Cliffordmurdock4237
Global nursing partnerships can develop cultural competence and standardisation across international nurse education programmes. Issues of context, cultural awareness and modes of engagement can influence the success of international collaboration. The 'Supporting Internationalisation of Traineeships in the Healthcare Sector' project, funded from 2017, brought together nine international partners from Finland, Poland, Spain and the UK to develop a pan-European quality audit process for clinical learning environments. As part of the evaluation, eight project partners were interviewed about the project and their criteria for a successful global partnership. The interviews allowed insight into previously hidden aspects of implementation. The importance of a scoping period for nursing global partnerships was highlighted that built on cultural diversity to explore common understandings. Attention to the use of prior expertise in internationalisation, or project objectives, could accelerate a global partnership to achieve a greater potential in its outcomes and cultural sensitivity. Framed in a clear structure, it is possible for global partnerships to embed ownership, autonomy and individual voice in partner organisations. The research concludes that only by growing international champions through funded and well constituted projects, that a genuine impact on the global health and educational needs in nursing can be met.
Adrenal schwannomas are extremely rare tumors often misdiagnosed. The patients are usually asymptomatic while some present with non-specific abdominal pain. Only a few cases are reported to date.
We here present a case of a 55-year-old Nepalese man presented with nonspecific abdominal pain at our Outpatient Department (OPD) found to have mass on ultrasonography of abdomen. On further investigation with Contrast Enhanced Computerized Tomography (CECT) of the abdomen and pelvis, a well-defined heterogeneous adrenal mass of size (7.8∗8.3∗6) cm with foci of calcification was seen in the left retroperitoneum. The intraoperative finding of adrenal mass and histopathology of resected mass was suggestive of schwannoma arising from the adrenal gland which was further confirmed by immunohistochemistry.
Adrenal schwannoma can mimic tumors like pheochromocytoma, adrenal adenoma, cortical carcinoma, neuroblastoma, and other masses. Only 1-3% of schwannomas are retroperitoneal. Radiological findings of this tumor are non-suggestive. The histological section shows spindle cells with Antoni A and Antoni B regions while positive staining of S-100 protein in Immunohistochemistry.
The diagnosis of adrenal schwannoma in the retroperitoneum is often challenging. The treatment of choice is surgical resection with a good prognosis.
The diagnosis of adrenal schwannoma in the retroperitoneum is often challenging. The treatment of choice is surgical resection with a good prognosis.
We retrospectively assessed the efficacy and safety of use of short-term formula diet therapy to achieve preoperative reduction in visceral fat immediately prior to highly invasive endoscopic surgery.
We reviewed 5 cancer patients who underwent thoracoscopic and/or laparoscopic-assisted esophagectomy or gastrectomy. The cases were those with a BMI ≥30kg/m
or waist circumference ≥100cm. Patients replaced one meal out of the three main meals with one or two sachets of formula diet (170-340kcal). The other two meals were set to 600kcal. The dietary therapy was implemented approximately 1month before the operation. Weight loss achieved after dietary therapy ranged from 6.4% to 14.1% (p<0.01). https://www.selleckchem.com/products/gsk2656157.html With the exception of one case, the decrease in visceral fat area ranged from 17.0%-40.7% (p=0.03). Postoperative complications were anastomotic insufficiency in two cases.
Although the decreases of the visceral fat were effectively implemented, the adverse effects on postoperative complications must be examined in the farther study.
It was suggested that use of formula diet to achieve preoperative visceral fat reduction in a short period of time immediately prior to highly invasive endoscopic cancer surgery would be an effective and safe strategy.
It was suggested that use of formula diet to achieve preoperative visceral fat reduction in a short period of time immediately prior to highly invasive endoscopic cancer surgery would be an effective and safe strategy.
Gastric mucormycosis is a rare condition that usually manifests in immunocompromised patients. It's a lethal disease with a poor prognosis requiring prompt diagnosis and aggressive management. Although found more commonly in immunocompromised patients, it can also affect the immunocompetent patient, highlighting the importance of clinical suspicion when dealing with a critically ill patient.
This is a case report on a patient who presented with penetrating trauma to the abdomen requiring surgical intervention. Damage control surgery was performed in the form of a right hemicolectomy ('clip and drop') for extensive colonic injuries (AAST Grade V) with contamination of the abdominal cavity [1]. In the days subsequent to the injury, he developed sepsis and progressive bowel ischaemia and necrosis, requiring surgical debridement. Histological findings revealed mucormycosis of the gastrointestinal tract.
The diagnosis of mucormycosis depends on high clinical suspicion as well as histopathological evidence. The management comprises of surgical debridement and appropriate antifungal therapy. Timeous diagnosis and adequate treatment may improve the prognosis.
This was a challenging case for the clinicians involved, highlighting that the clinician should consider this infection as a rare cause of bowel ischaemia in the back of their minds when dealing with such patients.
