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A comparative study of SAR-CoV-2 detection using RT-PCR based testing from a nasopharyngeal swab versus indwelling tracheostomy in patients with a tracheostomy 在气管切开术患者中使用基于 RT-PCR 的鼻咽拭子和留置气管插管检测 SAR-CoV-2 的比较研究
Pub Date : 2024-05-17 DOI: 10.12688/f1000research.145902.1
Sunicha Jiraboonsri, Nida Wright
Background Nasopharyngeal swab RT-PCR is the standard procedure for COVID-19 testing. In patients with tracheostomy with an altered airway that bypasses the nasopharynx, the yield of samples from different sites is unknown. This information will be essential for formulating a sample collection method for COVID-19 RT-PCR testing in patients undergoing tracheostomy. Methods This was a cross-sectional study. Nasopharyngeal swabs and tracheal secretion (via closed-circuit secretion suction) samples were collected from 100 patients with a non-plugging tracheostomy tube at Thammasat University Hospital, Pathum Thani, Thailand. The participants were aged between 1-96 years old for screening purposes during the pandemic. The detection results and cycle threshold (Ct) values from each site were analyzed using McNemar’s test with a 95% confidence interval. Results Four participants had positive results. One patient tested positive only for the nasopharyngeal swab, whereas the other tested positive only for the tracheal secretion sample. No statistically significant difference was found between the discordant and concordant groups (P = 1). Conclusions We found two discordant results among the four positive cases in the 100 patients. One patient tested positive only from the nasopharyngeal swab, whereas the other tested positive only from the tracheal sample. The percentage of agreement was 98, and the kappa coefficient value was 65.64% (p <0.001). According to these results, one sample from the nasopharynx or tracheal tube should be sufficient to determine the infection status of low-risk patients. For highly suspicious cases, multisite sampling should be performed. This study showed discordance in COVID-19 RT-PCR screening results using samples from nasopharyngeal swabs and tracheal secretions in tracheotomized patients. A multiple-site sample is suggested for highly suspicious patients with tracheostomy.
背景鼻咽拭子 RT-PCR 是检测 COVID-19 的标准程序。在气管切开术患者中,气道改变绕过了鼻咽部,不同部位样本的产量尚不清楚。这些信息对于制定气管切开术患者 COVID-19 RT-PCR 检测的样本采集方法至关重要。方法 这是一项横断面研究。研究人员从泰国巴吞他尼府 Thammasat 大学医院的 100 名非插入式气管造口术患者中采集了鼻咽拭子和气管分泌物(通过闭路分泌物抽吸)样本。参与者的年龄在 1-96 岁之间,目的是在大流行期间进行筛查。使用 McNemar 检验分析了每个地点的检测结果和周期阈值 (Ct),置信区间为 95%。结果 四名参与者检测结果呈阳性。其中一名患者的鼻咽拭子检测结果呈阳性,另一名患者的气管分泌物样本检测结果呈阳性。不一致组和一致组之间的差异无统计学意义(P = 1)。结论 在 100 名患者中的 4 个阳性病例中,我们发现了两个不一致的结果。一名患者的鼻咽拭子检测结果呈阳性,而另一名患者的气管样本检测结果呈阳性。吻合率为 98,卡帕系数为 65.64%(P <0.001)。根据上述结果,从鼻咽部或气管中采集一份样本就足以确定低风险患者的感染状况。对于高度可疑病例,应进行多部位采样。本研究显示,气管切开患者鼻咽拭子样本和气管分泌物样本的 COVID-19 RT-PCR 筛查结果不一致。建议对气管切开的高度可疑患者进行多部位采样。
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引用次数: 0
Case Report: Impact of gross total resection on survival in glioblastoma 病例报告:全切对胶质母细胞瘤存活率的影响
Pub Date : 2024-05-17 DOI: 10.12688/f1000research.150065.1
D. Chaulagain, V. Smolanka, A. Smolanka, T. Havryliv
Glioblastoma (GBM), known for its aggressive behavior and dismal prognosis. Traditional therapeutic methods, including adjuvant chemotherapy and radiotherapy in conjunction with maximally safe surgical resection, are designed to prolong survival and alleviate symptoms. This case report investigates the relationship between survival outcomes in glioblastoma patients and gross total resection (GTR). A recurring seizure disorder manifested in a 58-year-old female patient presented with left-sided lower limbs weakness and occurred twice weekly for a maximum duration of 20 seconds; this condition necessitated hospitalisation and subsequent surgical intervention. A gross total resection was executed with success, resulting in the accomplishment of complete tumor excision. The patient received radiotherapy after a six-week regimen of temozolomide chemotherapy that followed the surgical removal of tumor. Notably, following treatment, the patient reported a substantial amelioration of symptoms and has maintained a 24-month survival rate thus far, with continuous follow-up. This case highlights the potential for enhanced survival outcomes in the treatment of glioblastoma when gross total resection (GTR) is followed by adjuvant chemo-radiotherapy.
