Predictor of purnawidya performance post training of wound care blended learning method in DKI Jakarta

The COVID-19 pandemic situation has hampered wound care services. Apart from contact restrictions, patient and family anxiety to visit hospitals and health workers having diabetic wound care skills are still inadequate. Only 1 unit of First Level Health Facility (FKTP) has succeeded in developing a diabetic wound care polyclinic; thus, the percentage of diabetic wound sufferers who receive standard services is only 1 percent. This study aims to determine predictors of graduate performance after wound care training with blended learning methods in Jakarta Province in 2021. Descriptive quantitative method using a cross-sectional approach and primary data were collected using structured questionnaire survey technique. The study was carried out from August to September 2021. The population was all 44 graduates of wound care training with the blended learning method. The result shows that the correlation value (r) between age and performance score was 0.43 with a P-value of 0.007. It means that there is a statistically significant relationship between age and the graduate performance score. There is also a significant relationship between motivation and performance scores, with the correlation value (r) between motivation scores and performance scores of 0.37, P-value of 0.020. The dominant factor that affects graduate performance is motivation, with a P-value of 0.02. The magnitude of the variation that affects the dependent variable is 0.129, meaning that the motivation variable can explain 12-13 percent of the variation in the graduate performance score.

Nationwide Acute Stroke Care Quality and Disparity in Korea: Focusing on the Type of Healthcare Facilities and the Socioeconomic Status of Patients

Background: The quality ofstroke care has a significantimpact onmortality and complications. The purpose ofthisstudy wasto investigate the difference in the quality of acute stroke treatment according to the type of healthcare facility and the socioeconomic status of patients.Methods: Thisstudy used Health Insurance Review and Assessment Service’s Healthcare Quality Assessment for Stroke 2013 data and included 10,399 cases from 201 healthcare facilities. Quality of care was categorized from grade 1 (best group) to grade 5 (worst group) according to performance scores using 10 processindicators.Results: The mean performance score was 91.5. Only 31% of all patients received treatment at grade 1 hospitals while 10% received treatment at grade 3 or lower hospitals. The difference in performance score by the type of healthcare facility existed (tertiary hospitals: 94.3, general hospitals: 88.7).Ofthe 159 general hospitals, 66 hospitals provided grade 3 orlower quality care.NHI patients used more tertiary hospitalsthan MA patients(51% vs. 38%), and MA patientswere more likely to use general hospitals providing grade 3 or lower quality care (11% vs. 21%).Conclusions: This study showed that some general hospitals provided low quality stroke care, and MA patients were more likely to use those hospitals. In order to increase the quality and equity of stroke treatment, a strategy to gather patients at healthcare facilitiesthat provide appropriate medicalservices will be needed.

Surgical treatment of patients with extra-articular fractures of the distal humerus

Background. The article deals with extra-articular fractures of the distal humerus, according to the АО/ASIF classification, which includes types 12A–C, depending on the plane of the fracture and the nature of the fragment displacement. The purpose was to study the features of the lower third humeral fractures and to conduct a comparative analysis of the outcomes of surgical treatment. Material and methods. One hundred and twenty-seven patients with extra-articular fractures of the distal humerus were under observation. For retrospective analysis, they were divided into a comparison group (n = 92) who underwent traditional bone osteosynthesis and a study group (n = 35) in whom a rod-type external fixation device developed by us was used. The short- and long-term functional results were studied using the Mayo Elbow Performance Score. Results. Various indicators, established by us for comparison, and treatment outcomes were analyzed in 101 patients (comparison group — 68 people, study group — 33). Many values of these parameters were quite comparable in terms of the age, gender, hospitalization terms, duration of surgeries, etc., but the revealed differences in indicators still did not reach the level of statistical reliability (p > 0.05). Evaluation of the clinical use of the device proposed by us showed restoration of the humeral anatomy, quite comparable to that in bone osteosynthesis, and the achievement of the final result of treatment. However, the number of complications by type and by total number was significantly higher (4.5 times; p ˂ 0.001) in the comparison group, where it accounted for the largest share of cases of neuropathies (16.18 %), nonunions (8.82 %), elbow contractures (8.82 %) and heterotopic ossification (4.42 %). The final score on the Mayo Elbow Performance Score in the comparison group was 84.9 ± 10.2 points, in the study group — 92.6 ± 3.7 points. At the same time, the total number of positive treatment outcomes after bone osteosynthesis was 66.18 %, after transosseous osteosynthesis — 81.82 %. Conclusions. The analysis of the data obtained allows us to recommend a method of minimally invasive osteosynthesis with a rod device of external controlled fixation as a method of choice for wider clinical use in the treatment of patients with lower third humeral fractures.

