Teach-Back健康教育模式对学龄期手足口病患儿家属疾病认知水平及防护行为的影响

目的:探讨Teach-Back健康教育模式对学龄期手足口病(HFMD)患儿家属疾病认知水平及防护行为的影响。方法:2018年7月—2020年11月选取我院学龄期113名HFMD患儿家属为研究对象,按照随机数字表法分为对照组56例与观察组57例,对照组给予常规健康教育干预,观察组给予Teach-Back健康教育模式干预,观察两组患儿家属疾病认知水平、行为干预遵从率、患儿症状改善状况。结果:干预后,观察组患儿家属发病原因、传播途径、隔离治疗、并发症预防认知评分高于对照组(P<0.05);观察组患儿家属消毒隔离措施、饭前便后洗手、勤晒衣被、居家开窗通风遵从率高于对照组(P<0.05);观察组患儿发热、口腔溃疡、皮疹、食欲减退改善时间短于对照组(P<0.05)。结论:对学龄期HFMD患儿家属开展Teach-Back健康教育模式,可明显提高家属对疾病认知水平,提高行为干预遵从率,促进患儿恢复。     

Age estimation of Iraqi children and young adults based on third molar development and its relation to chronological age

ObjectivesThe study aimed to estimate the age of Iraqi children and young adults based on the third molar development to establish Iraqi reference material for orthodontic and forensic purposes, and to investigate the correlation between the estimated and chronological age.MethodsA retrospective analysis of digital orthopantographs of 1515 patients of Iraqi origin, aged from 6 to 25 years was conducted, and the developmental status of the mandibular right third molar for each patient was evaluated using Demirjian et al.’s method. Statistical analysis was carried out using “Mann-Whitney U-test” between genders. The linear regression analysis was performed to obtain “regression formulas” for dental age calculation with chronologic age.ResultsNo statistically significant differences were observed between Iraqi males and females at any age. The median of male and female age of initial calcification of the cuspal tips for mandibular third molars was 9 years, whereas 14 years was the median of age for both genders when the crown was completed. All mandibular right third molars have a complete root formation with apex closure at a median of male and female age 22 years.ConclusionsThe use of Demirjian et al.’s method was appropriate as a reliable age indicator for Iraqi population. A strong correlation was observed between these stages and chronological age. Consequently, reference data have been established for mandibular third molar development in Iraqi population.     

Examining Acute Coronary Syndrome Across Ethnicity,Sex, and Age

Acute coronary syndrome (ACS) remains one of the leading causes of death in the United States. With its heightened prevalence, considerable variabilities in the disease process exist across ethnicities, sex, and age. This creates substantial disparities in the recognition and management of ACS, which consequently contributes to poor outcomes. It is of utmost importance that nurse practitioners remain vigilant, cognizant, and maintain a high index of suspicion to accurately identify ACS presentations and thus efficaciously intervene to successfully manage the disease process.     

Understanding Hispanic Patient Satisfaction with Telehealth During COVID-19

BackgroundRecent studies have described the use of telehealth for pediatric surgical care during the COVID-19 pandemic. We aimed to evaluate equity in telehealth use by comparing rates of utilization and satisfaction with pediatric surgical telemedicine among Hispanic patients.MethodsWe conducted a retrospective cohort study of patients seen by a surgical subspecialty provider in the outpatient setting at a quaternary pediatric hospital between April 1 and June 30, 2020. Patients evaluated in the same three-month period in 2019 were analyzed as a historic control. Differences in Family Experience Survey (FES) responses based on race and ethnicity and preferred language of care were assessed using univariable and multivariable generalized linear modeling.ResultsThe pandemic cohort included fewer patients of Hispanic ethnicity and fewer Spanish-speakers. After controlling for visit type, comparison of Spanish-speaking and English-speaking patients revealed that Spanish-speaking families had significantly lower scores for FES items that evaluated healthcare provider explaining (IRR 0.74, 95% CI: 0.61–0.90), listening (IRR 0.76, 95% CI: 0.63–0.92), and time spent with the family (IRR 0.73, 95% CI: 0.60–0.89). There were no differences in FES responses based on insurance status or degree of medical complexity.ConclusionsTelehealth services were less commonly used among Hispanic and Spanish-speaking patients. Language may differentially affect family satisfaction with healthcare and telehealth solutions. Strategies to mitigate these inequities are needed and may include strengthening interpreter services and providing language-concordant care.Level of evidenceLevel IV.     

Age-related changes of lens thickness and density in different age phases

AIM: To explore the changes in lens thickness and density with age. METHODS: A Chinese population-based retrospective study was performed. A total of 497 individuals (490 right eyes and 495 left eyes), ranging from 3 to 69 years old were included. Lens images obtained from IOL Master 700 were used to measure lens thickness and density. Piecewise regression model was chosen to illustrate the relationship of lens thickness and density with age. RESULTS: The proportion of people aged 3-18, 19-40, over 40 was 38.6%, 50.9% and 10.5% respectively. The whole lens thickness decreased with age during the first 7 years of life, kept stable from 8 to 16 years old, and then increased at the rate of about 27 µm per year. The thickness of the lens cortex and nucleus tended to decrease first and then increase with age, which was dependent on age stages. The whole lens density also decreased with age until 7 years old. The increasing rate of lens density was different in different age groups. The whole lens density increased rapidly from 7 to 22 years old and slowed down after 22 years old. Similarly, the changing tendency of lens cortical and nuclear density differed in different age phases. CONCLUSION: Both lens thickness and density are significantly associated with age, whereas they do not change linearly with age. Moreover, it is necessary to increase the population over 40 years old and conduct further research.     

Temporal changes in extra-axial brain hematoma's signal intensity in magnetic resonance images of trauma patients: A preliminary,technical study

IntroductionDating the exact or estimated time of trauma is an important issue facing forensic medicine. Several clinical and radiological methods were used to achieve this purpose. In the recent study, we aimed to track the changes in the signal intensity of the extra-axial brain hematoma using magnetic resonance imaging (MRI) conventional sequences as well as diffusion-weighted imaging (DWI) and the apparent diffusion coefficient (ADC).Materials and methodsConsidering inclusion and exclusion criteria, all patients with blunt head trauma were involved. After proper management., stabilization, and resuscitation, the participants were assessed using conventional sequences of MRI and DWI twenty-four hours, forty-eight hours, and three weeks after the injury. Temporal changes of signal intensity were compared by Wilcoxon ranged test.ResultsSixteen patients sustaining blunt head trauma were included in this study. The study showed that during the time, diffusion restriction could be seen in an extraaxial hematoma. At the first 24 hours, the signal of hematoma was void in 87.5% of DWI and 100% of ADC. On the second day, they were hypo-signal in 75% of DWI and 100% 0f ADCs, and after three weeks, 100% of cases were hyper-signal in DWI and hypo-signal ADCs.ConclusionThis preliminary study has shown that the DWI can be used to detect and track the extra-axial hematoma. The signal intensity was void during the first twentyfour hours, although it became hypo-signal after 48 hours. Of note, the diffusion restriction is noted after three weeks.