胶质母细胞瘤(GBM)以其侵袭性和预后不良而闻名。传统的治疗方法,包括辅助化疗和放疗,以及最大限度安全的手术切除,旨在延长生存期和减轻症状。本病例报告探讨了胶质母细胞瘤患者的生存结果与大体全切除术(GTR)之间的关系。一名 58 岁的女性患者反复出现癫痫发作,表现为左侧下肢无力,每周发作两次,最长持续时间为 20 秒;这种情况需要住院治疗,随后进行手术干预。手术成功地完成了肿瘤的全切除。手术切除肿瘤后,患者在接受了为期六周的替莫唑胺化疗后接受了放疗。值得注意的是,在治疗后,患者的症状得到了很大改善,并且在持续的随访中保持了 24 个月的生存率。该病例突出表明,在治疗胶质母细胞瘤的过程中,如果在进行全切除术(GTR)后再进行辅助化疗和放疗,则有可能提高患者的生存率。
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引用次数: 0
Association between infertility and risk of cardiovascular diseases in young women 年轻女性不孕与心血管疾病风险之间的关系
Pub Date : 2024-05-17 DOI: 10.12688/f1000research.146939.1
Roshani Ganjare, Anjali Mangalaram
Scientists and medical experts are beginning to understand the significant role that a woman’s past reproductive experiences play in her potential risk of developing heart disease. Reproductive history is seldom considered when assessing the cardiovascular risk. Infertility, high blood pressure, and hypertension are risk factors for heart disease. Additional analyses were conducted to determine whether the apparent increase in risk could be influenced by other risk factors associated with infertility such as irregular menstruation, thyroid conditions, and waist circumference. This study aimed to investigate the association between cardiovascular risk and infertility in women and those who are fertile. The objectives of this study were to estimate the levels of serum creatinine kinase (MB) in both infertile and fertile control groups, as well as to estimate the LDL and HDL levels in the same groups. The study group comprised 78 participants, of which 39 were fertile and 39 were infertile. CK (MB), HDL, LDL, Uric acid, and high sensitivity C reactive Protein (hs-CRP) levels were analyzed. In this study, we discuss how infertility may share common pathways with cardiovascular diseases. Numerous mechanisms may be involved in mediating infertility, including ovulatory abnormalities, endometriosis, and uterine fibroids. For example, in addition to having lower HDL levels, women with polycystic ovary syndrome (PCOS) are more likely to have higher levels of total cholesterol, triglycerides, and LDL. PCOS patients typically exhibit elevated UA levels and hyperuricemia, which are commonly associated with increased androgen levels.
