Zobrazení zdroje stránky Reesgammelgaard7066

Patient- and family-centred care practices are a recommended part of contemporary care for the acutely ill hospitalized adult patients. However, how patient- and family-centred care is enacted in an adult hospital setting is not well understood.<br /><br /> The aim of this study is to explore the perceptions of patients, family members and nurses regarding family participation and collaboration in patient care within an acute care setting, including the barriers and facilitators.<br /><br /> This study used a mixed-methods sequential design.<br /><br /> Observer-as-participant observations and semistructured interviews were undertaken. Integration of the data was achieved through triangulation.<br /><br /> Triangulation revealed two metathemes. The first metatheme, 'continuum of family involvement', explained the central viewpoint of how family participation and collaboration in the care of acutely ill hospitalized adult patients was enacted. The second metatheme, 'nurses value family involvement', helped to explain and understand the barriers and facilitators to enacting family participation in the acute care setting.<br /><br /> Promoting family participation in the acute care setting requires supporting multiple levels of engagement. Developing a relationship, clear communication and open sharing of information amongst patients, family members and nurses is critical to supporting family involvement.<br /><br />Promoting family participation in the acute care setting requires supporting multiple levels of engagement. Developing a relationship, clear communication and open sharing of information amongst patients, family members and nurses is critical to supporting family involvement.<br /><br /> To investigate the effect of different milling protocols for different ceramic materials on the trueness and precision of milled ceramic crowns.<br /><br /> A definitive impression from a patient requiring a ceramic crown was used to fabricate forty glass ceramic crowns (VITABLOCS mark II, Vita Zahnfabrik) milled with wet, hard milling protocol, and 40 zirconia crowns (inCoris TZI, Dentsply, Sirona) milled with dry, soft milling protocol, using a 5-axis milling machine (inLab MC X5; Dentsply Sirona). Trueness and precision for different crown areas were evaluated with a 3D evaluation software (Geomagic Control X, 3D systems). Statistical analysis was performed between the 2 crown types with independent t-test, and analysis of variances followed by Bonferroni tests among crown areas for each crown.<br /><br /> All areas of the glass ceramic crowns had higher trueness than the zirconia crown areas (p &lt; 0.05). Crown areas of each crown type had significantly different trueness values (p &lt; 0.001, F = 175.17 for glass crowns,rowns. Soft milled zirconia crowns were generally overmilled in comparison with the reference design and glass crowns. However, glass crowns exhibited more undermilling in thin and deep areas. The crown area affected trueness, with external areas having better trueness than internal areas. The 5-axis milling machine had high precision, which was minimally affected by the ceramic type, milling protocol, or crown area.In this study, we aim to assess the association of dengue viremia with dengue severity. The study protocol was developed and registered in PROSPERO (CRD42016039864). We searched nine databases to find potential papers. Studies meeting the inclusion criteria were included. We, based our analysis on three outcomes which are disease severity, dengue serotype and disease infection type. Thirty studies with 3316 patients were included. Our analysis revealed that viremia is significantly higher in dengue hemorrhagic fever patients than dengue fever in days 5 to 6. Regarding the serotype of dengue, the maximum viremia titre of serotype 1 was significantly higher than serotype 3 and the viremia in dengue serotype 2 was significantly higher than serotype 4 in days 2 to 4. However, comparison of the daily viremia level between the primary and secondary dengue infection revealed that secondary infection was significantly higher than the primary infection on seventh day and on the eighth day. Viremia is strongly associated with disease severity and type of infection which gave viremia a high indicative power to be used as a clinical predictor. Dengue serotype is also associated with viral load with higher viremia in DENV-2/1.High altitude pregnancy is associated with increased frequency of low birth weight infants and neonatal complications, the risks of which are higher in women of low-altitude ancestry. Does ancestry also influence the risk of miscarriage (pregnancy loss less then 20 weeks) in high-altitude pregnancy? To answer this, 5386 women from La Paz, Bolivia (3300-4150 m) with ≥1 live-born infant were identified. Data were extracted from medical records including maternal and paternal ancestry, demographic factors, and reproductive history. The risk of miscarriage by ancestry was assessed using multivariate logistic regression, adjusting for parity, and maternal age. Andean women experienced first live-births younger than Mestizo or European women (21.7 ± 4.6 vs 23.4 ± 8.0 vs 24.1 ± 5.1, P less then .001). Andeans experienced more pregnancies per year of reproductive life (P less then .001) and had significantly higher ratios of live-births to miscarriages than women of Mestizo or European ancestry (P less then .001). Andean women were 24% less likely to have ever experienced a miscarriage compared to European women (OR0.76; CI0.62-0.90, P less then .001). The woman's partner's ancestry wasn't a significant independent predictor of miscarriage. In conclusion, the risk of miscarriage at high altitude is lower in Andean women. The lack of a paternal ancestry effect suggests underlying mechanisms relate more to differential maternal adaptation in early pregnancy than fetal genetics.Epidermal necrolysis (EN) compromises a spectrum of life-threatening dermatoses (Stevens-Johnson Syndrome [SJS], overlap syndrome and toxic epidermal necrolysis [TEN]). Currently, no active therapeutic regimen with unequivocal benefit exists for SJS/TEN. SCORTEN is the widely-used prognostic scale specific for SJS/TEN. Nevertheless, a new prognostic scale, the ABCD-10, has been recently proposed. In this context, acute renal failure (ARF) seems to be an important comorbidity that could influence prognosis in SJS/TEN patients more than it is assumed by these two scales. Our objectives were to compare the accuracy of the SCORTEN and ABCD-10 scales in predicting the mortality in SJS/TEN, and to investigate the influence of renal failure on prognosis. The prognostic results of 18 patients with EN treated in two referral centers between 2013 and 2018 are presented. [https://www.selleckchem.com/products/doxycycline.html read more] SCORTEN, ABCD-10 and renal function values were retrospectively collected for all patients. Out of the 18 patients who were analyzed, nine (50%) received only supportive therapy, four were treated with etanercept 50 mg in a single dose (22.