This was a challenging case for the clinicians involved, highlighting that the clinician should consider this infection as a rare cause of bowel ischaemia in the back of their minds when dealing with such patients.
Orthognathic surgery aims to restore the functional and esthetic standards of the face and non-surgical or minimally invasive procedures have been optimizing the results of facial orthosurgical treatments. This case report aimed to show the use of minimally invasive techniques that, associated with orthognathic surgery, represent a trend in current oral and maxillofacial rehabilitation.
A female patient, 28years old, white, sought care from the Dentistry team of the São Vicente de Paulo Hospital, in Passo Fundo, Brazil, complaining of mandibular prognathism, anteroposterior maxillary deficiency, dental crowding, malocclusion, functional and esthetic changes that negatively affected her psychosocial interactions and stomatognathic function. The treatment involved orthodontics, orthognathic surgery, and orofacial harmonization with dermal fillers.
The multidisciplinarity among the specialties of Oral and Maxillofacial Surgery and Traumatology, Orthodontics, and Orofacial Harmonization add and contribute to the process of planning and implementing the treatment proposed, as well as the prognosis toward patient satisfaction.
The surgical procedure associated with minimally invasive facial harmonization not only corrected the functional complaint of the patient but also played an important role in improving facial harmony, contributing significantly to self-esteem.
The surgical procedure associated with minimally invasive facial harmonization not only corrected the functional complaint of the patient but also played an important role in improving facial harmony, contributing significantly to self-esteem.
Endovascular aneurysm sealing (EVAS) with the Nellix system was introduced to reduce endovascular aneurysm repair (EVAR) perioperative complications, especially endoleaks. Herein we report a case of successful type 1A endoleak managed with detachable coils embolization after EVAS.
A 77-year-old male was referred for abdominal pain. The angio-CT scan confirmed the previous EVAS procedure and showed a type Is2 endoleak below the right renal artery resulting in a 2.5cm aortic blister with contrast medium filling the space between the aortic wall and the endobags. The patient was considered unfit for conventional open surgery and an endovascular approach with coil embolization Concerto Helix Detachable Coil System was chosen under local anesthesia. After intervention, a complete abdominal pain regression was registered. The 12- month CT follow-up showed endoleak sealing and Nellix system stability.
EVAS has been associated to a high endoleaks and complications incidence when compared to EVAR. The EVAS different device concept led to a different endoleak classification and management. Endoleak management main options include the Nellix system explantation or the Nellix in Nellix application, however these are nearly always not applicable, respectively, due to the high surgical risk condition and the Nellix system availability, especially in emergent setting. Despite the use of coil embolization is controversial, this tool is off-the-shelf and leads to a disease resolution in most of patients without other surgical options.
Proximal type Is2 embolization after EVAS is feasible with limited invasiveness.
Proximal type Is2 embolization after EVAS is feasible with limited invasiveness.Empirical evidence continues to accumulate suggesting cannabidiol (CBD) may have potential as an anxiolytic. Yet, research in the area is insufficient to support strong inferences. Accordingly, there is a need for additional empirical investigation. Research on the effects of CBD and anxiety requires a working knowledge of both. Understanding of contemporary CBD and anxiety research methods is critical to safely and convincingly test predictions regarding potential anxiolytic effects of CBD. The current paper outlines major design, methods, and safety considerations pertinent both to CBD administration and measuring effects on anxiety outcomes in order to facilitate needed research in this domain.Water security is an issue across the world as communities face ageing infrastructure, population increases and climate change. The application of digital water metering (DWM) to properties has had a demonstrable impact on water savings at the property and network levels, on efficiencies within water utilities, as well as on improvements to customer satisfaction scores. Gathering and processing near-real-time water usage data is very important for both end-users and utilities, as well as demand and supply management planning. The potential contribution of DWM to the three pillars of water sustainability (environmental, economic development and social equity) is often overlooked. In Australia and other jurisdictions water utilities are facing up to the challenge of climate change. However, business cases promoting DWM are often unsuccessful because the benefit side falls short of the cost side. This study sought to identify possible DWM benefits not previously considered through an extensive review of academic and industry literature, and then to view those benefits through the lens of sustainability. The 77 identified benefits of DWM were catalogued and a taxonomy was created. The study elicited the opinions of experts, before quantifying them, thus identifying two distinct contexts of benefit value; subsequently, it surveyed the views of customers and developed a stochastic model of benefit value. The model, named DWM360, was applied to the project data of a large metropolitan water utility in Australia to model their DWM proposal for cost savings, contribution to sustainability and uplift in customer satisfaction. This paper presents a novel focus on how the benefits of DWM assist water sustainability. It considers differing social norms that impact consumer acceptance of changes in metering and water charges. The study will be of interest to researchers as well as practitioners looking to identify sustainability aspects of DWM.