科学家和医学专家开始认识到,女性过去的生育经历对其罹患心脏病的潜在风险具有重要影响。在评估心血管风险时,生殖史很少被考虑在内。不孕、高血压和高血脂是心脏病的危险因素。我们还进行了其他分析,以确定风险的明显增加是否会受到与不孕症相关的其他风险因素(如月经不调、甲状腺疾病和腰围)的影响。这项研究旨在调查女性和有生育能力的女性心血管风险与不孕之间的关联。这项研究的目的是估算不孕和已育对照组的血清肌酸激酶(MB)水平,以及估算同组的低密度脂蛋白和高密度脂蛋白水平。研究小组由 78 名参与者组成,其中 39 人已育,39 人未育。对 CK(甲基溴)、高密度脂蛋白、低密度脂蛋白、尿酸和高敏 C 反应蛋白(hs-CRP)水平进行了分析。在这项研究中,我们讨论了不孕症如何与心血管疾病有着共同的发病途径。不孕症可能与多种机制有关,包括排卵异常、子宫内膜异位症和子宫肌瘤。例如,患有多囊卵巢综合症(PCOS)的女性除了高密度脂蛋白水平较低外,总胆固醇、甘油三酯和低密度脂蛋白水平也更高。多囊卵巢综合症患者通常表现出尿酸水平升高和高尿酸血症,这通常与雄激素水平升高有关。
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引用次数: 0
A Scoping Review of Existing Policy Instruments to Tackle Overweight and Obesity in India: Recommendations for a Social and Behaviour Change Communication Strategy 印度应对超重和肥胖问题的现有政策工具范围审查:关于社会和行为改变沟通战略的建议
Pub Date : 2024-05-17 DOI: 10.12688/f1000research.149857.1
Nishibha Thapliyal, Shalini Bassi, Deepika Bahl, Kavita Chauhan, Kathryn Backholer, Neena Bhatia, Suparna Ghosh-Jerath, Lopamudra Tripathy, Preetu Mishra, Seema Chandra, Monika Arora
Background The Indian government is committed to address various manifestations of malnutrition, including overweight and obesity, inorder to improve individual health and well-being. The scoping review aims to map existing national policy instruments (programmes, schemes, regulations and guidelines) addressing overweight and obesity in India and analysing them for Social and Behaviour Change Communication (SBCC) strategies. Methods Systematic identification and selection of policy instruments using ‘Arksey and O’Malley’ framework was conducted from central government ministry websites, between March and June 2023. These instruments focused on nutrition and/or physical activity, targeting specific demographic groups like pregnant women, lactating mothers, children (0-5 years and 5-9 years), or adolescents (10-19 years); excluding those focusing on specific diseases like micronutrient deficiencies, wasting, and stunting. Based on search strategy six policy instruments were included and analysed for SBCC strategies. Results While many policy instruments incorporated SBCC plans; the ‘National Programme for Prevention of Non-Communicable Diseases (NP-NCD)’ stands out as a significant policy initiative specifically targeting the prevention of overweight and obesity within the broader context of Non-Communicable Diseases. It adopts a comprehensive approach addressing key drivers contributing to overweight/obesity across multiple levels of behavioural influence i.e., individual, interpersonal, community and organisation for health promotion. However, there’s need to strengthen SBCC strategies related to prevention and management of obesity, especially screening and counselling, to cover all age groups with a particular focus on adolescents and youth. SBCC strategies can also be incorporated into India’s Integrated Nutrition Support Programme (POSHAN 2.0) and/or Reproductive, Maternal, New-born, Child, Adolescent Health and Nutrition (RMNCAH+N) under the National Health Mission. Conclusion This paper underscores the necessity for comprehensive strategies to address multifaceted origin of overweight and obesity. The NP-NCD stands out as a noteworthy initiative, and there is considerable potential for other programmes to emulate it SBCC strategies to bolster their overall effectiveness. Note : *Policy instrument’s throughout the paper has been used to cover programmes, schemes, regulations and guidelines.
背景 印度政府致力于解决营养不良的各种表现形式,包括超重和肥胖,以改善个人健康和福祉。此次范围界定审查旨在绘制印度解决超重和肥胖问题的现有国家政策工具(方案、计划、法规和指南),并分析这些工具的社会和行为改变沟通 (SBCC) 策略。方法 采用 "Arksey 和 O'Malley "框架,在 2023 年 3 月至 6 月期间从中央政府部委网站上对政策工具进行了系统识别和筛选。这些政策文件侧重于营养和/或体育活动,针对特定人口群体,如孕妇、哺乳期母亲、儿童(0-5 岁和 5-9 岁)或青少年(10-19 岁);不包括那些侧重于特定疾病的政策文件,如微量营养素缺乏症、消瘦和发育迟缓。根据搜索策略,纳入了六项政策工具,并对其 SBCC 策略进行了分析。结果 尽管许多政策工具都包含了 SBCC 计划,但 "国家非传染性疾病预防计划 (NP-NCD) "作为一项重要的政策措施,在非传染性疾病的大背景下专门针对超重和肥胖症的预防,显得尤为突出。该计划采用综合方法,从个人、人际、社区和组织等行为影响的多个层面解决导致超重/肥胖的关键因素,以促进健康。然而,有必要加强与肥胖症预防和管理有关的 SBCC 战略,特别是筛查和咨询,以覆盖所有年龄组,尤其侧重于青少年。还可将 SBCC 战略纳入印度的综合营养支持计划(POSHAN 2.0)和/或国家卫生使命下的生殖、孕产妇、新生儿、儿童、青少年健康和营养(RMNCAH+N)计划。结论 本文强调有必要采取综合战略,从多方面解决超重和肥胖问题。NP-NCD 是一项值得注意的举措,其他计划也有很大潜力效仿其 SBCC 战略,以提高其整体有效性。注: *本文中的政策工具包括方案、计划、法规和指导方针。
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引用次数: 0
Partner violence in healthcare settings on breastfeeding mothers: a scientometric analysis 医疗机构中的伴侣暴力对母乳喂养母亲的影响:科学计量分析
Pub Date : 2024-05-17 DOI: 10.12688/f1000research.146414.1
Endah Wahyutri
