hypoechogenic areas across the borders of hysterotomy-derived scars under suturing pressure must be undertaken by means of 2D transvaginal ultrasound scan, with the bonus that such exploration can be extended through several months to a 1 year period after surgery. The extent of dehiscent myometrium areas and the depth of the notch remaining between the serose and the cervical channel of the stigma can be used as reliable indicators for defective cicatrization processes and should be used as background information aiding in future gestations.  The 3D transvaginal ultrasound scan provides the practitioner with thorough records of myometrial failure and enhances the morphological study of iatrogenic pathologies originating from cesarean surgery.  The state and extent of healed vs failing cicatrization areas can be easily assessed by means of 3D transvaginal ultrasound scan. How to cite this article Troyano JM, Clavijo MT, Martinez-Wallin I, Molina-Betancor A, Alvarez-de-la-Rosa M, Padilla AI, Bajo-Arenas J. Cesarean Scar Hysterotomy: Assessment by Three-dimensional Transvaginal Ultrasound Scan. Donald School J Ultrasound Obstet Gynecol 2017;11(1):82-87.

754-P: Full-Fat and Low-Fat Dairy, within the Same Caloric Intake, Have Similar Impact on A1C and Cardiovascular Risk Factors: A Randomized Controlled Study

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 754-P
Author(s):  
JOANNA MITRI ◽  
SHAHEEN TOMAH ◽  
ADHAM MOTTALIB ◽  
VERONICA SALSBERG ◽  
SAHAR ASHRAFZADEH ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Caloric Intake ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Low Fat ◽  
Randomized Controlled

Stress, Cortisol and Suicide Risk

2019 ◽  
Author(s):  
Daryl Brian O'Connor
Keyword(s):  
Risk Factors ◽  
Suicidal Behavior ◽  
Suicide Risk ◽  
Stressful Events ◽  
Additional Risk ◽  
Global Health Issue ◽  
History Of ◽  
Hpa Axis Activity ◽  
The Impact

Suicide is a global health issue accounting for at least 800,000 deaths per annum. Numerous models have been proposed that differ in their emphasis on the role of psychological, social, psychiatric and neurobiological factors in explaining suicide risk. Central to many models is a stress-diathesis component which states that suicidal behavior is the result of an interaction between acutely stressful events and a susceptibility to suicidal behavior (a diathesis). This article presents an overview of studies that demonstrate that stress and dysregulated hypothalamic-pituitary-adrenal (HPA) axis activity, as measured by cortisol levels, are important additional risk factors for suicide. Evidence for other putative stress-related suicide risk factors including childhood trauma, impaired executive function, impulsivity and disrupted sleep are considered together with the impact of family history of suicide, perinatal and epigenetic influences on suicide risk.

Stress, anxiety, depression and burnout in frontline health care workers during COVID-19 pandemic: a brief systematic review and new data from Russia

2021 ◽  
Author(s):  
Ekaterina Mosolova ◽  
Dmitry Sosin ◽  
Sergey Mosolov
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Female Gender ◽  
Assessment Tools ◽  
Care Workers ◽  
Younger Age ◽  
Wide Range ◽  
Associated Risk Factors ◽  
Anxiety Depression ◽  
The Impact

During the COVID-19 pandemic, healthcare workers (HCWs) have been subject to increased workload while also exposed to many psychosocial stressors. In a systematic review we analyze the impact that the pandemic has had on HCWs mental state and associated risk factors. Most studies reported high levels of depression and anxiety among HCWs worldwide, however, due to a wide range of assessment tools, cut-off scores, and number of frontline participants in the studies, results were difficult to compare. Our study is based on two online surveys of 2195 HCWs from different regions of Russia during spring and autumn epidemic outbreaks revealed the rates of anxiety, stress, depression, emotional exhaustion and depersonalization and perceived stress as 32.3%, 31.1%, 45.5%, 74.2%, 37.7% ,67.8%, respectively. Moreover, 2.4% of HCWs reported suicidal thoughts. The most common risk factors include: female gender, nurse as an occupation, younger age, working for over 6 months, chronic diseases, smoking, high working demands, lack of personal protective equipment, low salary, lack of social support, isolation from families, the fear of relatives getting infected. These results demonstrate the need for urgent supportive programs for HCWs fighting COVID-19 that fall into higher risk factors groups.

The impact of a physician’s recommendation and gender on informed decision making: A randomized controlled study in a simulated decision situation

2020 ◽  
Author(s):  
Marie Eggeling ◽  
Anna Meinhardt ◽  
Ulrike Cress ◽  
Joachim Kimmerle ◽  
Martina Bientzle
Keyword(s):  
Decision Making ◽  
Cruciate Ligament ◽  
Treatment Options ◽  
General Information ◽  
Treatment Preference ◽  
Controlled Study ◽  
Treatment Preferences ◽  
Hypothetical Scenario ◽  
And Gender ◽  
The Impact

Objective: This study examined the influence of physicians’ recommendations and gender on the decision-making process in a preference-sensitive situation. Methods: N = 201 participants were put in a hypothetical scenario in which they suffered from a rupture of the anterior cruciate ligament (ACL). They received general information on two equally successful treatment options for this injury (surgery vs. physiotherapy) and answered questions regarding their treatment preference, certainty and satisfaction regarding their decision, and attitude toward the treatment options. Then participants watched a video that differed regarding physician’s recommendation (surgery vs. physiotherapy) and physician’s gender (female vs. male voice and picture). Afterward, they indicated again their treatment preference, certainty, satisfaction, and attitude, as well as the physician’s professional and social competence.Results: Participants changed their treatment preferences in the direction of the physician’s recommendation (P&lt;.001). Decision certainty (P&lt;.001) and satisfaction (P&lt;.001) increased more strongly if the physician’s recommendation was congruent with the participant’s prior attitude than if the recommendation was contrary to the participant’s prior attitude. Finally, participants’ attitudes toward the recommended treatment became more positive (surgery recommendation: P&lt;.001; physiotherapy recommendation: P&lt;.001). We found no influence of the physician’s gender on participants’ decisions, attitudes, or competence assessments.Conclusion: This research indicates that physicians should be careful with recommendations when aiming for shared decisions, as they might influence patients even if the patients have been made aware that they should take their personal preferences into account. This could be particularly problematic if the recommendation is not in line with the patient’s preferences.

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