A Simple Predictive Score to Distinguish between Disseminated Histoplasmosis and Tuberculosis in Patients with HIV

Disseminated histoplasmosis is a common differential diagnosis of tuberculosis in disease-endemic areas. We aimed to find a predictive score to orient clinicians towards disseminated histoplasmosis or tuberculosis when facing a non-specific infectious syndrome in patients with advanced HIV disease. We reanalyzed data from a retrospective study in Cayenne Hospital between January 1997–December 2008 comparing disseminated histoplasmosis and tuberculosis: 100 confirmed disseminated histoplasmosis cases and 88 confirmed tuberculosis cases were included. A simple logit regression model was constructed to predict whether a case was tuberculosis or disseminated histoplasmosis. From this model, a score may be obtained, where the natural logarithm of the probability of disseminated histoplasmosis/tuberculosis = +3.917962 × WHO performance score (1 if >2, 0 if ≤2) −1.624642 × Pulmonary presentation (1 yes, 0 no) +2.245819 × Adenopathies > 2 cm (1 yes, 0 no) −0.015898 × CD4 count − 0.001851 × ASAT − 0.000871 × Neutrophil count − 0.000018 × Platelet count + 6.053793. The area under the curve was 98.55%. The sensitivity of the model to distinguish between disseminated histoplasmosis and tuberculosis was 95% (95% CI = 88.7–98.3%), and the specificity was 93% (95% CI = 85.7.3–97.4%). In conclusion, we here present a clinical-biological predictive score, using simple variables available on admission, that seemed to perform very well to discriminate disseminated histoplasmosis from tuberculosis in French Guiana in well characterized patients.

Surgical Outcome of Giant Vestibular Schwannomas: A Retrospective Analysis

Background Giant vestibular schwannomas, more than 4.5 cm in diameter, are still representing the majority of vestibular schwannomas in developing countries. The philosophy of incomplete and intracapsular tumor excision has been introduced in the management of these giant tumors, balancing the long-term tumor control and postoperative clinical outcome. Objective The aim was to review the cases with giant vestibular schwannomas and studying their prevalence, morbidity, and mortality rates. Patients and Methods This study was conducted retrospectively on data of patients who had undergone microsurgical excision of vestibular schwannomas in our institute between January and December 2017. The functional outcome of the patients was assessed by comparing the preoperative and the postoperative neurological examination, as well as the Karnofsky performance score. Results Twenty-two cases with vestibular schwannomas were included in this study. Among these 22 cases, 15 cases had giant vestibular schwannomas (68.2%). The tumors’ largest extracanalicular diameters ranged from 4.5 cm to 6.2 cm. Postoperative images showed gross total excision of the tumor in 11 cases (73.3%), and subtotal excisions in four cases (26.7%). Twelve cases (80%) had postoperative facial palsy. We encountered no mortality in our cases and three cases (20%) were symptom-free postoperatively (apart from hearing affection). Conclusion Large and giant vestibular schwannomas are still commonly met in neurosurgical practice in developing countries; they have different behaviors and presentations from those of smaller tumors. Both patient and surgeon expectations from surgery should be toward no mortality and mild or no morbidities.

Assessment of Seismic Building Vulnerability Using Rapid Visual Screening Method through Web-Based Application for Malaysia

Rapid visual screening is a quick and simple approach often used by researchers to estimate the seismic vulnerability of buildings in an area. In this study, preliminary seismic vulnerability assessment of 500 buildings situated at Northern and Eastern George Town, Malaysia, was carried out by utilizing a modified FEMA-154 (2002) method that suits Malaysian conditions. Data were collected from online sources via Google Maps and Google Earth instead of traditional surveying data collection through street screening. The seismic assessment analysis of this study was based on the RVS performance score and the damage state classification for each building typology. This approach generates, for each building, a final performance score based on governing parameters such as structural resisting system, height, structural irregularities, building age, and soil type. The findings revealed the immediate need for effective seismic mitigation strategies, as 90% of the studied buildings required a further detailed analyses to pinpoint their exact seismic vulnerability performance. Most of the surveyed buildings were predicted to experience moderate-to-substantial damage, with 220 out of 500 being classed as damage state 2 (D2) and damage state 3 (D3). A GIS map, “RVS Malaysian Form-George Town Area”, was generated via ArcGIS and shared with the public to provide vital information for further research.

The Relationship Between Online Gamification Performance Score With Body Mass Index Of Overweight Nursing Students During Covid-19 Pandemic

Background: Online intervention platforms are effective for gathering data especially in this pandemic crisis we are currently experiencing, and it can help healthcare practitioners on future innovations. Numerous studies also show the importance of online nursing intervention platforms in the promotion of health on overweight and obese adults, by way of social media.Purpose: This study aimed to determine relationship between online gamification performance score with body mass index of overweight nursing students during covid-19 pandemic.Methods: The total number of participants were 60 based on the type of research employed, computation of BMI and proper assessment before the study was conducted to make sure that participants meet the inclusion criteria.Results: Evidence from this study illustrates that the performance assessment score in online gamification has almost no relationship with changes in the body mass index.Conclusion: There are no changes in the body mass index of the overweight nursing students whether exposed to usual daily activities or online gamification. Data indicates that the four (4) week intervention to online gamification does not have relational changes on body mass index