Background Partner violence is a significant issue affecting women’s health, particularly their breastfeeding practices in healthcare settings. Despite a considerable body of research on this topic, there is a need for a systematic overview of the existing literature to explore its thematic and structural developments. Methods This scientometric analysis covers a period of 45 years (1977-2022) and identifies 415 peer-reviewed articles published in English before 2023 from the Scopus database. The articles were included if they engaged with themes related to partner violence, healthcare settings, breastfeeding, and mothers, using predefined search terms and filters. Bibliometric data were decoded and visualized using VOSviewer and RStudio to analyze and visualize the scientific dialogue, trends, patterns, and networks in the literature regarding partner violence and its impact on breastfeeding mothers in healthcare settings. Results The study revealed a concentrated exploration of themes related to violence, healthcare provision, mental health, and women’s reproductive health. The co-occurrence network and thematic mapping illuminated seven pivotal clusters, revealing a complex narrative of interconnected research areas. Niche and emerging themes such as “Depression,” “HIV,” and “Covid-19” were identified, highlighting the evolving landscape of the research domain. Conclusions This analysis provides a panoramic overview of the existing literature, revealing intricate thematic structures and collaboration networks within the research on partner violence and breastfeeding mothers in healthcare settings. The study not only sheds light on the historical and current states of research but also pinpoints potential future directions, thereby assisting scholars and policymakers in navigating and prioritizing subsequent investigative endeavors.
背景 伴侣暴力是影响妇女健康的一个重要问题,尤其是她们在医疗机构中的母乳喂养行为。尽管有关这一主题的研究成果相当丰富,但仍有必要对现有文献进行系统性概述,以探讨其主题和结构发展。方法 本科学计量分析涵盖 45 年(1977-2022 年),从 Scopus 数据库中筛选出 415 篇在 2023 年之前发表的同行评审英文文章。这些文章涉及伴侣暴力、医疗机构、母乳喂养和母亲等主题,并使用了预定义的搜索条件和过滤器。使用 VOSviewer 和 RStudio 对文献计量数据进行解码和可视化,以分析和可视化文献中有关伴侣暴力及其对医疗机构中母乳喂养母亲的影响的科学对话、趋势、模式和网络。结果 该研究集中探讨了与暴力、医疗保健服务、心理健康和妇女生殖健康有关的主题。共现网络和主题图谱揭示了七个关键集群,揭示了相互关联的研究领域的复杂叙事。此外,还发现了 "抑郁症"、"艾滋病毒 "和 "Covid-19 "等新出现的小众主题,凸显了研究领域不断发展的态势。结论 本分析对现有文献进行了全景式概述,揭示了医疗机构中伴侣暴力和母乳喂养母亲研究中错综复杂的主题结构和合作网络。本研究不仅揭示了研究的历史和现状,还指出了潜在的未来方向,从而帮助学者和政策制定者确定后续调查工作的方向和优先顺序。
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引用次数: 0
Case Report: Radiological diagnosis of atypical meningioma 病例报告:非典型脑膜瘤的放射学诊断
Pub Date : 2024-05-17 DOI: 10.12688/f1000research.143254.1
Anjali Kumari, Gaurav V Mishra, Pratapsingh Parihar, Dhananjay Shinde, Sakshi Dudhe, Rakshanda Agrawal
Meningiomas are one of the most commonly occurring, extra-axial, primary tumors of central nervous system that are slow-growing in nature with a female predominance mostly occurring in the mid-late twenties. The clinical symptoms of atypical meningioma include headache, seizures, change in personality or behavior, development of a localized neurologic impairment, drowsiness, confusion, loss of hearing or tinnitus, fatigue on exertion, projectile vomiting and visual disturbances. If a meningioma is left untreated, it can cause problems such as loss of neurological function, weakness/numbness, hearing or vision loss, and balance problems. Sometimes there are worsening signs of persistent headaches, origin of new episodes of seizures, or increased intracranial pressure and neurological evaluation should be performed, followed by radiological studies if necessary. The best investigations for early diagnosis are CT and Magnetic Resonance Imaging scans (MRI). Total surgical excision of the tumor is the best management option for the neurological symptoms. In certain situations, such as atypical, malignant, or recurrent meningioma, radiation with a cumulative dose of 45-60 Gy is now employed There is a long-term re-occurrence rate of completely and incompletely resected atypical meningioma. Radiotherapy is beneficial in patients with low surgical risk, meningiomas in surgically inaccessible areas, and advanced age. Hormonal therapy and chemotherapy can be attempted when meningiomas are unresectable. In recurrent meningiomas, chemotherapy with hydroxyurea appears to be fairly active and has been mildly beneficial, as has hormonal therapy with progesterone antagonists. Thus, early diagnosis and management are essential to reduce neurological compromise and imprdaove the survival rate of patients with brain tumors.
脑膜瘤是中枢神经系统最常见的轴外原发性肿瘤之一,生长缓慢,女性居多,多发于 20 多岁。非典型脑膜瘤的临床症状包括头痛、抽搐、性格或行为改变、局部神经功能受损、嗜睡、意识模糊、听力减退或耳鸣、劳累、喷射性呕吐和视觉障碍。如果脑膜瘤不及时治疗,会导致神经功能丧失、虚弱/麻木、听力或视力减退以及平衡问题。有时会出现持续性头痛、新的癫痫发作或颅内压增高等恶化迹象,应进行神经系统评估,必要时进行放射学检查。早期诊断的最佳检查方法是 CT 和磁共振成像扫描(MRI)。手术切除肿瘤是治疗神经症状的最佳方案。在某些情况下,如非典型、恶性或复发性脑膜瘤,目前采用累积剂量为 45-60 Gy 的放射治疗。放疗对手术风险低、脑膜瘤位于手术无法到达的部位以及高龄患者有益。脑膜瘤无法切除时,可尝试荷尔蒙疗法和化疗。对于复发性脑膜瘤,使用羟基脲进行化疗似乎相当有效,并有轻微的疗效,使用孕酮拮抗剂进行激素治疗也是如此。因此,早期诊断和治疗对于减少神经系统损伤和提高脑肿瘤患者的存活率至关重要。
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引用次数: 0
Effect of osteopathic manipulation using SSDV protocol on improving motor coordination and hand eye coordination in children with developmental coordination disorder: a protocol for randomized controlled trial 使用 SSDV 方案进行整骨疗法对改善发育协调障碍儿童运动协调和手眼协调的影响:随机对照试验方案
Pub Date : 2024-05-17 DOI: 10.12688/f1000research.149731.1
Sharath Hullumani V, Raghumahanti Raghuveer, Moh’d Irshad Qureshi
Developmental Coordination Disorder (DCD) significantly impacts motor coordination and hand-eye coordination in children, affecting their daily activities and academic performance. This study aims to investigate the efficacy of Physical Rehabilitation utilizing the Sensory Stimulation and Developmental Vestibular (SSDV) protocol in improving motor coordination and hand-eye coordination in children diagnosed with DCD. Children diagnosed with DCD will be recruited and randomly allocated to either the intervention group receiving Physical Rehabilitation using the SSDV protocol or the control group receiving standard care. The intervention will involve a structured program incorporating sensory stimulation and developmental vestibular activities tailored to the individual needs of participants. Motor coordination and hand-eye coordination will be assessed using standardized measures such as the Movement Assessment Battery for Children (MABC) and the Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery VMI). Assessments will be conducted at baseline, post-intervention, and follow-up time points. This randomized controlled trial seeks to evaluate the effectiveness of Physical Rehabilitation using the SSDV protocol in enhancing motor coordination and hand-eye coordination in children with DCD. By employing standardized measures, this study aims to provide objective insights into the impact of the intervention. Findings from this trial may contribute to the development of evidence-based interventions for children with DCD, potentially improving their motor skills and overall functioning in daily life and academic settings. Registration: CTRI/2024/03/064467
发育协调障碍(DCD)严重影响儿童的运动协调能力和手眼协调能力,进而影响他们的日常活动和学习成绩。本研究旨在调查利用感官刺激和发育性前庭(SSDV)方案进行物理康复治疗对改善被诊断为发育协调障碍儿童的运动协调和手眼协调的效果。被诊断为 DCD 的儿童将被招募并随机分配到接受 SSDV 方案物理康复治疗的干预组或接受标准护理的对照组。干预措施将包括一项结构化计划,其中包含针对参与者个人需求量身定制的感官刺激和前庭发育活动。运动协调性和手眼协调性将采用标准化的测量方法进行评估,如儿童运动评估电池(MABC)和Beery-Buktenica视觉-运动整合发展测试(Beery VMI)。评估将在基线、干预后和随访时间点进行。这项随机对照试验旨在评估使用 SSDV 方案进行物理康复训练对提高 DCD 儿童运动协调能力和手眼协调能力的效果。通过采用标准化的测量方法,本研究旨在客观地了解干预措施的影响。本试验的结果可能有助于开发针对 DCD 儿童的循证干预措施,从而改善他们的运动技能以及在日常生活和学习环境中的整体功能。注册:CTRI/2024/03/064467
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引用次数: 0
Case Report: A rare case of lightning strike causing corneal burn injury 病例报告:一例罕见的雷击导致角膜烧伤的病例
Pub Date : 2024-05-17 DOI: 10.12688/f1000research.144207.1
Soumya Sharma, Sachin Daigavane
The likelihood of being hit by the likelihood of experiencing lightning within a year was approximately 1 in 960,000. Despite this alarming statistic, it is reassuring to know that the chances of surviving a lightning strike are relatively high; around 90% of people who are struck by lightning manage to survive. Lightning-caused ophthalmic injuries are caused by heat that can be generated through the direct or indirect flow of electric current, and by resistance and shock waves caused by heat. Electrical burn injuries rarely cause ocular complications, since the initial burn is typically fatal. We present a case of lightning injury that affected the eyes. and its treatment and a brief overview of the literature on the subject.
一年内遭遇雷击的可能性约为 96 万分之一。尽管这一统计数字令人震惊,但令人欣慰的是,雷击后幸存的几率相对较高;大约 90% 的雷击者都能幸存下来。雷电导致的眼部伤害是由电流直接或间接流动产生的热量以及热量引起的阻力和冲击波造成的。电烧伤很少引起眼部并发症,因为最初的烧伤通常是致命的。我们将介绍一例雷电伤及眼部的病例及其治疗方法,并简要概述相关文献。
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引用次数: 0
The “House of Trust”. A framework for quality healthcare and leadership. 信任之屋"。优质医疗保健和领导力框架。
Pub Date : 2024-05-17 DOI: 10.12688/f1000research.149711.1
K. Vanhaecht, Peter Lachman, C. Van der Auwera, D. Seys, F. Claessens, M. Panella, D. De Ridder
In healthcare, improvement leaders have been inspired by the frameworks from industry which have been adapted into control systems and certifications to improve quality of care for people. To address the challenge to regain trust in healthcare design and delivery, we propose a conceptual framework, i.e. the “House of Trust”. This House brings together the Juran Trilogy, the emerging concept of co-production in quality management and the multidimensional definition of quality, which describes core values as an integral part of the system to deliver person- and kin-centered care. In the “House of Trust” patients, their kin, healthcare providers, executives and managers feel at home, with a sense of belonging. If we want to build a care organization that inspires and radiates confidence to all stakeholders, highlighting the basic interactions between front- and back-office is required. An organization with both well-organized back- and front-offices can enable all to benefit from the trust each of them needs and deserves. A quality system does not depend on government inspection and regulations nor on external accreditation to develop itself into a House of Trust. Success will only be achieved if all involved continuously question themselves about the technical dimensions of quality and their core values during the “moment of truth”.
在医疗保健领域,改进工作的领导者受到了来自工业界的框架的启发,这些框架已被调整为控制系统和认证,以提高人们的医疗保健质量。为了应对在医疗保健设计和提供过程中重获信任的挑战,我们提出了一个概念框架,即 "信任之家"。信任之家 "汇集了 "朱兰三部曲"、质量管理中新兴的 "共同生产 "概念以及质量的多维定义,其中将核心价值描述为提供以人为本和以亲属为本的医疗服务体系的组成部分。在 "信任之家",患者、患者亲属、医疗服务提供者、行政人员和管理人员都有宾至如归的归属感。如果我们想建立一个能让所有利益相关者感到鼓舞和充满信心的医疗机构,就必须突出前台和后台之间的基本互动。一个同时拥有组织良好的后台和前台的组织,能够让所有人都受益于每个人所需要和应得的信任。一个质量体系要发展成为 "信任之家",并不依赖于政府的检查和规定,也不依赖于外部的认证。只有所有相关人员在 "关键时刻 "不断质疑自己的质量技术水平和核心价值观,才能取得成功。
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引用次数: 0
Concomitant Infection of Helicobacter pylori and Intestinal Parasites: Burden, Sociodemographic and Clinical Characteristics in Hospitalized Children and Adolescents in Northern Lebanon 幽门螺杆菌和肠道寄生虫并发感染:黎巴嫩北部住院儿童和青少年的负担、社会人口和临床特征
Pub Date : 2024-05-17 DOI: 10.12688/f1000research.148550.1
Sara Mina, Sara Daher, Nour Mina, Ghalia Khoder
Background Helicobacter pylori and intestinal parasites are well-known for their high prevalence in children, especially in developing countries. However, their concomitant infections are poorly documented. In this study, we aimed to evaluate the association between intestinal parasites and H. pylori among hospitalized children and adolescents with upper gastrointestinal complaints in Northern Lebanon. Methods A cross-sectional study was conducted involving 297 hospitalized pediatric patients, aged between 1 and 15 years, who presented with gastrointestinal symptoms. The socio-demographic, lifestyle, and gastrointestinal characteristics of all participants were analyzed. Fresh stool samples were collected and screened for the presence of intestinal parasites and H. pylori infections. Results 6.4% of the patients were positive for intestinal parasitic infections, 5.4% were positive for H. pylori infection, and 11.8% were co-infected. The results of the Chi-square test showed that H. pylori infection is significantly associated with parasitic infection but not with a particular species. The most frequent coinfection was H. pylori-Entamoeba histolytica (77.1%). Moreover, H. pylori infection was associated with overcrowding and infrequent washing of vegetables before eating. The prevalence of co-infections increased in patients of mothers with a primary educational level or less. In regards to clinical characteristics, our findings showed a statistically significant relationship between i) gastric reflux and H. pylori, and ii) severe diarrhea and parasitic infection. Conclusion Our data highlighted the association between H. pylori and intestinal parasitic infections. Thus, H. pylori detection could be taken into consideration while screening for parasitic infections in children and adolescents.
背景幽门螺杆菌和肠道寄生虫是众所周知的儿童高发疾病,尤其是在发展中国家。然而,关于它们同时感染的记录却很少。在这项研究中,我们旨在评估黎巴嫩北部因上消化道不适而住院的儿童和青少年中肠道寄生虫与幽门螺杆菌之间的关联。方法 我们对 297 名年龄在 1-15 岁之间、有胃肠道症状的住院儿童患者进行了横断面研究。研究分析了所有参与者的社会人口学特征、生活方式和胃肠道特征。采集了新鲜粪便样本,并对其中是否存在肠道寄生虫和幽门螺杆菌感染进行了筛查。结果 6.4%的患者肠道寄生虫感染呈阳性,5.4%的患者幽门螺杆菌感染呈阳性,11.8%的患者合并感染。卡方检验结果显示,幽门螺杆菌感染与寄生虫感染有显著相关性,但与特定的寄生虫种类无关。最常见的合并感染是幽门螺杆菌-组织溶解酵母菌(77.1%)。此外,幽门螺杆菌感染与过度拥挤和进食前不经常清洗蔬菜有关。初等教育水平或更低的母亲的患者合并感染的比例更高。在临床特征方面,我们的研究结果表明,①胃反流与幽门螺杆菌,②严重腹泻与寄生虫感染之间存在统计学意义上的显著关系。结论 我们的数据强调了幽门螺杆菌与肠道寄生虫感染之间的关系。因此,在对儿童和青少年进行寄生虫感染筛查时,可以考虑检测幽门螺杆菌。
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